Skip to main content Accessibility help
Hostname: page-component-684899dbb8-7wlv9 Total loading time: 0.474 Render date: 2022-05-26T23:05:25.048Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

3 - Understanding how decisions influence health

Published online by Cambridge University Press:  05 February 2013

Anne Andermann
McGill University, Montréal
Get access


Decision-making for health is a complex matter. Some decisions are banal everyday choices that we make at the individual level – decisions that are often shaped by many extrinsic forces. Should I buy sweets or a fruit as a snack? Will I drive or cycle to work today? While each individual decision may have relatively little importance, taken together and multiplied across the entire population, the effects can add up. Nonetheless, we are generally very preoccupied with these small decisions, while large-scale decisions made at a population or global level seem entirely beyond our control and tend to go unnoticed, even though they may have even more profound effects on our collective health. For instance, certain countries are attempting to develop nuclear weapons, other countries have a laissez faire attitude towards the oversight of financial markets risking worldwide economic crises, and others still continue to produce and export harmful products ranging from asbestos to machine guns and cluster bombs, which could have devastating impacts on the health of large numbers of people worldwide. Who is regulating these decisions? How can we better inform these decisions using the best available evidence? The purpose of this chapter is to provide an overview of decision-making for health from patient choice to global policy as a first step towards better understanding how these decisions are made and how we can intervene to improve health.

Individual health decisions

We all make decisions about our health. Some decisions are rather quick and painless, and others are more important and thought through. Some decisions we make for ourselves, and others are for the health of loved ones. Some decisions, particularly those that deal with questions of life and death, we hope that we never have to face, and, if we do, we would want someone well informed and trustworthy to be there to guide us through it. Thus there are a range of different health decisions made at an individual level, and a wide array of factors that influence these decisions. To illustrate these, and to provide an introduction to the extensive but disparate literature on the subject, I will use three case examples.

Evidence for Health
From Patient Choice to Global Policy
, pp. 26 - 73
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Hochbaum, G. Why people seek diagnostic X-rays. Public Health Rep 1956; 71: 377–80.CrossRefGoogle ScholarPubMed
Ajzen, I, Fishbein, M. Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice-Hall, 1980.Google Scholar
Ajzen, I. The theory of planned behavior. Organ Behav Hum Decis Processes 1991: 50: 179–211.CrossRefGoogle Scholar
Prochaska, J, DiClemente, C. Stages of change in the modification of problem behaviors. Prog Behav Modif 1992; 28: 183–218.Google ScholarPubMed
Nutbeam, D, Harris, E. Theory in a Nutshell: A Practical Guide to Health Promotion Theories, 2nd edn. Sydney, Australia: McGraw Hill, 2004.Google Scholar
West, R. Time for a change: putting the Transtheoretical (Stages of Change) Model to rest. Addiction 2005; 100(8): 1036–9.Google Scholar
Bandura, A. Social Learning & Personality Development. NJ: Holt, Rinehart & Winston Inc., 1975.Google Scholar
Task Force on Community Preventive Services; Zaza, S, Briss, P, Harris, K (ed.). The Guide to Community Preventive Services: What Works to Promote Health?Oxford: Oxford University Press, 2005. Available at: .
