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Sabo A, Kuan G, Sarimah A, Kuay HS, Kueh YC. Psychometric properties of the newly developed self-report environmental determinants of health questionnaire (EDH-Q): development and validation. BMC Psychol 2024; 12:438. [PMID: 39138511 PMCID: PMC11320778 DOI: 10.1186/s40359-024-01782-x] [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: 01/20/2024] [Accepted: 05/10/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The environmental determinants of health (EDH) have a significant impact on people's physical, mental, and social wellbeing. Everyone needs access to environmental resources of all types, including food, materials, and energy, to survive. Currently, no valid and reliable instrument exists for evaluating individuals' perceived levels of EDH. Hence, the purpose of this study was to develop and validate the environmental determinants of health questionnaire (EDH-Q) among undergraduate students in Nigeria. METHOD We conducted a cross-sectional survey among undergraduate students in Nigeria to assess the psychometric properties of the newly developed Environmental Determinants of Health Questionnaire (EDH-Q). Respondents were selected using a convenience sampling approach to evaluate their perceptions of environmental determinants of health. The Content Validity Index (CVI) and Face Validity Index (FVI) were calculated to ascertain the scale's content validity and response process validity, respectively. Additionally, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), composite reliability (CR), average variance extracted (AVE), Cronbach's alpha, and intraclass correlation coefficient (ICC) were computed to assess the scale's construct validity. RESULTS The study involved 300 respondents in the EFA (males 55.7%, females 44.3%) and 430 respondents in the CFA (males 54.0%, females 46.0%). In the EFA, two constructs were identified (the natural environment and the built environment). The EFA model was able to explain 63.57% of the total cumulative variance, and the factor correlation was 0.671. The whole scale Cronbach's alpha value was 0.947, while the two constructs' Cronbach's alpha values were 0.918 (natural environment) and 0.935 (built environment). In the CFA, six pairs of error covariances were included between items within the same construct to improve the fit indices of the initial proposed measurement model. The final re-specified measurement model showed that the EDH-Q, which has two constructs and 18 items, has adequate construct validity (CFI = 0.948, TLI = 0.938, SRMR = 0.046, RMSEA = 0.052, and RMSEA p-value = 0.344). The CRs were 0.845 (natural environment) and 0.854 (built environment). The ICCs were 0.976 (natural environment) and 0.970 (built environment). CONCLUSION The results show that the newly created EDH-Q has sufficient construct validity and may be utilized to assess participants' perceptions of their level of EDH. Researchers should examine this instrument in populations with different age ranges and other demographic characteristics, as the present study only applied it to undergraduate students who may share similar characteristics.
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Affiliation(s)
- Abdulwali Sabo
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Public and Environmental Health, Faculty of Basic Medical Sciences, Federal University Dutse, Dutse, Jigawa State, Nigeria
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Abdullah Sarimah
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hue San Kuay
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
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Brook A, Rendall G, Hearty W, Meier P, Thomson H, Macnamara A, Westborne R, Campbell M, McCartney G. What is the relationship between changes in the size of economies and mortality derived population health measures in high income countries: A causal systematic review. Soc Sci Med 2024; 357:117190. [PMID: 39178721 DOI: 10.1016/j.socscimed.2024.117190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/31/2024] [Accepted: 08/04/2024] [Indexed: 08/26/2024]
Abstract
CONTEXT The economy has been long recognised as an important determinant of population health and a healthy population is considered important for economic prosperity. AIM To systematically review the evidence for a causal bidirectional relationship between aggregate economic activity (AEA) at national level for High Income Countries, and 1) population health (using mortality and life expectancy rates as indicators) and 2) inequalities in population health. METHODS We undertook a systematic review of quantitative studies considering the relationship between AEA (GDP, GNI, GNP or recession) and population health (mortality or life expectancy) and inequalities for High Income Countries. We searched eight databases and grey literature. Study quality was assessed using an adapted version of the Effective Public Health Practice Project's Quality Assessment tool. We used Gordis' adaptation of the Bradford-Hill framework to assess causality. The studies were synthesised using Cochrane recommended alternative methods to meta-analysis and reported following the Synthesis without Meta-analysis (SWiM) guidelines. We assessed the certainty of the evidence base in line with GRADE principles. FINDINGS Of 21,099 records screened, 51 articles were included in our analysis. There was no evidence for a consistent causal relationship (either beneficial or harmful) of changes in AEA leading to changes in population health (as indicated by mortality or life expectancy). There was evidence suggesting that better population health is causally related to greater AEA, but with low certainty. There was insufficient evidence to consider the causal impact of AEA on health inequalities or vice versa. CONCLUSIONS Changes in AEA in High Income Countries did not have a consistently beneficial or harmful causal relationship with health, suggesting that impacts observed may be contextually contingent. We tentatively suggest that improving population health might be important for economic prosperity. Whether or not AEA and health inequalities are causally linked is yet to be established.
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Affiliation(s)
- Anna Brook
- Sheffield Centre for Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Georgia Rendall
- Public Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Wendy Hearty
- Public Health Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, Scotland, UK.
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, Scotland, UK.
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, Scotland, UK.
| | - Alexandra Macnamara
- Leeds University Teaching Hospitals NHS Trust, St. James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK.
| | - Rachel Westborne
- Sheffield Centre for Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, Scotland, UK.
| | - Gerry McCartney
- School of Social and Political Sciences, University of Glasgow, 40 Bute Gardens, Glasgow, G12 8RT, Scotland, UK.
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Burgaz C, Van-Dam I, Garton K, Swinburn BA, Sacks G, Asiki G, Claro R, Diouf A, Bartoletto Martins AP, Vandevijvere S. Which government policies to create sustainable food systems have the potential to simultaneously address undernutrition, obesity and environmental sustainability? Global Health 2024; 20:56. [PMID: 39068420 PMCID: PMC11282665 DOI: 10.1186/s12992-024-01060-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION A transformation of food systems is urgently needed, given their contribution to three ongoing and interlinked global health pandemics: (1) undernutrition and food insecurity, (2) obesity and non-communicable diseases (NCDs), and (3) climate change and biodiversity loss. As policymakers make decisions that shape food systems, this study aimed to identify and prioritise policies with double- or triple-duty potential to achieve healthier and more environmentally sustainable food systems. METHODS This study undertook a 4-step methodological approach, including (i) a compilation of international policy recommendations, (ii) an online survey, (iii) four regional workshops with international experts and (iv) a ranking for prioritisation. Policies were identified and prioritised based on their double- or triple-duty potential, synergies and trade-offs. Using participatory and transdisciplinary approaches, policies were identified to have double- or triple-duty potential if they were deemed effective in tackling two or three of the primary outcomes of interest: (1) undernutrition, (2) obesity/NCDs and (3) environmental degradation. RESULTS The desk review identified 291 recommendations for governments, which were merged and classified into 46 initially proposed policies. Based on the results from the online survey, 61% of those policies were perceived to have double- or triple-duty potential. During the workshops, 4 potential synergies and 31 trade-offs of these policies were identified. The final list of 44 proposed policies for healthier and more environmentally sustainable food systems created was divided into two main policy domains: 'food supply chains' and 'food environments'. The outcome with the most trade-offs identified was 'undernutrition', followed by 'environmental sustainability', and 'obesity/NCDs'. Of the top five expert-ranked food supply chain policies, two were perceived to have triple-duty potential: (a) incentives for crop diversification; (b) support for start-ups, and small- and medium-sized enterprises. For food environments, three of the top five ranked policies had perceived triple-duty potential: (a) affordability of healthier and more sustainable diets; (b) subsidies for healthier and more sustainable foods; (c) restrictions on children's exposure to marketing through all media. CONCLUSION This study identified and prioritised a comprehensive list of double- and triple-duty government policies for creating healthier and more environmentally sustainable food systems. As some proposed policies may have trade-offs across outcomes, they should be carefully contextualised, designed, implemented and monitored.
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Affiliation(s)
- Celia Burgaz
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
- Department of Geosciences, Environment and Society, Free University of Brussels (ULB), Brussels, Belgium.
| | - Iris Van-Dam
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Kelly Garton
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Deakin University, Melbourne, Australia
| | - Gershim Asiki
- Chronic Diseases Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Rafael Claro
- Nutrition Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition Alimentation Humaine, Université Cheikh Anta Diop, Dakar, Senegal
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LaFave LA, Clemmons N, Kotelchuck M, Morales Cozier N, Geltman A, Browne DR, Kenyon K. Activating Life Course Theory through a Whole System Prevention Framework to Address the Wicked Problem of Maternal and Infant Morbidity and Mortality. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:349-364. [PMID: 37271730 PMCID: PMC11143759 DOI: 10.1177/2752535x231170737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Racial/ethnic disparities in maternal and infant morbidity and mortality (MIM&M) is a wicked problem that is reinforced and perpetuated by our system[s] of care. Life Course Theory (LCT) helps to explain drivers of health disparities, but its application is challenged. An upstream approach that promotes systemic change requires the implementation of an expanded prevention framework that includes primordial and quaternary prevention. RESEARCH DESIGN We developed an innovative expanded Whole System Prevention Framework (WSPF) that incorporates LCT, prevention (including primordial and quaternary prevention) and systems thinking. STUDY SAMPLE We implemented this new conceptual Framework with two Healthy Start community partnerships through training, service mapping, and strategic planning to address upstream drivers of MIM&M. DATA COLLECTION AND ANALYSIS Service mapping revealed few Healthy Start upstream activities/services with the predominance being delivered downstream at the program (microsystem) level. RESULTS Service mapping provided a snapshot of the current service distribution of services across the systems. The preponderance were primary, secondary and tertiary prevention activities (75.5% and 65.6%) delivered at the program level (58.2% and 68%), revealing opportunities for upstream strategies to promote equity. The implementation process provided a new way to frame strategic planning and develop upstream strategies to promote health equity and reduce MIM&M. CONCLUSION The Whole System Prevention Framework and its implementation methodology could be applied to address other wicked problems.
