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Maison P, Bacon T, Daynes P, Decoene C, Mazet R, Vial T, Vignot S, Belgodère L, Oualikene-Gonin W, Ratignier-Carbonneil C. [Balancing drug regulation and health democracy: The role of patient and healthcare professional advisors at the ANSM]. Therapie 2024:S0040-5957(24)00070-2. [PMID: 38971714 DOI: 10.1016/j.therap.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/27/2024] [Accepted: 06/17/2024] [Indexed: 07/08/2024]
Abstract
The French National Agency for Health Products (ANSM) is a regulatory and public health agency. Its regulatory, health policing and public health protection activities require a perfect fit with the field and the various people involved in the use of health products. Since 2019, the ANSM has adapted its organisation, procedures and processes to encourage and improve interaction with its stakeholders, as part of its policy of openness towards civil society. To accompany this ambitious change and to support its staff, the Agency has recruited advisors corresponding to the main users of health products: prescribers (doctor's hospital and outpatient), pharmacists and patients. Working as a group or individually, they provide a "lived" user perspective on health products at each stage of the evaluation process. They may be involved in the assessment of dossiers, signals or applications received by the Agency, in the internal validation of reports or in discussions with stakeholders. They are particularly involved when the analysis requires expertise that goes beyond the technical, scientific or regulatory aspects. They may also work with ANSM staff to explain certain processes and difficulties in the field. Advisors help to ensure that regulatory and/or scientific expertise is clear and consistent with user experience. In addition to their scientific and therapeutic aspects, medicines are also economic, social and political issues. Their regulation is therefore particularly affected by the need for health democracy. This requires the active participation of health professionals, patients and, more broadly, civil society in the decision-making process. Civil society is a space occupied by a wide range of actors who exert pressure from different ideological positions to influence the regulation of health products. In this context, taking into account a plurality of viewpoints in the regulation of health products is necessary and complex, but its operation can be facilitated by the collective efforts of the actors and the adaptation of organisations, such as the integration of advisors.
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Affiliation(s)
- Patrick Maison
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; EA 7379, faculté de santé, université Paris-Est Créteil, CHI de Créteil, 94000 Créteil, France.
| | - Trystan Bacon
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; Collège universitaire de médecine générale, université Claude-Bernard Lyon 1, 69000 Lyon, France
| | - Pascale Daynes
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; Union francophone des patients partenaires, faculté de médecine, centre hospitalier universitaire Grenoble-Alpes, 38700 La Tronche, France
| | - Christophe Decoene
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; Pôle anesthésie-réanimation, centre hospitalier universitaire de Lille, 59000 Lille, France
| | - Roseline Mazet
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; Centre hospitalier universitaire de Grenoble-Alpes, 38000 Grenoble, France
| | - Thierry Vial
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; Service hospitalo-universitaire de pharmacotoxicologie, hospices civils de Lyon, 69000 Lyon, France
| | - Stéphane Vignot
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France; EA7509 IRMAIC, université de Reims Champagne-Ardenne, 51100 Reims, France; Département d'oncologie médicale, institut Godinot, 51100 Reims, France
| | - Laetitia Belgodère
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France
| | - Wahiba Oualikene-Gonin
- Agence nationale de sécurité du médicament et des produits de santé (ANSM), 93285 Saint-Denis, France
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Mendoza Y, González RE. Objective and subjective measures of air pollution and self-rated health: the evidence from Chile. Int Arch Occup Environ Health 2024; 97:413-433. [PMID: 38493267 DOI: 10.1007/s00420-024-02056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/06/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE The literature exploring individual differences in self-rated health has grown fast in recent years. Self-rated health (SRH) is a good indicator of general health status. This empirical study explores the association between outdoor air pollution and SRH in Chile. This type of analysis is infrequent in Latin America. METHODS We used objective and subjective air pollution measures. The first corresponds to PM2.5, and the latter to the perception of a high level of air pollution. Drawing on data from two independent and repeated nationwide surveys over the period 2006-2017 at the individual level in Chile, we performed repeated cross-sectional analyses for each year of survey application. Ordered Logit (OL) and Logit (L) multivariate models were used to investigate the association between SRH and air pollution measures, considering other socioeconomic and demographic covariates. RESULTS We found that the higher is the level of air pollution, the lower the SRH in Chile, regardless of whether air pollution is physically measured or perceived by respondents. The results were consistent over the years in the sign and significance of regression coefficients using two surveys and two forms of the outcome variable. CONCLUSIONS Our findings add evidence that air pollution is a relevant determinant of SRH. In addition, they show that subjective measures of air pollution can be as reliable as physical measures in the analysis of the association between air pollution and human health.
