scholarly journals Bringing the commercial determinants of health out of the shadows: a review of how the commercial determinants are represented in conceptual frameworks

2020 ◽  
Vol 30 (4) ◽  
pp. 660-664 ◽  
Author(s):  
Nason Maani ◽  
Jeff Collin ◽  
Sharon Friel ◽  
Anna B Gilmore ◽  
Jim McCambridge ◽  
...  
Keyword(s):  
Public Health ◽  
Private Sector ◽  
Health Outcomes ◽  
Population Health ◽  
Determinants Of Health ◽  
Wide Range ◽  
Food And Beverage ◽  
Problems And Solutions ◽  
Transnational Companies

Abstract Background The term ‘commercial determinants of health’ (CDOH) is increasingly focussing attention upon the role of tobacco, alcohol and food and beverage companies and others—as important drivers of non-communicable diseases (NCDs). However, the CDOH do not seem to be clearly represented in the most common social determinants of health (SDOH) frameworks. We review a wide range of existing frameworks of the determinants of health to determine whether and how commercial determinants are incorporated into current SDOH thinking. Methods We searched for papers and non-academic reports published in English since 2000 describing influences on population health outcomes. We included documents with a formal conceptual framework or diagram, showing the integration of the different determinants. Results Forty-eight framework documents were identified. Only one explicitly included the CDOH in a conceptual diagram. Ten papers discussed the commercial determinants in some form in the text only and fourteen described negative impacts of commercial determinants in the text. Twelve discussed positive roles for the private sector in producing harmful commodities. Overall, descriptions of commercial determinants are frequently understated, not made explicit, or simply missing. The role of commercial actors as vectors of NCDs is largely absent or invisible in many of the most influential conceptual diagrams. Conclusions Our current public health models may risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping the broader environment and individual behaviours, and thus population health outcomes.

New models and taxonomies to understand and address the commercial determinants of health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Gilmore ◽  
L Robertson ◽  
M Petticrew ◽  
N Maani Hessari
Keyword(s):  
Public Health ◽  
Determinants Of Health ◽  
Health Policies ◽  
Evidence Based ◽  
Health It ◽  
Public Health Policies ◽  
Problems And Solutions ◽  
Transnational Companies ◽  
Risk Framing ◽  
Effective Public Health

Abstract Current models of the determinants of health risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping population health. This presentation will propose a new conceptual model of the commercial determinants of health which recognises the commercial sector's direct, indirect, upstream and downstream influences on health. It will also present emerging evidence-based taxonomies that draw together evidence on the key corporate practices which stymie the implementation of effective public health policies. In so doing, the presentation will explore how we move from understanding to addressing the commercial determinants of health.

scholarly journals Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

2021 ◽  
Author(s):  
Bo Burström
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Healthcare System ◽  
Health Equity ◽  
Social Determinants ◽  
Primary Healthcare ◽  
Communicable Diseases ◽  
Determinants Of Health ◽  
Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

scholarly journals Future perspectives in addressing the global issue of vitamin D deficiency

2020 ◽  
Vol 79 (2) ◽  
pp. 246-251 ◽  
Author(s):  
M. M. Mendes ◽  
K. Charlton ◽  
S. Thakur ◽  
H. Ribeiro ◽  
S. A. Lanham-New
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Health Outcomes ◽  
Vitamin D Deficiency ◽  
Public Health Problem ◽  
Population Level ◽  
The Body ◽  
Global Public Health ◽  
Global Issue ◽  
Wide Range

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

Introduction

2020 ◽  
pp. 1-6
Author(s):  
Alisoun Milne
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Outcomes ◽  
Later Life ◽  
Social Categories ◽  
Age Related ◽  
Wide Range ◽  
Life Itself ◽  
Life Course Analysis

Despite much emphasis on mental illness in later life, limited work has focused on mental health. This book aims to address this deficit by exploring, and explaining, mental health outcomes in later life through the lens of critical social gerontology and via the conduit of life course analysis. It adopts an approach underpinned by a commitment to understanding, and making visible, the role of lifecourse, and age related inequalities in creating or amplifying risks to mental health, as well as exploring those issues that afford protection. It aims to offer a critical review of existing discourse and disrupt the ‘taken for granted’ paradigm, including in the dementia arena. This approach not only recognises that mental health in later life is a complex multi-dimensional issue that cuts across time, cohort, social categories and individual experiences but that it is affected by a wide range of lifecourse and age related issues. It also encourages the development of understanding that adopts a wide lens of analysis and of policy and service related responses that reduce risks to mental health during the lifecourse and in later life itself. Further, it engages with the potential to learn from older people’s perspectives and lives.

scholarly journals Health and Wellbeing Boards: a new dawn for public health partnerships?

2014 ◽  
Vol 22 (5/6) ◽  
pp. 220-229 ◽  
Author(s):  
Neil Perkins ◽  
David James Hunter
Keyword(s):  
Public Health ◽  
Literature Review ◽  
Health Outcomes ◽  
Population Health ◽  
Health Inequalities ◽  
Systematic Literature Review ◽  
Current Evidence ◽  
Content Type ◽  
Health Partnerships ◽  
Current Evidence Base

