Malnutrition, Public Health, and Ethics

2019 ◽  
pp. 570-584
Author(s):  
Jessica Fanzo
Keyword(s):  
Public Health ◽  
Food Security ◽  
Overweight And Obesity ◽  
Micronutrient Deficiencies ◽  
Intergenerational Justice ◽  
Ethical Challenges ◽  
Environmentally Sustainable ◽  
Nutritious Food ◽  
Trade Offs ◽  
Society Today

A major challenge for society today is how to secure and provide plentiful, healthy, and nutritious food for all in an environmentally sustainable and safe manner, while also addressing the multiple burdens of undernutrition, overweight and obesity, stunting and wasting, and micronutrient deficiencies, particularly for the most vulnerable. There are considerable ethical questions and trade-offs that arise when attempting to address this challenge, centered around integrating nutrition into the food security paradigm. This chapter attempts to highlight three key ethical challenges: the prioritization of key actions to address the multiple burdens of malnutrition, intergenerational justice issues of nutrition-impacted epigenetics, and the consequences of people’s diet choices, not only for humanity but also for the planet.

scholarly journals A Framework for Addressing the Twin Challenges of COVID-19 and Climate Change for Sustainable Agriculture and Food Security in South Asia

2021 ◽  
Vol 5 ◽  
Author(s):  
Golam Rasul
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Food Security ◽  
South Asia ◽  
Food Systems ◽  
Natural Capital ◽  
Health Sector ◽  
Integrated Approach ◽  
Climate Mitigation ◽  
Trade Offs

Climate change has begun to ravage agriculture and threaten food security in many parts of the world. The novel coronavirus pandemic (COVID-19) has further disrupted agricultural activities and supply chains and has become a serious threat for public health. Like in many developing countries, South Asian farmers are now facing the double challenge of addressing the impacts of a changing climate and managing the disruptions caused by COVID-19. Despite growing concern, there is limited understanding of how climate change, public health, and COVID-19 interact, and of the possible pathways to achieving a climate-friendly recovery from COVID-19 to achieve food and nutrition security. In view of this, this paper explores the multifaceted challenges that farmers are now facing in South Asia due to climate change and the disruption caused by COVID-19 from the agricultural and food security lens. The analysis reveals that the complex interactions of COVID-19 and climate change have impacted all dimensions of food security. These interlinkages demand an integrated approach in dealing with food, public health, and climate change to harness synergies and minimize trade-offs between food production, public health, and climate mitigation. I present a framework to address the immediate challenge of COVID-19 and the longer-term challenge of anthropogenic climate change. Key elements of the framework include the strengthening health sector response capacities, strengthening of local and regional food systems, making agriculture resilient to pandemics, adopting flexible and smart approaches—including the implementation of climate-smart agricultural interventions on different scales, promotion of appropriate research and innovation, and the integration of short-term support to address the challenges of COVID-19 to build long-term productivity, and resilience of food systems by investing on natural capital. This framework would enable policy makers to choose the appropriate policy responses at different scales, to address these twin challenges of COVID-19 and climate change.

Reframing Fatness: Critiquing ‘Obesity’

2018 ◽  
Author(s):  
Bethan Evans ◽  
Charlotte Cooper
Keyword(s):  
Public Health ◽  
Weight Loss ◽  
Michel Foucault ◽  
Overweight And Obesity ◽  
Health Concern ◽  
Public Health Concern ◽  
Policy Language ◽  
Religious Imagery ◽  
Fat Bodies

Over the last twenty years or so, fatness, pathologised as overweight and obesity, has been a core public health concern around which has grown a lucrative international weight loss industry. Referred to as a ‘time bomb’ and ‘the terror within’, analogies of ‘war’ circulate around obesity, framing fatness as enemy.2 Religious imagery and cultural and moral ideologies inform medical, popular and policy language with the ‘sins’ of ‘gluttony’ and ‘sloth’, evoked to frame fat people as immoral at worst and unknowledgeable victims at best, and understandings of fatness intersect with gender, class, age, sexuality, disability and race to make some fat bodies more problematically fat than others. As Evans and Colls argue, drawing on Michel Foucault, a combination of medical and moral knowledges produces the powerful ‘obesity truths’ through which fatness is framed as universally abject and pathological. Dominant and medicalised discourses of fatness (as obesity) leave little room for alternative understandings.

