Re-engineering health policy research to measure equity impacts

2019 ◽  
pp. 277-290
Author(s):  
Tim Doran ◽  
Richard Cookson
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Social Policy ◽  
Policy Research ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Policy Makers ◽  
Policy Interventions ◽  
Organizational Barriers ◽  
Analytical Tools

The determinants of health inequality have become increasingly well understood, but policy makers have repeatedly failed to address the issue effectively, and many public health interventions unintentionally worsen inequalities because they disproportionately benefit those with greater resources. This is a policy failure, but it is also a scientific failure. Although policy makers often understand that their decisions have differential impacts across society, the analytical tools used to inform policy lack a substantial perspective on equity, focusing on averages rather than social distributions, leading to inequitable solutions. In an age of social division driven by rising inequality, rigorous new methods for precisely measuring the equity impacts of health and social policy interventions are required, drawing on new partnerships between researchers across disciplines. By developing these methods, and using them to assess the effectiveness of major public health and healthcare initiatives, researchers can improve understanding of the structural, behavioural and organizational barriers to delivering equitable health outcomes. Policy makers will then have the necessary information to judge who gains and who loses from their decisions.

scholarly journals The Coronavirus 2019 pandemic in Canada: the impact of public health interventions on the course of the outbreak in Alberta and other provinces

2020 ◽  
Author(s):  
Mohamed Mahsin ◽  
Seungwon Lee ◽  
David Vickers ◽  
Alexis Guigue ◽  
Tyler Williamson ◽  
...  
Keyword(s):  
Public Health ◽  
British Columbia ◽  
Health Policy ◽  
Laboratory Data ◽  
Health Interventions ◽  
Time Interval ◽  
Public Health Interventions ◽  
Testing Strategies ◽  
Serial Interval ◽  
The Impact

Background: The SARS-CoV-2 disease 2019 (COVID-19) pandemic has spread across the world with varying impact on health systems and outcomes. We assessed how the type and timing of public- health interventions impacted the course of the outbreak in Alberta and other Canadian provinces. Methods: We used publicly-available data to summarize rates of laboratory data and mortality in relation to measures implemented to contain the outbreak and testing strategy. We estimated the transmission potential of SARS-CoV-2 before the state of emergency declaration for each province (R0) and at the study end date (Rt). Results: The first cases were confirmed in Ontario (January 25) and British Columbia (January 28). All provinces implemented the same health-policy measures between March 12 and March 30. Alberta had a higher percentage of the population tested (3.8%) and a lower mortality rate (3/100,000) than Ontario (2.6%; 11/100,000) or Quebec (3.1%; 31/100,000). British Columbia tested fewer people (1.7%) and had similar mortality as Alberta. Data on provincial testing strategies were insufficient to inform further analyses. Mortality rates increased with increasing rates of lab- confirmed cases in Ontario and Quebec, but not in Alberta. R0 was similar across all provinces, but varied widely from 2.6 (95% confidence intervals 1.9-3.4) to 6.4 (4.3-8.5), depending on the assumed time interval between onset of symptoms in a primary and a secondary case (serial interval). The outbreak is currently under control in Alberta, British Columbia and Nova Scotia (Rt <1). Interpretation: COVID-19-related health outcomes varied by province despite rapid implementation of similar health-policy interventions across Canada. Insufficient information about provincial testing strategies and a lack of primary data on serial interval are major limitations of existing data on the Canadian COVID-19 outbreak.

scholarly journals Prevention of HIV and Other Sexually Transmissible Infections in Expatriates and Traveler Networks: Qualitative Study of Peer Interaction in an Online Forum (Preprint)

2018 ◽  
Author(s):  
Gemma Crawford ◽  
Bruce Maycock ◽  
Rochelle Tobin ◽  
Graham Brown ◽  
Roanna Lobo
Keyword(s):  
Public Health ◽  
Health Interventions ◽  
Presentation Of Self ◽  
Inclusion Criteria ◽  
Public Health Interventions ◽  
Online Forum ◽  
Policy Makers ◽  
Sexually Transmissible Infections ◽  
Health Promoting

BACKGROUND In high-income countries such as Australia, an increasing proportion of HIV cases have been acquired overseas, including among expatriates and travelers. Australia’s national strategies have highlighted the need for public health interventions for priority populations. One approach is to expand efforts to places or spaces where expatriate communities reside. Online settings such as forums used by expatriates and travelers have potential for preventing sexually transmissible infections with those hard to reach through more traditional interventions. OBJECTIVE Our objectives were to (1) identify and describe domains of social interaction and engagement in 1 online forum used by Australian expatriates and travelers living or working in Thailand; and (2) make recommendations to health-promoting organizations and policy makers regarding the role of these forums in public health interventions with mobile populations who may be at risk of acquiring HIV or other sexually transmissible infections. METHODS We identified forums and users in 2 stages. We identified 13 online forums and analyzed them for inclusion criteria. We searched 1 forum that met the required criteria for users who met inclusion criteria (n=5). Discussion threads, rather than individual posts, were units of analysis. For each user, we collected as transcripts the first 100 posts and 10 most recent posts, including the thread in which they were posted. We analyzed and thematically coded each post (n=550). Transcripts and analyses were reviewed and refined by multiple members of the research team to improve rigor. Themes were not totally emergent but explored against symbolic interactionism concepts of presentation of self, meaning, and socialization. RESULTS Key domains were as follows: the forum (characteristics of the space and reasons for use), gaining access (forum hierarchy and rules), identity (presentation of self and role of language), advice, support, and information (sources of information, support provided, influencers, topics of discussion, and receptiveness to advice), and risk (expectations and perceptions). The forum exhibited evidence of unique language, rules and norms, and processes for managing conflict and key influencers. The forum was a substantial source of health information and advice provided to users via confirmation, reassurance, or affirmation of beliefs and experiences. Risk perception and expectations varied. Risk taking, including around sex, appeared to be a key expectation of travel or the experience of being an expatriate or traveler. CONCLUSIONS Australian expatriate and long-term traveler participation in the online forum formed, influenced, and reinforced knowledge, attitudes, interaction, and identity. Such forums can be used by policy makers and health-promoting organizations to provide supplementary sources of support and information to hard-to-reach mobile populations who may be at risk of acquiring HIV or other sexually transmissible infections. This will complement existing engagement with health professionals and other public health interventions.