World Health Organization. WHO Framework Convention on Tobacco Control. Geneva: World Health Organization, 2003.Google Scholar
Doll, R, Peto, R, Boreham, J, Sutherland, I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328(7455): 1519.CrossRefGoogle ScholarPubMed
Khaw, K, Wareham, N, Bingham, S et al. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Med 2008; 5(1): e12.CrossRefGoogle ScholarPubMed
Bury, M. Health and Illness in a Changing Society. London: Routledge, 1997.Google Scholar
Hope, T. Evidence-Based Patient Choice. London: King’s Fund Publishing, 1996.Google Scholar
Benbassat, J, Pilpel, D, Tidhar, M. Patients’ preferences for participation in clinical decision making: a review of published surveys. Behav Med 1998; 24(2): 81–8.CrossRefGoogle ScholarPubMed
Coulter, A. Partnership with patients: the pros and cons of shared clinical decision-making. J Health Serv Res Policy 1997; 2(2): 112–21.CrossRefGoogle Scholar
Coulter, A. Evidence based patient information is important, so there needs to be a national strategy to ensure it. BMJ 1998; 317: 225–6.CrossRefGoogle Scholar
Peugh, J, Belenko, S. Alcohol, drugs and sexual function: a review. J Psychoactive Drugs 2001; 33(3): 223–32.CrossRefGoogle ScholarPubMed
Evans, D, Blair, V, Greenhalgh, R, Hopwood, P, Howell, A. The impact of genetic counselling on risk perception in women with a family history of breast cancer. Br J Cancer 1994; 70: 934–8.CrossRefGoogle ScholarPubMed
Janis, I, Feshbach, S. Effects of fear-arousing communications. J Abnorm Soc Psychol 1953; 48: 78–92.CrossRefGoogle Scholar
Andersen, M, Smith, R, Meischke, H, Bowen, D, Urban, N. Breast cancer worry and mammography use by women with and without a family history in a population-based Sample. Cancer Epidemiol Biomarkers Prev 2003; 12: 314–20.Google Scholar
Howe, H. Social factors associated with breast self-examination among high risk women. Am J Public Health 1981; 71: 251–5.CrossRefGoogle ScholarPubMed
Walsh-Childers, K, Edwards, H, Grobmyer, S. Covering women’s greatest health fear: breast cancer information in consumer magazines. Health Commun 2011; 26(3): 209–20.CrossRefGoogle ScholarPubMed
Calman, K, Royston, G. Risk language and dialects. BMJ 1997; 315: 939–42.CrossRefGoogle ScholarPubMed
Bennett, P, Calman, K, Curtis, S, Fischbacher-Smith, D (eds.). Risk Communication and Public Health, 2nd edn. Oxford: Oxford University Press, 2010.CrossRef
Tennant, D. The communication of risks and the risks of communication. Risk Dec Pol 1997; 2(2): 147–53.CrossRefGoogle Scholar
Hyer, R, Covello, V. Effective Media Communication during Public Health Emergencies: A WHO Field Guide. Geneva: World Health Organization, 2005. Available at: .Google Scholar
Antoniou, A, Pharoah, P, Narod, S, et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 222 studies. Am J Hum Genet 2003; 72: 1117–30.CrossRefGoogle ScholarPubMed
Tversky, A, Kahneman, D. The framing of decisions and the psychology of choice. Science 1981; 211: 453–8.CrossRefGoogle Scholar
Newman, T. The power of stories over statistics. BMJ 2003; 327: 1424–7.CrossRefGoogle ScholarPubMed
Entwistle, V, Sheldon, T, Sowden, A, Watt, I. Supporting consumer involvement in decision-making: what constitutes quality in consumer health information?Int J Qual Health Care 1996; 8: 425–37.CrossRefGoogle ScholarPubMed
Elmore, J, Barton, M, Moceri, V, et al. Ten year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med 1998; 338(16): 1089–96.CrossRefGoogle ScholarPubMed
O’Connor, A, Rostom, A, Fiset, V, et al. Decision aids for patients facing health treatment or screening decisions: systematic review. BMJ 1999; 319: 731–4.CrossRefGoogle ScholarPubMed
Elwyn, G, O’Connor, A, Stacey, D, et al. on behalf of the International Patient Decision Aids Standards (IPDAS) Collaboration. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006; 333(7565): 417.CrossRefGoogle ScholarPubMed