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Affiliation(s)
- Yenniel Mendoza
- Department of Administration and Economics, Faculty of Law and Business, Universidad de la Frontera, Temuco, Chile.
| | - Ricardo E González
- Department of Forest Sciences and Environment, Faculty of Agricultural Sciences and Environment, Universidad de la Frontera, Temuco, Chile
- Centro Nacional de Excelencia para la Industria de la Madera (CENAMAD), Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
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De Luca GD, Lin X. The role of health and health systems in promoting social capital, political participation and peace: A narrative review. Health Policy 2024; 141:105009. [PMID: 38350755 DOI: 10.1016/j.healthpol.2024.105009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024]
Abstract
High levels of violence and insecurity are highly detrimental for societies. United Nations Sustainable Development Goal 16 is advocating for peaceful, accountable and inclusive institutions as one powerful channel to foster global development. Investing in health and health policies can potentially contribute achieving these objectives. After providing a conceptual framework, this article reviews the existing literature on the evidence of the role of health and health systems in promoting social capital and trust, political engagement and participation, and peace that closely relate to the objectives of Sustainable Development Goal 16. We provide evidence of a systematically positive impact of better physical and mental health on social capital, and on political participation, both contributing to the sustainability of inclusive democratic institutions. We also document that health and health systems can help supporting peace, both via the reduction of social inequality and grievances, and by reducing the disruptive effects of epidemic shocks. Overall, the study provides evidence that health and health systems can generate co-benefits outside the health domain by promoting social capital, political participation and peace.
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Affiliation(s)
| | - Xi Lin
- University of York, Heslington, YO105DD York, UK
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Cheng H, Jiang A. Neighborhood Governance and Happiness during the COVID-19 Pandemic: An Empirical Analysis of Wuhan's Lockdown. Behav Sci (Basel) 2023; 13:512. [PMID: 37366764 DOI: 10.3390/bs13060512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/04/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023] Open
Abstract
The outbreak of COVID-19 posed a challenge to global governance, residents' happiness, and economic systems around the world. Since the crux of previous research centers on the reactions of both local and national governments, studies on how governance arrangement at the neighborhood level influences people's happiness during the crisis response remain insufficient. This paper aims to explore the relationship between neighborhood governance and residents' happiness based on first-hand data collected during Wuhan's first lockdown. This study highlights the significance of neighborhood governance in crisis response, which includes providing diverse public services, ensuring access to life's necessities, and offering prompt medical treatment. All of these factors are essential for maintaining overall satisfaction with governance and contributing to the happiness of individuals within the community. However, active governance actions do not always lead to favorable results. For example, increased group participation may lead to social conflicts among those involved, ultimately diminishing one's happiness. Furthermore, the COVID-19 pandemic has acted as a risk 'amplifier', exposing and exacerbating pre-existing hukou-based social inequalities in the governance process. The impact of the pandemic on citizen happiness is the cumulative effect of both the immediate social crisis brought on by the pandemic and long-standing structural inequalities. To improve people's happiness and establish inclusive policies, this paper advocates for a 'people-centered' urban governance that enhances public satisfaction and addresses the needs and priorities of migrant populations.
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Affiliation(s)
- Hanbei Cheng
- School of Public Policy and Management, Tsinghua University, Beijing 100084, China
| | - Anli Jiang
- Center for Governance Studies, Beijing Normal University at Zhuhai, Zhuhai 519087, China
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Pacheco J, LaCombe S. The Link between Democratic Institutions and Population Health in the American States. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2022; 47:527-554. [PMID: 35576321 DOI: 10.1215/03616878-9978103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT This project investigates the role of state-level institutions in explaining variation in population health in the American states. Although cross-national research has established the positive effects of democracy on population health, little attention has been given to subnational units. The authors leverage a new data set to understand how political accountability and a system of checks and balances are associated with state population health. METHODS The authors estimate error correction models and two-way fixed effects models to estimate how the strength of state-level democratic institutions is associated with infant mortality rates, life expectancy, and midlife mortality. FINDINGS The authors find institutions that promote political accountability are associated with lower infant mortality across the states, while those that promote checks and balances are associated with longer life expectancy. They also find that policy liberalism is associated with better health outcomes. CONCLUSIONS Subnational institutions play an important role in population health outcomes, and more research is needed to understand the link between democracy and health. The authors are the first to explore the link between democratic institutions and population health within the United States, contributing to both the social science literature on the positive effects of democracy and the epidemiological literature on subnational health outcomes.
