scholarly journals The politics of public health: A rapid review of the impact of public health reform on population health outcomes

2021 ◽  
Vol 3 (1) ◽  
pp. 98-115
Author(s):  
Charlotte Riordon ◽  
Sionnach Hendra ◽  
Christine Johnson

Canada’s public health (PH) systems are vulnerable to constant system and structural changes, influenced by political and economic factors. This rapid review examines how PH system restructuring impacts population health outcomes, with special consideration of health equity. Due to a lack of Canadian evidence, international research was examined to produce recommendations for Canadian nurses, researchers, and decision-makers. Evidence indicates that PH spending and PH system organization have important impacts on population health outcomes and suggests PH reform has a negative impact on health equity. Opportunities for advocacy, activism, lobbying and capacity building to achieve health equity are discussed. Nurses, in a unique position between public policy and the lives of those they care for, are presented with the opportunity to effect social change through political action and to work across disciplines to address inequities. We encourage researchers and decision-makers to prioritize looking more deeply at the impact of PH reform.

Author(s):  
Vidya Anderson ◽  
William A. Gough ◽  
Branka Agic

The built environment is a physical determinant of health essential to the planning and development of a more equitable society. Communities face growing challenges due to environmental stressors such as climate change, with vulnerable communities experiencing a disproportionate burden of adverse health outcomes. The interdependencies between urban planning and public health outcomes are inextricable, with respect to improving access to healthier built environments for vulnerable and marginalized groups. Widespread implementation of nature-based solutions, such as green infrastructure, provides a multi-functional strategy to support sustainable development, increase climate resilience, enhance ecological connectivity, and create healthier communities. A Health Equity Impact Assessment presents the findings of a participatory research study utilizing key informant interviews of public health unit professionals (eight) and a survey of green infrastructure volunteers and workers (36) on the impact of green infrastructure on individual and community mental and physical well-being, service use, and perceived unmet needs, using Ontario, Canada as a case study. Study findings indicate that where green infrastructure is both productive and publicly accessible, the benefits were significant for vulnerable populations. These benefits include increased social connectivity, skills development, and food security. Green infrastructure could be a viable strategy to address environmental stressors, improve health equity, and support localization of the UN Sustainable Development Goals (SDGs).


2021 ◽  
pp. 003335492097842
Author(s):  
Jo Marie Reilly ◽  
Christine M. Plepys ◽  
Michael R. Cousineau

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.


Author(s):  
Jason Reece

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.


2021 ◽  
Vol 7 ◽  
pp. 233372142110201
Author(s):  
M. Courtney Hughes ◽  
Yujun Liu ◽  
Abby Baumbach

Background: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, raised worldwide concern. Since then, the COVID-19 pandemic has negatively influenced health and wellness across the globe and caused nearly three million deaths. This study focuses on informal caregivers of people with dementia, a disease that affects about 50 million older adults worldwide and requires much caregiving support. Objective: Examine the current literature on the impact of COVID-19 on the health and well-being of informal caregivers for people with dementia. Method: This rapid review was conducted across five electronic databases for quantitative and qualitative articles published through March 15, 2021. Results: The 10 studies included in this review reported quantitative descriptive data from across the globe; however, no studies existed from the U.S. or East Asia countries. All of the studies examined the psychological rather than physical impact of COVID-19 and highlighted risk and protective factors in the areas of psychosocial (resilience, neuropsychiatric, and social isolation), sociodemographic (gender and education), and environmental (home confinement, living arrangement, and dementia stage). Conclusion: COVID-19 has had a considerable negative impact on the psychological well-being of informal caregivers of people with dementia, namely causing more depression and anxiety than pre-pandemic.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Emalie Rosewarne ◽  
Michael Moore ◽  
Wai-Kwan Chislett ◽  
Alexandra Jones ◽  
Kathy Trieu ◽  
...  

Abstract Background Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy strategy in achieving policy change. Methods Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. Results A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. Conclusions The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.


JOUTICA ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. 255
Author(s):  
Kemal Farouq Mauladi ◽  
Nurul Fuad

Telecommunications technology is developing very rapidly, ranging from users or engineers. The development of smartphone smartphones is also increasingly in demand, so that the use of electricity needs is also increasing. The need for electricity usage has resulted in more standing voltage in some settlements. The establishment of sutet will have a negative impact on public health. In addition, the influence of electrical energy on humans occurs because the electrical energy generated by electricity generation or electricity that is channeled gives rise to electromagnetic fields. The higher the voltage required by an equipment, the greater the electric field that is distributed. Besides that, it can also find ways to reduce the negative impact of the electric and magnetic fields produced by SUTET which impacts the process of the occurrence of electric and magnetic fields on SUTET. From the problems above, the author intends to determine the effect or correlation between the impact of SUTET on cellphone network transmissions or channels. This research can later determine the negative impact caused by SUTET for the surrounding community, and the impact of SUTET radiation on cellular networks.


