Active Aging and Public Health: Evidence, Implications, and Opportunities

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Shilpa Dogra ◽  
David W. Dunstan ◽  
Takemi Sugiyama ◽  
Afroditi Stathi ◽  
Paul A. Gardiner ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Social Engagement ◽  
Critical Role ◽  
Annual Review ◽  
Publication Date ◽  
Active Aging ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Challenges

By 2050, 20% of the world's population will be over the age of 65 years, with projections that 80% of older adults will be living in low- to middle-income countries. Physical inactivity and sedentary time are particularly high in older adults, presenting unique public health challenges. In this article, we first review evidence that points to multiple beneficial outcomes of active aging, including better physical function, cognitive function, mental health, social health, and sleep and suggest the need to shift the research focus from chronic disease outcomes to more relevant outcomes that affect independence and quality of life. Second, we review the critical role of age-friendly environments in facilitating active aging equitably across different countries and cultures. Finally, we consider emerging opportunities related to social engagement and technology-enabled mobility that can facilitate active aging. In all these contexts, it is a priority to understand and address diversity within the global aging population. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Protecting older adults of Sri Lanka amid COVID-19

2020 ◽  
Author(s):  
Keshini Madara Marasinghe
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Sri Lanka ◽  
Community Dwelling ◽  
Term Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Aging Populations ◽  
Clinical Responses ◽  
Low And Middle Income

<p>Older adults over 60 are at a higher risk of getting severely sick and dying from COVID–19. Sri Lanka has one of the fastest aging populations in South and South–East Asia. In addition to having a rapidly aging population, Sri Lanka is a developing country with limited resources to accommodate the older population that can be significantly affected by COVID–19. Statistics up to date shows that older adults are at a much higher risk of dying from COVID–19. Older adults being at a much higher risk of contracting and dying from COVID–19 has important implications for the way in which public health and clinical responses should be developed. These implications have been largely overlooked in both high and low and middle–income countries when providing guidance and implementing regulations, which can have a greater impact in low and middle–income countries. Preparedness of the healthcare systems to respond to the pandemic with a lack of facilities, resources (i.e., ventilators) and staff in the healthcare system, specifically in hospitals, intensive care units and long–term care homes is a concern that should be taken into consideration when clinical responses are developed. Challenges around protecting community–dwelling older adults who are caregivers to grandchildren, receiving informal care from children in the same household, living in living in remote areas, or living alone or dependent on others need to be taken into consideration when developing public health responses.</p>

Mobile Health (mHealth) in Low- and Middle-Income Countries

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Judith McCool ◽  
Rosie Dobson ◽  
Robyn Whittaker ◽  
Chris Paton
Keyword(s):  
Private Sector ◽  
Digital Health ◽  
Mobile Technologies ◽  
Annual Review ◽  
Publication Date ◽  
Middle Income ◽  
Marginalized Communities ◽  
Middle Income Countries ◽  
Private Sector Investment ◽  
Low And Middle Income

This article reflects on current trends and proposes new considerations for the future of mobile technologies for health (mHealth). Our focus is predominantly on the value of and concerns with regard to the application of digital health within low- and middle-income countries (LMICs). It is in LMICs and marginalized communities that mHealth (within the wider scope of digital health) could be most useful and valuable. Peer-reviewed literature on mHealth in LMICs provides reassurance of this potential, often reflecting on the ubiquity of mobile phones and ever-increasing connectivity globally, reaching remote or otherwise disengaged populations. Efforts to adapt successful programs for LMIC contexts and populations are only just starting to reap rewards. Private-sector investment in mHealth offers value through enhanced capacity and advances in technology as well as the ability to meet increasing consumer demand for real-time, accessible, convenient, and choice-driven health care options. We examine some of the potential considerations associated with a private-sector investment, questioning whether a core of transparency, local ownership, equity, and safety are likely to be upheld in the current environment of health entrepreneurship. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Whole Inactivated Virus and Protein-Based COVID-19 Vaccines

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Peter J. Hotez ◽  
Maria Elena Bottazzi
Keyword(s):  
Neutralizing Antibodies ◽  
Scientific Community ◽  
Nonhuman Primates ◽  
Rapid Development ◽  
Annual Review ◽  
Publication Date ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cell Responses ◽  
Protein Particle

The rapid development and deployment of mRNA and adenovirus-vectored vaccines against coronavirus disease 2019 (COVID-19) continue to astound the global scientific community, but these vaccine platforms and production approaches have still not achieved global COVID-19 vaccine equity. Immunizing the billions of people at risk for COVID-19 in the world's low- and middle-income countries (LMICs) still relies on the availability of vaccines produced and scaled through traditional technology approaches. Vaccines based on whole inactivated virus (WIV) and protein-based platforms, as well as protein particle-based vaccines, are the most produced by LMIC vaccine manufacturing strategies. Three major WIV vaccines are beginning to be distributed widely. Several protein-based and protein particle-based vaccines are advancing with promising results. Overall, these vaccines are exhibiting excellent safety profiles and in some instances have shown their potential to induce high levels of virus neutralizing antibodies and T cell responses (and protection) both in nonhuman primates and in early studies in humans. There is an urgent need to continue accelerating these vaccines for LMICs in time to fully vaccinate these populations by the end of 2022 at the latest. Achieving these goals would also serve as an important reminder that we must continue to maintain expertise in producing multiple vaccine technologies, rather than relying on any individual platform. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Trends in Abortion Policies in Low- and Middle-Income Countries