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Affiliation(s)
- Lea Ayers LaFave
- JSI Research and Training Institute, Inc. (JSI), Boston, MA, USA
| | - Naomi Clemmons
- JSI Research and Training Institute, Inc. (JSI), Boston, MA, USA
| | | | | | - Ana Geltman
- JSI Research and Training Institute, Inc. (JSI), Boston, MA, USA
| | - Dianne R. Browne
- Southern New Jersey Perinatal Cooperative (SNJPC), Pennsauken, NJ, USA
| | - Katie Kenyon
- The Foundation for Delaware County (TFDC), Eddystone, PA, USA
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Fox NJ. Capitalism and the 'commercial determinants of health': A more-than-human micropolitics. Soc Sci Med 2024; 350:116925. [PMID: 38718438 DOI: 10.1016/j.socscimed.2024.116925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/26/2023] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
This paper argues that studies of the 'commercial determinants of health' (CDoH) need to acknowledge fully the part the capitalist mode of commodity production and exchange plays in producing negative health outcomes. This proposition is supported by recourse to a recent development in political economy that has established a more-than-human, relational and monist (or 'flat') ontology of capitalism, in place of the more conventional neo-Marxist perspective. This ontology reveals a dynamic to capitalism that operates beyond human intentionality, driven by the supply of, and demand for the capacities of commodities. This dynamic determines the production and consumption of all commodities, some among which (such as tobacco, alcohol and processed foods) contribute to ill-health. A case study of food consumption reveals how these supply and demand affects drive 'unhealthy' food choices by consumers. Ways to undermine this more-than-human dynamic are offered as an innovative approach to addressing the effects of commerce and capitalism upon health.
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Affiliation(s)
- Nick J Fox
- Department of Behavioural and Social Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
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Macintyre AK, Shipton D, Sarica S, Scobie G, Craig N, McCartney G. Assessing the effects of population-level political, economic and social exposures, interventions and policies on inclusive economy outcomes for health equity in high-income countries: a systematic review of reviews. Syst Rev 2024; 13:58. [PMID: 38331910 PMCID: PMC10851517 DOI: 10.1186/s13643-023-02429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND A fairer economy is increasingly recognised as crucial for tackling widening social, economic and health inequalities within society. However, which actions have been evaluated for their impact on inclusive economy outcomes is yet unknown. OBJECTIVE Identify the effects of political, economic and social exposures, interventions and policies on inclusive economy (IE) outcomes in high-income countries, by systematically reviewing the review-level evidence. METHODS We conducted a review of reviews; searching databases (May 2020) EconLit, Web of Science, Sociological Abstracts, ASSIA, International Bibliography of the Social Sciences, Public Health Database, Embase and MEDLINE; and registries PROSPERO, Campbell Collaboration and EPPI Centre (February 2021) and grey literature (August/September 2020). We aimed to identify reviews which examined social, political and/or economic exposures, interventions and policies in relation to two IE outcome domains: (i) equitable distribution of the benefits of the economy and (ii) equitable access to the resources needed to participate in the economy. Reviews had to include primary studies which compared IE outcomes within or between groups. Quality was assessed using a modified version of AMSTAR-2 and data synthesised informed by SWiM principles. RESULTS We identified 19 reviews for inclusion, most of which were low quality, as was the underlying primary evidence. Most reviews (n = 14) had outcomes relating to the benefits of the economy (rather than access to resources) and examined a limited set of interventions, primarily active labour market programmes and social security. There was limited high-quality review evidence to draw upon to identify effects on IE outcomes. Most reviews focused on disadvantaged groups and did not consider equity impacts. CONCLUSIONS Review-level evidence is sparse and focuses on 'corrective' approaches. Future reviews should examine a diverse set of 'upstream' actions intended to be inclusive 'by design' and consider a wider range of outcomes, with particular attention to socioeconomic inequalities.
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Affiliation(s)
- Anna K Macintyre
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK.
| | - Deborah Shipton
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Shifa Sarica
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Graeme Scobie
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Neil Craig
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Gerry McCartney
- School of Social & Political Sciences, University of Glasgow, Glasgow, UK
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Mudd AL, Bal M, Verra SE, Poelman MP, de Wit J, Kamphuis CBM. The current state of complex systems research on socioeconomic inequalities in health and health behavior-a systematic scoping review. Int J Behav Nutr Phys Act 2024; 21:13. [PMID: 38317165 PMCID: PMC10845451 DOI: 10.1186/s12966-024-01562-1] [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: 09/13/2023] [Accepted: 01/14/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Interest in applying a complex systems approach to understanding socioeconomic inequalities in health is growing, but an overview of existing research on this topic is lacking. In this systematic scoping review, we summarize the current state of the literature, identify shared drivers of multiple health and health behavior outcomes, and highlight areas ripe for future research. METHODS SCOPUS, Web of Science, and PubMed databases were searched in April 2023 for peer-reviewed, English-language studies in high-income OECD countries containing a conceptual systems model or simulation model of socioeconomic inequalities in health or health behavior in the adult general population. Two independent reviewers screened abstracts and full texts. Data on study aim, type of model, all model elements, and all relationships were extracted. Model elements were categorized based on the Commission on Social Determinants of Health framework, and relationships between grouped elements were visualized in a summary conceptual systems map. RESULTS A total of 42 publications were included; 18 only contained a simulation model, 20 only contained a conceptual model, and 4 contained both types of models. General health outcomes (e.g., health status, well-being) were modeled more often than specific outcomes like obesity. Dietary behavior and physical activity were by far the most commonly modeled health behaviors. Intermediary determinants of health (e.g., material circumstances, social cohesion) were included in nearly all models, whereas structural determinants (e.g., policies, societal values) were included in about a third of models. Using the summary conceptual systems map, we identified 15 shared drivers of socioeconomic inequalities in multiple health and health behavior outcomes. CONCLUSIONS The interconnectedness of socioeconomic position, multiple health and health behavior outcomes, and determinants of socioeconomic inequalities in health is clear from this review. Factors central to the complex system as it is currently understood in the literature (e.g., financial strain) may be both efficient and effective policy levers, and factors less well represented in the literature (e.g., sleep, structural determinants) may warrant more research. Our systematic, comprehensive synthesis of the literature may serve as a basis for, among other things, a complex systems framework for socioeconomic inequalities in health.
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Affiliation(s)
- Andrea L Mudd
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.
| | - Michèlle Bal
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Sanne E Verra
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - John de Wit
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
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Fan Q, Hussaini SMQ, Barrow LCJ, Feliciano JL, Pollack CE, Yabroff KR, Nogueira L. Association of area-level mortgage denial and guideline-concordant non-small-cell lung cancer care and outcomes in the United States. Cancer Med 2024; 13:e6921. [PMID: 38205942 PMCID: PMC10911071 DOI: 10.1002/cam4.6921] [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: 06/01/2023] [Revised: 12/08/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Racial and socioeconomic disparities in receipt of care for non-small-cell lung cancer (NSCLC) are well described. However, no previous studies have evaluated the association between mortgage denial rates and receipt of timely and guideline-concordant care for NSCLC and patient outcomes. METHODS We identified individuals ≥18 years diagnosed with NSCLC between 2014 and 2019 from the National Cancer Database. Using the Home Mortgage Disclosure Act database, we calculated the proportion of denied home loans to total loans at the zip-code level and categorized them into quintiles. Our outcomes included receipt of guideline-concordant care based on clinical and pathologic stage at diagnosis and the National Comprehensive Cancer Network guidelines, time from surgery to chemotherapy initiation, and overall survival. RESULTS Of the 629,288 individuals diagnosed with NSCLC (median age 69; IQR 61-76 years, 49.1% female), 47.8% did not receive guideline-concordant care. Residing in areas with higher mortgage denial rates and lower income was associated with worse guideline-concordant care overall (aRR = 1.28; 95% CI = 1.25-1.32) and for each cancer treatment modality, worse receipt of timely chemotherapy (aHR = 1.14; 95% CI = 1.11-1.17) and worse overall survival (aHR = 1.21; 95% CI = 1.19-1.22), compared with residing in areas with the lowest mortgage denial rate and highest income. CONCLUSIONS Area-level mortgage denial rate was associated with worse receipt of timely and guideline-concordant NSCLC care and survival. This highlights the critical need to understand and address systemic practices, such as mortgage denial, that limit access to resources and are associated with worse access to quality cancer care and outcomes.
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Affiliation(s)
- Qinjin Fan
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - S M Qasim Hussaini
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Lauren C J Barrow
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Josephine L Feliciano
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Craig E Pollack
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - K Robin Yabroff
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Leticia Nogueira
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Naik Y, Baker P, Ismail SA, Tillmann T, Bash K, Quantz D, Hillier-Brown F, Jayatunga W, Kelly G, Black M, Gopfert A, Roderick P, Barr B, Bambra C. Correction: Going upstream - an umbrella review of the macroeconomic determinants of health and health inequalities. BMC Public Health 2024; 24:38. [PMID: 38167016 PMCID: PMC10762923 DOI: 10.1186/s12889-023-17273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Affiliation(s)
- Yannish Naik
- Leeds Teaching Hospitals NHS Trust, Beckett St, Leeds, LS9 7TF, UK.
