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This chapter argues that neoliberal governmentality in immunization relocates the Turkish state's position regarding vaccine and immunization policies. Neoliberalism is often discussed in the context of privatization, performance, and effectiveness separately. However, more attention should be paid to the set of strategies that are employed in public policy processes to manage populations in terms of immunization, while intertwining power with knowledge. Following Foucault's concept of governmentality and taking it further within the context of biopolitics, this chapter focuses on different knowledge practices regarding vaccine and immunization policies in Turkey. In doing so, this case study applies a post-structural analysis to examine vaccine production, vaccine know-how, and immunization policies inscribed in policy documents as a form of knowledge practice. The analysis sheds light on the reflexive transformation of the concept of biopolitics, which is moving from state-oriented knowledge practices toward a neoliberal governmentality of immunization.

A rich literature has documented gender-based differences in health care utilization and outcomes. The role of risk attitude in explaining the variations is limited at best. This study examines gender differences in health utilities and risk attitudes.

Data on 13 health states were collected from 629 students via questionnaires at the Ben-Gurion University of the Negev in 2005. From each respondent, we assessed utilities for a subset of health states, using Time Trade-Off and Standard Gamble. A risk attitude coefficient was calculated for each respondent as a function of their utilities for all outcomes assessed. The risk coefficient derived from a closed-form utility model for men was compared to that of women using the t-statistic.

There was a statistically significant difference in the risk attitudes of men and women. Men had a concave utility function, representing risk aversion, while women had a near linear utility function, suggesting that women are risk neutral.

Differences in risk attitude may be an important contributor to gender-based disparities in health services utilization. More research is needed to assess its full impact on decision-making in health care.

Contrary to the popular view of mandates as rigid and dictatorial mechanisms, this article advances a view of mandates as mechanisms for cooperation and negotiation. The relationship between several state and local actors is investigated in Maryland, particularly within the context of the development of a "loosely" mandated public health program, the Targeted Funding Program (TFP). An analysis of the TFP and the actors involved in the program's development demonstrates how this program is designed to achieve much more than increased fiscal responsibility. The TFP is designed, and continues to be redesigned, to meet the political and professional objectives of various elected and appointed officials at the state and local levels.

The purpose of this paper is to evaluate the health‐states of unit under test (UUT) in aerospace systems by means of unreliable test outcomes, and the evaluation results can provide a guide for engineers to carry out proper maintenance prior to total failure.

In this paper, the authors formulate the health‐state evaluation (HSE) problem with unreliable test outcomes based on Bayes rule, and develop the Lagrangian relaxation and adaptive genetic algorithm (LRAGA) to solve it. The solution scheme can be viewed as a two‐level coordinated solution framework for the HSE problem. At the top level, the Lagrange multipliers are updated by using AGA. At the bottom level, each of the sub‐problems is solved by using AGA.

The experimental results show that the HSE model appears promising and the LRAGA can obtain the higher quality solution and converge to it at a faster rate than conventional methods (i.e. Lagrangian relaxation (LR), genetic algorithm (GA), simulated annealing (SA) and Lagrangian relaxation and genetic algorithm (LRGA).

The proposed method for the HSE problem of large‐scale systems which include thousands of faults and tests needs to be verified further.

The HSE results for aerospace systems can help engineers to carry out a schedule for prompt maintenance prior to UUTs' failure, to avoid the consequences of total failure. It is important to improve aerospace systems' safety, reliability, maintainability, affordability, and reduce life cycle cost.

This paper constructs the HSE model with unreliable test outcomes based on the Bayes rule and proposes a method based on LRAGA to solve the HSE problem.

Social and economic trends toward local governance form the context for health and mental health policy and the reorganization of care systems for cost-containment in the United States. Local management of public–private collaborations is promoted by state agencies as a means of rationalizing mental health care and community support services. This chapter analyses the local process of developing public–private partnerships for mental health care, based on an ethnographic case study of county Mental Health/Mental Retardation and behavioral health committees and coalitions in Texas, from 1995 to 2001. Following this period, local service agencies continued collaboration to increase community awareness and resources for care. Findings were that while the rapid transition to local control under conditions of reduced resources impeded implementation of a public–private mental health care system, commitment to a service safety net for persons with mental disabilities was sustained.