Priorities and ethics in health care

2013 ◽  
pp. 12-27
Author(s):  
Sian M. Griffiths ◽  
Robyn Martin ◽  
Don Sinclair
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Policy ◽  
Priority Setting ◽  
Public Health Policy ◽  
Policy Making ◽  
Public Health Ethics ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Role Ethics

This chapter aims to help you understand the language of ethics and the role ethics plays in public health, recognize ways in which public health ethics differ from bioethics, understand the principles of priority-setting within a constrained budget, appreciate how ethics should underpin public health interventions, and appreciate the importance of ethics-based public health policy-making.

scholarly journals Food industry influence on public health policy, research and practice in Latin America

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Mialon ◽  
E Perez ◽  
C Corvalan ◽  
C Monteiro ◽  
P Jaime ◽  
...  
Keyword(s):  
Public Health ◽  
Latin America ◽  
Health Policy ◽  
Public Health Policy ◽  
Food Industry ◽  
Policy Research ◽  
Health Policies ◽  
Policy Makers ◽  
Public Health Policies ◽  
Research And Practice

Abstract One of the key barriers to the development of public health policies, such as restrictions on marketing of unhealthy foods to children, is the influence of corporations, also known as corporate political activity' (CPA). This project aimed to identify the CPA of the food industry in Brazil, Colombia and Chile, over a 2-year period. This research consisted of a document analysis of publicly available information triangulated with interviews. It contributed to, and was based on methods developed by INFORMAS (International Network for Food and Obesity / non-communicable Diseases Research, Monitoring and Action Support), which aims to monitor food environments. In all three countries, the food industry lobbied against public health policies and had direct access to high ranking officials and policy makers. It also shifted the blame away from its products in the obesity and non-communicable diseases epidemic onto individuals and their lack of education. In Brazil, the food industry was active against a new front-of-pack labeling, setting up its own website to promote an alternative model and self-regulation. In Colombia, the food industry captured the media and had strong ties with the government, including through nutrition programmes. Public health advocates felt unsafe when speaking against the industry or its products. In Chile, despite advances with the introduction of public health policies to limit the sales and marketing of unhealthy products, the food industry, including the sweeteners industry, which was not affected by the recent legislation, was still influencing policy, research and practice. Food industry actors, including local companies and transnationals, used several CPA strategies in Latin America to try and influence public health policy, research and practice. It is urgent that policy makers, academics and other individuals in public health are aware of these practices and equipped with solutions to address undue influence by the food industry Key messages In Latin America, the food industry used several CPA practices, which collectively could have a negative influence on public health policy, research and practice. These practices could delay efforts to protect and promote public health in the region.

scholarly journals An analysis of COVID-19 clusters in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pooja Sengupta ◽  
Bhaswati Ganguli ◽  
Sugata SenRoy ◽  
Aditya Chatterjee
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Population Density ◽  
Case Studies ◽  
Compartment Model ◽  
Health Interventions ◽  
Disease Spread ◽  
Second Phase ◽  
Public Health Interventions ◽  
Homogeneous Groups

Abstract Background In this study we cluster the districts of India in terms of the spread of COVID-19 and related variables such as population density and the number of specialty hospitals. Simulation using a compartment model is used to provide insight into differences in response to public health interventions. Two case studies of interest from Nizamuddin and Dharavi provide contrasting pictures of the success in curbing spread. Methods A cluster analysis of the worst affected districts in India provides insight about the similarities between them. The effects of public health interventions in flattening the curve in their respective states is studied using the individual contact SEIQHRF model, a stochastic individual compartment model which simulates disease prevalence in the susceptible, infected, recovered and fatal compartments. Results The clustering of hotspot districts provide homogeneous groups that can be discriminated in terms of number of cases and related covariates. The cluster analysis reveal that the distribution of number of COVID-19 hospitals in the districts does not correlate with the distribution of confirmed COVID-19 cases. From the SEIQHRF model for Nizamuddin we observe in the second phase the number of infected individuals had seen a multitudinous increase in the states where Nizamuddin attendees returned, increasing the risk of the disease spread. However, the simulations reveal that implementing administrative interventions, flatten the curve. In Dharavi, through tracing, tracking, testing and treating, massive breakout of COVID-19 was brought under control. Conclusions The cluster analysis performed on the districts reveal homogeneous groups of districts that can be ranked based on the burden placed on the healthcare system in terms of number of confirmed cases, population density and number of hospitals dedicated to COVID-19 treatment. The study rounds up with two important case studies on Nizamuddin basti and Dharavi to illustrate the growth curve of COVID-19 in two very densely populated regions in India. In the case of Nizamuddin, the study showed that there was a manifold increase in the risk of infection. In contrast it is seen that there was a rapid decline in the number of cases in Dharavi within a span of about one month.

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