- Department of Public Health and Policy, University of Liverpool, 3Rd Floor, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - Peter Baker
- Global Health and Development Group, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Sharif A Ismail
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
- Department of Primary Care and Public Health, Imperial College London, Reynolds Building, St Dunstans Road, London, W6 8RP, UK
| | - Taavi Tillmann
- Institute for Global Health, Centre for Global Non-Communicable Diseases, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Kristin Bash
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Darryl Quantz
- NW School of Public Health, Health Education England North West, First Floor Regatta Place, Brunswick Business Park, Summers Road, Liverpool, L34BL, UK
| | - Frances Hillier-Brown
- Department of Sport and Exercise Sciences, Durham University, 42 Old Elvet, Durham, DH1 3HN, UK
| | - Wikum Jayatunga
- Institute of Health Informatics, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Gill Kelly
- Leeds Teaching Hospitals NHS Trust, Beckett St, Leeds, LS9 7TF, UK
| | - Michelle Black
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Anya Gopfert
- Junior Doctor and National Medical Director's Fellow, London, UK
| | - Peter Roderick
- Leeds Teaching Hospitals NHS Trust, Beckett St, Leeds, LS9 7TF, UK
| | - Ben Barr
- Department of Public Health and Policy, University of Liverpool, 3Rd Floor, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Clare Bambra
- Faculty of Medical Sciences, Newcastle University, Sir James Spence Building, Royal Victoria Infirmary, Newcastle Upon Tyne, NE1 4LP, UK
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Zhao L, Shen C, Liu M, Zhang J, Cheng L, Li Y, Yuan L, Zhang J, Tian J. Comparison of Reporting and Transparency in Published Protocols and Publications in Umbrella Reviews: Scoping Review. J Med Internet Res 2023; 25:e43299. [PMID: 37531172 PMCID: PMC10433027 DOI: 10.2196/43299] [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: 10/07/2022] [Revised: 02/15/2023] [Accepted: 05/05/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Inconsistencies between a protocol and its umbrella review (UR) may mislead readers about the importance of findings or lead to false-positive results. Furthermore, not documenting and explaining inconsistencies in the UR could reduce its transparency. To our knowledge, no study has examined the methodological consistency of the protocols with their URs and assessed the transparency of the URs when generating evidence. OBJECTIVE This study aimed to investigate the inconsistency of protocols with their URs in the methodology and assess the transparency of the URs. METHODS We searched medical-related electronic databases from their inception to January 1, 2022. We investigated inconsistencies between protocols and their publications and transparencies in the search strategy, inclusion criteria, methods of screening and data extraction, quality assessment, and statistical analysis. RESULTS We included 31 protocols and 35 publications. For the search strategy, 39 inconsistencies between the protocols and their publications were found in 26 of the 35 (74%) URs, and 16 of these inconsistencies were indicated and explained. There were 84 inconsistencies between the protocols and their URs regarding the inclusion criteria in 31 of the 35 (89%) URs, and 29 of the inconsistencies were indicated and explained. Deviations from their protocols were found in 12 of the 32 (38%) URs reporting the methods of screening, 14 of the 30 (47%) URs reporting the methods of data extraction, and 11 of the 32 (34%) URs reporting the methods for quality assessment. Of the 35 URs, 6 (17%) were inconsistent with their protocols in terms of the tools for quality assessment; one-half (3/6, 50%) of them indicated and explained the deviations. As for the statistical analysis, 31 of the 35 (89%) URs generated 61 inconsistencies between the publications and their protocols, and 16 inconsistencies were indicated and explained. CONCLUSIONS There was a high prevalence of inconsistencies between protocols and publications of URs, and more than one-half of the inconsistencies were not indicated and explained in the publications. Therefore, how to promote the transparency of URs will be a major part of future work.
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Affiliation(s)
- Liang Zhao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Caiyi Shen
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Ming Liu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jiaoyan Zhang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Luying Cheng
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
- Zigong First People's Hospital, Zigong, China
| | - Yuanyuan Li
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China
| | - Lanbin Yuan
- The First Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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11
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Eltayib RAA, Al-Azri M, Chan MF. The Impact of Sociodemographic, Macroeconomic, and Health Status and Resources on Infant Mortality Rates in Oman: Evidence from 1980 to 2022. Eur J Investig Health Psychol Educ 2023; 13:986-999. [PMID: 37366779 DOI: 10.3390/ejihpe13060075] [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: 04/27/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The infant mortality rate (IMR) is an important reflection of the well-being of infants and the overall health of the population. This study aims to examine the macroeconomic (ME), sociodemographic (SD), and health status and resources (HSR) effects on IMR, as well as how they may interact with each other. METHODS A retrospective time-series study using yearly data for Oman from 1980 to 2022. Partial Least Squares-Structural Equation Modelling (PLS-SEM) was utilized to develop the exploratory model of the determinants of IMR. RESULTS The model indicates that HSR determinants directly, but negatively, affect IMR (β = -0.617, p < 0.001). SD directly and positively affects IMR (β = 0.447, p < 0.001). ME only indirectly affects IMR (β = -0.854, p < 0.001). ME determinants also exert some direct influences on both HSR (β = 0.722, p < 0.001) and SD (β = -0.916, p < 0.001) determinants. CONCLUSIONS This study has indicated that IMR is a multi-faceted issue. It also highlighted the interplay of numerous variables and their influence on IMR, particularly the role that social status, the health sector, and the wealth of the country and its population play in reducing IMR. These findings indicate that an integrated policy that addresses socioeconomic and health-related factors and the overall ME environment is necessary for the health and well-being of the children and the population overall in Oman.
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Affiliation(s)
- Rawaa Abubakr Abuelgassim Eltayib
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat P.O. Box 123, Oman
| | - Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat P.O. Box 123, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat P.O. Box 123, Oman
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12
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Rose TC, Daras K, Manley J, McKeown M, Halliday E, Goodwin TL, Hollingsworth B, Barr B. The mental health and wellbeing impact of a Community Wealth Building programme in England: a difference-in-differences study. Lancet Public Health 2023; 8:e403-e410. [PMID: 37094594 DOI: 10.1016/s2468-2667(23)00059-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Wide differences in health exist between places in the UK, underscored by economic inequalities. Preston, an economically disadvantaged city in England, implemented a new approach to economic development, known as the Community Wealth Building programme. Public and non-profit organisations modified their procurement policies to support the development of local supply chains, improve employment conditions, and increase socially productive use of wealth and assets. We aimed to investigate the effect of this programme on population mental health and wellbeing. METHODS Difference-in-differences techniques compared trends in mental health outcomes in Preston, relative to matched control areas before (2011-15) and after (2016-19) the introduction of the programme. Outcomes were antidepressant prescribing, prevalence of depression, and mental health related hospital attendance rates using data provided by National Health Service Digital, the Quality and Outcomes Framework, and the Office for National Statistics. Additional analysis compared local authority measures of life satisfaction, median wages, and employment with synthetic counterfactuals created using Bayesian Structural Time Series. FINDINGS The introduction of the Community Wealth Building programme was associated with reductions in the prescribing of antidepressants (1·3 average daily quantities per person [95% CI 0·72-1·78) and prevalence of depression (2·4 per 1000 population [0·42-4·46]), relative to the control areas. The local population also experienced a 9% improvement in life satisfaction (95% credible interval 0-19·6%) and 11% increase in median wages (1·8-18·9%), relative to expected trends. Associations with employment and mental health related hospital attendance outcomes did not reach statistical significance. INTERPRETATION During the period in which the Community Wealth Building programme was introduced, there were fewer mental health problems than would have been expected compared with other similar areas, as life satisfaction and economic measures improved. This approach potentially provides an effective model for economic regeneration potentially leading to substantial health benefits. FUNDING National Institute for Health Research.
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Affiliation(s)
- Tanith C Rose
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Konstantinos Daras
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Julian Manley
- Centre for Citizenship and Community, School of Social Work, Care and Community, University of Central Lancashire, Preston, UK
| | - Mick McKeown
- School of Nursing, University of Central Lancashire, Preston, UK
| | - Emma Halliday
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, UK
| | | | - Bruce Hollingsworth
- Health Economics at Lancaster, Division of Health Research, Lancaster University, Lancaster, UK
| | - Ben Barr
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
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13
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Adisa O, McManus S. Community mental health through a complex systems lens. Lancet Public Health 2023; 8:e392-e393. [PMID: 37094595 DOI: 10.1016/s2468-2667(23)00080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Olumide Adisa
- Violence and Society Centre, City, University of London, London EC1V 0HB, UK; Institute of Social Justice and Crime, University of Suffolk, Ipswich, UK
| | - Sally McManus
- Violence and Society Centre, City, University of London, London EC1V 0HB, UK; School of Health and Psychological Sciences, City, University of London, London EC1V 0HB, UK; National Centre for Social Research, London, UK.