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Arifin EN, Hoon CY, Slesman L, Tan A. Self-rated health and perceived environmental quality in Brunei Darussalam: a cross-sectional study. BMJ Open 2022; 12:e060799. [PMID: 35981772 PMCID: PMC9394210 DOI: 10.1136/bmjopen-2022-060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This paper examines the relationship between individuals' perceptions of environmental quality and self-rated health (SRH) after controlling for dimensions of socioeconomic, demographic and healthy lifestyle variables. DESIGN A cross-sectional survey. SETTING The survey was conducted in Belait, an oil-rich and gas-rich district in Brunei Darussalam, from 17 October to 11 November 2019 and focused on the most populated subdistricts (Kuala Belait, Seria and Liang), where 97% of the people reside. PARTICIPANTS A final sample of 1000 respondents aged 18 years and older were randomly selected from the population of the chosen subdistricts, with 95% CI and ±3 margin of error. Due to variable selection, only 673 respondents were available for analysis. OUTCOME MEASURES SRH was dichotomised into 1 for good health and 0 otherwise. Perceptions of environmental quality included perceptions of the natural environment (air quality, marine quality, water supply, noise and olfactory pollution) and the social environment (crime). χ2 and logistic regression models were used to assess the relationship between individuals' perceived environmental quality and SRH. RESULTS Most respondents perceived themselves with good SRH (72%). The adjusted logistic regression shows that perceptions of air quality (OR=2.20, 95% CI 1.15 to 4.22, p=0.018) and marine resources (OR=1.84, 95% CI 1.24 to 2.74, p=0.002) in their surrounding areas were significantly associated with good SRH. However, other environmental variables were insignificantly associated with SRH. Among the control variables, healthy lifestyle and employment had positive associations with good SRH (OR=3.89, 95% CI 1.96 to 7.71, p=0.000, for exercising 3-5 times a week; OR=1.72, 95% CI 1.09 to 2.71, p=0.021, for being employed). In addition, frequent physical exercise compensated for the negative health impact of environmental pollution. CONCLUSIONS This study suggests that environmental quality has an important role in SRH. However, a healthy lifestyle measured with frequency of physical exercise seems to compensate for the adverse environmental effects on SRH.
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Affiliation(s)
- Evi Nurvidya Arifin
- Centre for Advanced Research (CARe), Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Chang-Yau Hoon
- Centre for Advanced Research (CARe), Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Ly Slesman
- Centre for Advanced Research (CARe), Universiti Brunei Darussalam, Gadong, Brunei Darussalam
| | - Abby Tan
- Chancellery, Universiti Brunei Darussalam, Gadong, Brunei Darussalam
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Zajacova A, Siddiqi A. A comparison of health and socioeconomic gradients in health between the United States and Canada. Soc Sci Med 2022; 306:115099. [PMID: 35779499 PMCID: PMC9383268 DOI: 10.1016/j.socscimed.2022.115099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
Data from the early 2000s indicated worse overall health and larger socioeconomic (SES) health inequalities in the U.S. than in Canada. Yet, sociopolitical contexts, health levels, and SES-health inequalities have changed in both countries during the intervening two decades. Drawing on new data, we update the comparison of health levels and SES-health gradients between the two countries. Analyses, focused on self-rated health, are based on two complementary sets of data sources: Resilience and Recovery (RR) data, a harmonized U.S.-Canada survey of social conditions collected in 2020 (N = 3743); and a pair of leading nationally representative health data sources from each country: the National Health Interview Surveys (NHIS, N = 104,027) and the Canadian Community Health Survey (CCHS, N = 97,605), both collected in 2017-2018. Health levels and disparities, net of demographic and socioeconomic covariates, were estimated using modified Poisson models for relative comparisons; descriptives and predicted levels of fair/poor health show the comparisons from absolute perspective. Both data sources show that U.S. adults continue to have significantly worse health than Canadians; the disadvantage may be due to SES differences between the two populations. However, the two data sources yield conflicting findings on SES-health inequalities: the RR data indicate no difference between the two countries in socioeconomic health gradients, while the NHIS/CCHS data show a significantly steeper gradient in the U.S. than in Canada for both education and income. Canadian adults continue to report better health than their U.S. peers, but it is unclear whether health inequalities remain smaller as well. We discuss potential reasons for the conflicting findings and call for a large new cross-national data collection, which will enable scholars and policymakers to better understand health and wellbeing in the U.S. and Canadian contexts.
