Cultivating a community of practice: the evolution of a health information specialists program for public librarians

PubMed Central

Clifton, Shari; Jo, Phill; Longo, Jean Marie; Malone, Tara

2017-01-01

Background To help improve the culture of health in Oklahoma—a state that frequently ranks poorly on multiple measures of health and wellness—faculty librarians from an academic health sciences library sought to create a collaborative network of health information professionals in Oklahoma’s public libraries through the implementation of the Health Information Specialists Program. Case Presentation Health sciences librarians offered a variety of consumer health information courses for public library staff across the state of Oklahoma for three years. Courses were approved by the Medical Library Association for credit toward the Consumer Health Information Specialization. A total of seventy-two participants from public libraries attended the courses, sixty-five achieved a Level I Consumer Health Information Specialization, and nine went on to achieve Level II. Conclusions Feedback from participants in the Health Information Specialists Program has indicated a positive impact on the health information expertise of participants, who in turn have used the knowledge that they gained to help their patrons. PMID:28670214

Cultivating a community of practice: the evolution of a health information specialists program for public librarians.

PubMed

Clifton, Shari; Jo, Phill; Longo, Jean Marie; Malone, Tara

2017-07-01

To help improve the culture of health in Oklahoma-a state that frequently ranks poorly on multiple measures of health and wellness-faculty librarians from an academic health sciences library sought to create a collaborative network of health information professionals in Oklahoma's public libraries through the implementation of the Health Information Specialists Program. Health sciences librarians offered a variety of consumer health information courses for public library staff across the state of Oklahoma for three years. Courses were approved by the Medical Library Association for credit toward the Consumer Health Information Specialization. A total of seventy-two participants from public libraries attended the courses, sixty-five achieved a Level I Consumer Health Information Specialization, and nine went on to achieve Level II. Feedback from participants in the Health Information Specialists Program has indicated a positive impact on the health information expertise of participants, who in turn have used the knowledge that they gained to help their patrons.

Science and social responsibility in public health.

PubMed

Weed, Douglas L; McKeown, Robert E

2003-11-01

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to public health as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession.

Science and social responsibility in public health.

PubMed Central

Weed, Douglas L; McKeown, Robert E

2003-01-01

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice as reflective of them. At one level, responsibility refers to accountability, as in being responsible for actions taken. A deeper meaning of responsibility corresponds to commitment to the pursuit and achievement of a valued end. Epidemiologists are committed to the scientific study of health and disease in human populations and to the application of scientific knowledge to improve the public's health. Responsibility is also closely linked to reliability. Responsible professionals reliably perform the tasks they set for themselves as well as the tasks society expects them to undertake. The defining axiom for our approach is that the health of the public is a social good we commit ourselves to pursue, thus assuming an obligation to contribute to its achievement. Epidemiologists cannot claim to be committed to public health as a social good and not accept the responsibility of ensuring that the knowledge gained in their roles as scientists is used to achieve that good. The social responsibilities of environmental health researchers are conspicuous in the environmental justice movement, for example, in community-based participatory research. Responsibility is an ethical concept particularly well suited to frame many key aspects of the ethics of our profession. PMID:14602514

Evaluating community-based public health leadership training.

PubMed

Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

2011-01-01

Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

Millennium Development Goals: how public health professionals perceive the achievement of MDGs

PubMed Central

Lomazzi, Marta; Laaser, Ulrich; Theisling, Mareike; Tapia, Leticia; Borisch, Bettina

2014-01-01

Background There have been various consultations on the Millennium Development Goals (MDGs) by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts’ points of view and these are mainly government driven. Designs The World Federation of Public Health Associations (WFPHA) has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs. The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Results Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention. Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. Conclusion The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework. PMID:25249060

The Public Health Information Network (PHIN) Preparedness Initiative

PubMed Central

Loonsk, John W.; McGarvey, Sunanda R.; Conn, Laura A.; Johnson, Jennifer

2006-01-01

The Public Health Information Network (PHIN) Preparedness initiative strives to implement, on an accelerated pace, a consistent national network of information systems that will support public health in being prepared for public health emergencies. Using the principles and practices of the broader PHIN initiative, PHIN Preparedness concentrates in the short term on ensuring that all public health jurisdictions have, or have access to, systems to accomplish known preparedness functions. The PHIN Preparedness initiative defines functional requirements, technical standards and specifications, and a process to achieve consistency and interconnectedness of preparedness systems across public health. PMID:16221945

Primary health care and public health: foundations of universal health systems.

PubMed

White, Franklin

2015-01-01

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. © 2015 S. Karger AG, Basel.

From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health OutcomesComment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities".

PubMed

O'Flynn, Janine

2016-04-30

Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes. © 2016 by Kerman University of Medical Sciences.

45 CFR 160.304 - Principles for achieving compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Principles for achieving compliance. 160.304 Section 160.304 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND... Principles for achieving compliance. (a) Cooperation. The Secretary will, to the extent practicable, seek the...

An evaluation of the Public Health Responsibility Deal: Informants' experiences and views of the development, implementation and achievements of a pledge-based, public-private partnership to improve population health in England.

PubMed

Durand, Mary Alison; Petticrew, Mark; Goulding, Lucy; Eastmure, Elizabeth; Knai, Cecile; Mays, Nicholas

2015-11-01

The Coalition Government's Public Health Responsibility Deal (RD) was launched in England in 2011 as a public-private partnership designed to improve public health in the areas of food, alcohol, health at work and physical activity. As part of a larger evaluation, we explored informants' experiences and views about the RD's development, implementation and achievements. We conducted 44 semi-structured interviews with 50 interviewees, purposively sampled from: RD partners (businesses, public sector and non-governmental organisations); individuals with formal roles in implementing the RD; and non-partners and former partners. Data were analysed thematically: NVivo (10) software was employed to manage the data. Key motivations underpinning participation were corporate social responsibility and reputational enhancement. Being a partner often involved making pledges related to work already underway or planned before joining the RD, suggesting limited 'added value' from the RD, although some pledge achievements (e.g., food reformulation) were described. Benefits included access to government, while drawbacks included resource implications and the risk of an 'uneven playing field' between partners and non-partners. To ensure that voluntary agreements like the RD produce gains to public health that would not otherwise have occurred, government needs to: increase participation and compliance through incentives and sanctions, including those affecting organisational reputation; create greater visibility of voluntary agreements; and increase scrutiny and monitoring of partners' pledge activities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health Outcomes

PubMed Central

O’Flynn, Janine

2016-01-01

Many public policy programs fail to translate ambitious headlines to on-the-ground action. The reasons for this are many and varied, but for public administration and management scholars a large part of the gap between ambition and achievement is the challenge associated with the operation of the machinery of government itself, and how it relates to the other parties that it relies on to fulfill these outcomes. In their article, Carey and Friel set out key reasons why public health scholars should seek to better understand important ideas in public administration. In commenting on their contribution, I draw out two critical questions that are raised by this discussion: (i) what are boundaries and what forms do they take? and (ii) why work across boundaries? Expanding on these key questions extends the points made by Carey and Friel on the importance of understanding public administration and will better place public health scholars and practitioners to realise health outcomes. PMID:27694672

Identifying public health competencies relevant to family medicine.

PubMed

Harvey, Bart J; Moloughney, Brent W; Iglar, Karl T

2011-10-01

Public health situations faced by family physicians and other primary care practitioners, such as severe acute respiratory syndrome (SARS) and more recently H1N1, have resulted in an increased interest to identify the public health competencies relevant to family medicine. At present there is no agreed-on set of public health competencies delineating the knowledge and skills that family physicians should possess to effectively face diverse public health challenges. Using a multi-staged, iterative process that included a detailed literature review, the authors developed a set of public health competencies relevant to primary care, identifying competencies relevant across four levels, from "post-MD" to "enhanced." Feedback from family medicine and public health educator-practitioners regarding the set of proposed "essential" competencies indicated the need for a more limited, feasible set of "priority" areas to be highlighted during residency training. This focused set of public health competencies has begun to guide relevant components of the University of Toronto's Family Medicine Residency Program curriculum, including academic half-days; clinical experiences, especially identifying "teachable moments" during patient encounters; resident academic projects; and elective public health agency placements. These competencies will also be used to guide the development of a family medicine-public health primer and faculty development sessions to support family medicine faculty facilitating residents to achieve these competencies. Once more fully implemented, an evaluation will be initiated to determine the degree to which these public health competencies are being achieved by family medicine graduates, especially whether they attained the knowledge, skills, and confidence necessary to effectively face diverse public health situations-from common to emergent. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Water reclamation, reuse and public health.