Purpose – The purpose of this paper is to consider the effectiveness of partnership working in public health and draws on a systematic review of public health partnerships and original research conducted by the authors. It then considers in the light of research evidence whether the recently established Health and Wellbeing Boards (HWBs) under the 2012 Health and Social Care Act will help agencies to work together more effectively to improve population health or will go the way of previous initiatives and fall short of their original promise. Design/methodology/approach – The paper is based on a systematic literature review conducted by the authors and empirical research focusing upon the ability of public health partnerships to reduce health inequalities and improve population health outcomes. It also draws on recent studies evaluating HWBs. Findings – The paper finds that, hitherto, public health partnerships have had limited impact on improving population health and reducing health inequalities and that there is a danger that HWBs will follow the same path-dependent manner of previous partnership initiatives with limited impact in improving population health outcomes and reducing health inequalities. Research limitations/implications – The research draws on a systematic literature review and further scoping review of public health partnerships, in addition to empirical research conducted by the authors. It also reviews the current evidence base on HWBs. It is recognised that HWBs are in their early stages and have not as yet had the time to fulfil their role in service collaboration and integration. Practical implications – The paper gives an overview of how and why public health partnerships in the past have not lived up to the expectations placed upon them. It then offers practical steps that HWBs need to take to take to ensure the mistakes of the past are not replicated in the future. Social implications – The research outlines how public health partnerships can operate in a more effective manner, to ensure a more seamless provision for service users. The paper then gives pointers as to how this can benefit HWBs and the wider community they serve. Originality/value – The paper draws on a comprehensive research study of the effectiveness of public health partnerships on improving health outcomes and a systematic literature review. In addition, it also draws upon the current evidence base evaluating HWBs, to inform the discussion on their future prospects, in regard to partnership working in public health and promoting service integration.

Market Failures, the Environment, and Human Health

2018 ◽  
Author(s):  
Karyn Morrissey
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Care ◽  
Ecosystem Services ◽  
Health Outcomes ◽  
Human Health ◽  
Free Market ◽  
Health Care Demand ◽  
Goods And Services

Knowledge of the important role that the environment plays in determining human health predates the modern public health era. However, the tendency to see health, disease, and their determinants as attributes of individuals rather than characteristics of communities meant that the role of the environment in human health was seldom accorded sufficient importance during much of the 20th century. Instead, research began to focus on specific risk factors that correlated with diseases of greatest concern, i.e., the non-communicable diseases such as cardiovascular disease, asthma, and diabetes. Many of these risk factors (e.g., smoking, alcohol consumption, and diet) were aspects of individual lifestyle and behaviors, freely chosen by the individual. Within this individual-centric framework of human health, the standard economic model for human health became primarily the Grossman model of health and health care demand. In this model, an individual’s health stock may be increased by investing in health (by consuming health services, for example) or decreased by endogenous (age) or exogenous (smoking) individual factors. Within this model, individuals used their available resources, their budget, to purchase goods and services that either increased or decreased their health stock. Grossman’s model provides a consumption-based approach to human health, where individuals purchase goods and services required to improve their individual health in the marketplace. Grossman’s model of health assumes that the goods and services required to optimize good health can be purchased through market-based interactions and that these goods and services are optimally priced—that the value of the goods and services are reflected in their price. In reality, many types of goods and services that are good for human health are not available to purchase, or if they are available they are undervalued in the free market. Across the environmental and health literature, these goods and services are, today, broadly referred to as “ecosystem services for human health.” However, the quasi-public good nature of ecosystem services for human health means that the private market will generate a suboptimal environment for both individual and public health outcomes. In the face of continued austerity and scarce public resources, understanding the role of the environment in human health may help to alleviate future health care demand by decreasing (or increasing) environmental risk (or benefits) associated with health outcomes. However, to take advantage of the role that the environment plays in human health requires a fundamental reorientation of public health policy and spending to include environmental considerations.

Public health nurses’ workforce factors and population health outcomes in the United States

2020 ◽  
Vol 37 (6) ◽  
pp. 829-836
Author(s):  
Seok Hyun Gwon ◽  
Young Ik Cho ◽  
Soonhwa Paek ◽  
Weiming Ke
Keyword(s):  
Public Health ◽  
United States ◽  
Health Outcomes ◽  
Population Health ◽  
The United States ◽  
Public Health Nurses

scholarly journals Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000–09

2016 ◽  
Vol 35 (5) ◽  
pp. 760-768 ◽  
Author(s):  
Elizabeth H. Bradley ◽  
Maureen Canavan ◽  
Erika Rogan ◽  
Kristina Talbert-Slagle ◽  
Chima Ndumele ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Outcomes ◽  
Social Services

scholarly journals The Dutch Cybersecurity Landscape: From Cyber ‘Air Castles’ to Concrete Building Blocks

2020 ◽  
Author(s):  
Max Smeets ◽  
Joost Bunk
Keyword(s):  
The Netherlands ◽  
Private Sector ◽  
Cyber Security ◽  
Building Blocks ◽  
Dutch Government ◽  
Wide Range ◽  
The Government ◽  
Coordination And Collaboration ◽  
Key Terms

Since 2010, the Netherlands has led a wide range of initiatives promoting cybersecurity and stability. The government currently engages with variety of stakeholders – including the private sector, civil society, state actors, and intergovernmental organizations – across multiple fora and organizations. Rather than being a passive participant, the Netherlands has been a catalyst, driving change in the field of cyber security both domestically and internationally. Yet, the challenge which lies ahead for the Dutch government is to make sure their cyber efforts as a whole will become greater than the sum of its parts. It will require increased coordination and collaboration across initiatives to turn the current patchwork into a synergistic endeavor. Our argument is presented in four parts. The first part provides an overview of the national cyber security strategies published since 2011. It also addresses which key terms have been defined by the Dutch government. The second part discusses the Dutch government’s views on sovereignty, international law and international cooperation. Part three analyzes the role of the private sector in the Netherlands. The final part concludes.

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