scholarly journals Visualizing Health Equity: Qualitative Perspectives on the Value and Limits of Equity Images

2021 ◽  
pp. 109019812199452
Author(s):  
Sarah S. Willen ◽  
Colleen C. Walsh ◽  
Abigail Fisher Williamson
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Systemic Change ◽  
Decision Makers ◽  
Health Educators ◽  
Community Members ◽  
Lower Socioeconomic Status ◽  
Systemic Racism ◽  
Health Crisis ◽  
Lower Socioeconomic

Background Health educators and advocacy groups often use side-by-side visual images to communicate about equity and to distinguish it from equality. Despite the near-ubiquity of these images, little is known about how they are understood by different audiences. Aims To assess the effectiveness of an image commonly used to communicate about health equity. Method In 167 interviews with health stakeholders in Greater Cleveland, Ohio, in 2018 to 2019, a commonly used health equity image was shown to participants, who were asked to interpret its meaning. Interviewees included 21 health professionals, 21 clinicians, 22 metro-wide decision makers, 24 community leaders, and 79 community members. Results About two thirds of our socioeconomically, racial/ethnically, educationally, and professionally diverse sample said the equity image helped clarify the distinction between “equality” and “equity.” Yet less than one third offered an interpretation consistent with the image’s goals of foregrounding not only injustice but also a need for systemic change. Patterns of misinterpretation were especially common among two groups: ideological conservatives and those of lower socioeconomic status. Conservatives were most likely to object to the image’s message. Conclusions Equity images are widely used by public health educators and advocates, yet they do not consistently communicate the message that achieving equity requires systemic change. In this moment of both public health crisis and urgent concern about systemic racism, new visual tools for communicating this crucial message are needed.

scholarly journals Expert Advisory Groups: Exploring the Sensemaking Proces s During a Public Health C risis R esponse

2018 ◽  
Author(s):  
Iva Seto ◽  
David Johnstone ◽  
Jennifer Campbell-Meier
Keyword(s):  
Public Health ◽  
Decision Makers ◽  
Process Information ◽  
Unexpected Event ◽  
Health Crisis ◽  
Creation Process ◽  
Public Health Crisis ◽  
Advisory Groups ◽  
Expert Advisory ◽  
Meaning Creation

In a public health crisis, experts (such as epidemiologists, public health officers, physicians and virologists) support key decision  makers with advice in a highly dynamic, pressured,  and time-sensitive context. Experts must process information (to provide advice) as quickly as possible, yet this must be balanced with ensuring the information is credible, reliable,  and relevant. When an unexpected event occurs, it may lead to a gap between what is  experienced and what was expected; sensemaking is a meaning creation process which is engaged to fill the gap. This research explores how experts engage in sensemaking during a  public health crisis.

Delhi’s public health crisis and the neglect of urbanisation

2020 ◽  
Vol 35 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Ivan Turok
Keyword(s):  
Public Health ◽  
Civil Society ◽  
Evidence Base ◽  
Decision Makers ◽  
Capital City ◽  
Compelling Evidence ◽  
Public Authorities ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Civil Society Organisations

India’s capital city Delhi is facing an unprecedented public health crisis that is not receiving sufficient government attention. Rapid urbanisation is part of the challenge. For too long public authorities have neglected the needs of its expanding poor communities for decent and dignified living conditions. Meanwhile, affluent groups benefit from various government privileges that seem difficult to justify. One way of disrupting the inertia is for civil society organisations to engage communities in building a compelling evidence base to hold decision-makers to account and demand social change.

scholarly journals If We Build It, Will They Come? Challenges of Adapting and Implementing a Smoking Cessation Program for the LGBTQ Community in Southcentral Texas

2020 ◽  
Vol 21 (1_suppl) ◽  
pp. 118S-123S
Author(s):  
Ronald D. Williams ◽  
Jeff M. Housman ◽  
Jacquelyn D. McDonald
Keyword(s):  
Public Health ◽  
Smoking Cessation ◽  
General Population ◽  
San Francisco ◽  
Tobacco Cessation ◽  
Health Educators ◽  
Community Members ◽  
Time Line ◽  
Participant Recruitment ◽  
Short Time

Studies indicate that tobacco use among lesbian, gay, bisexual, transgender, or queer (LGBTQ) community members is consistently higher than the general population. The Last Drag is a tobacco cessation program developed and implemented in 1991 in San Francisco, California, that has shown promise in assisting LGBTQ members with tobacco cessation. This article describes the practical challenges of adapting The Last Drag to be implemented in a southcentral Texas community. Primary challenges included short time line to expected implementation, issues with culturally insensitive language, and barriers to participant recruitment. Acknowledging and overcoming these challenges can assist public health educators who are addressing tobacco cessation in LGBTQ populations.

scholarly journals Declaring Racism a Public Health Crisis in the United States: Cure, Poison, or Both?