Pandemic Disease, Public Health, and Ethics

2019 ◽  
pp. 796-811 ◽  
Author(s):  
Maxwell Smith ◽  
Ross Upshur
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Scarce Resources ◽  
Ethical Frameworks ◽  
Health Measures ◽  
Care Workers ◽  
The Face ◽  
Conducting Research

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

Biosecurity and Public Health Ethics Issues Raised by Biological Threats

2019 ◽  
pp. 773-785
Author(s):  
Nicholas Evans ◽  
Thomas Inglesby
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Infectious Diseases ◽  
Ethical Issues ◽  
Emerging Infectious Diseases ◽  
Biological Weapon ◽  
Ethical Values ◽  
Dual Use ◽  
Health Concerns ◽  
Trade Offs

This chapter introduces ethical issues that arise in the context of biosecurity: policies and actions intended to prevent the development or emergence, or mitigate the consequences, of serious biological threats. These threats could include deliberate biological weapon attacks (bioterrorism), pandemics, emerging infectious diseases, or major laboratory accidents. The basic values that underpin these public health concerns are first introduced. Ethical issues that arise before, during, and following a biosecurity crisis are then examined, including issues of resource allocation, dual-use research, and the possibility of quarantine. Their resolution requires trade-offs among different ethical values, including utility, fairness, and liberty.

An Overview of the Ethics of Injury in Public Health

2019 ◽  
pp. 597-603
Author(s):  
Adnan A. Hyder
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Prevention And Control ◽  
Public Health Ethics ◽  
Ethical Challenges ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Ethics ◽  
Prompt Attention ◽  
And Control

This chapter briefly introduces ethics issues in injury prevention and control in low- and middle-income countries (LMICs), using a series of examples that prompt attention to the ethical principles of autonomy and justice. The chapter also introduces the section of The Oxford Handbook of Public Health Ethics dedicated to an examination of injury and public health ethics, with attention given to the complex ethical challenges arising in injury prevention and control in LMICs. The section’s two chapters discuss public health ethics issues arising in the prevention and control of unintentional injuries and intentional injuries, respectively. Those chapters define a set of ethics issues within international injury work and provide an initial analysis of the nature of those ethics issues, their specificity, and potential pathways for addressing them.

Navigating the Ethics of Big Data in Public Health

2019 ◽  
pp. 353-367
Author(s):  
Effy Vayena ◽  
Lawrence Madoff
Keyword(s):  
Public Health ◽  
Big Data ◽  
Credit Card ◽  
Health Sector ◽  
Public Health Research ◽  
Ethical Challenges ◽  
The Public ◽  
Health Community ◽  
Digital Disease Detection ◽  
The Public Sphere

“Big data,” which encompasses massive amounts of information from both within the health sector (such as electronic health records) and outside the health sector (social media, search queries, cell phone metadata, credit card expenditures), is increasingly envisioned as a rich source to inform public health research and practice. This chapter examines the enormous range of sources, the highly varied nature of these data, and the differing motivations for their collection, which together challenge the public health community in ethically mining and exploiting big data. Ethical challenges revolve around the blurring of three previously clearer boundaries: between personal health data and nonhealth data; between the private and the public sphere in the online world; and, finally, between the powers and responsibilities of state and nonstate actors in relation to big data. Considerations include the implications for privacy, control and sharing of data, fair distribution of benefits and burdens, civic empowerment, accountability, and digital disease detection.

The Ethics of AI in Biomedical Research, Patient Care, and Public Health

2020 ◽  
pp. 702-718 ◽  
Author(s):  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Public Health ◽  
Patient Care ◽  
Biomedical Research ◽  
Disease Surveillance ◽  
Ethical Issues ◽  
Ethical Review ◽  
Ethical Challenges ◽  
Healthcare Provision ◽  
Social Scientists ◽  
Ethical Frameworks

This chapter explores ethical issues raised by the use of artificial intelligence (AI) in the domain of biomedical research, healthcare provision, and public health. The litany of ethical challenges that AI in medicine raises cannot be addressed sufficiently by current regulatory and ethical frameworks. The chapter then advances the systemic oversight approach as a governance blueprint, which is based on six principles offering guidance as to the desirable features of oversight structures and processes in the domain of data-intense biomedicine: adaptivity, flexibility, inclusiveness, reflexivity, responsiveness, and monitoring (AFIRRM). In the research domain, ethical review committees will have to incorporate reflexive assessment of the scientific and social merits of AI-driven research and, as a consequence, will have to open their ranks to new professional figures such as social scientists. In the domain of patient care, clinical validation is a crucial issue. Hospitals could equip themselves with “clinical AI oversight bodies” charged with the task of advising clinical administrators. Meanwhile, in the public health sphere, the new level of granularity enabled by AI in disease surveillance or health promotion will have to be negotiated at the level of targeted communities.

