Affordable access to quality health and care is generally recognised as a basic human need and one of the grand challenges society currently faces, especially in the wake of the COVID-19 pandemic. Unfortunately, the focus on public health is driving a predominantly human-centric approach to One Health initiatives. Furthermore, the concerted reliance on innovation and technology-driven solutions may exacerbate the problem. Without the appropriate legal and policy framework to incentivise and capture the social value of research and innovation, there is a risk the resulting solutions will fail to achieve the balance between animal, environment, and human health. This chapter presents a legally supported approach, informed by the intellectual property framework and the policy objectives of Responsible Research and Innovation (RRI) and Value-Based Health and Care (VBHC) principles, to support the implementation of a true One Health framework. This enables the development of legal tools that will give credibility, legitimacy, and accountability to the design, development, and implementation of a sustainable One Health framework through meaningful and inclusive societal engagement.

For both developed and developing countries in the world, the twenty-first century will be marked by great challenges for healthcare systems. The overwhelming reason will be aging societies that will face an increase in multimorbid, chronic diseases which will include neurological diseases. The probability of surviving acute illness and the medical opportunities to prolong life in chronic-progressive disease will improve in future. As a result the numbers of neurological patients with respiratory impairment caused by prolonged, chronic or chronic-progressive life-threatening disease will increase. Minimizing dependency on life-supporting technologies and care, stabilizing vital functions, optimizing quality of life and participation and alleviating suffering are paramount goals for these patients. The therapeutic approach therefore must integrate intensive care, neurorespiratory care, rehabilitation and palliative care. Furthermore, patient-centered and family-oriented care, which covers the whole lifespan and bridges the gap between inpatient and outpatient care, is needed.

Individuals improvise around authoritarian control and government restrictions in everyday circumstances. By shifting the focus from gaining institutional access to meeting their needs, migrant workers make do and muddle through despite being relatively powerless vis-à-vis the Chinese state. Newcomers have devised strategies of survival to scrape together needs so that they can keep their jobs, save their disposable income, and attain medical treatment when necessary. At the individual level, they frequently rely on visiting illegal private health clinics or try to straddle the rural–urban divide. In community-based innovations, they negotiate with their employers to opt out of paying into social insurance schemes (and thereby run against the common notion that all outsiders want to be included) or craft small-scale, self-run insurance arrangements. These practices suggest that migrants have found ways to curtail some of the effects of social control, but notably it is mostly at the margins. The effects of political atomization are therefore muddled, and the state’s use of public service provision as a tool of social control largely remains intact.

Municipalities deflect demands for benefits instead of meeting them or denying them outright to resist and undermine elements of the central government’s urbanization strategy. This diffuse promise of phantom services operates at what is experienced by local officials and migrants as the person-by-person micro-level of provision. Urban authorities sometimes do so by establishing nearly impossible eligibility requirements or requiring paperwork that outsiders struggle to obtain. At times they also nudge migrants to seek health care or education elsewhere by enforcing dormant rules or by shutting down a locally available service provider. Local officials use these ploys for both political and practical reasons. Limiting access isolates and disempowers migrants and is cheaper than offering benefits. Phantom services are a consequence of the localization of the household registration system and a sign that new axes of inequality and gradations of second-class citizenship have emerged.

Health care comprises a major segment of the US economy and is a critical influence upon citizens’ quality of life. The quality of health care and access to it are negatively affected by corruption. So too is citizen compliance with public health policies, a fact that became apparent during the COVID-19 pandemic. Stay-at-home orders, for example, were significantly less effective in states with more extensive corruption. Low levels of trust in government contributed to those disparities. Such effects are more pronounced in poorer areas and Black communities. Racial contrasts in vaccine equity – access to vaccinations and related services – were pronounced and, again, reflected levels of corruption. Particularly intractable problems of collective action posed by structural corruption and structural racism must be addressed if disparities in the quality of health care are to be reduced.