Ubel, P, Loewenstein, G. The role of decision analysis in informed consent: choosing between intuition and systematicity. Soc Sci Med 1997; 44(5): 647–56.CrossRefGoogle ScholarPubMed
Maly, R, Bourque, L, Engelhardt, R. A randomized controlled trial of facilitating information giving to patients with chronic medical conditions: effects on outcomes of care. J Fam Pract 1999; 48(5): 356–63.Google ScholarPubMed
Kirmayer, L, Minas, H. The future of cultural psychiatry: an international perspective. Can J Psychiatry 2000; 45: 438–46.CrossRefGoogle Scholar
American Academy of Nursing Expert Panel on Culturally Competent Nursing Care. Culturally competent health care. Nurs Outlook 1992; 40(6): 277–83.Google Scholar
Callister, C. What Has the literature taught us about culturally competent care of women and children. MCN Am J Matern Child Nurs 2005; 30(6): 380–8.CrossRefGoogle ScholarPubMed
Lie, D, Lee-Rey, E, Gomez, A, Bereknyei, S, Braddock, C. Does cultural competency training of health professionals improve patient outcomes? A systematic review and proposed algorithm for future research. J Gen Intern Med 2011; 26(3): 317–25.CrossRefGoogle ScholarPubMed
Willis, W. Culturally competent nursing care during the perinatal period. J Perinat Neonatal Nurs 1999; 23(3): 45–59.CrossRefGoogle Scholar
Teka, T, Dagnew, M. Health behaviour of rural mothers to acute respiratory infections in children in Gondar, Ethiopia. East Afr Med J 1995; 72(10): 623–5.Google ScholarPubMed
Hodes, R. Cross-cultural medicine and diverse health beliefs: Ethiopians abroad. West J Med 1997; 166(1): 29–36.Google ScholarPubMed
Lock, M. On being ethnic: the politics of identity breaking and making in Canada, or, nevra on Sunday. Cult Med Psychiatry 1990; 14(2): 237–54.Google Scholar
Fadiman, A. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Strauss and Giroux, 1997.Google Scholar
Diekema, D and the Committee on Bioethics of the American Academy of Pediatrics. Responding to parental refusals of immunization of children. Pediatrics 2005; 115(5): 1428–31.Google ScholarPubMed
Bentley, M, Elder, J, Fukumoto, M et al. Acute childhood diarrhoea and maternal time allocation in the northern central Sierra of Peru. Health Policy Plan 1995; 10(1): 60–70.CrossRefGoogle ScholarPubMed
Andermann, A, Blancquaert, I. Genetic screening: a primer for primary care. Can Fam Physician 2010; 56(4): 333–9.Google ScholarPubMed
Andermann, A, Blancquaert, I, Déry, V. Genetic screening: a conceptual framework for programs and policy-making. J Health Serv Res Policy 2010; 15(2): 90–7.CrossRefGoogle Scholar
Diamond, Commissioner of Patents and Trademarks, v. Chakrabarty 447 U.S. 303 100 S. Ct. 2204 65 L. Ed. 2d 144, 1980.
Benowitz, S. French challenge to BRCA1 patent underlies European discontent. J Natl Cancer Inst 2002; 94(2): 80–1.CrossRefGoogle ScholarPubMed
Brice, P. Latest twist in gene patent saga as BRCA patent revoked. PHGfoundation: making science work for health, March 30, 2010. Available at: .Google Scholar
Knoppers, B, Hirtle, M, Glass, K. Commercialization of genetic research and public policy. Science 1999; 286(5448): 2277–8.CrossRefGoogle ScholarPubMed
Lippman, A. Prenatal genetic testing and screening: constructing needs and reinforcing inequities. Am J Law Med 1991; 17(1–2): 15–50.Google ScholarPubMed
Andermann, A, Blancquaert, I, Beauchamp, S, Costea, I. Guiding policy decisions for genetic screening: developing a systematic and transparent approach. Public Health Genomics 2011; 14(1): 9–16.CrossRefGoogle ScholarPubMed
Stewart-Brown, S and Farmer, A. Screening could seriously damage your health: Decisions to screen must take account of the social and psychological costs. BMJ 1997; 314(7080): 533–4.Google Scholar