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Affiliation(s)
- Anna Zajacova
- 5330 Social Science Centre, University of Western Ontario, London, ON, N6A 5C2, Canada.
| | - Arjumand Siddiqi
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
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Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138221. [PMID: 35805878 PMCID: PMC9266778 DOI: 10.3390/ijerph19138221] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/22/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
The aging transformation of digital health services faces issues of how to distinguish influencing factors, redesign services, and effectively promote measures and policies. In this study, in-depth interviews were conducted, and grounded theory applied to open coding, main axis coding, and selective coding to form concepts and categories. Trajectory equifinality modeling clarified the evolution logic of digital transformation. Based on the theory of service ecology, a digital health service aging model was constructed from the “macro–medium–micro” stages and includes governance, service, and technology transformation paths. The macro stage relies on organizational elements to promote the institutionalization of management and guide the transformation of governance for value realization, including the construction of three categories: mechanism, indemnification, and decision-making. The meso stage relies on service elements to promote service design and realize service transformation that is suitable for aging design, including the construction of three categories: organization, resources, and processes. The micro stage relies on technical elements to practice experiencing humanization, including the construction of three categories: target, methods, and evaluation. These results deepen the understanding of the main behaviors and roles of macro-organizational, meso-service, and micro-technical elements in digital transformation practice and have positive significance for health administrative agencies to implement action strategies.
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Hammami N, Erdoğan Y, Elgar FJ. Socioeconomic Position Mediates the Relationship between Family Social Benefits and Adolescent Life Satisfaction in 25 countries. CHILD INDICATORS RESEARCH 2022; 15:1761-1775. [PMID: 35251365 PMCID: PMC8885140 DOI: 10.1007/s12187-022-09929-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
The aims of this study were to assess the mediating role of household socioeconomic position (SEP) in the associations between the country-level factors: family social benefits, and public income support to single parent households (SPH), with the individual-level factor adolescent life satisfaction. Our sample consisted of adolescent (11, 13, and 15 years old) participants in the Health Behaviour in School-aged Children study (2013/2014) across Canada and 24 countries in Europe. We used World Bank data on country wealth from OECD data on social benefits for families and public income support to SPH. Multilevel linear regressions assessed mediated (indirect) associations of these country-level predictors, through SEP, with life satisfaction. Family social benefits ranged between 1.1% and 3.7% of country wealth. The direct association showed that family social benefits were associated with lower adolescent life satisfaction (β = -0.244, 95% Confidence Intervals [C.I.] = -0.306, -0.182, p < 0.0001) among all adolescents and for adolescents in SPH (β = -0.118, 95% C.I. = -0.161, -0.074, p < 0.0001). However, the mediated (indirect) association showed that family social benefits were associated with higher life satisfaction which is partially mediated by SEP (β = 0.087, 95% C.I. = 0.065, 0.109, p < 0.0001) among all adolescents and for adolescents in SPH as well (β = 0.041, 95% C.I. = 0.030, 0.052, p < 0.0001). Country policies may support the wellbeing of adolescents by reducing poverty and improving their socioeconomic position in society.
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Affiliation(s)
- Nour Hammami
- Institute for Health and Social Policy, McGill University, 1130 Pine Avenue West, Montreal, QC H3A1A3 Canada
- Johnson-Shoyama Graduate School of Public Policy, University of Regina, Regina, SK Canada
| | - Yasemin Erdoğan
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
| | - Frank J. Elgar
- Institute for Health and Social Policy, McGill University, 1130 Pine Avenue West, Montreal, QC H3A1A3 Canada
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Gugushvili A, Reeves A. How democracy alters our view of inequality - and what it means for our health. Soc Sci Med 2021; 283:114190. [PMID: 34242889 DOI: 10.1016/j.socscimed.2021.114190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Income inequality is associated with poor health when economic disparities are especially salient. Yet, political institutions may alter this relationship because democracies (as opposed to autocracies) may be more inclined to frame inequalities in negative rather than positive ways. Living in a particular political system potentially alters the messages individuals receive about whether inequality is large or small, good or bad, and this, in turn, might affect whether beliefs about inequality influence health. Further, media coverage of economic inequality may negatively affect health if it contributes toward the general perception that the gap between rich and poor has gone up, even if there has been no change in income differentials. METHODS In this study, we explore the relationship between democracy, perceptions of inequality, and self-rated health across 28 post-communist countries using survey and macro-level data, multilevel regression models, and inverse probability weighting to estimate the average treatment effect on the treated. RESULTS We find that self-rated health is higher in more democratic countries and lower among people who believe that inequality has risen in the last few years. Moreover, we observe that people in democracies are more likely to learn about rising inequality through watching television and that when they do it has a more harmful effect on their health than when people in autocracies learn about rising inequality through the same channel, suggesting that in countries where there is less trust in the television media learning about rising inequality is not as harmful for health. CONCLUSIONS Our results indicate that while democracies are generally good for well-being, they may not be unambiguously positive for health. This does not mean, of course, that inequality is good for health nor that, on average, autocracies have better health than democracies; but rather that being more aware of inequality can negatively affect self-rated health.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo, Postboks 1096 Blindern, 0317, Oslo, Norway.