2020 ◽  
Author(s):  
Leib Litman ◽  
Zohn Rosen ◽  
Cheskie Rosenzweig ◽  
Sarah L. Weinberger-Litman ◽  
Aaron J. Moss ◽  
...  

AbstractSociety is becoming increasingly dependent on survey research. However, surveys can be impacted by participants who are non-attentive, respond randomly to survey questions, and misrepresent who they are and their true attitudes. The impact that such respondents can have on public health research has rarely been systematically examined. In this study we examine whether Americans began to engage in dangerous cleaning practices to avoid Covid-19 infection. Prior findings reported by the CDC have suggested that people began to engage in highly dangerous cleaning practices during the Covid-19 pandemic, including ingesting household cleansers such as bleach. In a series of studies totaling close to 1400 respondents, we show that 80-90% of reports of household cleanser ingestion are made by problematic respondents. These respondents report impossible claims such as ‘recently having had a fatal heart attack’ and ‘eating concrete for its iron content’ at a similar rate to ingesting household cleaners. Additionally, respondents’ frequent misreading or misinterpreting the intent of questions accounted for the rest of such claims. Once inattentive, mischievous, and careless respondents are taken out of the analytic sample we find no evidence that people ingest cleansers to prevent Covid-19 infection. The relationship between dangerous cleaning practices and health outcomes also becomes non-significant once problematic respondents are taken out of the analytic sample. These results show that reported ingestion of household cleaners and other similar dangerous practices are an artifact of problematic respondent bias. The implications of these findings for public health and medical survey research, as well as best practices for avoiding problematic respondents in surveys are discussed.


2021 ◽  
Author(s):  
Emalie Rosewarne ◽  
Michael Moore ◽  
Wai-Kwan Chislett ◽  
Alexandra Jones ◽  
Kathy Trieu ◽  
...  

Abstract Background: Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy and policy strengthening strategy.Methods: Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the “Kotter Plus” 10-step public health advocacy evaluation framework was used to guide data extraction, analysis and synthesis.Results: A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction program. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established but communication of the vision to decision-makers was lacking, which reduced the impact of the program as decision-makers were not provided with a clear incentive for policy change. Program outputs were achieved; however, these did not translate to achieving broader strategic goals during a limited-term intervention in an unsympathetic political climate.Conclusions: The “Kotter Plus” 10-step framework was a useful tool for evaluating the success of the VSRP advocacy and policy strengthening strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within the partnerships and to decision-makers, to better influence policy and improve public health impact.


2009 ◽  
Vol 4 (2) ◽  
pp. 231-245 ◽  
Author(s):  
RICHARD COOKSON ◽  
MIKE DRUMMOND ◽  
HELEN WEATHERLY

AbstractHealth equity is one of the main avowed objectives of public health policy across the world. Yet economic evaluations in public health (like those in health care more generally) continue to focus on maximizing health gain. Health equity considerations are rarely mentioned. Health economists rely on the quasi-egalitarian value judgment that ‘a QALY is a QALY’ – that is QALYs are equally weighted and the same health outcome is worth the same no matter how it is achieved or to whom it accrues. This value judgment is questionable in many important circumstances in public health. For example, policy-makers may place rather little value on health outcomes achieved by infringing individual liberties or by discriminating on the basis of age, sex, or race. Furthermore, there is evidence that a majority of the general public wish to give greater weight to health gains accruing to children, the severely ill, and, to a lesser extent, the socio-economically disadvantaged. This paper outlines four approaches to explicit incorporation of equity considerations into economic evaluation in public health: (i) review of background information on equity, (ii) health inequality impact assessment, (iii) analysis of the opportunity cost of equity, and (iv) equity weighting of health outcomes. The first three approaches can readily be applied using standard methods of health technology assessment, where suitable data are available; whereas approaches for generating equity weights remain experimental. The potential benefits of considering equity are likely to be largest in cases involving: (a) interventions that target disadvantaged individuals or communities and are also relatively cost-ineffective and (b) interventions to encourage lifestyle change, which may be relatively ineffective among ‘hard-to-reach’ disadvantaged groups and hence may require re-design to avoid increasing health inequalities.


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