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BMJ 2009; 338 doi: (Published 10 June 2009) Cite this as: BMJ 2009;338:b2310

Human rights treaties have no measurable impact on health

Many international treaties on human rights include statements on citizens’ rights to health. In theory, countries that ratify these treaties should have healthier populations than those that don’t, but it’s hard to find a measurable difference. In one analysis of 170 countries, ratification of six treaties with a health element was not associated with any consistent improvement in health indicators such as infant and maternal mortality, prevalence of HIV, or life expectancy.

The authors did a cross sectional analysis then a before and after analysis, adjusting for important confounders. All they found was a significant and well known association between wealth and health. Overall, 65% of the countries (111/170) ratified all six treaties. Wealthy countries were no more likely to ratify all six treaties than were less wealthy countries.

The data came from widely available international sources including the World Health Organization, the United Nations, and non-governmental organisations specialising in civil liberties and human rights. Neither the cross sectional nor the before and after analysis had a complete set of data, so it’s possible that significant associations were missed. The authors think a more likely explanation is that ratifying human rights treaties doesn’t necessarily improve a nation’s health—not because the treaties don’t matter, but because they don’t work without external monitoring, accountability, and a legal system with the funds and freedom to challenge the state.

Cognitive behaviour therapy helps prevent depression in teens at risk

Teenagers with depressed parents are more likely to become depressed themselves; however, emerging evidence indicates that cognitive behaviour therapy can reduce the risk. Researchers recently tested the effect of eight weekly sessions of group cognitive behaviour therapy followed by six monthly sessions in 316 teenagers aged 13-17 years old. All had a parent with current or past depression and had mild symptoms or a past history of depression themselves. Cognitive behaviour therapy was better than …

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