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom.
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Ramos AP, Flores MJ, Ross ML. Where has democracy helped the poor? Democratic transitions and early-life mortality at the country level. Soc Sci Med 2020; 265:113442. [DOI: 10.1016/j.socscimed.2020.113442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/08/2020] [Accepted: 10/10/2020] [Indexed: 11/28/2022]
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Acharya A, Gerring J, Reeves A. Is health politically irrelevant? Experimental evidence during a global pandemic. BMJ Glob Health 2020; 5:e004222. [PMID: 33097548 PMCID: PMC7590354 DOI: 10.1136/bmjgh-2020-004222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To investigate how health issues affect voting behaviour by considering the COVID-19 pandemic, which offers a unique opportunity to examine this interplay. DESIGN We employ a survey experiment in which treatment groups are exposed to key facts about the pandemic, followed by questions intended to elicit attitudes toward the incumbent party and government responsibility for the pandemic. SETTING The survey was conducted amid the lockdown period of 15-26 April 2020 in three large democratic countries with the common governing language of English: India, the United Kingdom and the United States. Due to limitations on travel and recruitment, subjects were recruited through the M-Turk internet platform and the survey was administered entirely online. Respondents numbered 3648. RESULTS Our expectation was that respondents in the treatment groups would favour, or disfavour, the incumbent and assign blame to government for the pandemic compared with the control group. We observe no such results. Several reasons may be adduced for this null finding. One reason could be that public health is not viewed as a political issue. However, people do think health is an important policy area (>85% agree) and that government has some responsibility for health (>90% agree). Another reason could be that people view public health policies through partisan lenses, which means that health is largely endogenous, and yet we find little evidence of polarisation in our data. Alternatively, it could be that the global nature of the pandemic inoculated politicians from blame and yet a majority of people do think the government is to blame for the spread of the pandemic (~50% agree). CONCLUSIONS While we cannot precisely determine the mechanisms at work, the null findings contained in this study suggest that politicians are unlikely to be punished or rewarded for their failures or successes in managing COVID-19 in the next election. TRIAL REGISTRATION Initial research hypotheses centred on expected variation between two treatments, as set forth in a detailed pre-analysis plan, registered at E-Gap: http://egap.org/registration/6645. Finding no difference between the treatments, we decided to focus this paper on the treatment/control comparison. Importantly, results that follow the pre-analysis plan strictly are entirely consistent with results presented here: null findings obtained throughout.
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Affiliation(s)
| | | | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, Oxford, Oxfordshire, UK
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Kim HHS, Jung JH. Ageism, Religiosity, and Wellbeing Among Older Adults: Evidence From the European Social Survey (ESS4). Res Aging 2020; 43:214-226. [PMID: 32873186 DOI: 10.1177/0164027520953632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research shows that ageism (systemic discrimination against people because of their age) significantly undermines physical and psychological wellbeing, particularly among older adults. Our aim is to contribute to the literature by investigating whether this negative association varies across national religious context. We estimate multilevel models by drawing on a subset of data (ages 55 and above) from the fourth round of the European Social Survey (2008/2009). We find that ageism is negatively related to measures of wellbeing (happiness, life satisfaction, self-rated health). More importantly, the relationship is less pronounced in countries with higher levels of religiosity. These findings suggest that the country's religious environment serves as a buffer against deleterious health consequences of ageism for the older population. Our study thus provides additional evidence on ageism as a critical risk factor and sheds novel light on the moderating role of country-level religiosity as a protective factor.