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14
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McHugh N, Baker R, Bambra C. Policy actors' perceptions of public participation to tackle health inequalities in Scotland: a paradox? Int J Equity Health 2023; 22:57. [PMID: 36997962 PMCID: PMC10062251 DOI: 10.1186/s12939-023-01869-8] [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: 12/02/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Health inequalities are persistent and widening with transformative policy change needed. Radically shifting policy to tackle upstream causes of inequalities is likely to require public participation to provide a mandate, evidence and to address questions of co-design, implementation and acceptability. The aim of this paper is to explore perceptions among policy actors on why and how the public should be involved in policymaking for health inequalities. METHODS In 2019-2020, we conducted exploratory, in-depth, semi-structured interviews with 21 Scottish policy actors from a range of public sector bodies and agencies and third sector organisations that work in, or across, health and non-health sectors. Data were analysed thematically and used to examine implications for the development of participatory policymaking. RESULTS Policy actors viewed public participation in policymaking as intrinsically valuable for democratic reasons, but the main, and more challenging, concern was with how it could affect positive policy change. Participation was seen as instrumental in two overlapping ways: as evidence to improve policies to tackle health inequalities and to achieve public acceptance for implementing more transformative policies. However, our analysis suggests a paradox: whilst policy actors place importance on the instrumental value of public participation, they simultaneously believe the public hold views about health inequalities that would prevent transformative change. Finally, despite broad agreement on the need to improve public participation in policy development, policy actors were uncertain about how to make the necessary changes due to conceptual, methodological and practical challenges. CONCLUSIONS Policy actors believe in the importance of public participation in policy to address health inequalities for intrinsic and instrumental reasons. Yet, there is an evident tension between seeing public participation as a route to upstream policies and a belief that public views might be misinformed, individualistic, short-term or self-interested and doubts about how to make public participation meaningful. We lack good insight into what the public think about policy solutions to health inequalities. We propose that research needs to shift from describing the problem to focusing more on potential solutions and outline a potential way forward to undertake effective public participation to tackle health inequalities.
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Affiliation(s)
- Neil McHugh
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, Scotland, UK.
| | - Rachel Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle, England, UK
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15
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Broomhead T, Baker SR. From micro to macro: Structural determinants and oral health. Community Dent Oral Epidemiol 2023; 51:85-88. [PMID: 36749674 DOI: 10.1111/cdoe.12803] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/22/2022] [Accepted: 10/11/2022] [Indexed: 02/08/2023]
Abstract
The structural determinants of health include social, economic and political mechanisms which generate social stratification and the socioeconomic positions of individuals within society. Despite their importance, these 'causes of the causes' are still relatively under-studied within oral health research. Yet it is important to assess the effects of these 'upstream' determinants, given that most individuals cannot influence or change them. It is also important to move beyond focusing primarily on downstream determinants and approaches at the individual or household level. This review will offer a brief overview of what is currently known about structural determinants and upstream interventions in relation to oral health. The review starts by briefly summarizing oral health focused studies of structural determinants, including welfare regimes, governance and macroeconomic, social and public policies. Current knowledge on upstream interventions associated with oral health such as community water fluoridation, sugar sweetened beverage taxes and dental payment structures will also be covered. The article will then assess gaps in the research base, including current limitations and barriers-as well as opportunities-in analysing the effects of structural determinants and upstream interventions. The review finishes by suggesting next steps for better understanding and addressing these determinants and interventions-including considerations around theory, data and approaches from other fields such as systems science-with the hope that these can help make contributions to future policy decision making processes.
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Affiliation(s)
- Tom Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sarah R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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16
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Patterson AC. Is Economic Growth Good for Population Health? A Critical Review. CANADIAN STUDIES IN POPULATION 2023; 50:1. [PMID: 36938118 PMCID: PMC10009865 DOI: 10.1007/s42650-023-00072-y] [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: 09/01/2022] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
A large multidisciplinary literature discusses the relationship between economic growth and population health. The idea that economic growth is good for societies has inspired extensive academic debate, but conclusions have been mixed. To help shed light on the subject, this paper focuses on opportunities for consensus in this large literature. Much scholarship finds that the health-growth relationship varies according to (1) which aspect of "health" is under consideration, (2) shape (e.g., positive linear or logarithmic), (3) issues of timing (e.g., growth over the short or long term), (4) a focus on health inequalities as opposed to population averages, and (5) multivariable relationships with additional factors. After reflecting upon these findings, I propose that economic growth promotes health in some respects, for some countries, and in conjunction with other life-supporting priorities, but does not by itself improve population health generally speaking. I then argue there is already wide, interdisciplinary consensus to support this stance. Moreover, policies focusing exclusively on economic growth threaten harm to both population health and growth, which is to say that political dynamics are also implicated. Yet multivariable approaches can help clarify the bigger picture of how growth relates to health. For moving this literature forward, the best opportunities may involve the simultaneous analysis of multiple factors. The recognition of consensus around these issues would be welcome, and timely. Supplementary Information The online version contains supplementary material available at 10.1007/s42650-023-00072-y.
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17
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Rodríguez-García MJ, Navarro-Yáñez CJ, Zapata-Moya ÁR. Local Welfare Systems and Health Inequalities: The Effects of Institutional Overlapping and Local Variations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15447. [PMID: 36497519 PMCID: PMC9739049 DOI: 10.3390/ijerph192315447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
A growing research agenda shows the importance of local welfare systems in understanding socio-spatial inequalities in health. Welfare services provided by local governments overlap with those provided by other levels of government. Thus, differences in the provision of welfare services between municipalities could explain differences in residents' health, moderating the magnitude of health inequalities if local governments deploy actions capable of positively influencing the social determinants of health. This article attempts to analyse this idea in the Spanish case, exploring the influence of local policies according to the orientation of municipal spending on three indicators of the population's health status: self-perceived health, healthy practices and activity limitations due to health problems. A multilevel cross-sectional study was designed using information from two waves of the 2006-2007 and 2011-2012 National Health Survey for the population aged 15 years and older (N = 31,378) residing in Spanish municipalities of 20,000 inhabitants or over (N = 373). The results show that the magnitude of inequalities in self-perceived health, in the adoption of healthy practices and in daily activity limitations by social class are smaller as municipalities" spending was oriented towards policy areas considered as redistributive. Therefore, the proposed institutional overlap thesis could help understand the role of subnational governments on the magnitude of health inequalities, as well as in comparative analysis between countries with institutional systems in which local governments have a greater or lesser capacity to provide welfare services.
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18
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Kondo MC, McIntire RK, Bilal U, Schinasi LH. Reduction in socioeconomic inequalities in self-reported mental health conditions with increasing greenspace exposure. Health Place 2022; 78:102908. [PMID: 36193582 PMCID: PMC11151689 DOI: 10.1016/j.healthplace.2022.102908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Michelle C Kondo
- USDA Forest Service, Northern Research Station, 100 North 20th Street, Suite 205, Philadelphia, PA, 19103, USA.
| | - Russell K McIntire
- Jefferson College of Population Health, Thomas Jefferson University, 901 Walnut St., 10th Floor, Philadelphia, PA, USA.
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Leah H Schinasi
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
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19
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Lupu D, Tiganasu R. The implications of globalization on COVID-19 vaccination in Europe. Sci Rep 2022; 12:17474. [PMID: 36261454 PMCID: PMC9580415 DOI: 10.1038/s41598-022-21493-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/28/2022] [Indexed: 01/12/2023] Open
Abstract
Although globalization has left its mark on economic dynamism, causing conditionalities among various aspects (market openness, production networks, technological and information developments, migratory flows, international cooperation, humanitarian support, etc.), the less pleasant side of it should not be omitted, i.e. the emergence of the framework for the faster diffusion of epidemiological diseases. Thus, with the onset of the SARS-CoV-2 virus, its widespread circulation is a serious challenge for the provision of efficient solutions to combat it, especially in countries with fragile health systems, poor institutional quality and lack of resources. In this paper we aim to investigate the implications of globalization on the COVID-19 vaccination of the population. The period under analysis is January 1, 2021-January 1, 2022, using montly data, and the object of our study are 48 European states. To capture the relationship between globalization and the vaccination rate, we applied regression models, including a number of factors that may influence the progress of vaccination. In order to test the robustness of the results, the two-stage least squares (2SLS) regressions was used. The regression models developed underlined that globalization impacts the degree of vaccination. More globalized economies are more competitive in COVID-19 management, and the significance of this effect comes from better interconnection in global markets and easier access to medical discoveries. At the same time, countries with a higher vaccination rate are associated with higher levels of development. Based on the results obtained, we proposed some policy recommendations to increase the propensity to vaccinate, ensure equity in the distribution of vaccines and provide financial support to developing countries.
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Affiliation(s)
- Dan Lupu
- grid.8168.70000000419371784Faculty of Economics and Business Administration, Alexandru Ioan Cuza University of Iasi, Carol I Boulevard, no.22, Iasi, Romania
| | - Ramona Tiganasu
- grid.8168.70000000419371784Faculty of Law, Centre for European Studies, Alexandru Ioan Cuza University of Iasi, Carol I Boulevard, no. 19, Iasi, Romania
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20
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Freudenberg N. Integrating Social, Political and Commercial Determinants of Health Frameworks to Advance Public Health in the twenty-first Century. INTERNATIONAL JOURNAL OF HEALTH SERVICES : PLANNING, ADMINISTRATION, EVALUATION 2022; 53:207314221125151. [PMID: 36113468 DOI: 10.1177/00207314221125151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Existing frameworks seek to elucidate the social, political, and commercial determinants of health in order to inform practice, policy, and research that can improve health and reduce health inequities. Each approach has widened the scope of public health practice and research and identified new partners and targets for intervention. But as the public health crises of the past decade have shown, these frameworks have not yet yielded insights that have enabled the public health profession and movement to prevent or overcome dominant threats to global health and health equity. This report explores the value of an integrated framework that combines insights from previous scholarship and practice using the social, political, and commercial determinants of health. It proposes the questions such an integration would need to answer and suggests processes and tasks that could lead to the creation of a blended framework.
