scholarly journals Correlations between Changes in Medical Opioid Dispensing and Contributions of Fentanyl to Opioid-Related Overdose Fatalities: Exploratory Analyses from Canada

2021 ◽  
Vol 18 (14) ◽  
pp. 7507
Author(s):  
Wayne Jones ◽  
Min-Hye (Angelica) Lee ◽  
Ridhwana Kaoser ◽  
Benedikt Fischer
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Relative Contribution ◽  
Defined Daily Doses ◽  
Nonmedical Use ◽  
Pearson's R ◽  
Opioid Deaths ◽  
Related Mortality ◽  
Pearson’S R

Canada is experiencing an epidemic of opioid-related mortality, with increasing yet heterogeneous fatality patterns from illicit/synthetic (e.g., fentanyl) opioids. The present study examined whether differential provincial reductions in medical opioid dispensing following restrictive regulations (post-2010) were associated with differential contributions of fentanyl to opioid mortality. Annual provincial opioid dispensing totals in defined daily doses/1000 population/day, and change rates in opioid dispensing for the 10 provinces for (1) 2011–2018 and (2) “peak-year” to 2018 were derived from a pan-Canadian pharmacy-based dispensing panel. Provincial contribution rates of fentanyl to opioid-related mortality (2016–2019) were averaged. Correlation values (Pearson’s R) between provincial changes in opioid dispensing and the relative fentanyl contributions to mortality were computed for the two scenarios. The correlation between province-based changes in opioid dispensing (2011–2018) and the relative contribution of fentanyl to total opioid deaths (2016–2019) was −0.70 (t = 2.75; df = 8; p = 0.03); the corresponding correlation for opioid dispensing changes (“peak-year” to 2018) was −0.59 (t = −2.06; df = 8; p = 0.07). Provincial reductions in medical opioid dispensing indicated (near-)significant correlations with fentanyl contribution rates to opioid-related death totals. Differential reductions in pharmaceutical opioid availability may have created supply voids for nonmedical use, substituted with synthetic/toxic (e.g., fentanyl) opioids and leading to accelerated opioid mortality. Implications of these possible unintended adverse consequences warrant consideration for public health policy.

scholarly journals Geographical Patterns in Drug-Related Mortality and Suicide: Investigating Commonalities in English Small Areas

2019 ◽  
Vol 16 (10) ◽  
pp. 1831
Author(s):  
Peter Congdon
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Policy ◽  
Public Health Policy ◽  
Geographic Pattern ◽  
Small Areas ◽  
Geographical Patterns ◽  
Related Mortality

There are increasing concerns regarding upward trends in drug-related deaths in a number of developed societies. In some countries, these have been paralleled by upward trends in suicide. Of frequent concern to public health policy are local variations in these outcomes, and the factors underlying them. In this paper, we consider the geographic pattern of drug-related deaths and suicide for 2012–2016 across 6791 small areas in England. The aim is to establish the extent of commonalities in area risk factors between the two outcomes, with a particular focus on impacts of deprivation, fragmentation and rurality.

Public Health: Policy and Politics

2001 ◽  
Vol 9 (6) ◽  
pp. 507-509 ◽  
Author(s):  
Rob Baggott ◽  
David J Hunter
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy

Fat, Stigma, and Public Health Policy

2005 ◽  
Author(s):  
Leslie A. Crimin ◽  
Carol T. Miller
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Fat Stigma

Federal Public Health Authority

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Federal Agencies ◽  
Public Health Authority ◽  
Commerce Clause ◽  
Individual Mandate ◽  
National Federation ◽  
Health Laws ◽  
Health Regulations

This chapter explores the powers of Congress to pass federal public health laws and to delegate authority to federal agencies. The chapter starts with an explanation of Congress’s limited, enumerated powers and how this limits Congress to certain arenas of authority. It next explores the evolution Congress’s use of the Commerce Clause to pass public health laws, before exploring Congress’s use of the Taxing and Spending Clause. The chapter provides examples of how Congress has used both the Commerce Clause and its taxing and spending power to effectuate public health policy. Next, the chapter explains the National Federation of Independent Businesses v. Sebelius case; it details challenges to the Affordable Care Act’s individual mandate and Medicaid and explains the implications of the Supreme Court’s holdings. Lastly, the chapter explains Congress’s authority to delegate authority to federal administrative agencies to issue and enforce public health regulations.

Persons with Disabilities and Public Health Ethics

2019 ◽  
pp. 218-231
Author(s):  
Monika Mitra ◽  
Linda Long-Bellil ◽  
Robyn Powell
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Ethical Issues ◽  
The United States ◽  
Policy And Practice ◽  
Persons With Disabilities ◽  
Public Health Decision ◽  
Health Decision ◽  
Health Policy And Practice

This chapter draws on medical, social, and legal perspectives to identify and highlight ethical issues pertaining to the treatment, representation, and inclusion of persons with disabilities in public health policy and practice. A brief history of disability in the United States is provided as a context for examining the key ethical issues related to public health policy and practice. Conceptual frameworks and approaches to disability are then described and applied. The chapter then discusses the imperativeness of expanding access to public health programs by persons with disabilities, the need to address implicit and structural biases, and the importance of including persons with disabilities in public health decision-making.

scholarly journals Television News Coverage of Public Health Issues and Implications for Public Health Policy and Practice

2019 ◽  
Vol 40 (1) ◽  
pp. 167-185 ◽  
Author(s):  
Sarah E. Gollust ◽  
Erika Franklin Fowler ◽  
Jeff Niederdeppe
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Television News ◽  
News Coverage ◽  
Health Issues ◽  
Public Attention ◽  
Policy And Practice ◽  
Tv News ◽  
Health Policy And Practice

Television (TV) news, and especially local TV news, remains an important vehicle through which Americans obtain information about health-related topics. In this review, we synthesize theory and evidence on four main functions of TV news in shaping public health policy and practice: reporting events and information to the public (surveillance); providing the context for and meaning surrounding health issues (interpretation); cultivating community values, beliefs, and norms (socialization); and attracting and maintaining public attention for advertisers (attention merchant). We also identify challenges for TV news as a vehicle for improving public health, including declining audiences, industry changes such as station consolidation, increasingly politicized content, potential spread of misinformation, and lack of attention to inequity. We offer recommendations for public health practitioners and researchers to leverage TV news to improve public health and advance health equity.

scholarly journals Public health decisions in the COVID-19 pandemic require more than ‘follow the science’

2021 ◽  
pp. medethics-2020-107134
Author(s):  
Thana Cristina de Campos-Rudinsky ◽  
Eduardo Undurraga
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Health Policy ◽  
Empirical Evidence ◽  
Empirical Data ◽  
Public Health Policy ◽  
Scientific Evidence ◽  
Ethical Reasoning ◽  
Reliable Data ◽  
Good Decision

Although empirical evidence may provide a much desired sense of certainty amidst a pandemic characterised by uncertainty, the vast gamut of available COVID-19 data, including misinformation, has instead increased confusion and distrust in authorities’ decisions. One key lesson we have been gradually learning from the COVID-19 pandemic is that the availability of empirical data and scientific evidence alone do not automatically lead to good decisions. Good decision-making in public health policy, this paper argues, does depend on the availability of reliable data and rigorous analyses, but depends above all on sound ethical reasoning that ascribes value and normative judgement to empirical facts.

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