2021 ◽  
Vol 9 ◽  
Author(s):  
Lilliann Paine ◽  
Patanjali de la Rocha ◽  
Antonia P. Eyssallenne ◽  
Courtni Alexis Andrews ◽  
Leanne Loo ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Structural Change ◽  
Health Equity ◽  
The United States ◽  
Systematic Change ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Diversity And Inclusion ◽  
Community Organizers

Declaring racism a public health crisis has the potential to shepherd meaningful anti-racism policy forward and bridge long standing divisions between policy-makers, community organizers, healers, and public health practitioners. At their best, the declarations are a first step to address long standing inaction in the face of need. At their worst, the declarations poison or sedate grassroots momentum toward anti-racism structural change by delivering politicians unearned publicity and slowing progress on health equity. Declaring racism as a public health crisis is a tool that must be used with clarity and caution in order to maximize impact. Key to holding public institutions accountable for creating declarations is the direct involvement of Black and Indigenous People of Color (BIPOC) led groups and organizers. Sharing power, centering their voices and working in tandem, these collaborations ensure that declarations push for change from the lens of those most impacted and authentically engage with the demands of communities and their legacies. Superficial diversity and inclusion efforts that bring BIPOC people and organizers into the conversation and then fail to implement their ideas repeat historical patterns of harm, stall momentum for structural change at best, and poison the strategy at worst. In this paper we will examine three declarations in the United States and analyze them utilizing evaluative criteria aligned with health equity and anti-racism practices. Finally, we offer recommendations to inform anti-racist public health work for meaningful systematic change toward decentralization and empowerment of communities in their health futures.

scholarly journals Methods to support evidence-informed decision-making in the midst of COVID-19: creation and evolution of a rapid review service from the National Collaborating Centre for Methods and Tools

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah E. Neil-Sztramko ◽  
Emily Belita ◽  
Robyn L. Traynor ◽  
Emily Clark ◽  
Leah Hagerman ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Lessons Learned ◽  
Decision Makers ◽  
Rapid Review ◽  
Final Report ◽  
Health Crisis ◽  
Public Health Decision ◽  
Public Health Crisis ◽  
Health Decision

Abstract Background The COVID-19 public health crisis has produced an immense and quickly evolving body of evidence. This research speed and volume, along with variability in quality, could overwhelm public health decision-makers striving to make timely decisions based on the best available evidence. In response to this challenge, the National Collaborating Centre for Methods and Tools developed a Rapid Evidence Service, building on internationally accepted rapid review methodologies, to address priority COVID-19 public health questions. Results Each week, the Rapid Evidence Service team receives requests from public health decision-makers, prioritizes questions received, and frames the prioritized topics into searchable questions. We develop and conduct a comprehensive search strategy and critically appraise all relevant evidence using validated tools. We synthesize the findings into a final report that includes key messages, with a rating of the certainty of the evidence using GRADE, as well as an overview of evidence and remaining knowledge gaps. Rapid reviews are typically completed and disseminated within two weeks. From May 2020 to July 21, 2021, we have answered more than 31 distinct questions and completed 32 updates as new evidence emerged. Reviews receive an average of 213 downloads per week, with some reaching over 7700. To date reviews have been accessed and cited around the world, and a more fulsome evaluation of impact on decision-making is planned. Conclusions The development, evolution, and lessons learned from our process, presented here, provides a real-world example of how review-level evidence can be made available – rapidly and rigorously, and in response to decision-makers’ needs – during an unprecedented public health crisis.

scholarly journals Policing Is a Public Health Issue: The Important Role of Health Educators