PubMed

Rose, J B

2007-01-01

The number of people who have limited access to high-quality water has increased, and while this is a growing global crisis, water issues, problems and solutions are often seen as localised. Water reuse and reclamation will play a significant role in achieving sustainability and public health protection in the future. The wastewater and reuse community should be responsible for monitoring sewage impacts and improvements as demonstrated through pathogen reduction with appropriate treatment. Viruses, Cryptosporidium and Giardia can all be reduced during treatment anywhere from 99% to 99.9999%, achieving drinking water quality, if so desired. Recommendations to achieve better access to scientific information for decision making include: 1) developing a global data base for biological contaminant loading from wastewater and 2) defining the public health protection via reuse and reclamation.

Income-related children's health inequality and health achievement in China.

PubMed

Chen, Lu; Wu, Ya; Coyte, Peter C

2014-10-29

This study assessed income-related health inequality and health achievement in children in China, and additionally, examined province-level variations in health achievement. Longitudinal data on 19,801 children under 18 years of age were derived from the China Health and Nutrition Survey. Income-related health inequality and health achievement were measured by the Health Concentration and Health Achievement Indices, respectively. Panel data with a fixed effect multiple regression model was employed to examine province-level variations in health achievement. A growing trend was towards greater health inequality among Chinese children over the last two decades. Although health achievement was getting better over time, the pro-rich inequality component has lessened the associated gain in achievement. Health achievement was positively impacted by middle school enrollments, the urbanization rate, inflation-adjusted per capita gross domestic product, and per capita public health spending. This study has provided evidence that average health status of Chinese children has improved, but inequality has widened. Widening inequality slowed the growth in health achievement for children over time. There were wide variations in health achievement throughout China.

Demystifying Data: Data Use in State and Local Public Health Nutrition Programs--Measuring Achievement of the 1990 Health Promotion/Disease Prevention Objectives for the Nation. Proceedings of the Continuing Education Conference for the Association of State and Territorial Public Health Nutrition Directors and Association of Faculties of Graduate Programs in Public Health Nutrition (Chapel Hill, North Carolina, May 21-24, 1985).

ERIC Educational Resources Information Center

Kaufman, Mildred, Comp.

This document contains the proceedings from the Conference of State and Territorial Public Health Nutrition Directors and Faculties of Graduate Programs in Public Health Nutrition designed to improve participants' proficiency in data management. It includes an introduction by Mildred Kaufman, a conference agenda, and the following presentations:…

42 CFR 405.2416 - Visiting nurse services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... achieved. (2) Personal care services, to the extent covered under Medicare as home health services. These... 42 Public Health 2 2014-10-01 2014-10-01 false Visiting nurse services. 405.2416 Section 405.2416 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE...

Six challenges in modelling for public health policy.

PubMed

Metcalf, C J E; Edmunds, W J; Lessler, J

2015-03-01

The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014). Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Evaluation of a federally funded workforce development program: The Centers for Public Health Preparedness☆

PubMed Central

Sobelson, Robyn K.; Young, Andrea C.

2017-01-01

The Centers for Public Health Preparedness (CPHP) program was a five-year cooperative agreement funded by the Centers for Disease Control and Prevention (CDC). The program was initiated in 2004 to strengthen terrorism and emergency preparedness by linking academic expertise to state and local health agency needs. The purposes of the evaluation study were to identify the results achieved by the Centers and inform program planning for future programs. The evaluation was summative and retrospective in its design and focused on the aggregate outcomes of the CPHP program. The evaluation results indicated progress was achieved on program goals related to development of new training products, training members of the public health workforce, and expansion of partnerships between accredited schools of public health and state and local public health departments. Evaluation results, as well as methodological insights gleaned during the planning and conduct of the CPHP evaluation, were used to inform the design of the next iteration of the CPHP Program, the Preparedness and Emergency Response Learning Centers (PERLC). PMID:23380597

A hive of activity: the future of public health.

PubMed

Kisely, S; Jones, J

1995-07-01

In consultation with primary and secondary care, public health has a crucial role in improving the health of the population through health promotion, advice on appropriateness and effectiveness of services and communicable disease control. The speciality of public health medicine can only achieve this goal if it is allowed a degree of stability after the numerous organisational changes of the last two decades. The 'beehive model' of public health may offer an organisational structure that is adaptable to further health service change, reflects the rise in multidisciplinary working, guarantees freedom of speech and is sustainable within existing manpower numbers.

Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities - a qualitative study.

PubMed

Rosenkötter, Nicole; Clemens, Timo; Sørensen, Kristine; Brand, Helmut

2013-11-14

The European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity. Semi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs. The ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients' rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity. When comparing the emerging themes from the interviews conducted with the responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development.

Twentieth anniversary of the European Union health mandate: taking stock of perceived achievements, failures and missed opportunities – a qualitative study

PubMed Central

2013-01-01

Background The European Union (EU) health mandate was initially defined in the Maastricht Treaty in 1992. The twentieth anniversary of the Treaty offers a unique opportunity to take stock of EU health actions by giving an overview of influential public health related EU-level policy outputs and a summary of policy outputs or actions perceived as an achievement, a failure or a missed opportunity. Methods Semi-structured expert interviews (N = 20) were conducted focusing on EU-level actions that were relevant for health. Respondents were asked to name EU policies or actions that they perceived as an achievement, a failure or a missed opportunity. A directed content analysis approach was used to identify expert perceptions on achievements, failures and missed opportunities in the interviews. Additionally, a nominal group technique was applied to identify influential and public health relevant EU-level policy outputs. Results The ranking of influential policy outputs resulted in top positions of adjudications and legislations, agencies, European Commission (EC) programmes and strategies, official networks, cooperative structures and exchange efforts, the work on health determinants and uptake of scientific knowledge. The assessment of EU health policies as being an achievement, a failure or a missed opportunity was often characterized by diverging respondent views. Recurring topics that emerged were the Directorate General for Health and Consumers (DG SANCO), EU agencies, life style factors, internal market provisions as well as the EU Directive on patients’ rights in cross-border healthcare. Among these recurring topics, expert perceptions on the establishment of DG SANCO, EU public health agencies, and successes in tobacco control were dominated by aspects of achievements. The implementation status of the Health in All Policy approach was perceived as a missed opportunity. Conclusions When comparing the emerging themes from the interviews conducted with the responsibilities defined in the EU health mandate, one can identify that these responsibilities were only partly fulfilled or acknowledged by the respondents. In general, the EU is a recognized public health player in Europe which over the past two decades, has begun to develop competencies in supporting, coordinating and supplementing member state health actions. However, the assurance of health protection in other European policies seems to require further development. PMID:24225055

A Review of Literature to Understand the Complexity of Equity, Ethics and Management for Achieving Public Health Goals in India

PubMed Central

Garg, Pankaj; Nagpal, Jitender

2014-01-01

In the context of inadequate public spending on health care in India (0.9% of the GDP); government liberalized its policies in the form of subsidized lands and tax incentives, resulting in the mushrooming of private hospitals and clinics in India. Paradoxically, a robust framework was not developed for the regulation of these health care providers, resulting in disorganized health sector, inadequate financing models, and lack of prioritization of services, as well as a sub-optimal achievement of the Millennium Development Goals (MDG). We systematically reviewed the evidence base regarding regulation of private hospitals, applicability of private-public mix, state of health insurance and effective policy development for India, while seeking lessons on regulation of private health systems, from South African (a developing country) and Australian (a developed country) health care systems. PMID:24701465

Assessing the Impact of School-Based Health Centers on Academic Achievement and College Preparation Efforts: Using Propensity Score Matching to Assess School-Level Data in California

ERIC Educational Resources Information Center

Bersamin, Melina; Garbers, Samantha; Gaarde, Jenna; Santelli, John

2016-01-01

This study examines the association between school-based health center (SBHC) presence and school-wide measures of academic achievement and college preparation efforts. Publicly available educational and demographic data from 810 California public high schools were linked to a list of schools with an SBHC. Propensity score matching, a method to…

Surviving and Thriving-Shifting the Public Health Response to HIV-Exposed Uninfected Children: Report of the 3rd HIV-Exposed Uninfected Child Workshop.

