The impact of social assistance programs on population health: a systematic review of research in high-income countries

Purpose – Similar to the recent emergence of food banks in other affluent nations, the genesis and ultimate entrenchment of food banks in Canada has been tightly intertwined with the dismantling of the welfare state. Through an examination of Canadian data, the authors elucidate the implications of entrenching voluntary, extra-governmental, charitable food assistance programs as an adjunct to publicly funded social assistance programs. The paper aims to discuss these issues. Design/methodology/approach – Publicly available food bank reports, population health survey data, and the results of a study of low-income families in Toronto are reviewed to examine the food security status of social assistance recipients and their use of food banks. Findings – In 2012, 70 percent of households in Canada who were reliant on social assistance were food insecure. Social assistance recipients comprise at least half of food bank clientele and have done so for as long as this information has been tracked, but the assistance provided by food banks appears insufficient to alter households’ food insecurity. Although food banks currently distribute over 200 million pounds of food annually, the scale of their operations pales in comparison to the food needs of those who seek their help. Originality/value – In the 30 years since food banks began in Canada, there has been considerable research into this response, as well as extensive population monitoring of food insecurity. Canada provides an informative case study of an affluent country's long-term dependency on charitable food assistance and the impact this has on the food insecurity of those reliant on social assistance programs.

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Are electoral autocracies better for the poor? Evidence from social assistance programs

Research & Politics ◽

10.1177/2053168020950152 ◽

2020 ◽

Vol 7 (3) ◽

pp. 205316802095015

Author(s):

Matthew D. Fails

Keyword(s):

Human Development ◽

Recent Work ◽

Social Assistance ◽

Future Research ◽

Assistance Programs ◽

The Poor ◽

Electoral Authoritarianism ◽

Development Outcomes ◽

Playing Fields ◽

The Impact

Autocratic elections occur on uneven playing fields, yet their regular contestation compels ruling parties to pay attention to citizens’ demands. This claim is at the heart of research linking multiparty elections in autocracies to improvements in human development. Recent work, however, casts doubt on the theoretical and empirical basis of such claims. This paper addresses this debate by focusing specifically on the adoption of social assistance programs, an often theorized but seldom examined link in the chain connecting electoral autocracy with improvements in human development. I demonstrate that electoral autocracies are more likely to adopt these programs than closed autocracies and that the impact largely works through within-country changes in the presence of electoral authoritarianism. The results are consistent with the argument that such regimes are more responsive to citizens’ demands. However, they also remind researchers that the goal of such regimes is to win elections; there is little preventing them from crafting targeted social policies that secure the loyalty of the voting public but without the attendant improvements in broad measures of human development. I conclude with suggestions for how future research can better understand how authoritarian governance shapes development outcomes.

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OP64 The impact of political economy on population health: a systematic review of reviews

10.1136/jech-2019-ssmabstracts.65 ◽

2019 ◽

Author(s):

G McCartney ◽

W Hearty ◽

J Arnot ◽

F Popham ◽

A Cumbers ◽

...

Keyword(s):

Systematic Review ◽

Political Economy ◽

Population Health ◽

Review Of Reviews ◽

The Impact

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Impact of obstetric unit closures, travel time and distance to obstetric services on maternal and neonatal outcomes in high-income countries: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-036852 ◽

2020 ◽

Vol 10 (12) ◽

pp. e036852

Author(s):

Reem Saleem Malouf ◽

Claire Tomlinson ◽

Jane Henderson ◽

Charles Opondo ◽

Peter Brocklehurst ◽

...

Keyword(s):

Systematic Review ◽

Grey Literature ◽

Risk Of Bias ◽

High Income ◽

Travel Distance ◽

Neonatal Outcomes ◽

Increased Risk ◽

Maternal And Neonatal Outcomes ◽

The Impact ◽

Travel Distances

ObjectivesTo systematically review (1) The effect of obstetric unit (OU) closures on maternal and neonatal outcomes and (2) The association between travel distance/time to an OU and maternal and neonatal outcomes.DesignSystematic review of any quantitative studies with a comparison group.Data sourcesEmbase, MEDLINE, PsycINFO, Applied Social Science Index and Abstracts, Cumulative Index to Nursing and Allied Health and grey literature were searched.MethodsEligible studies explored the impact of closure of an OU or the effect of travel distance/time on prespecified maternal or neonatal outcomes. Only studies of women giving birth in high-income countries with universal health coverage of maternity services comparable to the UK were included. Identification of studies, extraction of data and risk of bias assessment were undertaken by at least two reviewers independently. The risk of bias checklist was based on the Cochrane Effective Practice and Organisation of Care criteria and the Newcastle-Ottawa scale. Heterogeneity across studies precluded meta-analysis and synthesis was narrative, with key findings tabulated.Results31 studies met the inclusion criteria. There was some evidence to suggest an increase in babies born before arrival following OU closures and/or associated with longer travel distances or time. This may be associated with an increased risk of perinatal or neonatal mortality, but this finding was not consistent across studies. Evidence on other maternal and neonatal outcomes was limited but did not suggest worse outcomes after closures or with longer travel times/distances. Interpretation of findings for some studies was hampered by concerns around how accurately exposures were measured, and/or a lack of adjustment for confounders or temporal changes.ConclusionIt is not possible to conclude from this review whether OU closure, increased travel distances or times are associated with worse outcomes for the mother or the baby.PROSPERO registration numberCRD42017078503.