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Affiliation(s)
- Nicholas Freudenberg
- Distinguished Professor of Public Health, 2009City University of New York School of Public Health and Health Policy, New York, NY, USA
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21
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Gonzalez-Holguera J, Gaille M, del Rio Carral M, Steinberger J, Marti J, Bühler N, Kaufmann A, Chiapperino L, Vicedo-Cabrera AM, Schwarz J, Depoux A, Panese F, Chèvre N, Senn N. Translating Planetary Health Principles Into Sustainable Primary Care Services. Front Public Health 2022; 10:931212. [PMID: 35937241 PMCID: PMC9355637 DOI: 10.3389/fpubh.2022.931212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/13/2022] [Indexed: 12/27/2022] Open
Abstract
Global anthropogenic environmental degradations such as climate change are increasingly recognized as critical public health issues, on which human beings should urgently act in order to preserve sustainable conditions of living on Earth. "Planetary Health" is a breakthrough concept and emerging research field based on the recognition of the interdependent relationships between living organisms-both human and non-human-and their ecosystems. In that regards, there have been numerous calls by healthcare professionals for a greater recognition and adoption of Planetary Health perspective. At the same time, current Western healthcare systems are facing their limits when it comes to providing affordable, equitable and sustainable healthcare services. Furthermore, while hospital-centrism remains the dominant model of Western health systems, primary care and public health continue to be largely undervalued by policy makers. While healthcare services will have to adapt to the sanitary impacts of environmental degradations, they should also ambition to accompany and accelerate the societal transformations required to re-inscribe the functioning of human societies within planetary boundaries. The entire health system requires profound transformations to achieve this, with obviously a key role for public health. But we argue that the first line of care represented by primary care might also have an important role to play, with its holistic, interdisciplinary, and longitudinal approach to patients, strongly grounded in their living environments and communities. This will require however to redefine the roles, activities and organization of primary care actors to better integrate socio-environmental determinants of health, strengthen interprofessional collaborations, including non-medical collaborations and more generally develop new, environmentally-centered models of care. Furthermore, a planetary health perspective translated in primary care will require the strengthening of synergies between institutions and actors in the field of health and sustainability.
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Affiliation(s)
| | - Marie Gaille
- Laboratory SPHERE, UMR 7219, University Paris Diderot CNRS, Paris, France
| | | | - Julia Steinberger
- Institute of Geography and Sustainability, University of Lausanne, Lausanne, Switzerland
| | - Joachim Marti
- Department of Epidemiology and Health Systems, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Nolwenn Bühler
- STS Lab, Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alain Kaufmann
- ColLaboratoire (ColLAB), University of Lausanne, Lausanne, Switzerland
| | - Luca Chiapperino
- STS Lab, Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Joelle Schwarz
- Department of Family Medicine, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Anneliese Depoux
- Centre Virchow-Villermé and Centre des Politiques de la Terre, Université Paris Cité, Paris, France
| | - Francesco Panese
- Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Nathalie Chèvre
- Faculty of Geosciences and the Environment, Institute of Earth Surface Dynamics (IDYST), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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22
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Zimmer RP, Moore JB, Yang M, Evans J, Best S, McNeill S, Harrison D, Martin H, Montez K. Strategies and Lessons Learned from a Home Delivery Food Prescription Program for Older Adults. J Nutr Gerontol Geriatr 2022; 41:217-234. [PMID: 35694773 PMCID: PMC11289850 DOI: 10.1080/21551197.2022.2084204] [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] [Indexed: 10/18/2022]
Abstract
Food insecurity (FI) is a growing health problem, worsening during the COVID-19 pandemic. Fresh food prescription programs (FFRx) have been shown to increase healthy eating and decrease FI, but few FFRx are community-informed, or theory based. Our FFRx was a delivery program developed to alleviate FI for older adults. It was implemented in an academic medical center and guided by the Capabilities, Opportunities, Motivations, and Behaviors and Theoretical Domains Framework. We tested impacts of the program on FI, Fruit and Vegetable (FV) intake, depression, and loneliness at six-month intervals. During the FFRx, 31 people completed surveys every six months. FI decreased by an average of 2.03 points (p = <.001) while FV intake increased from a mean of 2.8 servings per day to 2.9 servings per day (p = .53). Depression and loneliness scores stayed stable. Preliminary data from this FFRx program, a partnership between an academic medical center and community partners, had positive impacts on FI.
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Affiliation(s)
- Rachel P Zimmer
- Atrium Health Wake Forest Baptist, Winston Salem, North Carolina, USA
- Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| | - Justin B Moore
- Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| | - Mia Yang
- Atrium Health Wake Forest Baptist, Winston Salem, North Carolina, USA
- Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
| | - Joni Evans
- Atrium Health Wake Forest Baptist, Winston Salem, North Carolina, USA
| | - Scott Best
- HOPE of Winston Salem, Winston Salem, North Carolina, USA
| | - Sheena McNeill
- HOPE of Winston Salem, Winston Salem, North Carolina, USA
| | | | - Heather Martin
- Second Harvest Food Bank, Winston Salem, North Carolina, USA
| | - Kimberly Montez
- Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
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Brand-Correa L, Brook A, Büchs M, Meier P, Naik Y, O'Neill DW. Economics for people and planet-moving beyond the neoclassical paradigm. Lancet Planet Health 2022; 6:e371-e379. [PMID: 35397225 PMCID: PMC9226380 DOI: 10.1016/s2542-5196(22)00063-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 05/26/2023]
Abstract
Despite substantial attention within the fields of public and planetary health on developing an economic system that benefits both people's health and the environment, heterodox economic schools of thought have received little attention within these fields. Ecological economics is a school of thought with particular relevance to public and planetary health. In this article, we discuss implications of key ecological economics ideas for public and planetary health, especially those related to critiques of gross domestic product as a measure of progress and economic growth as the dominant goal for economic and policy decision making. We suggest that ecological economics aligns well with public health goals, including concern for equality and redistribution. Ecological economics offers an opportunity to make the transition to an economic system that is designed to promote human and planetary health from the outset, rather than one where social and environmental externalities must be constantly corrected after the fact. Important ideas from ecological economics include the use of a multidimensional framework to evaluate economic and social performance, the prioritisation of wellbeing and environmental goals in decision making, policy design and evaluation that take complex relationships into account, and the role of provisioning systems (the physical and social systems that link resource use and social outcomes). We discuss possible interventions at the national scale that could promote public health and that align with the prioritisation of social and ecological objectives, including universal basic income or services and sovereign money creation. Overall, we lay the foundations for additional integration of ecological economics principles and pluralist economic thinking into public and planetary health scholarship and practice.
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Affiliation(s)
- Lina Brand-Correa
- Faculty of Environmental and Urban Change, York University, Toronto, ON, Canada; Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, UK
| | - Anna Brook
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Milena Büchs
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Yannish Naik
- School of Health and Related Research, University of Sheffield, Sheffield, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Daniel W O'Neill
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, UK
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24
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Løvhaug AL, Granheim SI, Djojosoeparto SK, Harrington JM, Kamphuis CBM, Poelman MP, Roos G, Sawyer A, Stronks K, Torheim LE, Twohig C, Vandevijvere S, van Lenthe FJ, Terragni L. The potential of food environment policies to reduce socioeconomic inequalities in diets and to improve healthy diets among lower socioeconomic groups: an umbrella review. BMC Public Health 2022; 22:433. [PMID: 35246074 PMCID: PMC8895543 DOI: 10.1186/s12889-022-12827-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 02/14/2022] [Indexed: 12/19/2022] Open
Abstract
Socioeconomic inequalities in diets need to be tackled to improve population diets and prevent obesity and diet-related non-communicable diseases. The potential of food environment policies to reduce such inequalities has to date however not been appraised. The objective of this umbrella review was to assess the impact of food environment policies on socioeconomic inequalities in diets and to identify knowledge gaps in the existing literature, using the Healthy Food Environment Policy Index as a conceptual framework. The policies considered in the umbrella review are within six domains: 1) food composition 2) food labelling 3) food promotion 4) food provision 5) food retail 6) food pricing. A systematic search for systematic literature reviews on the effect of food environment policies on dietary-related outcomes across socioeconomic groups and published in English between 2004 and 2019 was conducted. Sixteen systematic literature reviews encompassing 159 primary studies were included, covering food composition (n = 2), food labelling (n = 3), food provision (n = 2), food prices (n = 13) and food in retail (n = 4). Quality assessment using the “Assessing the Methodological Quality of Systematic Reviews” quality rating scale showed that review quality was mainly low or critically low. Results suggest that food taxation may reduce socioeconomic inequalities in diets. For all other policy areas, the evidence base was poor. Current research largely fails to provide good quality evidence on impacts of food environment policies on socioeconomic inequalities in diets. Research to fill this knowledge gap is urgently needed.
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Affiliation(s)
- Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway.
| | - Sabrina Ionata Granheim
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Hamar, Norway
| | - Sanne K Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
| | - Janas M Harrington
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Maartje P Poelman
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, Netherlands
| | - Gun Roos
- Consumption Research Norway (SIFO), OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Alexia Sawyer
- Department of Public and Occupational Health, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Cliona Twohig
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | | | - Frank J van Lenthe
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, Netherlands.,Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Laura Terragni
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Oslo, Norway
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25
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O'Brien R, Bair EF, Venkataramani AS. Death by Robots? Automation and Working-Age Mortality in the United States. Demography 2022; 59:607-628. [PMID: 35195250 DOI: 10.1215/00703370-9774819] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The decline of manufacturing employment is frequently invoked as a key cause of worsening U.S. population health trends, including rising mortality due to "deaths of despair." Increasing automation-the use of industrial robots to perform tasks previously done by human workers-is one structural force driving the decline of manufacturing jobs and wages. In this study, we examine the impact of automation on age- and sex-specific mortality. Using exogenous variation in automation to support causal inference, we find that increases in automation over the period 1993-2007 led to substantive increases in all-cause mortality for both men and women aged 45-54. Disaggregating by cause, we find evidence that automation is associated with increases in drug overdose deaths, suicide, homicide, and cardiovascular mortality, although patterns differ by age and sex. We further examine heterogeneity in effects by safety net program generosity, labor market policies, and the supply of prescription opioids.