PubMed

Slogrove, Amy L; Becquet, Renaud; Chadwick, Ellen G; Côté, Hélène C F; Essajee, Shaffiq; Hazra, Rohan; Leroy, Valériane; Mahy, Mary; Murenga, Maurine; Wambui Mwangi, Jacqueline; Oyiengo, Laura; Rollins, Nigel; Penazzato, Martina; Seage, George R; Serghides, Lena; Vicari, Marissa; Powis, Kathleen M

2018-01-01

Great gains were achieved with the introduction of the United Nations' Millennium Development Goals, including improved child survival. Transition to the Sustainable Development Goals (SDGs) focused on surviving, thriving, and transforming, representing an important shift to a broader public health goal, the achievement of which holds the promise of longer-term individual and societal benefits. A similar shift is needed with respect to outcomes for infants born to women living with HIV (WLHIV). Programming to prevent vertical HIV transmission has been successful in increasingly achieving a goal of HIV-free survival for infants born to WLHIV. Unfortunately, HIV-exposed uninfected (HEU) children are not achieving comparable health and developmental outcomes compared with children born to HIV-uninfected women under similar socioeconomic circumstances. The 3rd HEU Child Workshop, held as a satellite session of the International AIDS Society's 9th IAS Conference in Paris in July 2017, provided a venue to discuss HEU child health and development disparities. A summary of the Workshop proceedings follows, providing current scientific findings, emphasizing the gap in systems for long-term monitoring, and highlighting the public health need to establish a strategic plan to better quantify the short and longer-term health and developmental outcomes of HEU children.

An Account of Collective Actions in Public Health

PubMed Central

Siegal, Neomi; Bonnie, Richard J.

2009-01-01

Aggregated health decisions by individuals are of paramount importance to public health professionals and policymakers, especially in situations where collective participation is a prerequisite for achieving an important public health goal such as herd immunity. In such circumstances, concerted action often falls short of the common good through lack of sufficient participation. Collective action problems are traditionally attributed to rational egoists seeking to promote their interests and enjoy a “free ride.” We call attention, however, to the behavioral features of collective action and their implications for solving public health policy problems. PMID:19608946

Two Decades of Enhancing Children’s Environmental Health Protection at the U.S. Environmental Protection Agency

PubMed Central

Firestone, Michael; Berger, Martha; Foos, Brenda; Etzel, Ruth

2016-01-01

Summary: This article provides an overview of public health efforts by the U.S. Environmental Protection Agency (EPA) during the past two decades to protect children’s health from environmental hazards. It highlights examples of concrete steps and accomplishments toward improving environmental protection and health outcomes achieved through public policy, rules and regulations, increased scientific understanding, and public health messaging. Additionally, examples of future challenges for better understanding and improving children’s environmental health are discussed. PMID:27905272

The Impact of Worksite Clinics on Teacher Healthcare Utilization and Cost, Self-reported Health Status, and Student Academic Achievement growth in a Public School District.

PubMed

Engberg, John B; Harris-Shapiro, Jon; Hines, David; McCarver, Patti; Liu, Harry H

2018-05-29

To examine the impact of worksite clinics on healthcare utilization and cost, self-reported health status, and student achievement growth in a public school district. We used insurance claims, health risk assessment, and student achievement growth data for active teachers during 2007-2015. A difference-in-differences approach was applied to measure the impact of worksite clinics. Compared to using a community-based clinic as the usual source of primary care, using a worksite clinic was associated with significantly lower inpatient admissions (53 vs. 31 per 1,000 teacher years), annual healthcare cost ($5,043 vs. $4,298 in 2016 US dollars, a difference of $62 per teacher per month), and annual absent work hours (63 vs. 61). No significant differences were detected in self-reported health status or student achievement growth. Worksite clinics reduce teacher healthcare cost and absenteeism.

VISUAL BEACH: SOFTWARE FOR ACHIEVING BEACH AESTHETIC AND PUBLIC HEALTH PROTECTION

EPA Science Inventory

The Beaches Environmental Assessment and Coastal Health Act of 2000 directs the EPA to assure that 100% of significant public beaches are managed by 2008. Under the Act EPA is developing a program to monitor beach water quality and strategies for timely notification of the public...

The next public health revolution: public health information fusion and social networks.

PubMed

Khan, Ali S; Fleischauer, Aaron; Casani, Julie; Groseclose, Samuel L

2010-07-01

Social, political, and economic disruptions caused by natural and human-caused public health emergencies have catalyzed public health efforts to expand the scope of biosurveillance and increase the timeliness, quality, and comprehensiveness of disease detection, alerting, response, and prediction. Unfortunately, efforts to acquire, render, and visualize the diversity of health intelligence information are hindered by its wide distribution across disparate fields, multiple levels of government, and the complex interagency environment. Achieving this new level of situation awareness within public health will require a fundamental cultural shift in methods of acquiring, analyzing, and disseminating information. The notion of information "fusion" may provide opportunities to expand data access, analysis, and information exchange to better inform public health action.

The Next Public Health Revolution: Public Health Information Fusion and Social Networks

PubMed Central

Fleischauer, Aaron; Casani, Julie; Groseclose, Samuel L.

2010-01-01

Social, political, and economic disruptions caused by natural and human-caused public health emergencies have catalyzed public health efforts to expand the scope of biosurveillance and increase the timeliness, quality, and comprehensiveness of disease detection, alerting, response, and prediction. Unfortunately, efforts to acquire, render, and visualize the diversity of health intelligence information are hindered by its wide distribution across disparate fields, multiple levels of government, and the complex interagency environment. Achieving this new level of situation awareness within public health will require a fundamental cultural shift in methods of acquiring, analyzing, and disseminating information. The notion of information “fusion” may provide opportunities to expand data access, analysis, and information exchange to better inform public health action. PMID:20530760

Applying total quality management concepts to public health organizations.

PubMed Central

Kaluzny, A D; McLaughlin, C P; Simpson, K

1992-01-01

Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

Public Health Impact of Frailty: Role of Physical Therapists.

PubMed

Gustavson, A M; Falvey, J R; Jankowski, C M; Stevens-Lapsley, J E

2017-01-01

Frailty is an emerging and immediate public health concern given the growing aging population. The condition of frailty is characterized by a reduction in physiologic reserve, which places frail older adults at considerable risk for further functional decline, hospitalization, institutionalization, and death. Recent research suggests that frailty may be reversible, which could result in significant improvement in public health. Thus, a strong impetus exists to develop strategies for frail older adults that achieve the Triple Aim through better promotion of population health, optimization of patient experiences, and delivery of high-quality care at minimal cost. Physical therapists often treat frail older adults, yet how physical therapists can contribute to preventing or reversing frailty in healthcare settings has not been described, and may potentially influence patient outcomes and healthcare spending. Therefore, the purpose of this publication is to outline the potential role of physical therapists in achieving the Triple Aim for the frail older adult population.

PUBLIC HEALTH IMPACT OF FRAILTY: ROLE OF PHYSICAL THERAPISTS

PubMed Central

GUSTAVSON, A.M.; FALVEY, J.R.; JANKOWSKI, C.M.; STEVENS-LAPSLEY, J.E.

2017-01-01

Frailty is an emerging and immediate public health concern given the growing aging population. The condition of frailty is characterized by a reduction in physiologic reserve, which places frail older adults at considerable risk for further functional decline, hospitalization, institutionalization, and death. Recent research suggests that frailty may be reversible, which could result in significant improvement in public health. Thus, a strong impetus exists to develop strategies for frail older adults that achieve the Triple Aim through better promotion of population health, optimization of patient experiences, and delivery of high-quality care at minimal cost. Physical therapists often treat frail older adults, yet how physical therapists can contribute to preventing or reversing frailty in healthcare settings has not been described, and may potentially influence patient outcomes and healthcare spending. Therefore, the purpose of this publication is to outline the potential role of physical therapists in achieving the Triple Aim for the frail older adult population. PMID:28244550

The laboratory efficiencies initiative: partnership for building a sustainable national public health laboratory system.