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Pascale Allotey ◽  
T.K. Sundari Ravindran ◽  
Vithiya Sathivelu
Keyword(s):  
Annual Review ◽  
Publication Date ◽  
Human Rights Law ◽  
Middle Income ◽  
Sexual Autonomy ◽  
Middle Income Countries ◽  
Local Contexts ◽  
Vested Interests ◽  
Cultural Mores ◽  
Low And Middle Income

The decision to terminate a pregnancy is not one that is taken lightly. The need for an abortion reflects limited sexual autonomy, ineffective or lack of access to contraceptive options, or a health indication. Abortion is protected under human rights law. That notwithstanding, access to abortions continues to be contested in many parts of the world, with vested interests from politically and religiously conservative states, patriarchal societies, and cultural mores, not just within local contexts but also within a broader geopolitical context. Criminalization of a women's choice not to carry a pregnancy is a significant driver of unsafe procedures, and even where abortions are provided legally, the policies remain constrained by the practice or by a lack of coherence. This review outlines the trends in abortion policy in low- and middle-income countries and highlights priority areas to ensure that women are safe and able to exercise their reproductive rights. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 1, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Consumer Protection for Financial Inclusion in Low- and Middle-Income Countries: Bridging Regulator and Academic Perspectives

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Seth Garz ◽  
Xavier Giné ◽  
Dean Karlan ◽  
Rafe Mazer ◽  
Caitlin Sanford ◽  
...  
Keyword(s):  
Financial Services ◽  
Imperfect Information ◽  
Future Research ◽  
Annual Review ◽  
Publication Date ◽  
Middle Income ◽  
Middle Income Countries ◽  
Potential Problems ◽  
Growth And Change ◽  
Low And Middle Income

Markets for consumer financial services are growing rapidly in low- and middle-income countries and are being transformed by digital technologies and platforms. With growth and change come concerns about protecting consumers from firm exploitation due to imperfect information and contracting as well as from their own decision-making limitations. We seek to bridge regulator and academic perspectives on these underlying sources of harm and five potential problems that can result: high and hidden prices, overindebtedness, postcontract exploitation, fraud, and discrimination. These potential problems span product markets old and new and could impact micro- and macroeconomies alike. Yet there is little consensus on how to define, diagnose, or treat such problems. Evidence-based consumer financial protection will require substantial advances in theory and especially empirics, and we outline key areas for future research. Expected final online publication date for the Annual Review of Financial Economics, Volume 13 is November 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Forest Restoration in Low- and Middle-Income Countries

2021 ◽  
Vol 46 (1) ◽  
Author(s):  
Jeffrey R. Vincent ◽  
Sara R. Curran ◽  
Mark S. Ashton
Keyword(s):  
Forest Restoration ◽  
Social Science Research ◽  
Science Research ◽  
Forest Recovery ◽  
Annual Review ◽  
Publication Date ◽  
Forest Transition ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

A series of international initiatives have set ambitious goals for restoring global forests. This review synthesizes natural and social science research on forest restoration (FR), with a focus on restoration on cleared land in low- and middle-income countries. We define restoration more broadly than reestablishing native forests, given that landholders might prefer other forest types. We organize the review loosely around ideas in the forest transition literature. We begin by examining recent trends in FR and forest transition indicators. We then investigate two primary parts of the forest transition explanation for forest recovery: wood scarcity, including its connection to restoration for climate change mitigation, and the dynamic relationships between migration and land use. Next, we review ecological and silvicultural aspects of restoration on cleared land. We conclude by discussing selected interventions to promote restoration and the challenge of scaling up restoration to achieve international goals. Expected final online publication date for the Annual Review of Environment and Resources, Volume 46 is October 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Advancements in and Integration of Water, Sanitation, and Solid Waste for Low- and Middle-Income Countries

2021 ◽  
Vol 46 (1) ◽  
Author(s):  
Abishek Sankara Narayan ◽  
Sara J. Marks ◽  
Regula Meierhofer ◽  
Linda Strande ◽  
Elizabeth Tilley ◽  
...  
Keyword(s):  
Solid Waste ◽  
Solid Waste Management ◽  
Integrated Approach ◽  
Positive Interactions ◽  
Annual Review ◽  
Publication Date ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Right ◽  
Low And Middle Income