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Affiliation(s)
- Harris Hyun-Soo Kim
- Department of Sociology, 26717Ewha Womans University, Seoul, Republic of Korea
| | - Jong Hyun Jung
- 54761School of Social Sciences, Nanyang Technological University, Singapore
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Tsai FJ, Turbat B. Is countries' transparency associated with gaps between countries' self and external evaluations for IHR core capacity? Global Health 2020; 16:10. [PMID: 31959196 PMCID: PMC6972006 DOI: 10.1186/s12992-020-0541-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 01/08/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND This study aims to evaluate the gap between countries' self-evaluation and external evaluation regarding core capacity of infectious disease control required by International Health Regulations and the influence factors of the gap. METHODS We collected countries' self-evaluated scores (International Health Regulations Monitoring tool, IHRMT) of 2016 and 2017, and external evaluation scores (Joint External Evaluation, JEE) from WHO website on 4rd and 27rd November, 2018. There were 127 and 163 countries with IHRMT scores in 2016 and in 2017, and 74 countries with JEE scores included in the analysis. The gap between countries' self-evaluation and external evaluation was represented by the difference between condensed IHR scores and JEE. Civil liberties (CL) scores were collected as indicators of the transparency of each country. The Human Development Index (HDI) and data indicating the density of physicians and nurses (HWD) were collected to reflect countries' development and health workforce statuses. Then, chi-square test and logistic regression were performed to determine the correlation between the gap of IHRMT and JEE, and civil liberties, human development, and health workforce status. RESULTS Countries' self-evaluation scores significantly decreased from 2016 to 2017. Countries' external evaluation scores are consistently 1 to 1.5 lower than self-evaluation scores. There were significantly more countries with high HDI status, high CL status and high HWD status in groups with bigger gap between IHRMT and JEE. And countries with higher HDI status presented a higher risk of having bigger gap between countries' self and external scores (OR = 3.181). CONCLUSION Our study result indicated that countries' transparency represented by CL status do play a role in the gap between IHR and JEE scores. But HDI status is the key factor which significantly associated with the gap. The main reason for the gap in the current world is the different interpretation of evaluation of high HDI countries, though low CL countries tended to over-scored their capacity.
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Affiliation(s)
- Feng-Jen Tsai
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 110 Taiwan
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Battsetseg Turbat
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 110 Taiwan
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Food democracy, health disparities and the New York City trans fat policy. Public Health Nutr 2019; 23:738-746. [PMID: 31839022 DOI: 10.1017/s1368980019003306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate food democracy and health disparities in the New York City (NYC) trans fat policy process. DESIGN Texts from semi-structured interviews, public testimony and comments on the policy were analysed using categorization and thematic coding. A priori content analysis for themes of food democracy was followed by open, axial and selective coding for sub-themes on health disparities. Data and method triangulation and respondent validation were used to establish data dependability, trustworthiness and representativeness. SETTING NYC. PARTICIPANTS Interviews from a purposive, snowballed sample of thirty-three participants included restaurateurs, scientists, health and consumer advocates, consumers and policy makers. Additionally, 261 pages of transcript from public testimony of fifty-three participants and a purposive sample of public comments on the policy from a pool of 2157 were analysed. RESULTS Principles of food democracy involving inclusive citizenship, access to information, collaborative participation and focus on collective good were well represented in the data. Additionally, sub-themes linked to health disparities included: government responsibility for fairer access to healthier foods; recognition that people made choices based on circumstances; concern for vulnerable groups; and outrage with a food industry viewed as unconcerned for public health. CONCLUSIONS Principles of food democracy present in the successful process of adoption of the 2006 NYC trans fat policy addressed nutrition-related health. Food democracy is a contemporary food system and policy approach with potential for public health benefits in reducing nutrition-related health disparities.
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Akgungor S, Alaei K, Chao WF, Harrington A, Alaei A. Correlation between human rights promotion and health protection: a cross country analysis. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2019. [DOI: 10.1108/ijhrh-07-2018-0050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the correlation among health outcomes, and civil and political rights (CPR) and also economic, social and cultural rights.
Design/methodology/approach
The study uses cross-sectional data from 161 countries. The authors use health outcomes and human rights variables in the model. In order to combine dimensions of human rights, this paper uses factor analysis and obtains proxy variables that measure economic, social and cultural rights and CPR. The two proxy variables are used as independent variables to explain variations in health in a regression model. The paper then classifies countries by cluster analysis and explores the patterns of different components of human rights and health outcomes across country clusters.
Findings
The regression model demonstrates that the economic, social and cultural rights variables explain variations in all health outcomes. The relationship between CPR and health is weaker than that of the economic, social and cultural rights. Cluster analysis further reveals that despite the country’s commitment to CPR, those that highly respect economic, social and cultural rights lead to superior health outcomes. The more respect a country has for economic, social and cultural rights, the better the health outcomes for the citizens of that country.
Practical implications
National policies should consider equal emphasis on all dimensions of human rights for further improvements in health.
Originality/value
The sole promotion of CPR such as democracy and empowerment, absence of adequate support of economic, social and cultural rights such as rights to housing, education, food and work can only contribute partially to health.
