Public Health Foundations for Population Health Managers

Abstract Background The political system is an important influencing factor for population health but is often neglected in the public health literature. This scoping review uses insights from political science to explore the possible public health consequences of the rise of populist radical right (PRR) parties in Europe, with welfare state policy as a proxy. The aim is to generate hypotheses about the relationship between the PRR, political systems and public health. Methods A literature search on PubMed, ScienceDirect and Google Scholar resulted in 110 original research articles addressing 1) the relationship between the political system and welfare state policy/population health outcomes or 2) the relationship between PRR parties and welfare state policy/population health outcomes in Europe. Results The influence of political parties on population health seems to be mediated by welfare state policies. Early symptoms point towards possible negative effects of the PRR on public health, by taking a welfare chauvinist position. Despite limited literature, there are preliminary indications that the effect of PRR parties on health and welfare policy depends on vote-seeking or office-seeking strategies and may be mediated by the political system in which they act. Compromises with coalition partners, electoral institutions and the type of healthcare system can either restrain or exacerbate the effects of the PRR policy agenda. EU laws and regulations can to some extent restrict the nativist policy agenda of PRR parties. Conclusions The relationship between the PRR and welfare state policy seems to be mediated by the political system, meaning that the public health consequences will differ by country. Considering the increased popularity of populist parties in Europe and the possibly harmful consequences for public health, there is a need for further research on the link between the PRR and public health.

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Dual MD–MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health

Public Health Reports ◽

10.1177/0033354920978422 ◽

2021 ◽

pp. 003335492097842

Author(s):

Jo Marie Reilly ◽

Christine M. Plepys ◽

Michael R. Cousineau

Keyword(s):

Public Health ◽

United States ◽

Population Health ◽

Health Care Policy ◽

The United States ◽

Extensive Literature ◽

Master Of Public Health ◽

Telephone Interviews ◽

Public Health Training ◽

The Impact

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.

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4.C. Round table: Joining forces: frameworks for international and multi-sectoral collaborations in health information

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.141 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Public Health ◽

Big Data ◽

Health Information ◽

Population Health ◽

Round Table ◽

Secondary Use ◽

Use Of Data ◽

National Initiatives ◽

Information Research

Abstract Countries have a wide range of lifestyles, environmental exposures and different health(care) systems providing a large natural experiment to be investigated. Through pan-European comparative studies, underlying determinants of population health can be explored and provide rich new insights into the dynamics of population health and care such as the safety, quality, effectiveness and costs of interventions. Additionally, in the big data era, secondary use of data has become one of the major cornerstones of digital transformation for health systems improvement. Several countries are reviewing governance models and regulatory framework for data reuse. Precision medicine and public health intelligence share the same population-based approach, as such, aligning secondary use of data initiatives will increase cost-efficiency of the data conversion value chain by ensuring that different stakeholders needs are accounted for since the beginning. At EU level, the European Commission has been raising awareness of the need to create adequate data ecosystems for innovative use of big data for health, specially ensuring responsible development and deployment of data science and artificial intelligence technologies in the medical and public health sectors. To this end, the Joint Action on Health Information (InfAct) is setting up the Distributed Infrastructure on Population Health (DIPoH). DIPoH provides a framework for international and multi-sectoral collaborations in health information. More specifically, DIPoH facilitates the sharing of research methods, data and results through participation of countries and already existing research networks. DIPoH's efforts include harmonization and interoperability, strengthening of the research capacity in MSs and providing European and worldwide perspectives to national data. In order to be embedded in the health information landscape, DIPoH aims to interact with existing (inter)national initiatives to identify common interfaces, to avoid duplication of the work and establish a sustainable long-term health information research infrastructure. In this workshop, InfAct lays down DIPoH's core elements in coherence with national and European initiatives and actors i.e. To-Reach, eHAction, the French Health Data Hub and ECHO. Pitch presentations on DIPoH and its national nodes will set the scene. In the format of a round table, possible collaborations with existing initiatives at (inter)national level will be debated with the audience. Synergies will be sought, reflections on community needs will be made and expectations on services will be discussed. The workshop will increase the knowledge of delegates around the latest health information infrastructure and initiatives that strive for better public health and health systems in countries. The workshop also serves as a capacity building activity to promote cooperation between initiatives and actors in the field. Key messages DIPoH an infrastructure aiming to interact with existing (inter)national initiatives to identify common interfaces, avoid duplication and enable a long-term health information research infrastructure. National nodes can improve coordination, communication and cooperation between health information stakeholders in a country, potentially reducing overlap and duplication of research and field-work.

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Artificial intelligence for good health: a scoping review of the ethics literature

BMC Medical Ethics ◽

10.1186/s12910-021-00577-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Kathleen Murphy ◽

Erica Di Ruggiero ◽

Ross Upshur ◽

Donald J. Willison ◽

Neha Malhotra ◽

...

Keyword(s):

Public Health ◽

Artificial Intelligence ◽

Global Health ◽

Population Health ◽

Health Systems ◽

Scoping Review ◽

Industrial Revolution ◽

Ethical Issues ◽

Grey Literature ◽

Ethical Implications

Abstract Background Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.

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A public health perspective on mental health: lessons for population health in the 21st century

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2021.44 ◽

2021 ◽

pp. 1-4

Author(s):

James V. Lucey

Keyword(s):

Public Health ◽

Mental Health ◽

Population Health ◽

Royal College ◽

Public Support ◽

Healthcare Systems ◽

Lessons Learned ◽

Public Health Perspective ◽

The World ◽

Shared Commitment

In December 2019, clinicians and academics from the disciplines of public health and psychiatry met in Dublin at the Royal College of Surgeons in Ireland (RCSI), to restate their shared commitment to population health. The purpose of this review is to bring our discussion to a wider audience. The meeting could not have been more timely. Six weeks later, the COVID-19 emergency emerged in China and within 12 months it had swept the world. This paper, the contents of which were presented at that meeting in December recommended that future healthcare would be guided more by public health perspectives and informed by an understanding of health economics, population health and the lessons learned by psychiatry in the 20th century. Ultimately two issues are at stake in 21st century healthcare: the sustainability of our healthcare systems and the maintenance of public support for population health. We must plan for the next generation of healthcare. We need to do this now since it is clear that COVID-19 marks the beginning of 21st century medicine.

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