Tensions in public health policy: patient engagement, evidence-based public health and health inequalities

The ‘First Thousand Days’ refers to the period from conception to the child’s second birthday. It is increasingly gaining traction as a concept to guide public health policy. It is seen as a crucial window of opportunity for interventions that improve child and population health. This review outlines the origin and growth of the First Thousand Days concept, and the evidence behind it, particularly in the areas of brain development and cognition; mental and emotional health; nutrition and obesity; programming and economic benefits. The review then describes UK experience of use of the concept to inform policy, and a recent government inquiry that mandates more widespread implementation.

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Evidence Based Public Health Policy Making: Tool Support

2019 IEEE World Congress on Services (SERVICES) ◽

10.1109/services.2019.00080 ◽

2019 ◽

Cited By ~ 1

Author(s):

Ioannis Basdekis ◽

Konstantin Pozdniakov ◽

Marios Prasinos ◽

Konstantina Koloutsou

Keyword(s):

Public Health ◽

Health Policy ◽

Public Health Policy ◽

Policy Making ◽

Tool Support ◽

Evidence Based

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Diet and physical activity as determinants of weight gain, overweight and obesity: The WCRF/AICR evidence and policy implications

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001561 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Isobel Bandurek ◽

Emily Almond ◽

Susannah Brown ◽

Giota Mitrou ◽

Ifigeneia Bourgiezi ◽

...

Keyword(s):

Public Health ◽

Physical Activity ◽

Health Policy ◽

Weight Gain ◽

Public Health Policy ◽

Screen Time ◽

Overweight And Obesity ◽

Evidence Based ◽

Diet And Physical Activity ◽

Adults And Children

AbstractIntroductionGlobally, over 1.97 billion adults and 338 million children and adolescents are living with overweight and obesity, increasing the risk of numerous co-morbidities, including at least 12 cancers(1). WCRF/AICR conducted a literature review of diet and physical activity as determinants of weight gain, overweight and obesity in adults and children. We also introduce a novel evidence-based policy framework for promoting physical activity, and linked database, currently in development as part of the EU-funded CO-CREATE project on child and adolescent obesity prevention.Materials and MethodsEvidence on diet and physical activity as determinants and risk of weight gain, overweight and obesity was systematically extracted from existing reviews and a systematic search for recent meta-analyses, then collated and analysed. The WCRF Continuous Update Project Expert Panel drew conclusions about which exposures influence risk of weight gain, overweight and obesity, using pre-defined criteria that included evidence of biological plausibility.ResultsThe Panel identified strong evidence that several diet and physical activity related exposures influence the risk of weight gain, overweight and obesity in adults and children (see table 1). Separate conclusions were drawn for adults and children in relation to screen time, considered a marker of sedentary time.However, the Panel noted that as exposures tend to cluster, physiologically interact and share common biological mechanisms, they should not be regarded as absolutely ‘singular'but an integrated concept of interrelated exposures within a pattern of lifestyle. Table 1.Risk of weight gain, overweight and obesitySTRONG EVIDENCEDECREASES RISKINCREASES RISKCONVINCINGWalkingScreen time (children)Sugar sweetened drinksPROBABLEAerobic physical activityFoods containing dietary fibre‘Mediterranean type’ dietary patternHaving been breastfedScreen time (adults)‘Fast foods’‘Western type’ dietFor full list of footnotes, see Energy Balance and Body Fatness report(1).DiscussionHealthy dietary patterns help prevent excess weight gain. Achieving such patterns requires attention to the broader economic, environmental and social factors that influence and constrain people's behaviour. The findings of this report support the need for evidence-based public health policy to help create health-enabling environments, particularly for children and adolescents. The WCRF International MOVING framework(2) presents a package of policies to promote physical activity, which alongside wider public health policy can help address the multiple drivers of overweight and obesity.