Austoker, J. Gaining informed consent for screening is difficult – but many misconceptions need to be undone. BMJ 1999; 319(7212): 722–3.Google ScholarPubMed
Woloshin, S, Schwartz, L. Numbers needed to decide. J Natl Cancer Inst 2009; 101 (17): 1163–5.CrossRefGoogle ScholarPubMed
Langbehn, D, Brinkman, R, Falush, D, Paulsen, J, Hayden, M. A new model for prediction of the age of onset and penetrance for Huntington’s disease based on CAG length. Clin Genet 2004; 65: 267–77.CrossRefGoogle ScholarPubMed
Lawson, K, Wiggins, S, Green, T et al. Adverse psychological events occurring in the first year after predictive testing for Huntington’s disease. The Canadian Collaborative Study Predictive Testing. J Med Genet 1996; 33(10): 856–62.CrossRefGoogle ScholarPubMed
Hubbard, R, Wald, E. Exploding the Gene Myth: How Genetic Information is Produced and Manipulated by Scientists, Physicians, Employers, Insurance Companies, Educators and Law Enforcers. Boston: Beacon Press, 1993.Google Scholar
Holtzman, N. Proceed with Caution: Predicting Genetic Risks in the Recombinant DNA Era. Baltimore: John Hopkins University Press, 1989.Google Scholar
World Health Organization. Genomics and World Health: Report of the Advisory Committee on Health Research. Geneva: World Health Organization, 2002.Google Scholar
Banta, H. Considerations in defining evidence for public health. Int J Technol Assess Health Care 2003; 19(3): 559–72.CrossRefGoogle ScholarPubMed
Dobrow, M, Goel, V, Lemieux-Charles, L, Black, N. The impact of context on evidence utilization: a framework for expert groups developing health policy recommendations. Soc Sci Med 2006; 63(7): 1811–24.CrossRefGoogle ScholarPubMed
Morestin, F, Gauvin, F-P, Hogue, M-C, Benoit, F. Method for Synthesizing Knowledge about Public Policies. Quebec: National Collaborating Centre for Healthy Public Policy, Institut national de santé publique du Québec (INSPQ), 2011. Available at: .Google Scholar
Pawson, R, Greenhalgh, T, Harvey, G, Walshe, K. Realist review – a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy 2005; 10(Suppl 1): 21–34.CrossRefGoogle ScholarPubMed
Wilson, J, Jungner, G. Principles and Practice of Screening for Disease. Geneva: World Health Organization, 1968. Available at: .Google ScholarPubMed
Nuffield Council on Bioethics. Public Health: Ethical Issues. London: Nuffield Council on Bioethics, 2007.Google Scholar
Gail, M, Brinton, L, Byar, D et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989; 81(24): 1879–86.CrossRefGoogle ScholarPubMed
Lander, E, Linton, L, Birren, B et al.. Initial sequencing and analysis of the human genome. Nature 2001; 409(6822): 860–921.CrossRefGoogle ScholarPubMed
Bell, J. Predicting disease using genomics. Nature 2004; 429(6990): 453–6.CrossRefGoogle ScholarPubMed
Collins, F. Shattuck lecture – medical and societal consequences of the Human Genome Project. N Engl J Med 1999; 341(1): 28–37.CrossRefGoogle ScholarPubMed
Task Force on Community Preventive Services; Zaza, S, Briss, P, Harris, K (ed.). The Guide to Community Preventive Services: What Works to Promote Health? Oxford: Oxford University Press, 2005. Available at: .Google Scholar
Carlsten, C, Halperin, A, Crouch, J, Burke, W. Personalized medicine and tobacco-related health disparities: is there a role for genetics?Ann Fam Med 2011; 9(4): 366–71.CrossRefGoogle Scholar
Collier, R. Predisposed to risk but not change. CMAJ 2012; 184: E407–8.CrossRefGoogle Scholar
Wade, N. A Decade Later, Genetic Map Yields Few New Cures. The New York Times. June 12, 2010. Available at: .Google Scholar
World Health Organization. Report of a WHO Meeting on Collaboration in Medical Genetics. Geneva: World Health Organization, 2002.Google Scholar
Organisation for Economic Co-operation and Development. The Paris Declaration on Aid Effectiveness. Paris: Organisation for Economic Co-operation and Development. Available at: .