Brazilian federalism was important in the political game of combating the pandemic for three reasons. First, Brazil's public health system depends heavily on intergovernmental relations between Union, states, and municipalities because there is a policy portfolio based on federative cooperation. Second, the subnational governments' autonomy to act against COVID-19 was constantly questioned by the Federal Government – the conflict between the President and governors was a key piece in all health policy. Finally, states and local governments were primarily responsible for policies to fight against pandemic, but the absence and/or wrong measures taken by the Federal Government (such as the delay in purchasing vaccines) generated intergovernmental incoordination, increased territorial inequality, and reduced the effectiveness of subnational public policies, especially those linked to social isolation. In this context, Brazilian federalism played a dual role in the pandemic. On the one hand, the federative structure partially succeeded in averting an even worse scenario, mitigating the impact of mistaken presidential decisions. The role of subnational governments, especially of the states, was critical as a counterweight to federal decisions. On the other hand, the President actively acted against governors and mayors and, above all, sought to weaken intergovernmental articulations within the Unified Health System (SUS), the federative model designed three decades ago. One could say that the federative actors, such as the Supreme Court (Supremo Tribunal Federal – STF) and subnational governments, were the main obstacles for the Bolsonarist antiscientific agenda. The success of this reaction to President Bolsonaro's negationist populism was partial, but the results of the fight against COVID-19 would have been much worse without these federalist barriers.

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.

Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.

Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.

There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

The U.S. mental health service delivery system consists of a broad array of inpatient and ambulatory services operated under governmental, corporate, nonprofit, and entrepreneurial auspices. Granted this complex mixture of control patterns, a primary question to be addressed by this paper is the degree to which this set of services can be conceptualized as a system at any level of social organization beyond a single control point for a subset of services. This paper will also explore the utility of systems formulations, including cybernetic processes, for addressing the question of whether mental health services can be controlled and directed to such a degree that they act in concert across different control points. Reference will be made to exogenous systems, such as public and private reimbursement programs, that may influence control processes. Some directions for future research will also be explored.

This study aims to analyze the way Indonesian and the US laws regulate the reality and implications of legal issues regarding telemedicine, including the protection of citizens in using telemedicine.

This normative legal study used secondary data comprising primary and secondary legal materials based on the law as a norm. The normative legal method was used because the data were based on laws and regulations, reports, journals and research governing telemedicine in Indonesia and the USA.

The results showed similarities between Indonesia and the USA regarding health services as part of protecting human rights. The differences in implementing telemedicine are from a legal aspect. The legal comparison of telemedicine implementation between the two countries resulted in differences in regulation, informed consent, medical records, practice licenses and medical prescriptions.

This study discussed telemedicine’s legal aspects in Indonesia and the USA.

This study aimed to determine the implementation and guidelines used by the USA to be considered for adoption by Indonesia for legal certainty.

The results showed that legal threats could be a weakness of law in Indonesia. Therefore, the government should develop guidelines about telemedicine to accommodate citizens’ legal protection and certainty.

This study is original and could be used as a reference for policymakers in Indonesia and the USA in protecting citizens using telemedicine services. The findings provide a perspective based on Health Law in Indonesia.

The study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending across the 21 selected states of India.

The tools of absolute β-and σ-convergence are used in the analysis to test the regional convergence. The average annual growth rate across the states is the dependent variable for β-convergence, and time is the second dependent variable but is used for s-convergence. In contrast, the initial value of NRHM expenditure and the coefficient of variation of NRHM expenditure are used as independent variables, respectively. Descriptive statistics are also used for the study. The data are annual and cover the panel from 2007 to 2020.

The study attests to the hypothesis of β-and σ-convergence for the selected states in the period mentioned. The observed convergence in NRHM expenditure is due to the shift in the government's attention from the non-high focus high focus states to high states through the national rural health mission policy. The coefficient of variation across the states also shows a declining trend and provides the robustness of the σ-convergence.

As far as the literature is concerned, none of the existing studies examines the convergence of a public health expenditure scheme like the National Rural Health Mission across the Indian states by applying the techniques of β-and σ-convergence. The novelty of the study is using the newly updated dataset and validating the convergence hypotheses in the National Rural Health Mission expenditure case.