PubMed

Ridderhof, John C; Moulton, Anthony D; Ned, Renée M; Nicholson, Janet K A; Chu, May C; Becker, Scott J; Blank, Eric C; Breckenridge, Karen J; Waddell, Victor; Brokopp, Charles

2013-01-01

Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners.

The Laboratory Efficiencies Initiative: Partnership for Building a Sustainable National Public Health Laboratory System

PubMed Central

Moulton, Anthony D.; Ned, Renée M.; Nicholson, Janet K.A.; Chu, May C.; Becker, Scott J.; Blank, Eric C.; Breckenridge, Karen J.; Waddell, Victor; Brokopp, Charles

2013-01-01

Beginning in early 2011, the Centers for Disease Control and Prevention and the Association of Public Health Laboratories launched the Laboratory Efficiencies Initiative (LEI) to help public health laboratories (PHLs) and the nation's entire PHL system achieve and maintain sustainability to continue to conduct vital services in the face of unprecedented financial and other pressures. The LEI focuses on stimulating substantial gains in laboratories' operating efficiency and cost efficiency through the adoption of proven and promising management practices. In its first year, the LEI generated a strategic plan and a number of resources that PHL directors can use toward achieving LEI goals. Additionally, the first year saw the formation of a dynamic community of practitioners committed to implementing the LEI strategic plan in coordination with state and local public health executives, program officials, foundations, and other key partners. PMID:23997300

A public health achievement under adversity: the eradication of poliomyelitis from Peru, 1991.

PubMed

Sobti, Deepak; Cueto, Marcos; He, Yuan

2014-12-01

The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America's story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public-private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru's Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements.

"Health for All" in England and Brazil?

PubMed

Duncan, Peter; Bertolozzi, Maria Rita; Cowley, Sarah; Egry, Emiko Yoshikawa; Chiesa, Anna Maria; de Siqueira França, Francisco Oscar

2015-01-01

This article discusses the achievements and challenges that England and Brazil face in relation to their capacity to address inequalities in health through health promotion and public health policies. Using secondary data (policy texts and related documents), this article contextualizes, explains, and critically appraises health promotion and public health efforts for the reduction of inequalities in health in the 2 countries. A historic documentary analysis was undertaken, with hermeneutics as the methodological framework. The global economic crisis has prompted the so-called developed economies of Europe to reconsider their economic and social priorities. England represents a state facing this kind of challenge. Equally, Brazil is assuming new positions not only on the world stage but also in terms of the relationship it has with its citizens and the priorities it has for state welfare. The United Kingdom continues to finance a health care system allowing universal access in the form of the National Health Service, and state concern about the public health task of reducing inequalities has recently been underlined in policy. For Brazil, although there have been recent achievements related to population access to healthcare, challenges continue, especially with regard to the quality of care. © SAGE Publications 2015.

Influencing public health without authority.

PubMed

Suresh, K

2012-01-01

This paper analyzes the present processes, products and needs of post-graduate public health education for the health programming, implementation and oversight responsibilities at field level and suggests some solutions for the institutes to adopt or adapt for improving the quality of their scholars. Large number of institutions has cropped up in India in the recent years to meet the growing demand of public health specialists/practitioners in various national health projects, international development partners, national and international NGOs. Throwing open MPH courses to multi-disciplinary graduate's is a new phenomenon in India and may be a two edged sword. On one hand it is advantageous to produce multi-faceted Public health postgraduates to meet the multi tasking required, on the other hand getting all of them to a common basic understanding, demystifying technical teaching and churning out products that are acceptable to the traditional health system. These Institutions can and must influence public health in the country through producing professionals of MPH/ MD degree with right attitude and skill-mix. Engaging learners in experimentation, experience sharing projects, stepping into health professionals' roles and similar activities lead to development of relatively clear and permanent neural traces in the brain. The MPH institutes may not have all efficient faculties, for which they should try to achieve this by inviting veterans in public health and professionals from corporate health industry for interface with students on a regular basis. The corporate and public health stalwarts have the capacities to transmit the winning skills and knowledge and also inspire them to adopt or adapt in order to achieve the desired goals.

The World Health Organization European Health in Prisons Project After 10 Years: Persistent Barriers and Achievements

PubMed Central

Gatherer, Alex; Moller, Lars; Hayton, Paul

2005-01-01

The recognition that good prison health is important to general public health has led 28 countries in the European Region of the World Health Organization (WHO) to join a WHO network dedicated to improving health within prisons. Within the 10 years since that time, vital actions have been taken and important policy documents have been produced. A key factor in making progress is breaking down the isolation of prison health services and bringing them into closer collaboration with the country’s public health services. However, barriers to progress remain. A continuing challenge is how best to move from policy recommendations to implementation, so that the network’s fundamental aim of noticeable improvements in the health and care of prisoners is further achieved. PMID:16186449

Public Health Law Reform

PubMed Central

Gostin, Lawrence O.

2001-01-01

Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agencies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system. PMID:11527757

Public health law reform.

PubMed

Gostin, L O

2001-09-01

Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agen cies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system.

Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Century

PubMed Central

Wang, Y. Claire; Harris, Andrea; Auerbach, John; Koo, Denise; O’Carroll, Patrick

2017-01-01

Public health is what we do together as a society to ensure the conditions in which everyone can be healthy. Although many sectors play key roles, governmental public health is an essential component. Recent stressors on public health are driving many local governments to pioneer a new Public Health 3.0 model in which leaders serve as Chief Health Strategists, partnering across multiple sectors and leveraging data and resources to address social, environmental, and economic conditions that affect health and health equity. In 2016, the US Department of Health and Human Services launched the Public Health 3.0 initiative and hosted listening sessions across the country. Local leaders and community members shared successes and provided insight on actions that would ensure a more supportive policy and resource environment to spread and scale this model. This article summarizes the key findings from those listening sessions and recommendations to achieve Public Health 3.0. PMID:28880837

Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Century.

PubMed

DeSalvo, Karen B; Wang, Y Claire; Harris, Andrea; Auerbach, John; Koo, Denise; O'Carroll, Patrick

2017-09-07

Public health is what we do together as a society to ensure the conditions in which everyone can be healthy. Although many sectors play key roles, governmental public health is an essential component. Recent stressors on public health are driving many local governments to pioneer a new Public Health 3.0 model in which leaders serve as Chief Health Strategists, partnering across multiple sectors and leveraging data and resources to address social, environmental, and economic conditions that affect health and health equity. In 2016, the US Department of Health and Human Services launched the Public Health 3.0 initiative and hosted listening sessions across the country. Local leaders and community members shared successes and provided insight on actions that would ensure a more supportive policy and resource environment to spread and scale this model. This article summarizes the key findings from those listening sessions and recommendations to achieve Public Health 3.0.

Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

PubMed

Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.

The factors affecting Nigeria's success toward implementation of global public health priorities.

PubMed

Echebiri, Vitalis C

2015-06-01

This paper examines the challenges facing the Nigerian government toward the implementation of global public health priories. The Nigerian government recognizes the need to implement these priorities by putting in place the necessary policy framework, but political instability, poor infrastructural development and inadequate funding have remained barriers toward the achievement of success in implementing these priorities. The rest of the paper elucidates the fact that despite leadership and influence from the World Health Organization and other United Nations agencies, and some responses from the Nigerian government, tackling these public health problems requires much more fundamental reform to primary health services and a reduction in poverty. Although the government has shown enough political will to tackle these problems, it is expected that a better result will be achieved through injecting more funds into the Nigerian health sector, and deploying astute health administrators to manage the sector rather than pure health professionals without managerial acumen. © The Author(s) 2014.

Strategies for public health research in European Union countries.