European Commission on Public Health. What are Rare Diseases?Brussels, Belgium: European Commission on Public Health, 2006.Google Scholar
MacDonald, N. Aboriginal children suffer while governments ignore Jordan’s PrincipleCMAJ 2012; 184: 853.CrossRefGoogle ScholarPubMed
Gray, J. Evidence based policy making. BMJ 2004; 329(7473): 988–9.CrossRefGoogle Scholar
Makni, H, St-Hilaire, C, Robb, L, Larouche, K, Blancquaert, I. La spectrométrie de mass en tandem et le dépistage néonatale sanguine au Québec: rapport sommaire. Montréal: Agence d’évaluation des technologies et des modes d’intervention en santé, 2007.Google Scholar
Andermann, A, Beauchamp, S, Costea, I, Blancquaert, I. Guiding Decision-Making for Population Based Screening: An Approach Applicable to Genetics [unpublished report]. Montreal: Agence d’évaluation des technologies et des modes d’intervention en santé (AETMIS), 2007.Google Scholar
Douste-Blazy, P, Monchamp, MA, d’Aubert, F. French National Plan for Rare Diseases 2005–2008: Ensuring Equity in Access to Diagnosis, Treatment and Provision of Care. Paris, France: Ministère de la santé et de la protection sociale and Secrétariat d’État aux personnes handicapées, 2004.Google Scholar
Nuffield Council on Bioethics. Genetic Screening: A Supplement to the 1993 Report by the Nuffield Council on Bioethics. London, UK: Nuffield Council on Bioethics, 2006.Google Scholar
Wilson, J, Jungner, G. Principles and Practice of Screening for Disease. Geneva: World Health Organization, 1968. Available at: .Google ScholarPubMed
Andermann, A, Blancquaert, I, Beauchamp, S, Déry, V. Revisiting Wilson and Jungner in the genomic age: A review of screening criteria over the past 40 years. Bull World Health Organ 2008; 86(4): 1–3.CrossRefGoogle ScholarPubMed
Daniels, N, Kennedy, B, Kawachi, I. Justice, health and health policy. In: Danis, M, Clancy, C, Churchill, L (eds.). Ethical Dimensions of Health Policy. Oxford: Oxford University Press, 2002, pp. 19–50.Google Scholar
Grosse, S, Boyle, C, Botkin, J et al. Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. MMWR Recomm Rep 2004; 53(RR13): 1–36.Google ScholarPubMed
Pollitt, R. International perspectives on newborn screening. J Inherit Metab Dis 2006; 29(2–3): 390–6.CrossRefGoogle ScholarPubMed
Kingdon, J. Agendas, Alternatives and Public Policies, 2nd edn. New York, NY: Longman Press, 2003.Google Scholar
Stone, D. Policy Paradox: The Art of Political Decision Making. New York, NY: WW Norton & Company, 2002.Google Scholar
Manciaux, M, Fliedner, T. World health: a mobilizing utopia? In: Gunn, S, Mansourian, P, Davies, A, Piel, A, Sayers, B, (eds.). Understanding the Global Dimensions of Health. New York, NY: Springer, 2005, pp. 69–82.CrossRefGoogle Scholar
International Labour Organization. Accelerating Action against Child Labour. Geneva: International Labour Organization, 2010. Available at: .Google Scholar
Roggero, P, Mangiaterra, V, Bustreo, F, Rosati, F. The health impact of child labor in developing countries: evidence from cross-country data. Am J Public Health 2007; 97(2): 271–5.CrossRefGoogle ScholarPubMed
Dantas, R, Santana, V. Child and adolescent labor, socioeconomic status, and reduced adult height. Int J Occup Environ Health 2010; 16(2): 153–9.CrossRefGoogle ScholarPubMed
Asogwa, S. Sociomedical aspects of child labor in Nigeria. J Occup Med 1986; 28(1): 46–8.CrossRefGoogle ScholarPubMed
Mathews, R, Reis, C, Iacopino, V. Child labor. A matter of health and human rights. J Ambul Care Manage 2003; 26(2): 181–2.CrossRefGoogle ScholarPubMed
Esin, M, Bulduk, S, Ince, H. Workrelated risks and health problems of working children in urban Istanbul, Turkey. J Occup Health 2005; 47(5): 431–6.CrossRefGoogle ScholarPubMed