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McCartney G, Hearty W, Arnot J, Popham F, Cumbers A, McMaster R. Impact of Political Economy on Population Health: A Systematic Review of Reviews. Am J Public Health 2019; 109:e1-e12. [PMID: 31067117 PMCID: PMC6507992 DOI: 10.2105/ajph.2019.305001] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 01/08/2023]
Abstract
Background. Although there is a large literature examining the relationship between a wide range of political economy exposures and health outcomes, the extent to which the different aspects of political economy influence health, and through which mechanisms and in what contexts, is only partially understood. The areas in which there are few high-quality studies are also unclear. Objectives. To systematically review the literature describing the impact of political economy on population health. Search Methods. We undertook a systematic review of reviews, searching MEDLINE, Embase, International Bibliography of the Social Sciences, ProQuest Public Health, Sociological Abstracts, Applied Social Sciences Index and Abstracts, EconLit, SocINDEX, Web of Science, and the gray literature via Google Scholar. Selection Criteria. We included studies that were a review of the literature. Relevant exposures were differences or changes in policy, law, or rules; economic conditions; institutions or social structures; or politics, power, or conflict. Relevant outcomes were any overall measure of population health such as self-assessed health, mortality, life expectancy, survival, morbidity, well-being, illness, ill health, and life span. Two authors independently reviewed all citations for relevance. Data Collection and Analysis. We undertook critical appraisal of all included reviews by using modified Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria and then synthesized narratively giving greater weight to the higher-quality reviews. Main Results. From 4912 citations, we included 58 reviews. Both the quality of the reviews and the underlying studies within the reviews were variable. Social democratic welfare states, higher public spending, fair trade policies, extensions to compulsory education provision, microfinance initiatives in low-income countries, health and safety policy, improved access to health care, and high-quality affordable housing have positive impacts on population health. Neoliberal restructuring seems to be associated with increased health inequalities and higher income inequality with lower self-rated health and higher mortality. Authors' Conclusions. Politics, economics, and public policy are important determinants of population health. Countries with social democratic regimes, higher public spending, and lower income inequalities have populations with better health. There are substantial gaps in the synthesized evidence on the relationship between political economy and health, and there is a need for higher-quality reviews and empirical studies in this area. However, there is sufficient evidence in this review, if applied through policy and practice, to have marked beneficial health impacts. Public Health Implications. Policymakers should be aware that social democratic welfare state types, countries that spend more on public services, and countries with lower income inequalities have better self-rated health and lower mortality. Research funders and researchers should be aware that there remain substantial gaps in the available evidence base. One such area concerns the interrelationship between governance, polities, power, macroeconomic policy, public policy, and population health, including how these aspects of political economy generate social class processes and forms of discrimination that have a differential impact across social groups. This includes the influence of patterns of ownership (of land and capital) and tax policies. For some areas, there are many lower-quality reviews, which leave uncertainties in the relationship between political economy and population health, and a high-quality review is needed. There are also areas in which the available reviews have identified primary research gaps such as the impact of changes to housing policy, availability, and tenure.
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Affiliation(s)
- Gerry McCartney
- Gerry McCartney, Wendy Hearty, and Julie Arnot are with Public Health Science, NHS Health Scotland, Glasgow, Scotland. Frank Popham is with Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow. Gerry McCartney, Andrew Cumbers, and Robert McMaster are with Adam Smith Business School, University of Glasgow
| | - Wendy Hearty
- Gerry McCartney, Wendy Hearty, and Julie Arnot are with Public Health Science, NHS Health Scotland, Glasgow, Scotland. Frank Popham is with Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow. Gerry McCartney, Andrew Cumbers, and Robert McMaster are with Adam Smith Business School, University of Glasgow
| | - Julie Arnot
- Gerry McCartney, Wendy Hearty, and Julie Arnot are with Public Health Science, NHS Health Scotland, Glasgow, Scotland. Frank Popham is with Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow. Gerry McCartney, Andrew Cumbers, and Robert McMaster are with Adam Smith Business School, University of Glasgow
| | - Frank Popham
- Gerry McCartney, Wendy Hearty, and Julie Arnot are with Public Health Science, NHS Health Scotland, Glasgow, Scotland. Frank Popham is with Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow. Gerry McCartney, Andrew Cumbers, and Robert McMaster are with Adam Smith Business School, University of Glasgow
| | - Andrew Cumbers
- Gerry McCartney, Wendy Hearty, and Julie Arnot are with Public Health Science, NHS Health Scotland, Glasgow, Scotland. Frank Popham is with Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow. Gerry McCartney, Andrew Cumbers, and Robert McMaster are with Adam Smith Business School, University of Glasgow
| | - Robert McMaster
- Gerry McCartney, Wendy Hearty, and Julie Arnot are with Public Health Science, NHS Health Scotland, Glasgow, Scotland. Frank Popham is with Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow. Gerry McCartney, Andrew Cumbers, and Robert McMaster are with Adam Smith Business School, University of Glasgow
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Ruiz-Cantero MT, Guijarro-Garvi M, Bean DR, Martínez-Riera JR, Fernández-Sáez J. Governance commitment to reduce maternal mortality. A political determinant beyond the wealth of the countries. Health Place 2019; 57:313-320. [PMID: 31146194 PMCID: PMC6873917 DOI: 10.1016/j.healthplace.2019.05.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 03/16/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022]
Abstract
Some countries reached, in 2015, the Millennium Development Goal of reducing maternal mortality to 96 or less maternal deaths per 100,000 live births. Others, however, did not. This paper analyses the strength of the association between maternal mortality and each of the six components of Governance-a political determinant scarcely explored in the literature-in 174 countries. It was found that the greater the governance, the lower maternal mortality, independently of a country's wealth. We used all six indicators of the World Bank's Worldwide Governance Indicators Project in 2015: government effectiveness, regulatory quality, rule of law, control of corruption, voice and accountability, and political stability and absence of violence. Findings were encouraging as maternal mortality in low-income countries with higher government effectiveness and regulatory quality was similar to that of medium-income countries with lower government effectiveness and regulatory quality. To achieve the post-2015 sustainable development goal on preventable maternal mortality-which persists despite economic development-all governance dimensions are essential and represent interdependent cornerstones.