Insurance coverage can indicate medical acceptance of procedures and products, as well as serve as a proxy for ethical views, social views, and employer views on appropriate health care. This is particularly the case in the realm of reproduction, especially in relation to assisted reproduction and abortion. First, the chapter will provide historical overview of the means in which innovative techniques have acquired “established” status, as indicated by health insurance coverage and for some techniques, the option to obtain federal research funds on the path to becoming established. Second, the chapter will explain the ways in which abortion has been treated differently by insurance plans, especially governmental insurance plans such as Medicaid, as well as Congressional appropriations riders, which have specifically prohibited federal employee health benefit plans from providing coverage for abortions. Third, the chapter will discuss existing state mandates for insurance coverage of fertility treatment with an emphasis on in vitro fertilization. The chapter will then move on to insurance coverage of egg freezing with an emphasis on what are seen as “employee perks” by large companies like Google and Facebook, whose early coverage of egg freezing was covered by the media. More recently, Walmart, Amazon, and a growing number of law firms have been adding egg freezing and in vitro fertilization to their health insurance coverage for employees. Insurance coverage can have a substantial role in normalizing a treatment, especially in the realm of reproductive innovation, and can constitute significant action especially when legislators are actively avoiding a topic.

Sex and gender have a significant relationship to health and health outcomes for women, men, and sexually and gender-diverse people. Sex relates to biological attributes, whether born female or male, while gender identity relates to how someone feels and experiences their gender, which may or may not be different to their physiology or sex at birth. Biological characteristics expose women and men to different health risks and health conditions. Gender also exposes people to different health risks, and gender inequity impacts on their potential to achieve health and well-being.

Chronic conditions, or non-communicable diseases, are the leading cause of death worldwide. Chronic conditions are responsible for 41 million deaths and 17 million premature deaths across the world each year. Most of these deaths are due to four major conditions: cardiovascular disease, cancer, chronic respiratory disease and diabetes. However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the need to manage these are major healthcare concerns of the industrialised world.

This chapter introduces First Nations approaches to health care that have relevance for the Australian and Aotearoa New Zealand contexts. It examines the historical influences that impacted the health and well-being of First Nations in these countries and considers the need for adopting First Nations approaches to health care practice such as cultural safety, cultural responsiveness and other cultural frameworks. Several of the principles for practice are transferrable to international First Nations communities as well as culturally and linguistically diverse populations.

The school nurse is a nurse who works in a range of education settings, across all age groups. While Australia does not have a formal national school health service, nurses have worked in schools for over a century. Today, they are employed in various independent schools, colleges and fragmented programs within government schools. There has been interest in recent years in growing the presence of nurses in Australian schools to facilitate access to health care for students from disadvantaged backgrounds.

The third industrial revolution saw the creation of computers and an increased use of technology in industry and households. We are now in the fourth industrial revolution: cyber, with advances in artificial intelligence, automation and the internet of things. The third and fourth revolutions have had a large impact on health care, shaping how health and social care are planned, managed and delivered, as well as supporting wellness and the promotion of health. This growth has seen the advent of the discipline of health informatics with several sub-specialty areas emerging over the past two decades. Informatics is used across primary care, allied health, community care and dentistry, with technology supporting the primary health care continuum. This chapter explores the development of health informatics as a discipline and how health care innovation, technology, governance and the workforce are supporting digital health transformation.

Cultural competence and cultural safety support health professionals to recognise everyone as unique in order to promote optimal health outcomes. This allows for the acknowledgement of diversity that exists within and between individuals and groups in health care. In practice, this represents the broader understanding of culture in health care, and encompasses the dynamic influences of culture on attitudes, values and beliefs. Alongside culture, the understanding of diversity is inclusive of – yet not exclusive to – age and generation, sex and gender identity, socio-economic status, occupation, ethnicity or migrant experience, religion or spirituality, and ability or disability.

Globally, people in prison often come from the most deprived sections of society due to adverse political, economic, environmental, social and lifestyle factors. This group experiences chronic and complex mental and physical health conditions at higher rates than the general population, including mental health conditions, chronic non-communicable and communicable conditions and acquired brain injury. They also have higher rates of tobacco smoking, high-risk alcohol consumption, illicit drug use and injecting drug use. As many as 90 per cent of people in custody have a diagnosis of either a mental health condition or addiction. Often, people in prison have under-utilised health care in the community and, for many, the first interaction with health services occurs during incarceration. Therefore, incarceration may provide an opportunity to access treatment to improve health and for appropriate health care to be initiated.