PubMed

Grimaud, Olivier; McCarthy, Mark; Conceição, Claudia

2013-11-01

'Health' is an identifiable theme within the European Union multi-annual research programmes. Public Health Innovation and Research in Europe (PHIRE), led by the European Public Health Association, sought to identify public health research strategies in EU member states. Within PHIRE, national public health associations reviewed structures for health research, held stakeholder workshops and produced reports. This information, supplemented by further web searches, including using assisted translation, was analysed for national research strategies and health research strategies. All countries described general research strategies, outlining organizational and capacity objectives. Thematic fields, including health, are mentioned in some strategies. A health research strategy was identified for 15 EU countries and not for 12. Ministries of health led research strategies for nine countries. Public health research was identified in only three strategies. National research strategies did not refer to the European Union's health research programme. Public health research strategies of European countries need to be developed by ministries of health, working with the research community to achieve the European Research Area.

Public health systems research: the state of the field.

PubMed

Bagley, Prue; Lin, Vivian

2008-11-01

Public health infrastructure provides the building blocks required for the system to achieve public health goals. A systems approach to public health has been suggested as a means to tackle persistent and emerging problems. Systems and infrastructure are attracting increased research attention. A review of the Australian and international literature suggests an absence of empirical evidence about how the system and its component parts does, or should, work and highlights some of the difficulties associated with generating such evidence. It also indicates there is significant scope for further research.

Sustaining success: aligning the public health workforce in South-Eastern Europe with strategic public health priorities.

PubMed

Bjegovic-Mikanovic, Vesna; Santric-Milicevic, Milena; Cichowska, Anna; von Krauss, Martin Krayer; Perfilieva, Galina; Rebac, Boris; Zuleta-Marin, Ingrid; Dieleman, Marjolein; Zwanikken, Prisca

2018-06-01

To map out the Public Health Workforce (PHW) involved in successful public health interventions. We did a pilot assessment of human resources involved in successful interventions addressing public health challenges in the countries of South-Eastern Europe (SEE). High-level representatives of eight countries reported about success stories through the coaching by experts. During synthesizing qualitative data, experts applied triangulation by contacting additional sources of evidence and used the framework method in data analysis. SEE countries tailored public health priorities towards social determinants, health equalities, and prevention of non-communicable diseases. A variety of organizations participated in achieving public health success. The same applies to the wide array of professions involved in the delivery of Essential Public Health Operations (EPHOs). Key enablers of the successful work of PHW were staff capacities, competences, interdisciplinary networking, productivity, and funding. Despite diversity across countries, successful public health interventions have similar ingredients. Although PHW is aligned with the specific public health success, a productive interface between health and other sectors is crucial for rolling-out successful interventions.

[The introduction of the achievements of medical science in public health practice with using modern information technologies].

PubMed

Horban', A Ie

2012-01-01

The article analyzes some factors that complicate the availability of scholarly communication professionals of health of Ukraine to introduce the achievements of medical science into practice. Improved access will help the implementation created by the Ministry of Health of Ukraine United e-data-processing system.

Analysis of full-text publication and publishing predictors of abstracts presented at an Italian public health meeting (2005-2007).

PubMed

Castaldi, S; Giacometti, M; Toigo, W; Bert, F; Siliquini, R

2015-09-29

In Public Health, a thorough review of abstract quality evaluations and the publication history of studies presented at scientific meetings has never been conducted. To analyse the long-term outcome of quality abstracts submitted to conferences of Italian Society of Hygiene and Public Health (SItI) from 2005 to 2007, we conducted a second analysis of previously published material aiming to estimate full-text publication rate of high quality abstract presented at Italian public health meetings, and to identify predictors of full-text publication. The search was undertaken through scientific databases and search engines and through the web sites of the major Italian journals of Public Health. For each publication confirmed as a full text paper, the journal name, impact factor, year of publication, gender of the first author, type of study design, characteristics of the results and sample size were collected. The overall publication rate of the abstracts presented is 23.5%; most of the papers were published in Public Health journals (average impact factor: 3.007). Non universitary affiliation had resulted in a lower probability of publication, while some of the Conference topics had predisposed the studies to an increased likelihood of publication as well as poster form presentation. The method presented in this study provides a good framework for the evaluation of the scientific evidence. The findings achieved should be taken into consideration by the Scientific Societies during the contributions selection phase, with the aim of achieving a continuous improvement of work quality. In the future, it would be interesting to survey the abstract authors to identify reasons for unpublished data.

An evaluation of the International Monetary Fund's claims about public health.

PubMed

Stuckler, David; Basu, Sanjay; Gilmore, Anna; Batniji, Rajaie; Ooms, Gorik; Marphatia, Akanksha A; Hammonds, Rachel; McKee, Martin

2010-01-01

The International Monetary Fund's recent claims concerning its impact on public health are evaluated against available data. First, the IMF claims that health spending either does not change or increases with IMF-supported programs, but there is substantial evidence to the contrary. Second, the IMF claims to have relaxed strict spending requirements in response to the 2008-9 financial crisis, but there is no evidence supporting this claim, and some limited evidence from the Center for Economic Policy Research contradicting it. Third, the IMF states that wage ceilings on public health are no longer part of its explicit conditionalities to poor countries, as governments can choose how to achieve public spending targets; but in practice, ministers are left with few viable alternatives than to reduce health budgets to achieve specific IMF-mandated targets, so the result effectively preserves former policy. Fourth, the IMF's claim that it has increased aid to poor countries also seems to be contradicted by its policies of diverting aid to reserves, as well as evidence that a very small fraction of the Fund's new lending in response to the financial crisis has reached poor countries. Finally, the IMF's claim that it follows public health standards in tobacco control contrasts with its existing policies, which fail to follow the guidelines recommended by the World Bank and World Health Organization. The authors recommend that the IMF (1) become more transparent in its policies, practices, and data to allow improved independent evaluations of its impact on public health (including Health Impact Assessment) and (2) review considerable public health evidence indicating a negative association between its current policies and public health outcomes.

[The justification of the level of public financing of health care to enhance health of population of the Russian Federation].

PubMed

Ulumbekova, G Z

2013-01-01

The article discusses the justification of management of public financing of health care in Russia. The technique of comparative analysis and evaluation of dependences between public health care financing and indicators of population health has been applied. It is demonstrated that to achieve the values of 75.6 years of life expectancy at birth and 11 of total mortality as target indicators of population health up to 2018 the amount of public health care financing is to be increased up to 1.5 times or up to 6% of GDP per year in prices of 2011. The sources of additional health care financing are proposed.

Comprehensive effective and efficient global public health surveillance

PubMed Central

2010-01-01

At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources. Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR[2005]); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers. To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners. We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it’s needed, where it’s needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship of public health information; and second, the right of individuals to access real-time public health information that might impact their lives. The vision can be accomplished through an interoperable, global public health grid. Adopting guiding principles, the global community should circumscribe the overlapping interest, shared vision, and mutual benefit between the security and public health communities and define the boundaries. A global forum needs to be established to guide the consensus governance required for public health information sharing in the 21st century. PMID:21143825

Comprehensive effective and efficient global public health surveillance.

PubMed

McNabb, Scott J N

2010-12-03

At a crossroads, global public health surveillance exists in a fragmented state. Slow to detect, register, confirm, and analyze cases of public health significance, provide feedback, and communicate timely and useful information to stakeholders, global surveillance is neither maximally effective nor optimally efficient. Stakeholders lack a globa surveillance consensus policy and strategy; officials face inadequate training and scarce resources.Three movements now set the stage for transformation of surveillance: 1) adoption by Member States of the World Health Organization (WHO) of the revised International Health Regulations (IHR[2005]); 2) maturation of information sciences and the penetration of information technologies to distal parts of the globe; and 3) consensus that the security and public health communities have overlapping interests and a mutual benefit in supporting public health functions. For these to enhance surveillance competencies, eight prerequisites should be in place: politics, policies, priorities, perspectives, procedures, practices, preparation, and payers.To achieve comprehensive, global surveillance, disparities in technical, logistic, governance, and financial capacities must be addressed. Challenges to closing these gaps include the lack of trust and transparency; perceived benefit at various levels; global governance to address data power and control; and specified financial support from globa partners.We propose an end-state perspective for comprehensive, effective and efficient global, multiple-hazard public health surveillance and describe a way forward to achieve it. This end-state is universal, global access to interoperable public health information when it's needed, where it's needed. This vision mitigates the tension between two fundamental human rights: first, the right to privacy, confidentiality, and security of personal health information combined with the right of sovereign, national entities to the ownership and stewardship of public health information; and second, the right of individuals to access real-time public health information that might impact their lives.The vision can be accomplished through an interoperable, global public health grid. Adopting guiding principles, the global community should circumscribe the overlapping interest, shared vision, and mutual benefit between the security and public health communities and define the boundaries. A global forum needs to be established to guide the consensus governance required for public health information sharing in the 21st century.