2021 ◽  
pp. 109019812110010
Author(s):  
Paul J. Fleming ◽  
William D. Lopez ◽  
Maren Spolum ◽  
Riana Elyse Anderson ◽  
Angela G. Reyes ◽  
...  
Keyword(s):  
Public Health ◽  
Well Being ◽  
Evidence Base ◽  
Health Issue ◽  
Public Health Issue ◽  
Health Educators ◽  
Systemic Racism ◽  
Marginalized Communities ◽  
Community Organizers ◽  
Public Health Institutions

For decades, marginalized communities have been naming the harms of policing—and the systemic racism that undergirds it—for health and well-being. Only recently have policing practices and racism within policing gained more widespread attention in public health. Building on social justice and emancipatory traditions in health education, we argue that health educators are uniquely prepared to use the evidence base to reframe narratives that drive aggressive policing and their disproportionate impacts on communities of color, promote disinvestment in militarized policing, and build relationships with community-based organizations and community organizers developing community-centered approaches to safety. Using public health institutions and institutions of higher education as examples, we suggest specific strategic actions that health educators can take to address policing as a public health issue. Health educators are uniquely poised to work with diverse community and institutional partners to support social movements that create community-centered, equitable approaches to public safety and health.

scholarly journals Frequency and Determinants of Vitamin D Deficiency Among Premenopausal and Postmenopausal Women: A Multicenter Study in Karachi, Pakistan

2021 ◽  
Author(s):  
Uzma Shamsi ◽  
Iqbal Azam ◽  
Azra Shamsi ◽  
Dua Shamsi ◽  
David Callen
Keyword(s):  
Public Health ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Winter Season ◽  
Lower Socioeconomic Status ◽  
Vigorous Exercise ◽  
Younger Women ◽  
Lower Socioeconomic ◽  
Menopausal Women ◽  
The Mean

Abstract Background: Vitamin D deficiency is becoming a serious public health problem, even in sun-drenched cities like Karachi, Pakistan. We investigated the prevalence of vitamin D deficiency VDD and its association with sociodemographic characteristics, anthropometric measures, and lifestyle factors among Pakistani women (n = 784). Methods: Face-to-face interviews were conducted to collect information from premenopausal and menopausal women and serum 25(OH)D was measured after the interview. Results: The mean age of the women was 46.2 years, and the mean 25-hydroxyvitamin D (+/- SD) levels were 22.9 ng/ml (+/-20.3). A total of 57% of women were vitamin D deficient with higher vitamin D deficiency found among premenopausal (64.7%) women compared to menopausal women (49%). Factors associated with vitamin D deficiency were lower socioeconomic status (OR 2.00; 95% CI 1.15–3.48), younger age with highest vitamin D deficiency in < 35 years of age (OR 3.11; 95% CI 1.76–5.51), and winter season (OR 1.51, 95% CI 1.07-2.15) after adjusting for multiple confounders. The use of vitamin D supplement use (OR 0.59, 95% CI 0.38-0.92) and vigorous exercise (OR 0.20, 95 % CI 0.05-0.80) was protective against vitamin D deficiency. Conclusions: The study shows a high prevalence of vitamin D deficiency, with detrimental health effects among younger women belonging to lower socioeconomic status during the winter season. The use of vitamin D supplements and vigorous exercise were protective measures. Public health campaigns are needed for education and awareness about vitamin D deficiency to improve vitamin D status for younger women living in poor environments.

scholarly journals Methods to support evidence-informed decision-making in the midst of COVID-19: Creation and evolution of a rapid review service from the National Collaborating Centre for Methods and Tools

2021 ◽  
Author(s):  
Sarah E. Neil-Sztramko ◽  
Emily Belita ◽  
Robyn L. Traynor ◽  
Emily Clark ◽  
Leah Hagerman ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Makers ◽  
Rapid Review ◽  
Final Report ◽  
Health Crisis ◽  
Public Health Decision ◽  
Public Health Crisis ◽  
Relevant Evidence ◽  
Health Decision ◽  
Comprehensive Search