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NATIONAL GUIDELINES FOR HIGH-COST DRUGS IN BRAZIL: ACHIEVEMENTS AND CONSTRAINTS OF AN INNOVATIVE NATIONAL EVIDENCE-BASED PUBLIC HEALTH POLICY

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462313000056 ◽

2013 ◽

Vol 29 (2) ◽

pp. 198-206 ◽

Cited By ~ 6

Author(s):

Paulo D. Picon ◽

Alberto Beltrame ◽

David Banta

Keyword(s):

Public Health ◽

Health Policy ◽

Healthcare System ◽

Public Health Policy ◽

Policy Making ◽

Social Inequalities ◽

Critical Issue ◽

Public Healthcare ◽

Evidence Based ◽

National Guidelines

Introduction: The translation of best evidence into practice has become an important purpose of policy making in health care. In Brazil, a country of continental dimensions with widespread regional and social inequalities, the dissemination and use of the best-evidence in policy making is a critical issue for the healthcare system.Objectives: The main purpose of this study is to describe an evidence-based public health policy with special emphasis on guidelines creation for high-cost medicines. We also describe how that strategy was diffused to the judiciary system and to other parts of the healthcare system.Results: We present an 11-year follow-up of a national project for creating and updating guidelines for high-cost medicines in Brazil. A total of 109 national guidelines were published (new or updated versions) for 66 selected diseases, the first such effort in Brazilian history. The project influenced the Brazilian legislature, which has recently established a Federal Law requiring national guidelines for any new technology listed for payment by the Brazilian public healthcare system.Conclusion: We were able to involve many different stakeholders in a partnership between academia and policy makers, which made possible the widespread dissemination of the clinical practice guidelines. Problems and constraints were also encountered. This evolving public health strategy might be useful for other developing countries.

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Assessing public health policy approaches to level-up the gradient in health inequalities: the Gradient Evaluation Framework

Public Health ◽

10.1016/j.puhe.2013.11.011 ◽

2014 ◽

Vol 128 (3) ◽

pp. 246-253 ◽

Cited By ~ 9

Author(s):

J.K. Davies ◽

N.S. Sherriff

Keyword(s):

Public Health ◽

Health Policy ◽

Health Inequalities ◽

Public Health Policy ◽

Evaluation Framework

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Overcoming Limits of “Evidence-Based” Methods to Effectively Translate Science For Environmental Public Health Policy Audiences

Epidemiology ◽

10.1097/01.ede.0000276757.79506.38 ◽

2007 ◽

Vol 18 (Suppl) ◽

pp. S141

Author(s):

A Kyle ◽

J Balmes ◽

M Smith

Keyword(s):

Public Health ◽

Health Policy ◽

Public Health Policy ◽

Evidence Based ◽

Environmental Public Health

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The Swedish national public health policy and its achievements after ten years

European Journal of Public Health ◽

10.1093/eurpub/ckz185.710 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

N Lindqvist

Keyword(s):

Public Health ◽

Health Policy ◽

Health Inequalities ◽

Public Health Policy ◽

Policy Framework ◽

Political Agenda ◽

Health Work ◽

Public Health Perspective ◽

National Public Health ◽

The Government

Abstract Public health issues and their equality aspects have been on the political agenda in Sweden since the early 1980s. Already in the 1990s, the Government presented the first public health policy bill. This highlighted the conditions for a sustainable development from a public health perspective. Increased equality was set to be the overriding objective in prioritizing public health work and that priority should be given to efforts that would improve the situation of the most disadvantaged. The foundation of today’s public health policy was laid in 2003 when the parliament decided on a new bill in which an overall goal for national public health policy was established: ‘Creating social conditions for good health on equal terms for the entire population’. The bill also established a cross-sectoral target structure for the overall public health work with eleven target areas. It also pointed out that public health policy is cross-sectoral and must be a part in all policy areas. In June 2008, the parliament adopted the bill A Renewed Public Health Policy. Changes made were (among other things) a rewording of the target areas, but many of the starting points were kept. The Swedish Commission for Equity in Health was set up in 2015 and given two main tasks, to produce a proposal that can help to reduce the health inequalities in society and to work for raised awareness of health inequalities in society and among stakeholders. The work of the commission was finished in 2017 and presents an analysis of how the public health policy works in practice, with regard to the intentions of policy framework. A number of problems or areas of development appear which the Commission considers need to be addressed. The presentation will first give a short overview of the Swedish public health policy from 2008 and will then present the commission’s conclusions and proposals for development areas.

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