Teaching Public Health Networks in England: an innovative approach to building public health capacity and capability.

PubMed

Orme, J; Pilkington, P; Gray, S; Rao, M

2009-12-01

This paper examines the development and achievements of the Teaching Public Health Networks (TPHNs) in England; an initiative that aimed to catalyse collaborative working between the public health workforce and further and higher education, to enhance public health knowledge in the wider workforce with a view to enhancing capacity to tackle inequalities and meeting public health targets. This paper highlights activities under three outcomes: mobilizing resources, people, money and materials; building capacity through training and infrastructure development; and raising public and political awareness. The TPHN approach is shown to have led to innovative developments in public health education and training, including engagement with professionals that have not previously had exposure to public health. This paper aims to disseminate the learning from this complex public health initiative, now in its third year of development, and to share examples of good practice. It is hoped that other countries can use the TPHN approach as a model to address the various common and country-specific challenges in public health workforce development.

Pedagogical Models for Enhancing the Cross-Cultural Online Public Health Learning Environment

ERIC Educational Resources Information Center

Banerjee, Srikanta; Firtell, Jill

2017-01-01

Background: Online distance learning (e-learning) is an established method for providing higher education on a global scale due to its potential to reduce inequalities particularly in the area of public health education. Simultaneously, multicultural education is a key component of health education and can be achieved by fostering cultural…

Building Capacity through Action Research Curricula Reviews

ERIC Educational Resources Information Center

Lee, Vanessa; Coombe, Leanne; Robinson, Priscilla

2015-01-01

In Australia, graduates of Master of Public Health (MPH) programmes are expected to achieve a set of core competencies, including a subset that is specifically related to Indigenous health. This paper reports on the methods utilised in a project which was designed using action research to strengthen Indigenous public health curricula within MPH…

Interviewing Key Informants: Strategic Planning for a Global Public Health Management Program

ERIC Educational Resources Information Center

Kun, Karen E.; Kassim, Anisa; Howze, Elizabeth; MacDonald, Goldie

2013-01-01

The Centers for Disease Control and Prevention's Sustainable Management Development Program (SMDP) partners with low- and middle-resource countries to develop management capacity so that effective global public health programs can be implemented and better health outcomes can be achieved. The program's impact however, was variable. Hence, there…

[Dynamics and interactions between the university community and public health 2.0].

PubMed

Rodríguez-Gómez, Rodolfo

2016-01-01

To explore the experiences of a group of participants in a university community with the web in general and with digital contents on public health, to describe their motivations and to understand how social networks influence their interaction with content on public health. Qualitative research. Deep semi-structured interviews were conducted to understand the phenomenon. Five categories emerged after the study: socialization and internalization of the cyberculture, social marketing linked to the web and public health, culture of fear and distrust, the concept of health, and the health system and public health. Participants have internalized the web and have given it a strong symbolic capital. The challenges of public health 2.0 are not only to achieve interaction with users and to get a place in cyberspace, but also to fight against the stigma of the "public" and to take advantage of the influence of the web on small-world networks to communicate.

Advances in public health accreditation readiness and quality improvement: evaluation findings from the National Public Health Improvement Initiative.

PubMed

McLees, Anita W; Thomas, Craig W; Nawaz, Saira; Young, Andrea C; Rider, Nikki; Davis, Mary

2014-01-01

Continuous quality improvement is a central tenet of the Public Health Accreditation Board's (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Evaluate the extent to which NPHII awardees have achieved program goals. NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. NPHII performance improvement managers or principal investigators. Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. NPHII appears to be supporting awardees' initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population.

A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology

PubMed Central

Burris, Scott; Ashe, Marice; Levin, Donna; Penn, Matthew; Larkin, Michelle

2017-01-01

Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health. PMID:26667606

A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology.

PubMed

Burris, Scott; Ashe, Marice; Levin, Donna; Penn, Matthew; Larkin, Michelle

2016-01-01

Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health.

Horizontal inequity in public health care service utilization for non-communicable diseases in urban Vietnam

PubMed Central

Kien, Vu Duy; Van Minh, Hoang; Giang, Kim Bao; Weinehall, Lars; Ng, Nawi

2014-01-01

Background A health system that provides equitable health care is a principal goal in many countries. Measuring horizontal inequity (HI) in health care utilization is important to develop appropriate and equitable public policies, especially policies related to non-communicable diseases (NCDs). Design A cross-sectional survey of 1,211 randomly selected households in slum and non-slum areas was carried out in four urban districts of Hanoi city in 2013. This study utilized data from 3,736 individuals aged 15 years and older. Respondents were asked about health care use during the previous 12 months; information included sex, age, and self-reported NCDs. We assessed the extent of inequity in utilization of public health care services. Concentration indexes for health care utilization and health care needs were constructed via probit regression of individual utilization of public health care services, controlling for age, sex, and NCDs. In addition, concentration indexes were decomposed to identify factors contributing to inequalities in health care utilization. Results The proportion of healthcare utilization in the slum and non-slum areas was 21.4 and 26.9%, respectively. HI in health care utilization in favor of the rich was observed in the slum areas, whereas horizontal equity was achieved among the non-slum areas. In the slum areas, we identified some key factors that affect the utilization of public health care services. Conclusion Our results suggest that to achieve horizontal equity in utilization of public health care services, policy should target preventive interventions for NCDs, focusing more on the poor in slum areas. PMID:25095780

An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS).

PubMed

Marten, Robert; McIntyre, Diane; Travassos, Claudia; Shishkin, Sergey; Longde, Wang; Reddy, Srinath; Vega, Jeanette

2014-12-13

Brazil, Russia, India, China, and South Africa (BRICS) represent almost half the world's population, and all five national governments recently committed to work nationally, regionally, and globally to ensure that universal health coverage (UHC) is achieved. This analysis reviews national efforts to achieve UHC. With a broad range of health indicators, life expectancy (ranging from 53 years to 73 years), and mortality rate in children younger than 5 years (ranging from 10·3 to 44·6 deaths per 1000 livebirths), a review of progress in each of the BRICS countries shows that each has some way to go before achieving UHC. The BRICS countries show substantial, and often similar, challenges in moving towards UHC. On the basis of a review of each country, the most pressing problems are: raising insufficient public spending; stewarding mixed private and public health systems; ensuring equity; meeting the demands for more human resources; managing changing demographics and disease burdens; and addressing the social determinants of health. Increases in public funding can be used to show how BRICS health ministries could accelerate progress to achieve UHC. Although all the BRICS countries have devoted increased resources to health, the biggest increase has been in China, which was probably facilitated by China's rapid economic growth. However, the BRICS country with the second highest economic growth, India, has had the least improvement in public funding for health. Future research to understand such different levels of prioritisation of the health sector in these countries could be useful. Similarly, the role of strategic purchasing in working with powerful private sectors, the effect of federal structures, and the implications of investment in primary health care as a foundation for UHC could be explored. These issues could serve as the basis on which BRICS countries focus their efforts to share ideas and strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Promise (and Pitfalls) of Public Health Policy Surveillance.

PubMed

Hodge, James G

2016-12-01

Though public health policy surveillance is an integral tool in correlating the law to scientifically based public health law studies, drawing accurate legal conclusions from collected data can be challenging. Data may be of poor quality, inaccessible to law and policy makers, or inapplicable to other jurisdictions over time and place. As Burris et al. (2016) advocate, modern, sophisticated, and interactive data collection systems would render more precise legal analysis tied to public health improvements. Although policy surveillance is promising, public health officials, health care providers, attorneys, and researchers must be skilled and prepared to successfully navigate and resolve potential pitfalls for its benefits to be fully realized. Among the significant challenges related to policy surveillance are: (1) timing; (2) agenda setting; (3) predictable misuse; and (4) politics inherent in a federalist public health legal infrastructure. As public health data infrastructure is developed, better legal approaches must be simultaneously crafted to achieve optimal public health outcomes. Copyright © 2016 by Duke University Press.

Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

PubMed Central

Mitra, Amal K.; Rodriguez-Fernandez, Gisela

2010-01-01

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC. PMID:20623022

Latin America and the Caribbean: assessment of the advances in public health for the achievement of the Millennium Development Goals.

PubMed

Mitra, Amal K; Rodriguez-Fernandez, Gisela

2010-05-01

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC.

Public Health in the Vilna Ghetto as a Form of Jewish Resistance

PubMed Central

Beinfeld, Solon; Hildebrandt, Sabine; Glantz, Leonard; Grodin, Michael A.

2015-01-01

We describe the system of public health that evolved in the Vilna Ghetto as an illustrative example of Jewish innovation and achievement during the Holocaust. Furthermore, we argue that by cultivating a sophisticated system of public health, the ghetto inmates enacted a powerful form of Jewish resistance, directly thwarting the intention of the Nazis to eliminate the inhabitants by starvation, epidemic, and exposure. In doing so, we aim to highlight applicable lessons for the broader public health literature. We hope that this unique story may gain its rightful place in the history of public health as an insightful case study of creative and progressive solutions to universal health problems in one of the most challenging environments imaginable. PMID:25521892

Social movements and public health advocacy in action: the UK people's health movement.

PubMed

Kapilashrami, Anuj; Smith, Katherine E; Fustukian, Suzanne; Eltanani, Mor Kandlik; Laughlin, Sue; Robertson, Tony; Muir, Janet; Gallova, Eva; Scandrett, Eurig

2016-09-01

There are growing calls within public health for researchers and practitioners working to improve and protect the public's health to become more involved in politics and advocacy. Such a move takes practitioners and researchers beyond the traditional, evidence-based public health paradigm, raising potential dilemmas and risks for those who undertake such work. Drawing on the example of the People's Health Movement, this short paper argues that advocacy and social movements are an essential component of public health's efforts to achieve great health equity. It outlines how the Scottish branch of the People's Health Movement sought to overcome potential tensions between public health evidence and advocacy by developing a regional manifesto for health via transparent and democratic processes which combine empirical and experiential evidence. We suggest that this is an illustrative example of how potential tensions between public health research and advocacy can be overcome, through bottom-up movements of solidarity and action. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessing the level of public health partner spending using the funding formula analysis tool.

PubMed

Bernet, Patrick M

2012-01-01

Public health services are delivered through a variety of organizations. Traditional accounting of public health expenditures typically captures only spending by government agencies. New Hampshire collected information from public health partners, such as community centers that host smoking cessation classes or health education done by Girls, Inc. This study compares the new data to spending by government agencies, focusing on breakdowns by fund source and service categories. Expanded funds secured by these partners account for a 42% of all local public health spending, and they spent 4 times more than government agencies on promoting healthy behavior. The funding formula analysis tool revealed that these partners spent in ways that would be politically difficult to achieve. In an era of declining budgets, an understanding of public health's partners is increasingly vital.

(Public) Health and Human Rights in Practice.

PubMed

Annas, George J; Mariner, Wendy K

2016-02-01

Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing. Copyright © 2016 by Duke University Press.

Social media, knowledge translation, and action on the social determinants of health and health equity: A survey of public health practices.

PubMed

Ndumbe-Eyoh, Sume; Mazzucco, Agnes

2016-11-01

The growth of social media presents opportunities for public health to increase its influence and impact on the social determinants of health and health equity. The National Collaborating Centre for Determinants of Health at St. Francis Xavier University conducted a survey during the first half of 2016 to assess how public health used social media for knowledge translation, relationship building, and specific public health roles to advance health equity. Respondents reported that social media had an important role in public health. Uptake of social media, while relatively high for personal use, was less present in professional settings and varied for different platforms. Over 20 per cent of those surveyed used Twitter or Facebook at least weekly for knowledge exchange. A lesser number used social media for specific health equity action. Opportunities to enhance the use of social media in public health persist. Capacity building and organizational policies that support social media use may help achieve this.

Exploring an Undergraduate Public Health Learning Environment through the Teaching for Understanding (TfU) Framework

ERIC Educational Resources Information Center

MacLeod, Fiona

2009-01-01

Background: The BSc Public Health and Health Promotion at University College Cork (UCC) aims to produce graduates who are passionate about their discipline. Teachers need to communicate this "passion" to students, but it can be difficult to know whether this has been achieved. The TFU framework makes such an outcome explicit, through…

Social marketing, stages of change, and public health smoking interventions.

PubMed

Diehr, Paula; Hannon, Peggy; Pizacani, Barbara; Forehand, Mark; Meischke, Hendrika; Curry, Susan; Martin, Diane P; Weaver, Marcia R; Harris, Jeffrey

2011-04-01

As a "thought experiment," the authors used a modified stages of change model for smoking to define homogeneous segments within various hypothetical populations. The authors then estimated the population effect of public health interventions that targeted the different segments. Under most assumptions, interventions that emphasized primary and secondary prevention, by targeting the Never Smoker, Maintenance, or Action segments, resulted in the highest nonsmoking life expectancy. This result is consistent with both social marketing and public health principles. Although the best thing for an individual smoker is to stop smoking, the greatest public health benefit is achieved by interventions that target nonsmokers.

Global Disease Detection-Achievements in Applied Public Health Research, Capacity Building, and Public Health Diplomacy, 2001-2016.

PubMed

Rao, Carol Y; Goryoka, Grace W; Henao, Olga L; Clarke, Kevin R; Salyer, Stephanie J; Montgomery, Joel M

2017-11-01

The Centers for Disease Control and Prevention has established 10 Global Disease Detection (GDD) Program regional centers around the world that serve as centers of excellence for public health research on emerging and reemerging infectious diseases. The core activities of the GDD Program focus on applied public health research, surveillance, laboratory, public health informatics, and technical capacity building. During 2015-2016, program staff conducted 205 discrete projects on a range of topics, including acute respiratory illnesses, health systems strengthening, infectious diseases at the human-animal interface, and emerging infectious diseases. Projects incorporated multiple core activities, with technical capacity building being most prevalent. Collaborating with host countries to implement such projects promotes public health diplomacy. The GDD Program continues to work with countries to strengthen core capacities so that emerging diseases can be detected and stopped faster and closer to the source, thereby enhancing global health security.

Evaluating impacts of air pollution in China on public health: Implications for future air pollution and energy policies

NASA Astrophysics Data System (ADS)

Wang, Xiaoping; Mauzerall, Denise L.

Our objective is to establish the link between energy consumption and technologies, air pollution concentrations, and resulting impacts on public health in eastern China. We use Zaozhuang, a city in eastern China heavily dependent on coal, as a case study to quantify the impacts that air pollution in eastern China had on public health in 2000 and the benefits in improved air quality and health that could be obtained by 2020, relative to business-as-usual (BAU), through the implementation of best available emission control technology (BACT) and advanced coal gasification technologies (ACGT). We use an integrated assessment approach, utilizing state-of-the-science air quality and meteorological models, engineering, epidemiology, and economics, to achieve this objective. We find that total health damages due to year 2000 anthropogenic emissions from Zaozhuang, using the "willingness-to-pay" metric, was equivalent to 10% of Zaozhuang's GDP. If all health damages resulting from coal use were internalized in the market price of coal, the year 2000 price would have more than tripled. With no new air pollution controls implemented between 2000 and 2020 but with projected increases in energy use, we estimate health damages from air pollution exposure to be equivalent to 16% of Zaozhuang's projected 2020 GDP. BACT and ACGT (with only 24% penetration in Zaozhuang and providing 2% of energy needs in three surrounding municipalities) could reduce the potential health damage of air pollution in 2020 to 13% and 8% of projected GDP, respectively. Benefits to public health, of substantial monetary value, can be achieved through the use of BACT; health benefits from the use of ACGT could be even larger. Despite significant uncertainty associated with each element of the integrated assessment approach, we demonstrate that substantial benefits to public health could be achieved in this region of eastern China through the use of additional pollution controls and particularly from the use of advanced coal gasification technology. Without such controls, the impacts of air pollution on public health, presently considerable, will increase substantially by 2020.