scholarly journals Social determinants of dietary patterns, food basket costs and expenditure on alcohol and tobacco amongst Greenland Inuit

2021 ◽  
pp. 1-10
Author(s):  
Peter Bjerregaard ◽  
Christina Viskum Lytken Larsen
Keyword(s):  
Public Health ◽  
Dietary Patterns ◽  
Social Position ◽  
Alcoholic Beverages ◽  
Targeted Interventions ◽  
Balanced Diet ◽  
Nutritious Food ◽  
Food Basket ◽  
Purchase Patterns ◽  
The Cost

Abstract Objective: Dietary transition, obesity and risky use of alcohol and tobacco are challenges to public health among indigenous peoples. The aim of the article was to explore the role of social position in dietary patterns and expenditures on food and other commodities. Design: Countrywide population health survey. Setting: Greenland. Participants: 2436 Inuit aged 15+ years. Results: Less than half of the expenditures on commodities (43 %) were used to buy nutritious food, and the remaining to buy non-nutritious food (21 %), alcoholic beverages (18 %) and tobacco (18 %). Participants were classified according to five dietary patterns. The cost of a balanced diet and an unhealthy diet was similar, but the cost per 1000 kJ was higher and the energy consumption was lower for the balanced diet. Participants with low social position chose the unhealthy pattern more often than those with high social position (40 % v. 24 %; P < 0·0001), whereas those with high social position more often chose the balanced alternative. Participants with low social position spent less money on the total food basket than those with high social position but more on non-nutritious food, alcohol and tobacco. Conclusions: Cost seems to be less important than other mechanisms in the shaping of social dietary patterns and the use of alcohol and tobacco among the Inuit in Greenland. Rather than increasing the price of non-nutritious food or subsidising nutritious food, socially targeted interventions and public health promotion regarding food choice and prevention of excessive alcohol use and smoking are needed to change the purchase patterns.

scholarly journals The academic viewpoint on Big data and patient data ownership (as seen in the scientific literature)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Mircheva ◽  
M Mirchev
Keyword(s):  
Public Health ◽  
Big Data ◽  
Medical Research ◽  
Information And Communication Technologies ◽  
Patient Information ◽  
Scientific Literature ◽  
Medical Data ◽  
Patient Data ◽  
Academic Community ◽  
Ethical Challenges

Abstract Background Ownership of patient information in the context of Big Data is a relatively new problem, apparently not yet fully understood. There are not enough publications on the subject. Since the topic is interdisciplinary, incorporating legal, ethical, medical and aspects of information and communication technologies, a slightly more sophisticated analysis of the issue is needed. Aim To determine how the medical academic community perceives the issue of ownership of patient information in the context of Big Data. Methods Literature search for full text publications, indexed in PubMed, Springer, ScienceDirect and Scopus identified only 27 appropriate articles authored by academicians and corresponding to three focus areas: problem (ownership); area (healthcare); context (Big Data). Three major aspects were studied: scientific area of publications, aspects and academicians' perception of ownership in the context of Big Data. Results Publications are in the period 2014 - 2019, 37% published in health and medical informatics journals, 30% in medicine and public health, 19% in law and ethics; 78% authored by American and British academicians, highly cited. The majority (63%) are in the area of scientific research - clinical studies, access and use of patient data for medical research, secondary use of medical data, ethical challenges to Big data in healthcare. The majority (70%) of the publications discuss ownership in ethical and legal aspects and 67% see ownership as a challenge mostly to medical research, access control, ethics, politics and business. Conclusions Ownership of medical data is seen first and foremost as a challenge. Addressing this challenge requires the combined efforts of politicians, lawyers, ethicists, computer and medical professionals, as well as academicians, sharing these efforts, experiences and suggestions. However, this issue is neglected in the scientific literature. Publishing may help in open debates and adequate policy solutions. Key messages Ownership of patient information in the context of Big Data is a problem that should not be marginalized but needs a comprehensive attitude, consideration and combined efforts from all stakeholders. Overcoming the challenge of ownership may help in improving healthcare services, medical and public health research and the health of the population as a whole.

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