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Affiliation(s)
| | - Marta Guijarro-Garvi
- Public Health Research Group, University of Alicante, Spain; Department of Economics, University of Cantabria, Spain.
| | - Donna Rose Bean
- School of Nursing & Health Studies, University of Miami, USA.
| | | | - José Fernández-Sáez
- Public Health Research Group, University of Alicante, Spain; Unitat de Suport a la Recerca Terres de l'Ebre, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i, Gurina (IDIAPJGol), Spain.
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Madeiras JG, Silva ES, Yamaguchi MU, Bertolini SMMG, Costa CKF, Christofel HK, Bernuci MP, Massuda EM. Socioeconomic and demographic determinants in the provision of assistance to elderly people with a fractured femur. CIENCIA & SAUDE COLETIVA 2019; 24:97-104. [PMID: 30698244 DOI: 10.1590/1413-81232018241.03862017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 03/29/2017] [Indexed: 12/21/2022] Open
Abstract
Femur fracture affects the elderly with high morbidity and mortality. The purpose of the present study was to analyze the profile of the assistance given to the elderly who have femoral fractures, relating to their socioeconomic and demographic conditions, in the state of Paraná between the years 2008 to 2013. These relationships were obtained through factor analysis and the development and analysis of the following rates: PAE - the potential of primary health care to the elderly, whose variable was represented by the contribution of the elderly to the municipal GDP, PAP - the potential of the primary health care to the population, represented by GDP per capita and TE - treatment efficiency represented by the annual rate of fractures and annual rate of death per residence. The municipalities were classified according to the rate variation range. In relation to PAE, 10 municipalities were classified with low potential of care for the elderly, 357 with moderate potential and 32 had low potential. In relation to PAE, 12 municipalities were classified with low potential of primary care for the elderly, 303 with moderate potential and 84 had low potential. In relation to TE, 109 municipalities showed high treatment efficiency, 110 with moderate efficiency and 180 had low efficiency. Our conclusion was that the performance of the economy exerts significant influence on femoral fracture morbidity in the elderly.
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Affiliation(s)
- Joselene Gomes Madeiras
- Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1936, Zona 08. 87050-390 Maringá PR Brasil.
| | - Eraldo Shunk Silva
- Programa de Pós-Gradução em Bioestatística, Universidade Estadual de Maringá. Maringá PR Brasil
| | - Mirian Ueda Yamaguchi
- Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1936, Zona 08. 87050-390 Maringá PR Brasil.
| | | | | | | | - Marcelo Picinin Bernuci
- Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1936, Zona 08. 87050-390 Maringá PR Brasil.
| | - Ely Mitie Massuda
- Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1936, Zona 08. 87050-390 Maringá PR Brasil.
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Does Migrant Status and Household Registration Matter? Examining the Effects of City Size on Self-Rated Health. SUSTAINABILITY 2018. [DOI: 10.3390/su10072204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The social network of international health aid. Soc Sci Med 2018; 206:67-74. [DOI: 10.1016/j.socscimed.2018.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 02/22/2018] [Accepted: 04/04/2018] [Indexed: 11/23/2022]
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Politics and population health: Testing the impact of electoral democracy. Health Place 2016; 40:66-75. [DOI: 10.1016/j.healthplace.2016.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 03/26/2016] [Accepted: 04/22/2016] [Indexed: 11/19/2022]
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