Noweir, M, Osman, H, Abbas, F, Abou-Taleb, A, Mansour, T. Child labour in Egypt. II. Impact of work environment on health. J Egypt Public Health Assoc 1993; 68(3-4): 443–67.Google Scholar
Mull, L, Kirkhorn, S. Child labor in Ghana cocoa production: focus upon agricultural tasks, ergonomic exposures, and associated injuries and illnesses. Public Health Rep 2005; 120(6): 649–55.CrossRefGoogle ScholarPubMed
Awan, S, Nasrullah, M, Cummings, K. Health hazards, injury problems, and workplace conditions of carpet-weaving children in three districts of Punjab, Pakistan. Int J Occup Environ Health 2010; 16(2): 115–21.CrossRefGoogle ScholarPubMed
Mallik, S, Chaudhuri, R, Biswas, R, Biswas, B. A study on morbidity pattern of child labourers engaged in different occupations in a slum area of Calcutta. J Indian Med Assoc 2004; 102(4): 198–200.Google Scholar
Pinzon-Rondon, A, Koblinsky, S, Hofferth, S, Pinzon-Florez, C, Briceno, L. Work-related injuries among child street-laborers in Latin America: prevalence and predictors. Rev Panam Salud Publica 2009; 26(3): 235–43.CrossRefGoogle ScholarPubMed
Saddik, B, Williamson, A, Nuwayhid, I, Black, D. The effects of solvent exposure on memory and motor dexterity in working children. Public Health Rep 2005; 120(6): 657–63.CrossRefGoogle ScholarPubMed
Feingold, E, Wasser, J. Walk-through surveys for child labor. Am J Ind Med 1994; 26(6): 803–7.CrossRefGoogle ScholarPubMed
Fineran, S, Gruber, J. Youth at work: adolescent employment and sexual harassment. Child Abuse Negl 2009; 33(8): 550–9.CrossRefGoogle ScholarPubMed
Doocy, S, Crawford, B, Boudreaux, C, Wall, E. The risks and impacts of portering on the well-being of children in Nepal. J Trop Pediatr 2007; 53(3): 165–70.CrossRefGoogle ScholarPubMed
Audu, B, Geidam, A, Jarma, H. Child labor and sexual assault among girls in Maiduguri, Nigeria. Int J Gynaecol Obstet 2009; 104(1): 64–7.CrossRefGoogle ScholarPubMed
Fekadu, D, Alem, A, Hagglof, B. The prevalence of mental health problems in Ethiopian child laborers. J Child Psychol Psychiatry 2006; 47(9): 954–9.CrossRefGoogle ScholarPubMed
Largie, S, Field, T, Hernandez-Reif, M, Sanders, C, Diego, M. Employment during adolescence is associated with depression, inferior relationships, lower grades, and smoking. Adolescence 2001; 36(142): 395–401.Google ScholarPubMed
Chen, C, Chen, W, Lew-Ting, C et al. Employment experience in relation to alcohol, tobacco, and betel nut use among youth in Taiwan. Drug Alcohol Depend 2006; 84(3): 273–80.CrossRefGoogle ScholarPubMed
Tandon, S, Marshall, B, Templeman, A, Sonestein, F. Health access and status of adolescents and young adults using youth employment and training programs in an urban environment. J Adolesc Health 2008; 43(1): 30–7.CrossRefGoogle Scholar
Santana, V, Cooper, S, Roberts, R, Araujo-Filho, J. Adolescent students who work: gender differences in school performance and self-perceived health. Int J Occup Environ Health 2005; 11: 294–301.CrossRefGoogle Scholar
Kassouf, A, McKee, M, Mossialos, E. Early entrance to the job market and its effect on adult health: evidence from Brazil. Health Policy Plan. 2001; 16: 21–8.CrossRefGoogle ScholarPubMed
Leinberger-Jabari, A, Parker, D, Oberg, C. Child labor, gender and health. Public Health Rep 2005; 120: 642–7.CrossRefGoogle ScholarPubMed
Mintz, A, DeRouen, K. Understanding Foreign Policy Decision Making. Cambridge: Cambridge University Press, 2010.CrossRefGoogle Scholar
Walt, G. Health Policy: An Introduction to Process and Power. London: Zed Books, 1994.Google Scholar