The water, sanitation, and solid waste sectors are closely related and have many interactions between their respective service chains in low-and middle-income countries. Currently, these interactions mostly lead to cross-contamination, and opportunities for co-benefits are seldom realized. This review presents the key advancements within each of these three development sectors in the past two decades. We identify numerous similarities such as decentralization, resource recovery, community involved planning, and digitalization. Despite the potential for synergies and the opportunities to maximize positive interactions, there have been few attempts to break the existing sectoral silos in order to integrate these three service chains. We argue that, with the right enabling environment, an integrated approach to holistically planning and implementing water supply, sanitation, and solid waste management can create positive interactions resulting in co-benefits among complementary development goals. Expected final online publication date for the Annual Review of Environment and Resources, Volume 46 is October 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Protecting older adults of Sri Lanka amid COVID-19

2020 ◽  
Author(s):  
Keshini Madara Marasinghe
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Sri Lanka ◽  
Community Dwelling ◽  
Term Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Aging Populations ◽  
Clinical Responses ◽  
Low And Middle Income

<p>Older adults over 60 are at a higher risk of getting severely sick and dying from COVID–19. Sri Lanka has one of the fastest aging populations in South and South–East Asia. In addition to having a rapidly aging population, Sri Lanka is a developing country with limited resources to accommodate the older population that can be significantly affected by COVID–19. Statistics up to date shows that older adults are at a much higher risk of dying from COVID–19. Older adults being at a much higher risk of contracting and dying from COVID–19 has important implications for the way in which public health and clinical responses should be developed. These implications have been largely overlooked in both high and low and middle–income countries when providing guidance and implementing regulations, which can have a greater impact in low and middle–income countries. Preparedness of the healthcare systems to respond to the pandemic with a lack of facilities, resources (i.e., ventilators) and staff in the healthcare system, specifically in hospitals, intensive care units and long–term care homes is a concern that should be taken into consideration when clinical responses are developed. Challenges around protecting community–dwelling older adults who are caregivers to grandchildren, receiving informal care from children in the same household, living in living in remote areas, or living alone or dependent on others need to be taken into consideration when developing public health responses.</p>

scholarly journals Protecting older adults of Sri Lanka amid COVID-19

2020 ◽  
Author(s):  
Keshini Madara Marasinghe
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Health Care ◽  
Sri Lanka ◽  
Health Care System ◽  
Middle Income ◽  
Remote Areas ◽  
Middle Income Countries ◽  
Preventative Measures ◽  
Clinical Responses

Older adults are at a higher risk of dying from COVID-19 and the risk is much higher in low and middle-income countries. Lloyd-Sherlock, P. et al raise four concerns that needs to be considered when developing public health and clinical responses to COVID-19 to protect older adults in LMICs and this paper applies these concerns to the context of Sri Lanka and provides simple and immediate measures to proactively prevent the spread of COVID-19 among older adults in Sri Lanka. These measures include but does not limit to: 1) considering the difficulties health care system may face in the case of a COVID-19 surge and taking immediate preventative measures to limit the spread of COVID-19 in the country; 2) implementing measures in LTCs to prevent the spread among LTC residents and staff; 3) proactively including older adults especially those who are dependent and from remote areas in government responses; and 4) taking into considerations family dynamics unique to Sri Lanka and providing supportive measures to reduce exposure through government and other available resources. Sri Lanka being a LMIC and therefore more vulnerable, must take immediate actions to minimize the impacts COVID-19 could potentially have on the country, while there is still time.

scholarly journals African countries established COVID-19 testing in one month: Here’s how they did it

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Timothy Amukele ◽  
Ryland N. Spence
Keyword(s):  
Public Health ◽  
World Health ◽  
Success Story ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Challenges ◽  
Control And Prevention ◽  
Private And Public ◽  
Health Organization

Background: As a novel and deadly acute respiratory syndrome, which later became known as coronavirus disease 2019 (COVID-19), spread beyond China in late January 2020, there were no laboratories in Africa that could test for the disease. However, in early March, just over a month later, 42 African countries had developed the expertise and resources to perform COVID-19 testing. Our goal was to document this public health success story, learn from it, and use it to inform future public health action.Intervention: Three groups were primarily responsible for establishing COVID-19 testing capacity in Africa. The first group comprised early test manufacturers who reacted with incredible speed and ingenuity early in the pandemic, such as the German company TIB MolBiol that developed a molecular test for COVID-19 before the SARS-CoV-2 genome sequence was available. The second group included private and public donors such as the Jack Ma Foundation, and the last were the coordinators of the rollout, such as the World Health Organization and the Africa Centres for Disease Control and Prevention (CDC).Lessons learnt: The first lesson was that speed is critical, especially during a crisis. It was also demonstrated that being a predictable and transparent trusted institution opens doors and improves effectiveness. Africa CDC, which was only three years old, was able to secure significant resources from external partners and rapidly build substantial testing capacity within Africa because it is a trusted institution.Recommendations: Low- and middle-income countries must build local trusted institutions to better prepare for public health challenges.

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