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Electronic Health Records, Interoperability and Patient Safety in Health Systems of High-income Countries: A Systematic Review Protocol

BMJ Open ◽

10.1136/bmjopen-2020-044941 ◽

2021 ◽

Vol 11 (7) ◽

pp. e044941

Author(s):

Edmond Li ◽

Jonathan Clarke ◽

Ana Luisa Neves ◽

Hutan Ashrafian ◽

Ara Darzi

Keyword(s):

Systematic Review ◽

Patient Safety ◽

Electronic Health Records ◽

Health Systems ◽

Risk Of Bias ◽

High Income ◽

The Body ◽

Health Records ◽

Electronic Health ◽

The Impact

IntroductionThe availability and routine use of electronic health records (EHRs) have become commonplace in healthcare systems of many high-income countries. While there is an ever-growing body of literature pertaining to their use, evidence surrounding the importance of EHR interoperability and its impact on patient safety remains less clear. There is, therefore, a need and opportunity to evaluate the evidence available regarding this relationship so as to better inform health informatics development and policies in the years to come. This systematic review aims to evaluate the impact of EHR interoperability on patient safety in health systems of high-income countries.Methods and analysisA systematic literature review will be conducted via a computerised search through four databases: PubMed, Embase, Health Management Information Consortium and PsycInfo for relevant articles published between 2010 and 2020. Outcomes of interest will include impact on patient safety and the broader effects on health systems. Quality of the randomised quantitative studies will be assessed using Cochrane Risk of Bias Tool. Non-randomised papers will be evaluated with the Risk of Bias In Non-Randomised Studies—of Interventions tool. Drummond’s Checklist will be used for publications pertaining to economic evaluation. The National Institute for Health and Care Excellence quality appraisal checklist will be used to assess qualitative studies. A narrative synthesis will be conducted for included studies, and the body of evidence will be summarised in a summary of findings table.Ethics and disseminationThis review will summarise published studies with non-identifiable data and, thus, does not require ethical approval. Findings will be disseminated through preprints, open access peer-reviewed publications, and conference presentations.PROSPERO registration numberCRD42020209285.

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The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews

BMC Public Health ◽

10.1186/s12889-021-10630-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hugh Alderwick ◽

Andrew Hutchings ◽

Adam Briggs ◽

Nicholas Mays

Keyword(s):

Systematic Review ◽

Health Care ◽

Population Health ◽

Social Services ◽

Health Care Organizations ◽

Local Health ◽

Local Health Care ◽

Review Of Reviews ◽

Evidence Of Impact ◽

The Impact

Abstract Background Policymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity. Methods We carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data. Results The 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse. Conclusions In theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health.

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School functioning of children with perinatal HIV-infection in high-income countries: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0252746 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252746

Author(s):

Stefanie E. M. van Opstal ◽

Marlies N. Wagener ◽

Harald S. Miedema ◽

Elisabeth M. W. J. Utens ◽

Femke K. Aarsen ◽

...

Keyword(s):

Systematic Review ◽

Hiv Infection ◽

School Attendance ◽

High Income ◽

School Functioning ◽

School Age Children ◽

School Age ◽

Perinatal Hiv ◽

National Norms ◽

The Impact

Introduction Since the introduction of combination antiretroviral therapy, human immunodeficiency virus (HIV) infection is a manageable chronic disease. However, school-age children (4–18 years) living with HIV could still experience problems with functioning at school, due to the impact of the virus itself, medication, comorbidities and social stigma. School functioning covers academic achievement, school attendance, and social relationships and is of utmost importance to optimize normal participation. Methods To gain insight in school functioning problems of perinatally HIV-infected children, we performed a systematic review of the literature in multiple databases from January 1997 up to February 2019. Studies were included if they described outcomes of school functioning of school-age children perinatally infected with HIV, in high-income countries. Meta-analyses were performed for sufficiently comparable studies. Results and discussion Results from 32 studies show that HIV-infected children experience more problems in various areas of school functioning in comparison with national norms, matched healthy controls, siblings and HIV-exposed uninfected (HEU) children. The most pronounced differences concerned the usage of special educational services, general learning problems, and mathematics and reading performance scores. Comparisons with both national norms and siblings/HEU children show that the differences between HIV-infected children and siblings/HEU children were less pronounced. Moreover, siblings/HEU children also reported significantly worse outcomes compared to national norms. This suggests that problems in school functioning cannot be solely attributed to the HIV-infection, but that multiple socio-economic and cultural factors may play a role herein. Conclusion Perinatally HIV-infected children seem vulnerable to problems in various areas of school functioning. Therefore, monitoring of school functioning should be an important aspect in the care for these children. A family-focused approach with special attention to a child’s socio-environmental context and additional attention for siblings and HEU children, is therefore recommended.

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