Pogge, T. Relational conceptions of justice: Responsibilities for health outcomes. In: Anand, S, Peter, F, Sen, A, (eds.). Public Health, Ethics and Equity. Oxford: Oxford University Press, 2004. pp. 135–62.Google Scholar
Manderson, L, Whiteford, L. Health, globalization and the fallacy of the level playing field. In: Whiteford, L, Manderson, L (eds.). Global Health Policy, Local Realities: The Fallacy of the Level Playing Field. Boulder, CO: Lynne Rienner Publishers, 2000, pp. 1–19.Google Scholar
Woods, N. Order, globalization and inequality in world politics. In: Hurrell, A, Woods, N eds. Inequality, Globalization and World Politics. Oxford: Oxford University Press, 1999, pp. 8–35.CrossRefGoogle Scholar
Palmer, A, Tomkinson, J, Phung, C, et al. Does ratification of human-rights treaties have effects on population health?Lancet 2009; 373(9679): 1987–92.CrossRefGoogle ScholarPubMed
Commission on Human Rights. The Right of Everyone to the Enjoyment of the Highest attainable standard of physical and mental health [Resolution 2002/31: E/2002/23-E/CN.4/2002/200]. Geneva: Commission on Human Rights, 2002.Google Scholar
Sandler, T. Global Collective Action. Cambridge: Cambridge University Press, 2004.CrossRefGoogle Scholar
Woods, N. Whose aid? Whose influence? China, emerging donors and the silent revolution in development assistance. Int Aff 2008; 84(6): 1205–21.CrossRefGoogle Scholar
Whiteford, L, Rylko-Bauer, B, Farmer, P. Global Health in times of violence: finding hope. In: Rylko-Bauer, B, Whiteford, L, Farmer, P, (eds.). Global Health in Times of Violence. Santa Fe: School for Advanced Research Press, 2009, pp. 223–32.Google Scholar
Farmer, P. Pathologies of Power: Health, Human Rights and the New War on the Poor. Berkley, CA: University of California Press, 2005.Google Scholar
Sutherland, T. Lewis Hine: The Child Labour Photos That Shamed America. BBC News April 11, 2012. Available at: .
Parker, D. Before their Time: The World of Child Labour. New York: Quantuck Lane Press, 2007. Available at: .Google Scholar
Lee, K, Buse, K, Fustukian, S (eds.). Health Policy in a Globalising World. Cambridge: Cambridge University Press, 2002.
Beck, U. Power in the Global Age. Cambridge: Polity Press, 2005.Google Scholar
Jacobsen, K. Introduction to Global Public Health. Sudbury MA: Jones and Bartlett Publishers, 2008.Google Scholar
McNeill, D. Five Years In, Gauging Impact of Gates Grants. The New York Times December 20, 2010. Available at: .Google Scholar
Bowman, A. The flip side to Bill Gates’ charity billions. New Internationalist Magazine. April 1, 2012. Available at: .Google Scholar
Kane, M. Preventing cancer with vaccines: progress in the global control of cancer. Cancer Prev Res 2012; 5(1): 24–9.CrossRefGoogle Scholar
Welsh, J, Woods, N (eds.) Exporting Good Governance: Temptations and Challenges in Canada’s Aid Program. Waterloo, ON: The Centre for International Governance Innovation and Wilfrid Laurier University Press, 2007.
World Bank. World Development Indicators Online. Washington, DC: World Bank, 2008.Google Scholar
UN General Assembly. United Nations Millennium Declaration: Resolution Adopted by the General Assembly (A/55/L.2). New York: United Nations, 2000. Available at: .Google Scholar
Macklin, R. Ethics and Equity in Access to HIV Treatment – 3 by 5 initiative. Geneva: World Health Organization, 2004. Available at: .Google Scholar
De Maeseneer, J, Roberts, R, Demarzo, M et al. Tackling NCDs: a different approach is needed. Lancet 2012; 379(9829): 1860–1.CrossRefGoogle ScholarPubMed
Sixty-Second World Health Assembly. Resolution WHA62.12: Primary health care, including health system strengthening. Geneva: World Health Organization, 2009. Available at: .