Abstract The COVID-19 public health crisis has produced an immense and quickly evolving body of evidence. This research speed and volume, along with variability in quality, could overwhelm public health decision-makers striving to make timely decisions based on the best available evidence. In response to this challenge, the National Collaborating Centre for Methods and Tools developed a Rapid Evidence Service, building on internationally accepted rapid review methodologies, to address priority COVID-19 public health questions. Each week, we receive requests from public health decision-makers and frame the prioritized topics into searchable questions. We develop and conduct a comprehensive search strategy and critically appraise all relevant evidence using validated tools. We synthesize the findings into a final report that includes key messages, with a rating of the certainty of the evidence using GRADE, as well as an overview of evidence and remaining knowledge gaps. Rapid reviews are typically completed and disseminated within one to two weeks. As of February 25, 2021, we have answered more than 27 distinct questions and completed 21 updates as new evidence emerged. The overview of our process, presented here, provides a real-world example of how review-level evidence can be made available – rapidly and rigorously, and in response to decision-makers’ needs – during an unprecedented public health crisis.

scholarly journals Health Equilibrium Methodology (HEM), a digital tool in public health work for health equity

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Hallmyr ◽  
K Wretlind ◽  
M Magnusson
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Web Application ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Health Work ◽  
Community Members ◽  
Digital Tool ◽  
Numeric Data ◽  
High Level

Abstract HEM draws on theories for health behavior and power relations. The methodology contains a structured documentation for formative and summative purposes. Strive for a high level of participation, control and influence from individuals and community members is a foundation pillar. Systematic use of theories allows for answering the fundamental question “in what way do we anticipate the planned intervention to contribute to closing the health gap?” Social Cognitive Theory (SCT) considers social and physical environment. HEM currently involve several SCT determinants in planning and evaluation; self- efficacy, observational learning, facilitating, expectations of outcome, reciprocal determination. The qualitative procedure is described below. Numeric data are also collected. Step one (before action, e.g. a dialogue-meeting): Consider which determinant(s) may be affected by the planned action, and by what mechanisms. Step two: Carry out the action. Step three: Describe what happened, based on input from the participants and the anticipated determinants and mechanisms. Step four: Systematic self-critical review based on common grounds for discrimination. Examples: Was it difficult to engage or include participants because of language, gender, function variation, national background or other factor? In retrospect, can you identify stereotypes in the examples you used? Did anybody else at the event act to maintain prejudice or exclusion? Step five: consider implications for methodological development. Step six: Formative collective evaluation based on reflections from step four and implications from step five. Stakeholders using HEM gather regularly for workshops based on their HEM-reports, aiming at developing tools for increasing health equity. HEM is implemented in public health work of Angered Hospital and the Dental Public Health, Region Västra Götaland, and is used by 20 different stakeholders. A web-application has been developed to facilitate documentation and spread.

scholarly journals Methods to support evidence-informed decision-making in the midst of COVID- 19: Creation and evolution of a rapid review service from the National Collaborating Centre for Methods and Tools

2021 ◽  
Author(s):  
Sarah Neil-Sztramko ◽  
Emily Belita ◽  
Robyn L. Traynor ◽  
Emily Clark ◽  
Leah Hagerman ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Lessons Learned ◽  
Decision Makers ◽  
Rapid Review ◽  
Final Report ◽  
Health Crisis ◽  
Public Health Decision ◽  
Public Health Crisis ◽  
Health Decision

Abstract Background The COVID-19 public health crisis has produced an immense and quickly evolving body of evidence. This research speed and volume, along with variability in quality, could overwhelm public health decision-makers striving to make timely decisions based on the best available evidence. In response to this challenge, the National Collaborating Centre for Methods and Tools developed a Rapid Evidence Service, building on internationally accepted rapid review methodologies, to address priority COVID-19 public health questions. Methods Each week, we receive requests from public health decision-makers and frame the prioritized topics into searchable questions. We develop and conduct a comprehensive search strategy and critically appraise all relevant evidence using validated tools. We synthesize the findings into a final report that includes key messages, with a rating of the certainty of the evidence using GRADE, as well as an overview of evidence and remaining knowledge gaps. Rapid reviews are typically completed and disseminated within two weeks. Results As of May 12, 2021, we have answered more than 29 distinct questions and completed 28 updates as new evidence emerged. Reviews receive an average of 200 downloads per week, with some reaching up to 5000. To date reviews have been accessed and cited around the world, and a more fulsome evaluation of impact on decision making is planned. Conclusions The development, evolution, and lessons learned from our process, presented here, provides a real-world example of how review-level evidence can be made available – rapidly and rigorously, and in response to decision-makers’ needs – during an unprecedented public health crisis.

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