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Affiliation(s)
- Rourke O'Brien
- Department of Sociology and Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
| | - Elizabeth F Bair
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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26
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Khalturina DA, Zykov VA, Zubkova TS. “Health in All Policies” Approach and Health Impact Assessment in Russia and the world. Public Health 2022. [DOI: 10.21045/2782-1676-2021-1-4-15-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study presents analysis of the international and Russian experience of implementation of “health in all policies” approach into legislation, as well as of health impact assessment. Certain steps towards the implementation of this approach have already been made in Russia, however, in general, there is still a lot to be done. It was revealed that the current system regulatory impact assessment (RIA) in Russia has a narrow focus and is focused on protecting the interests of business, which does not correspond to the well-established world practice, which presupposes complex RIA, including the impact of regulation on public health. Recommendations for strengthening the principle of “health by all policies” in Russian legislation and the introduction of the practice of assessing the regulatory impact on public health in Russia are presented.
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Affiliation(s)
- D. A. Khalturina
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - V. A. Zykov
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - T. S. Zubkova
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
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27
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Shah N, Walker IF, Naik Y, Rajan S, O'Hagan K, Black M, Cartwright C, Tillmann T, Pearce-Smith N, Stansfield J. National or population level interventions addressing the social determinants of mental health - an umbrella review. BMC Public Health 2021; 21:2118. [PMID: 34794401 PMCID: PMC8599417 DOI: 10.1186/s12889-021-12145-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Social circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198). Results We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk. Conclusion This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12145-1.
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Affiliation(s)
- Neha Shah
- City University London, Northampton Square, EC1V 0HB, London, UK.
| | - Ian F Walker
- Hull York Medical School, University of York, Heslington, York, YO10 5DD, England
| | - Yannish Naik
- Leeds Teaching Hospitals NHS Trust, Great St George Street, Leeds, LS1 3EX, England
| | - Selina Rajan
- Department of Health Services Research and Policy, The London School of Hygiene and Tropical Medicine, London, WC1E 7H, UK
| | - Kate O'Hagan
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Michelle Black
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent, Sheffield, S1 4DA, England
| | - Christopher Cartwright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England
| | - Taavi Tillmann
- Centre for Global Non-Communicable Disease, Institute for Global Health, UCL, 30 Guilford, London, WC1N 1EH, UK
| | - Nicola Pearce-Smith
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Jude Stansfield
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
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28
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Brown M, McCann E, Donohue G, Martin CH, McCormick F. LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11366. [PMID: 34769885 PMCID: PMC8582806 DOI: 10.3390/ijerph182111366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings of the study support the need to develop and implement a curriculum for LGBTQ+ health in nursing and midwifery pre-registration programmes with learning aims and outcomes. Academics need support and tools to prepare and deliver LGBTQ+ health content to nurses and midwives as they ultimately have the potential to improve the experiences of LGBTQ+ people when accessing healthcare.
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Affiliation(s)
- Michael Brown
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT97BL, UK;
| | - Edward McCann
- School of Nursing and Midwifery, Trinity College Dublin, D02 T283 Dublin, Ireland; (E.M.); (G.D.)
| | - Gráinne Donohue
- School of Nursing and Midwifery, Trinity College Dublin, D02 T283 Dublin, Ireland; (E.M.); (G.D.)
| | | | - Freda McCormick
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT97BL, UK;
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29
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McGowan VJ, Buckner S, Mead R, McGill E, Ronzi S, Beyer F, Bambra C. Examining the effectiveness of place-based interventions to improve public health and reduce health inequalities: an umbrella review. BMC Public Health 2021; 21:1888. [PMID: 34666742 PMCID: PMC8524206 DOI: 10.1186/s12889-021-11852-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Locally delivered, place-based public health interventions are receiving increasing attention as a way of improving health and reducing inequalities. However, there is limited evidence on their effectiveness. This umbrella review synthesises systematic review evidence of the health and health inequalities impacts of locally delivered place-based interventions across three elements of place and health: the physical, social, and economic environments. METHODS Systematic review methodology was used to identify recent published systematic reviews of the effectiveness of place-based interventions on health and health inequalities (PROGRESS+) in high-income countries. Nine databases were searched from 1st January 2008 to 1st March 2020. The quality of the included articles was determined using the Revised Assessment of Multiple Systematic Reviews tool (R-AMSTAR). RESULTS Thirteen systematic reviews were identified - reporting 51 unique primary studies. Fifty of these studies reported on interventions that changed the physical environment and one reported on changes to the economic environment. Only one primary study reported cost-effectiveness data. No reviews were identified that assessed the impact of social interventions. Given heterogeneity and quality issues, we found tentative evidence that the provision of housing/home modifications, improving the public realm, parks and playgrounds, supermarkets, transport, cycle lanes, walking routes, and outdoor gyms - can all have positive impacts on health outcomes - particularly physical activity. However, as no studies reported an assessment of variation in PROGRESS+ factors, the effect of these interventions on health inequalities remains unclear. CONCLUSIONS Place-based interventions can be effective at improving physical health, health behaviours and social determinants of health outcomes. High agentic interventions indicate greater improvements for those living in greater proximity to the intervention, which may suggest that in order for interventions to reduce inequalities, they should be implemented at a scale commensurate with the level of disadvantage. Future research needs to ensure equity data is collected, as this is severely lacking and impeding progress on identifying interventions that are effective in reducing health inequalities. TRIAL REGISTRATION PROSPERO CRD42019158309.
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Affiliation(s)
- V J McGowan
- Population Health Sciences Institute, Newcastle University, 5th Floor, Ridley 1, Newcastle Upon Tyne, NE1 7RU UK
- Fuse – The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - S. Buckner
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - R. Mead
- Department of Health Research, Lancaster University, Lancaster, UK
- LiLaC – Liverpool and Lancaster Universities Collaboration for Public Health Research, Lancaster, UK
| | - E. McGill
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - S. Ronzi
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - F. Beyer
- Population Health Sciences Institute, Newcastle University, 5th Floor, Ridley 1, Newcastle Upon Tyne, NE1 7RU UK
- Fuse – The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - C. Bambra
- Population Health Sciences Institute, Newcastle University, 5th Floor, Ridley 1, Newcastle Upon Tyne, NE1 7RU UK
- Fuse – The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
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30
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Maksimov SA, Shalnova SA, Kutsenko VA, Balanova YA, Muromtseva GA, Kapustina AV, Evstifeeva SE, Imaeva AE, Karamnova NS, Drapkina OM. Effect of regional living conditions on middle-term cardiovascular outcomes: data from prospective stage of the ESSE-RF study. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To assess regional living conditions with cardiovascular outcomes based on prospective stage of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.Material and methods. We used data from a 3- and 5-year prospective stage of the ESSE-RF study (2012-2013). For initial screening, 16210 people aged 25-64 were included. To characterize the regions of residence, 5 regional indices (RIs) were used. The following endpoints were considered: cardiovascular death, myocardial infarction, stroke, composite endpoint (cardiovascular death + myocardial infarction + stroke). To assess the correlations, generalized estimating equations with nested data structure (individuals in the regions) were used. The studied associations were adjusted for a wide range of potential effect modifiers.Results. There are multiple direct associations of RIs with the likelihood of all endpoints. The exception was the reverse association of Industrial RI with cardiovascular death. The most stable associations regarded Mixed RI, Industrial RI and Socio-geographical RI, with a high RI significance in endpoint development, compared with well-known individual cardiovascular risk factors. Separate associations were noted for Economic RI and Demographic RI.Conclusion. The results indicate a significant contribution of a number of regional living conditions to individual risk of fatal and non-fatal cardiovascular outcomes.
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Affiliation(s)
- S. A. Maksimov
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - Yu. A. Balanova
- National Medical Research Center for Therapy and Preventive Medicine
| | - G. A. Muromtseva
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kapustina
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. E. Evstifeeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. E. Imaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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Frumkin H. COVID-19, the Built Environment, and Health. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:75001. [PMID: 34288733 PMCID: PMC8294798 DOI: 10.1289/ehp8888] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Since the dawn of cities, the built environment has both affected infectious disease transmission and evolved in response to infectious diseases. COVID-19 illustrates both dynamics. The pandemic presented an opportunity to implement health promotion and disease prevention strategies in numerous elements of the built environment. OBJECTIVES This commentary aims to identify features of the built environment that affect the risk of COVID-19 as well as to identify elements of the pandemic response with implications for the built environment (and, therefore, for long-term public health). DISCUSSION Built environment risk factors for COVID-19 transmission include crowding, poverty, and racism (as they manifest in housing and neighborhood features), poor indoor air circulation, and ambient air pollution. Potential long-term implications of COVID-19 for the built environment include changes in building design, increased teleworking, reconfigured streets, changing modes of travel, provision of parks and greenspace, and population shifts out of urban centers. Although it is too early to predict with confidence which of these responses may persist, identifying and monitoring them can help health professionals, architects, urban planners, and decision makers, as well as members of the public, optimize healthy built environments during and after recovery from the pandemic. https://doi.org/10.1289/EHP8888.
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Affiliation(s)
- Howard Frumkin
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
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32
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Schuler MS, Prince DM, Collins RL. Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015-2018 National Survey on Drug Use and Health. LGBT Health 2021; 8:330-339. [PMID: 34101498 PMCID: PMC8252906 DOI: 10.1089/lgbt.2020.0390] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: We characterize disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants in a nationally representative sample. Methods: Data on 153,939 adults (including 11,133 LGB adults) were from the 2015-2018 National Survey on Drug Use and Health. Separate Poisson regression models were used to estimate the relative risk (RR) that gay/lesbian and bisexual adults, respectively, experienced each health determinant, relative to heterosexual adults of the same gender and age group (ages 18-25, 26-34, 35-49, and 50-64). Statistically significant RR estimates were interpreted as a disparity. Results: Bisexual females exhibited disparities on all economic/health care access factors (no college degree, household poverty, means-tested assistance, unemployment, and lacking health insurance) across nearly all age groups; lesbian/gay females exhibited disparities in means-tested assistance and health insurance for some age groups. Notably fewer economic disparities were observed among gay and bisexual males. LGB adults (across identity, gender, and age group) were more likely to live alone, to have never been married, and to report low religious service attendance. Bisexual and lesbian/gay females, across age groups, had 1.7-2.2 times the risk of a lifetime arrest for a criminal offense, relative to same-age heterosexual females. Conclusions: Our results highlight that LGB females, particularly bisexual females, experience significant disparities in economic determinants of health, and all LGB subgroups exhibited disparities in some of the examined social determinants of health. The observed disparities, which spanned across age groups, likely contribute to disparities in physical and mental health observed among LGB adults.
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Affiliation(s)
| | - Dana M. Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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33
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Khanolkar AR, Patalay P. Socioeconomic inequalities in co-morbidity of overweight, obesity and mental ill-health from adolescence to mid-adulthood in two national birth cohort studies. THE LANCET REGIONAL HEALTH. EUROPE 2021; 6:100106. [PMID: 34308407 PMCID: PMC8291042 DOI: 10.1016/j.lanepe.2021.100106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from childhood to mid-adulthood, and differences by sex and cohort. METHODS Data were from 1958 National Child Development Study (NCDS58) and 1970 British Cohort Study (BCS70) [total N=30,868, 51% males] assessed at ages 10, 16, 23/26, 34 and 42 years. Socioeconomic indicators included childhood and adulthood social class and educational level. Risk for i. having healthy BMI and mental ill-health, ii. overweight and good mental health, and iii. overweight and mental ill-health was analysed using multinomial logistic regression. FINDINGS Socioeconomic disadvantage was consistently associated with greater risk for overweight-mental ill-health comorbidity at all ages (RRR 1.43, 2.04, 2.38, 1.64 and 1.71 at ages 10, 16, 23, 34 and 42 respectively for unskilled/skilled vs. professional/managerial class). The observed inequalities in co-morbidity were greater than those observed for either condition alone (overweight; RRR 1.39 and 1.25, mental ill-health; 1.36 and 1.22 at ages 16 and 42 respectively, for unskilled/skilled vs. professional/managerial class). In adulthood, both childhood and adulthood socioeconomic disadvantage were independently associated with comorbid overweight-mental ill-health, with a clear inverse gradient between educational level and risk for comorbidity. For instance, for the no education group (compared to university education) the RRR is 6.11 (95% CI 4.31-8.65) at age 34 and 4.42 (3.28-5.96) at age 42. There were no differences observed in the extent of inequalities by sex and differences between cohorts were limited. INTERPRETATION While socioeconomic disadvantage in childhood and adulthood are consistently and independently associated with greater risk for mental ill-health and being overweight separately, these associations are even larger for their comorbidity across the lifecourse. These findings are significant given the increasing global prevalence of obesity and mental ill-health, and their implications for lifelong health and mortality. FUNDING This research was supported by grants from the Wellcome Trust (ISSF3/ H17RCO/NG1) and Medical Research Council (MRC) [MC_UU_00019/3].
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Affiliation(s)
- Amal R. Khanolkar
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, WC1E 7HB London, United Kingdom
- Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, WC1E 7HB London, United Kingdom
- Centre for Longitudinal Studies, UCL, London, United Kingdom
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34
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Alderwick H, Hutchings A, Briggs A, Mays N. The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews. BMC Public Health 2021; 21:753. [PMID: 33874927 PMCID: PMC8054696 DOI: 10.1186/s12889-021-10630-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Policymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity. METHODS We carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data. RESULTS The 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse. CONCLUSIONS In theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health.
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Affiliation(s)
- Hugh Alderwick
- Health Foundation, 8 Salisbury Square, London, EC4Y 8AP UK
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Andrew Hutchings
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Adam Briggs
- Health Foundation, 8 Salisbury Square, London, EC4Y 8AP UK
- University of Warwick, Coventry, CV4 7AL UK
| | - Nicholas Mays
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
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Yoshioka-Maeda K, Fujii H. Characteristics of Departments That Provided Primary Support for Households with Complex Care Needs in the Community: A Preliminary Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9040403. [PMID: 33916173 PMCID: PMC8065787 DOI: 10.3390/healthcare9040403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
To prevent emergency admissions and save medical costs, support should be provided to households that include people with complex care needs to allow them to continue living in their own homes. This community-based, cross-sectional study was conducted to (1) identify which departments that public health nurses (PHNs) worked have been the primary providers of support for households with complex care needs and (2) clarify the length of time required by each department to resolve primary health problems. We analyzed 148 households with complex care needs that were registered in City A from April 2018 to July 2019. Four types of departments were the primary support providers for complex care households: the department supporting persons with disabilities (n = 54, 36.5%), public/community health centers (n = 47, 31.8%), department of older adults (n = 29, 19.6%), and welfare offices (n = 18, 12.2%). The Mantel–Cox test showed that welfare offices mainly supported households in economic distress and needed significantly less time to resolve their primary health issues than other departments. For early detection and resolution of primary health problems for households with complex care needs, PHNs and healthcare professionals should focus on their economic distress and enhanced multidisciplinary approaches.
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Affiliation(s)
- Kyoko Yoshioka-Maeda
- Department of Health Promotion, National Institute of Public Health, 2-3-6, Minami, Wako-shi, Saitama 351-0197, Japan
- Correspondence: ; Tel.: +81-48-458-6111
| | - Hitoshi Fujii
- Department of Medical Statistics, School of Nursing, Mejiro University, 320 Ukiya, Iwatsuki-ku, Saitama-shi, Saitama 339-8501, Japan;
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Maani N, VAN Schalkwyk MC, Petticrew M, Galea S. The Commercial Determinants of Three Contemporary National Crises: How Corporate Practices Intersect With the COVID-19 Pandemic, Economic Downturn, and Racial Inequity. Milbank Q 2021; 99:503-518. [PMID: 33783862 PMCID: PMC8241267 DOI: 10.1111/1468-0009.12510] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Policy Points The United States finds itself in the middle of an unprecedented combination of crises: a global pandemic, economic crisis, and unprecedented civic responses to structural racism. While public sector responses to these crises have faced much justified criticism, the commercial determinants of these crises have not been sufficiently examined. In this commentary we examine the nature of the contributions of such actors to the conditions that underpin these crises in the United States through their market and nonmarket activities. On the basis of this analysis, we make recommendations on the role of governance and civil society in relation to such commercial actors in a post-COVID-19 world.
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Affiliation(s)
- Nason Maani
- Boston University School of Public Health.,London School of Hygiene and Tropical Medicine.,SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University
| | | | - Mark Petticrew
- London School of Hygiene and Tropical Medicine.,SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University
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Brownson RC, Kumanyika SK, Kreuter MW, Haire-Joshu D. Implementation science should give higher priority to health equity. Implement Sci 2021; 16:28. [PMID: 33740999 PMCID: PMC7977499 DOI: 10.1186/s13012-021-01097-0] [Citation(s) in RCA: 236] [Impact Index Per Article: 78.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/09/2021] [Indexed: 01/08/2023] Open
Abstract
Background There is growing urgency to tackle issues of equity and justice in the USA and worldwide. Health equity, a framing that moves away from a deficit mindset of what society is doing poorly (disparities) to one that is positive about what society can achieve, is becoming more prominent in health research that uses implementation science approaches. Equity begins with justice—health differences often reflect societal injustices. Applying the perspectives and tools of implementation science has potential for immediate impact to improve health equity. Main text We propose a vision and set of action steps for making health equity a more prominent and central aim of implementation science, thus committing to conduct implementation science through equity-focused principles to achieve this vision in U.S. research and practice. We identify and discuss challenges in current health disparities approaches that do not fully consider social determinants. Implementation research challenges are outlined in three areas: limitations of the evidence base, underdeveloped measures and methods, and inadequate attention to context. To address these challenges, we offer recommendations that seek to (1) link social determinants with health outcomes, (2) build equity into all policies, (3) use equity-relevant metrics, (4) study what is already happening, (5) integrate equity into implementation models, (6) design and tailor implementation strategies, (7) connect to systems and sectors outside of health, (8) engage organizations in internal and external equity efforts, (9) build capacity for equity in implementation science, and (10) focus on equity in dissemination efforts. Conclusions Every project in implementation science should include an equity focus. For some studies, equity is the main goal of the project and a central feature of all aspects of the project. In other studies, equity is part of a project but not the singular focus. In these studies, we should, at a minimum, ensure that we “leave no one behind” and that existing disparities are not widened. With a stronger commitment to health equity from funders, researchers, practitioners, advocates, evaluators, and policy makers, we can harvest the rewards of the resources being invested in health-related research to eliminate disparities, resulting in health equity.