Van Lerberghe, W, Evans, T, Rasanathan, K et al. World Health Report 2008. Primary Health Care: Now More than Ever. Geneva: World Health Organization, 2008. Available at: .Google Scholar
Andermann, A. Breaking away from the disease-focused paradigm. Lancet 2010; 376(9758): 2073–4.CrossRefGoogle ScholarPubMed
International Labour Organization. Minimum Age Convention (C138): Convention Concerning Minimum Age for Admission to Employment (Entry into Force: 19 Jun 1976). Geneva: International Labour Organization, 1973. Available at: .Google Scholar
International Labour Organization. Worst Forms of Child Labour Recommendation (R190): Recommendation Concerning the Prohibition and Immediate Action for the Elimination of the Worst Forms of Child Labour. Geneva: International Labour Organization, 1999. Available at: .Google Scholar
International Labour Organization. Worst Forms of Child Labour Convention (C182): Convention Concerning the Prohibition and Immediate Action for the Elimination of the Worst Forms of Child Labour (Entry into Force: 19 Nov 2000). Geneva: International Labour Organization, 1999. Available at: .Google Scholar
Sixty-Second World Health Assembly. Resolution WHA62.12, May 2009. Primary Health Care, Including Health System Strengthening. Geneva: World Health Organization. Available at: .
Sixtieth World Health Assembly. Resolution WHA60.26, May 2007. Workers’ Health: Global Plan of Action. Geneva: World Health Organization. Available at: .
Hesketh, T, Gamlin, J, Woodhead, M. Policy in child labour. Arch Dis Child 2006; 91(9): 721–3.CrossRefGoogle ScholarPubMed
Carothers, R, Breslin, C, Denomy, J, Foad, M. Promoting occupational safety and health for working children through microfinance programming. Int J Occup Environ Health 2010; 16(2): 180–90.CrossRefGoogle ScholarPubMed
Parker, D. Street children and child labour around the world. Lancet 2002; 360(9350): 2067–71.CrossRefGoogle ScholarPubMed
Horton, R. The continuing invisibility of women and children. Lancet 2010; 375: 1942–3.CrossRefGoogle ScholarPubMed
Scanlon, T, Prior, V, Lamarao, M, Lynch, M, Scanlon, F. Child labour. BMJ 2002; 325(7361): 401–3.CrossRefGoogle ScholarPubMed
National Institute for Occupational Safety and Health. Child Labour Research Needs: Recommendations from the NIOSH Child Labor Working Team (NIOSH Publication No. 97-143). Atlanta: US Centers for Disease Control and Prevention, 1997.Google Scholar
Gunn, S, Ostos, Z. Dilemmas in tackling child labour: the case of scavenger children in the Philippines. Int Labour Rev 1992; 131(6): 629–46.Google Scholar
Kelley, P. Global health: governance and policy development. Infect Dis Clin North Am 2011; 25(2): 435–53.CrossRefGoogle ScholarPubMed
Meier, B, Fox, A. International obligations through collective rights: moving from foreign health assistance to global health governance. Health Hum Rights 2010; 12(1): 61–72.Google ScholarPubMed
Ruger, J. Global health governance as shared health governance. J Epidemiol Community Health 2012; 66(7): 653–61.CrossRefGoogle ScholarPubMed
Kickbusch, I, Hein, W, Silberschmidt, G. Addressing global health governance challenges through a new mechanism: the proposal for a Committee C of the World Health Assembly. J Law Med Ethics 2010; 38(3): 550–63.CrossRefGoogle ScholarPubMed
Gostin, L. Meeting the survival needs of the world’s least healthy people: a proposed model for global health governance. JAMA 2007; 298(2): 225–8.CrossRefGoogle ScholarPubMed
Ottersen, O, Frenk, J, Horton, R. The Lancet-University of Oslo Commission on Global Governance for Health, in collaboration with the Harvard Global Health Institute. Lancet 2011; 378(9803): 1612–3.CrossRefGoogle ScholarPubMed
Braillon, A. Who will fear the Commission on Global Governance for Health?Lancet 2012; 379(9818): 803–4.CrossRefGoogle ScholarPubMed
Pang, T, Daulaire, N, Keusch, G, et al. The new age of global health governance holds promise. Nat Med 2010; 16(11): 1181.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats