scholarly journals Linking health and social data in Brazil: challenges and potentials for public health research

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Barreto

Abstract Health research using linked routine population-based data collected for non-research purposes has increased in recent years. In Brazil, the Centre for Data and Knowledge Integration for Health (CIDACS-Fiocruz) was created in 2016 in Salvador with the objective of integrating data to answer research questions related to public health. In CIDACS, efforts are made to obtain high-quality linked data while adhering to security, ethical use and privacy issues. Efforts have been made to conduct operations with respect to implementing the appropriate structures, processes and controls over the original and integrated datasets in order to provide relevant data for research purposes. Two different cohorts have been constructed. The “100 Million Brazilian Cohort” comprises of individuals registered in a National Social Register from 2001 linked to data from different social protection programs ('exposures') and outcomes from various health-related Brazilian National databases (deaths, births, infectious diseases). The main aim is to explore the impact of social protection programs on health using natural experiment approaches. By studying the effect of social policies, they increase our possibilities to explore links between the social and economic determinants and health. The CIDACS Birth Cohort is also a population-based cohort derived from linked data, developed to investigate the relationships between prenatal and early life events on health-related outcomes for infants and children, in the context of social inequalities. The overall objective is to research the effect of obstetric and prenatal conditions on birth, growth, morbidity, and survival in a dynamic cohort. CIDACS is expected to be an important resource for researchers and policymakers interested in enhancing the evidence base pertaining to different aspects of health, as well as investigating the role of social determinants of health and the potential effects of social and environmental policies on health.

Author(s):  
Mauricio Lima Barreto ◽  
Maria Yuri Ichihara ◽  
Bethania de Araujo Almeida ◽  
Marcos Ennes Barreto ◽  
Liliana Cabral ◽  
...  

The Center for Data and Knowledge Integration for Health (CIDACS) was created in 2016 in Salvador (Bahia, Brazil). This paper aims to present a profile of CIDACS, including its current databases. CIDACS aims to conduct interdisciplinary studies and research, develop new scientific methodology and promote professional training using linked large-scale databases and high-performance computational resources in a secure environment. Administrative data is at the core of the activities conducted by CIDACS. The advantages of administrative data include significantly larger sample sizes, an inherent longitudinal structure and high-quality information. The center’s research projects are primarily focused on enhancing the understanding surrounding the impact of social protection policies (e.g., public cash-transfer and housing programs) on health outcomes in low-income populations throughout Brazil. CIDACS’ primary data source is citizens who register with the Cadastro Único program, which encompasses individuals eligible to receive benefits from over 20 governmental social programs. CIDACS has two separate environments for data handling: 1) Data Production Center, a secure room housing the computational infrastructure for ingesting, storing, cleaning, processing and linking original databases, as well as extracting research-ready datasets and 2) Data Analysis Environment, a computational infrastructure based on data safe haven principles, which allows researchers to access and process requested datasets. Brazil has a large public health community that uses national health and social databases for research programs, and the linkage of different databases has been a widely employed practice in the country. CIDACS is the result of efforts by researchers, policymakers and public health officials to use and improve the quality of Brazilian health databases. CIDACS is expected to be an important resource for researchers and policymakers interested in improving the evidence base in different aspects of health, as well as with regard to the social determinants of health and the effects of social and environmental policies on health in general.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emma Tonkin ◽  
Trevor Webb ◽  
Julie Henderson ◽  
Paul R. Ward ◽  
John Coveney ◽  
...  

Abstract Background Consumer trust in food systems is essential for consumers, food industry, policy makers and regulators. Yet no comprehensive tool for measuring consumer trust in food systems exists. Similarly, the impact that trust in the food system has on health-related food behaviours is yet to be empirically examined. The aim of this research was to develop a comprehensive instrument to measure trust in the food system (the Dimensions of Trust in Food Systems Scale (DOTIFS scale) and use it to explore whether trust in the food system impacts consumers’ health-related behaviours. Methods The DOTIFS scale was developed using sociological theories of trust and pre-existing instruments measuring aspects of trust. It was pilot tested and content validity was assessed with 85 participants. A mixed-methods exploration of the health-related behaviours of 18 conveniently sampled Australian consumers with differing trust scores determined by the DOTIFS scale was then conducted. During March–July 2019 shopping- and home-observations were used to assess participants’ food safety practices and exposure to public health fortification programs, while the CSIRO Healthy Diet Score determined their adherence to national dietary guidelines. Results The DOTIFS scale was found to have high comprehension, ease of use and content validity. Statistical analysis showed scale scores significantly trended as predicted by participants’ stated level of trust. Differences were found in the way individuals with more or less trust in the food system comply with national dietary guidelines, are exposed to public health fortification programs, and adhere to recommended food safety practices. Conclusions The DOTIFS scale is a comprehensive, sociologically- and empirically- informed assessment of consumer trust in food systems that can be self-administered online to large populations and used to measure changes in consumer trust over time. The differences in health-related behaviours between individuals with varying levels of trust warrant further investigation.


2018 ◽  
Vol 23 (1) ◽  
pp. 117-138 ◽  
Author(s):  
Yeonsoo Kim ◽  
Mari Luz Zapata Ramos

Purpose The purpose of this paper is to examine how stakeholders perceive the motives behind fast food companies’ public health-related corporate social responsibility (CSR) and general social issue-related CSR initiatives, and their responses toward CSR in terms of supportive communication intent, investment intent, and purchase intent. The authors further examine the impact of perceived CSR motives on intent and whether a healthier chain image has an effect on stakeholder responses. Design/methodology/approach An online experiment was conducted. This study employed a randomized 2 (CSR type: health-related CSR vs generic social issue-related CSR)×2 (chain image: healthier chain vs general fast-food chain) full factorial design using general stakeholder samples. Findings For an ordinary fast food restaurant, generic social issue-related CSR programs elicited significantly more positive perceptions of CSR motives, supportive communication intent and investment intent, than public-health related CSR. When a company has a healthier image, stakeholders do not distinguish between CSR types. Stakeholders perceive both CSR types as stemming from mutually beneficial motives and show neutral to slightly positive reactions to both CSR. A positively perceived CSR motive plays a determinant role in anticipating communication, investment, and purchase intents. Originality/value This is the first study that examines stakeholder perception of motives behind and responses toward fast food chains’ health-related vs generic social issue-related CSR initiatives, in light of corporate image. The study findings help public relations practitioners, public health professionals, parent groups, and legislators understand stakeholders’ reactions toward CSR initiatives in the fast food industry and help them monitor practices for improvements.


2018 ◽  
Vol 21 (18) ◽  
pp. 3407-3421 ◽  
Author(s):  
Melissa Mialon ◽  
Jonathan Mialon

AbstractObjectiveTo identify the corporate political activity (CPA) of major food industry actors in France.DesignWe followed an approach based on information available in the public domain. Different sources of information, freely accessible to the public, were monitored.Setting/SubjectsData were collected and analysed between March and August 2015. Five actors were selected: ANIA (Association Nationale des Industries Agroalimentaires/National Association of Agribusiness Industries); Coca-Cola; McDonald’s; Nestlé; and Carrefour.ResultsOur analysis shows that the main practices used by Coca-Cola and McDonald’s were the framing of diet and public health issues in ways favourable to the company, and their involvement in the community. ANIA primarily used the ‘information and messaging’ strategy (e.g. by promoting deregulation and shaping the evidence base on diet- and public health-related issues), as well as the ‘policy substitution’ strategy. Nestlé framed diet and public health issues, and shaped the evidence base on diet- and public health-related issues. Carrefour particularly sought involvement in the community.ConclusionsWe found that, in 2015, the food industry in France was using CPA practices that were also used by other industries in the past, such as the tobacco and alcohol industries. Because most, if not all, of these practices proved detrimental to public health when used by the tobacco industry, we propose that the precautionary principle should guide decisions when engaging or interacting with the food industry.


2017 ◽  
Vol 47 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Anette Fischer Pedersen ◽  
Peter Vedsted

Aims: Negative cancer beliefs have been associated with late stage at cancer diagnosis. High levels of negative cancer beliefs have been found among individuals with low socioeconomic position and ethnic minority women, but the impact of cancer experience on cancer beliefs is unexamined. The aim of this study was to examine whether cancer beliefs are associated with cancer experience. Methods: This was a cross-sectional population-based study. Telephone interviews of 2992 Danish residents (30+) were carried out using the Awareness and Beliefs about Cancer Measure (ABC). Respondents reported whether they or someone close had been diagnosed with cancer and whether they agreed/disagreed with three positively and three negatively framed cancer beliefs. Results: Respondents with someone close diagnosed was reference group. Compared with these, respondents with no cancer experience (RRadj=0.91, 95% CI=0.84–0.98) or who had had cancer themselves (RRadj=0.87, 0.77–0.98) were less likely to believe that cancer treatment is worse than the cancer itself, and respondents with no cancer experience were less likely to believe that a diagnosis of cancer is a death sentence (RRadj=0.83, 0.70–0.98), but more likely to report that they did not want to know if they had cancer (RRadj=1.31, 1.01–1.71). Conclusions: The results suggest that cancer beliefs are sensitive to cancer experience. This is an important addition to previous results focusing on the association between cancer beliefs and static factors such as socioeconomic position and ethnicity. Since cancer beliefs may determine health-related behaviour, it is important that negative cancer beliefs are addressed and possibly reframed in population-based interventions.


2020 ◽  
Vol 8 (6) ◽  
pp. 1-140
Author(s):  
Timea R Partos ◽  
Rosemary Hiscock ◽  
Anna B Gilmore ◽  
J Robert Branston ◽  
Sara Hitchman ◽  
...  

Background Increasing tobacco prices through taxation is very effective for reducing smoking prevalence and inequalities. For optimum effect, understanding how the tobacco industry and smokers respond is essential. Tobacco taxation changes occurred in the UK over the study period, including annual increases, a shift in structure from ad valorem to specific taxation and relatively higher increases on roll-your-own tobacco than on factory-made cigarettes. Objectives Understanding tobacco industry pricing strategies in response to tax changes and the impact of tax on smokers’ behaviour, including tax evasion and avoidance, as well as the effect on smoking inequalities. Synthesising findings to inform how taxation can be improved as a public health intervention. Design Qualitative analysis and evidence synthesis (commercial and Nielsen data) and longitudinal and aggregate cross-sectional analyses (International Tobacco Control Policy Evaluation Project data). Setting The UK, from 2002 to 2016. Data sources and participants Data were from the tobacco industry commercial literature and retail tobacco sales data (Nielsen, New York, NY, USA). Participants were a longitudinal cohort (with replenishment) of smokers and ex-smokers from 10 surveys of the International Tobacco Control Policy Evaluation Project (around 1500 participants per survey). Main outcome measures (1) Tobacco industry pricing strategies, (2) sales volumes and prices by segments over time and (3) smokers’ behaviours, including products purchased, sources, brands, consumption, quit attempts, success and sociodemographic differences. Review methods Tobacco industry commercial literature was searched for mentions of tobacco products and price segments, with 517 articles extracted. Results The tobacco industry increased prices on top of tax increases (overshifting), particularly on premium products, and, recently, the tobacco industry overshifted more on cheap roll-your-own tobacco than on factory-made cigarettes. Increasingly, price rises were from industry revenue generation rather than tax. The tobacco industry raised prices gradually to soften impact; this was less possible with larger tax increases. Budget measures to reduce cheap product availability failed due to new cheap factory-made products, price marking and small packs. In 2014, smokers could buy factory-made (roll-your-own tobacco) cigarettes at real prices similar to 2002. Exclusive roll-your-own tobacco and mixed factory-made cigarettes and roll-your-own tobacco use increased, whereas exclusive factory-made cigarette use decreased, alongside increased cheap product use, rather than quitting. Quitting behaviours were associated with higher taxes. Smokers consumed fewer factory-made cigarettes and reduced roll-your-own tobacco weight over time. Apparent illicit purchasing did not increase. Disadvantaged and dependent smokers struggled with tobacco affordability and were more likely to smoke cheaper products, but disadvantage did not affect quit success. Limitations Different for each data set; triangulation increased confidence. Conclusions The tobacco industry overshifted taxes and increased revenues, even when tax increases were high. Therefore, tobacco taxes can be further increased to reduce price differentials and recoup public health costs. Government strategies on illicit tobacco appear effective. Large, sudden tax increases would reduce the industry’s ability to manipulate prices, decrease affordability and increase quitting behaviours. More disadvantaged, and dependent, smokers need more help with quitting. Future work Assessing the impact of tax changes made since 2014; changing how tax changes are introduced (e.g. sudden intermittent or smaller continuous); and tax changes on tobacco initiation. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 6. See the NIHR Journals Library website for further project information.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabrielle Brankston ◽  
Eric Merkley ◽  
David N. Fisman ◽  
Ashleigh R. Tuite ◽  
Zvonimir Poljak ◽  
...  

Abstract Background A variety of public health measures have been implemented during the COVID-19 pandemic in Canada to reduce contact between individuals. The objective of this study was to provide empirical contact pattern data to evaluate the impact of public health measures, the degree to which social contacts rebounded to normal levels, as well as direct public health efforts toward age- and location-specific settings. Methods Four population-based cross-sectional surveys were administered to members of a paid panel representative of Canadian adults by age, gender, official language, and region of residence during May (Survey 1), July (Survey 2), September (Survey 3), and December (Survey 4) 2020. A total of 4981 (Survey 1), 2493 (Survey 2), 2495 (Survey 3), and 2491 (Survey 4) respondents provided information about the age and setting for each direct contact made in a 24-h period. Contact matrices were constructed and contacts for those under the age of 18 years imputed. The next generation matrix approach was used to estimate the reproduction number (Rt) for each survey. Respondents with children under 18 years estimated the number of contacts their children made in school and extracurricular settings. Results Estimated Rt values were 0.49 (95% CI: 0.29–0.69) for May, 0.48 (95% CI: 0.29–0.68) for July, 1.06 (95% CI: 0.63–1.52) for September, and 0.81 (0.47–1.17) for December. The highest proportion of reported contacts occurred within the home (51.3% in May), in ‘other’ locations (49.2% in July) and at work (66.3 and 65.4% in September and December). Respondents with children reported an average of 22.7 (95% CI: 21.1–24.3) (September) and 19.0 (95% CI 17.7–20.4) (December) contacts at school per day per child in attendance. Conclusion The skewed distribution of reported contacts toward workplace settings in September and December combined with the number of reported school-related contacts suggest that these settings represent important opportunities for transmission emphasizing the need to support and ensure infection control procedures in both workplaces and schools.


2021 ◽  
Vol 12 ◽  
Author(s):  
James O. Norton ◽  
Kortnee C. Evans ◽  
Ayten Yesim Semchenko ◽  
Laith Al-Shawaf ◽  
David M. G. Lewis

COVID-19 has had a profound negative effect on many aspects of human life. While pharmacological solutions are being developed and implemented, the onus of mitigating the impact of the virus falls, in part, on individual citizens and their adherence to public health guidelines. However, promoting adherence to these guidelines has proven challenging. There is a pressing need to understand the factors that influence people’s adherence to these guidelines in order to improve public compliance. To this end, the current study investigated whether people’s perceptions of others’ adherence predict their own adherence. We also investigated whether any influence of perceived social norms was mediated by perceptions of the moral wrongness of non-adherence, anticipated shame for non-adherence, or perceptions of disease severity. One hundred fifty-two Australians participated in our study between June 6, 2020 and August 21, 2020. Findings from this preliminary investigation suggest that (1) people match their behavior to perceived social norms, and (2) this is driven, at least in part, by people using others’ behavior as a cue to the severity of disease threat. Such findings provide insight into the proximate and ultimate bases of norm-following behavior, and shed preliminary light on public health-related behavior in the context of a pandemic. Although further research is needed, the results of this study—which suggest that people use others’ behavior as a cue to how serious the pandemic is and as a guide for their own behavior—could have important implications for public health organizations, social movements, and political leaders and the role they play in the fight against epidemics and pandemics.


Author(s):  
Flood Colleen M ◽  
Thomas Bryan

This chapter examines both the power and limitations of litigation as a means of facilitating accountability for the advancement of public health. While almost half of the world’s constitutions now contain a justiciable right to health, the impact of litigation has been mixed. Judicial accountability has, in some cases, advanced state obligations to realize the highest attainable standard of health, but in other cases, litigation has threatened the solidarity undergirding public health systems. There is significant country-to-country variation in interpreting health-related human rights, as well as differing views of the proper role of courts in interpreting and enforcing these rights. Surveying regional human rights systems and national judicial efforts to address health and human rights, it is necessary to analyze how courts have approached—and how they should approach—litigation of the right to health and health-related human rights to improve health for all.


2020 ◽  
pp. 002073142094982
Author(s):  
Ilinca A. Dutescu

The urgent public health threat of antimicrobial resistance (AMR) has received much attention from the world’s most important health agencies and national governmental organizations. However, despite large investments being allocated to strategizing national and international plans for addressing this public health problem, the incidence of untreatable, antimicrobial-resistant diseases continues to rise in many nations. To avoid returning to a society in which common infections once again become deadly, one must consider the often-ignored root causes driving inappropriate behaviors relating to antimicrobial use, such as the history of antimicrobial drug development, the effects of commodifying health-related services, and the rise in social inequalities. By employing the lens of political economy to analyze the phenomenon of AMR on national and international scales, it is found that the acceptance of neoliberalism as a governing ideology by authorities is hindering our ability to globally combat AMR through the depoliticization of issues that require political intervention to stimulate change. Differences in level of AMR and approaches to pharmaceutical governance between social democratic and liberal welfare states provide validity to this hypothesis.


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