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Affiliation(s)
- Ross C Brownson
- Prevention Research Center, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA. .,Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63130, USA.
| | - Shiriki K Kumanyika
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA, 19104, USA
| | - Matthew W Kreuter
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Debra Haire-Joshu
- Center for Diabetes Translation Research and Center for Obesity Prevention and Policy Research, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
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Simpson J, Albani V, Bell Z, Bambra C, Brown H. Effects of social security policy reforms on mental health and inequalities: A systematic review of observational studies in high-income countries. Soc Sci Med 2021; 272:113717. [PMID: 33545493 DOI: 10.1016/j.socscimed.2021.113717] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 11/17/2022]
Abstract
Evidence increasingly shows that changes to social security policies can affect population mental health. Thus, in the context of rising burden of mental illness, it is of major importance to better understand how expansions and contractions to the social security system may impact on mental health of both adults and children. The aim of this systematic review is to provide a synthesis of observational literature on the effects on mental health and inequalities in mental health of social security reforms. We conducted a systematic review of quantitative observational studies of specific national and regional social security policy changes in high-income countries and summarised the mental health effects of these policies. We searched seven electronic databases, including Medline, PsychInfo, Embase, CINAHL, ASSIA (Proquest), Scopus and Research Papers in Economics from January 1979 to June 2020. We included both objective and subjective mental health and wellbeing measures. The study quality was assessed using the Validity Assessment tool for econometric studies. We identified 13,403 original records, thirty-eight of which were included in the final review. Twenty-one studies evaluated expansionary social security policies and seventeen studies evaluated contractionary policies. Overall, we found that policies that improve social security benefit eligibility/generosity are associated with improvements in mental health, as reported by fourteen of the included studies. Social security policies that reduce eligibility/generosity were related to worse mental health, as reported by eleven studies. Ten studies found no effect for either policies contracting or expanding welfare support. Fourteen studies also evaluated the impact on mental health inequalities and found that contractionary policies tend to increase inequalities whereas expansionary policies have the opposite effect. Changes in social security policies can have significant effects on mental health and health inequalities across different recipient groups. Such health effects should be taken into account when designing future social policy reforms.
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Affiliation(s)
- Julija Simpson
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 4LP, UK.
| | - Viviana Albani
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 4LP, UK
| | - Zoe Bell
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 4LP, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 4LP, UK
| | - Heather Brown
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 4LP, UK
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Mentis AFA, Dardiotis E, Efthymiou V, Chrousos GP. Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews. BMC Med 2021; 19:6. [PMID: 33435977 PMCID: PMC7805241 DOI: 10.1186/s12916-020-01873-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The etiologies of chronic neurological diseases, which heavily contribute to global disease burden, remain far from elucidated. Despite available umbrella reviews on single contributing factors or diseases, no study has systematically captured non-purely genetic risk and/or protective factors for chronic neurological diseases. METHODS We performed a systematic analysis of umbrella reviews (meta-umbrella) published until September 20th, 2018, using broad search terms in MEDLINE, SCOPUS, Web of Science, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations & Theses, JBI Database of Systematic Reviews and Implementation Reports, DARE, and PROSPERO. The PRISMA guidelines were followed for this study. Reference lists of the identified umbrella reviews were also screened, and the methodological details were assessed using the AMSTAR tool. For each non-purely genetic factor association, random effects summary effect size, 95% confidence and prediction intervals, and significance and heterogeneity levels facilitated the assessment of the credibility of the epidemiological evidence identified. RESULTS We identified 2797 potentially relevant reviews, and 14 umbrella reviews (203 unique meta-analyses) were eligible. The median number of primary studies per meta-analysis was 7 (interquartile range (IQR) 7) and that of participants was 8873 (IQR 36,394). The search yielded 115 distinctly named non-genetic risk and protective factors with a significant association, with various strengths of evidence. Mediterranean diet was associated with lower risk of dementia, Alzheimer disease (AD), cognitive impairment, stroke, and neurodegenerative diseases in general. In Parkinson disease (PD) and AD/dementia, coffee consumption, and physical activity were protective factors. Low serum uric acid levels were associated with increased risk of PD. Smoking was associated with elevated risk of multiple sclerosis and dementia but lower risk of PD, while hypertension was associated with lower risk of PD but higher risk of dementia. Chronic occupational exposure to lead was associated with higher risk of amyotrophic lateral sclerosis. Late-life depression was associated with higher risk of AD and any form of dementia. CONCLUSIONS We identified several non-genetic risk and protective factors for various neurological diseases relevant to preventive clinical neurology, health policy, and lifestyle counseling. Our findings could offer new perspectives in secondary research (meta-research).
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Affiliation(s)
- Alexios-Fotios A Mentis
- Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece; and, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Vasiliki Efthymiou
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Athens, Greece
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40
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Widding-Havneraas T, Pedersen SH. The role of welfare regimes in the relationship between childhood economic stress and adult health: a multilevel study of 20 European countries. SSM Popul Health 2020; 12:100674. [PMID: 33083511 PMCID: PMC7552090 DOI: 10.1016/j.ssmph.2020.100674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/22/2020] [Accepted: 09/26/2020] [Indexed: 11/18/2022] Open
Abstract
Childhood economic conditions are important for adult health, and welfare regimes may modify this relationship by altering exposure to social determinants of health. We examine the association between childhood economic stress (CES) and self-rated health (SRH) and cancer (any type), and how welfare regimes may influence these associations. We used data from European Social Survey round 7. Our study is based on 30 024 individuals between 25 to 75 years from 20 European countries grouped into five welfare regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern). Multilevel models were used to assess the association between CES and SRH/cancer, and interactions between CES and welfare regimes. CES increased the risk of poor SRH (RR 1.41, 95% CI 1.29–1.54) and cancer (RR 1.19, 95% CI 1.02–1.37). Controlling for adult socioeconomic status slightly reduced risk for poor SRH, but not cancer. CES increased the probability of poor SRH in the Southern and Eastern regime, and the probability of cancer in the Anglo-Saxon regime, relative to the Scandinavian regime. Childhood economic stress increases the risk of poor self-rated health and cancer. More comprehensive welfare states mitigate these associations, which emphasizes the impact of welfare policies on long-term health outcomes of childhood economic conditions. The association between childhood economic stress and adult self-rated health and cancer was examined. The interaction of childhood economic stress and welfare regimes was tested on a large data set with 20 European countries. The article draws on welfare regime and life course theory. Childhood economic stress increased risk of poor self-rated health and cancer in adulthood. Welfare regimes affected the association between childhood economic stress and adult poor self-rated health and cancer.
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Affiliation(s)
- Tarjei Widding-Havneraas
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Norway
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Mialon M. An overview of the commercial determinants of health. Global Health 2020; 16:74. [PMID: 32807183 PMCID: PMC7433173 DOI: 10.1186/s12992-020-00607-x] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background Different terms are described in the literature that refer to commercial determinants as drivers of ill-health. The aim of the present review was to provide an overview of the commercial determinants of health, through a review of the literature on this subject. The review was conducted in December 2019 and updated in February 2020. Searches were conducted from peer-reviewed scientific articles, commentaries, books, and books chapters, with no restriction in their publication dates and languages. Main body The commercial determinants of health cover three areas. First, they relate to unhealthy commodities that are contributing to ill-health. Secondly, they include business, market and political practices that are harmful to health and used to sell these commodities and secure a favourable policy environment. Finally, they include the global drivers of ill-health, such as market-driven economies and globalisation, that have facilitated the use of such harmful practices. Short conclusion The discussion on the commercial determinants of health offers a unique opportunity to shift the dominant paradigm in public health, where individual behaviours are considered to be driven by inadequate environments. Ill-health, damages to the environment, and health and social inequalities, might be better understood through a commercial determinant lens.
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Affiliation(s)
- Melissa Mialon
- School of Public Health, University of São Paulo, São Paulo, Brazil.
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42
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Simpson J, Brown H, Bell Z, Albani V, Bambra C. Investigating the relationship between changes in social security benefits and mental health: a protocol for a systematic review. BMJ Open 2020; 10:e035993. [PMID: 32595158 PMCID: PMC7322275 DOI: 10.1136/bmjopen-2019-035993] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Poor mental health is one of the greatest causes of disability in the world. Evidence increasingly shows that population mental health may be influenced by national social security policies. This systematic review aims to establish the relationship between social security and mental health in order to help inform recommendations for policy-makers, practitioners and future research. METHODS AND ANALYSIS A systematic review of quantitative observational studies investigating mental health outcomes related to changes in social security policies will be conducted. Six major databases, including Medline, PsychInfo, Embase, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index Abstracts and Scopus, as well as Research Papers in Economics will be searched from January 1979 to April 2020. The electronic database searches will be supplemented by reference and citation searches as well as hand-searching of key journals. The outcomes of interest are objective or subjective mental health outcomes, including stress, anxiety, depression, self-reported mental health scores, subjective well-being and suicide. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the quality of the studies will be assessed by the validity assessment framework designed for appraising econometric studies. A narrative synthesis will be conducted for all included studies. If data permit, study findings will be synthesised by conducting a meta-analysis. ETHICS AND DISSEMINATION As it will be a systematic review, without primary data collection, there will be no requirement for ethical approval. Findings will be disseminated through peer-reviewed publications and in various media, for example, conferences or symposia. PROSPERO REGISTRATION NUMBER CRD42019154733.
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Affiliation(s)
- Julija Simpson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Heather Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Zoe Bell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Viviana Albani
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Gwede CK. Bringing a Spotlight to the Influences of Social Determinants of Health. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:211-213. [PMID: 32088850 DOI: 10.1007/s13187-020-01718-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Clement K Gwede
- Moffitt Cancer Center and University of South Florida, 12902 Magnolia Dr., FOW-EDU, Tampa, FL, 33612, USA.
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