US Centers for Disease Control and Prevention and Its Partners' Contributions to Global Health Security.

PubMed

Tappero, Jordan W; Cassell, Cynthia H; Bunnell, Rebecca E; Angulo, Frederick J; Craig, Allen; Pesik, Nicki; Dahl, Benjamin A; Ijaz, Kashef; Jafari, Hamid; Martin, Rebecca

2017-12-01

To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.

Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?

PubMed

Rabbani, Fauziah; Shipton, Leah; White, Franklin; Nuwayhid, Iman; London, Leslie; Ghaffar, Abdul; Ha, Bui Thi Thu; Tomson, Göran; Rimal, Rajiv; Islam, Anwar; Takian, Amirhossein; Wong, Samuel; Zaidi, Shehla; Khan, Kausar; Karmaliani, Rozina; Abbasi, Imran Naeem; Abbas, Farhat

2016-09-07

Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.

Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions.

PubMed

Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian

2016-01-01

The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

[Teaching performance assessment in Public Health employing three different strategies].

PubMed

Martínez-González, Adrián; Moreno-Altamirano, Laura; Ponce-Rosas, Efrén Raúl; Martínez-Franco, Adrián Israel; Urrutia-Aguilar, María Esther

2011-01-01

The educational system depends upon the quality and performance of their faculty and should therefore be process of continuous improvement. To assess the teaching performance of the Public Health professors, at the Faculty of Medicine, UNAM through three strategies. Justification study. The evaluation was conducted under a mediational model through three strategies: students' opinion assessment, self-assessment and students' academic achievement. We applied descriptive statistics, Student t test, ANOVA and Pearson correlation. Twenty professors were evaluated from the Public Health department, representing 57% of all them who teach the subject. The professor's performance was highly valued self-assessment compared with assessment of student opinion, was confirmed by statistical analysis the difference was significant. The difference amongst the three evaluation strategies became more evident between self-assessment and the scores obtained by students in their academic achievement. The integration of these three strategies offers a more complete view of the teacher's performance quality. Academic achievement appears to be a more objective strategy for teaching performance assessment than students' opinion and self-assessment.

Competitive funding and structures for public health research in European countries.

PubMed

McCarthy, Mark; Conceição, Claudia; Grimaud, Olivier; Katreniakova, Zuzana; Saliba, Amanda; Sammut, Marvic; Narkauskaité, Laura

2013-11-01

The European Union is giving increasing emphasis to research as a driver for innovation and economic development. The European collaborative study PHIRE (Public Health Innovation and Research in Europe) investigated the funding and structures of public health research at national level in European countries. Background materials were prepared for national public health associations of European countries to hold workshops or discussions with research and policy stakeholders on their public health research systems. The reports, supplemented from internet sources for 23 EU countries (four did not contribute), provided information for framework analysis. All countries have public funding and administrative structures for research, but structures for public health research are more varied. In most countries, competitive health research funding is controlled by the Ministry of Science, with little input from the Ministry of Health. In four countries, Ministries of Health provide competitive funding alongside Ministries of Science, and in two countries there is a single health research council. There is no comparative reporting of public health research funding, and little connection with European public health research programmes. Europe needs a comprehensive picture of national and regional systems of public health research, in order to critically assess them and better adapt to changes and challenges, and to achieve a European Research Area for public health.

Great expectations for the World Health Organization: a Framework Convention on Global Health to achieve universal health coverage.

PubMed

Ooms, G; Marten, R; Waris, A; Hammonds, R; Mulumba, M; Friedman, E A

2014-02-01

Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

State-level variations in income-related inequality in health and health achievement in the US.

PubMed

Xu, Ke Tom

2006-07-01

The objective of this study was to examine state-level variations in income-related inequality in health and overall health achievement in the US. Data that were representative of the US and each state in 2001 were extracted from the Current Population Survey 2001. Income-related inequality in health and health achievement were measured by Health Concentration and Health Achievement Indices, respectively. Significant variations were found across states in income-related inequality in health and health achievement. In particular, states in the south and east regions, on average, experienced a higher degree of health inequality and lower health achievement. About 80% of the state-level variation in health achievement could be explained by demographics, economic structure and performance, and state and local government spending and burden. In contrast, medical care resource indicators were not found to contribute to health achievement in states. States with better health achievement were more urbanized, had lower proportions of minority groups, females and the elderly, fewer individuals below the poverty line, larger primary industry, and lower unemployment rates. Also, per capita state and local government spending, particularly the proportion spent on public health, was positively associated with better health achievement. Because of the direct implications of health level and distribution in resource allocation and social norms, states with a lower level of health achievement need to prioritize efforts in increasing and reallocating resources to diminish health inequality and to improve population health.

Why has the Universal Coverage Scheme in Thailand achieved a pro-poor public subsidy for health care?

PubMed Central

2012-01-01

Background Thailand has achieved universal health coverage since 2002 through the implementation of the Universal Coverage Scheme (UCS) for 47 million of the population who were neither private sector employees nor government employees. A well performing UCS should achieve health equity goals in terms of health service use and distribution of government subsidy on health. With these goals in mind, this paper assesses the magnitude and trend of government health budget benefiting the poor as compared to the rich UCS members. Method Benefit incidence analysis was conducted using the nationally representative household surveys, Health and Welfare Surveys, between 2003 and 2009. UCS members are grouped into five different socio-economic status using asset indexes and wealth quintiles. Findings The total government subsidy, net of direct household payment, for combined outpatient (OP) and inpatient (IP) services to public hospitals and health facilities provided to UCS members, had increased from 30 billion Baht (US$ 1 billion) in 2003 to 40-46 billion Baht in 2004-2009. In 2003 for 23% and 12% of the UCS members who belonged to the poorest and richest quintiles of the whole-country populations respectively, the share of public subsidies for OP service was 28% and 7% for the poorest and the richest quintiles, whereby for IP services the share was 27% and 6% for the poorest and richest quintiles respectively. This reflects a pro-poor outcome of public subsidies to healthcare. The OP and IP public subsidies remained consistently pro-poor in subsequent years. The pro-poor benefit incidence is determined by higher utilization by the poorest than the richest quintiles, especially at health centres and district hospitals. Thus the probability and the amount of household direct health payment for public facilities by the poorest UCS members were less than their richest counterparts. Conclusions Higher utilization and better financial risk protection benefiting the poor UCS members are the results of extensive geographical coverage of health service infrastructure especially at district level, adequate finance and functioning primary healthcare, comprehensive benefit package and zero copayment at points of services. PMID:22992431

Achieving Healthy School Siting and Planning Policies: Understanding Shared Concerns of Environmental Planners, Public Health Professionals, and Educators

PubMed Central

Cohen, Alison

2013-01-01

Policy decisions regarding the quality of the physical school environment—both, school siting and school facility planning policies—are often considered through the lens of environmental planning, public health, or education policy, but rarely through all three. Environmental planners consider environmental justice issues on a local level and/or consider the regional impact of a school. Public health professionals focus on toxic exposures and populations particularly vulnerable to negative health outcomes. Educators and education policymakers emphasize investing in human capital of both students and staff. By understanding these respective angles and combining these efforts around the common goals of achieving adequacy and excellence, we can work towards a regulatory system for school facilities that recognizes children as a uniquely vulnerable population and seeks to create healthier school environments in which children can learn and adults can work. PMID:20359991

Critical Opportunities for Public Health Law: A Call for Action

PubMed Central

Wood, Jennifer; Burris, Scott; Wagenaar, Alexander C.; Ibrahim, Jennifer K.; Swanson, Jeffrey W.

2013-01-01

Although legal interventions are responsible for many sentinel public health achievements, law is underutilized as a tool for advancing population health. Our purpose was to identify critical opportunities for public health lawmaking. We articulated key criteria and illustrated their use with 5 examples. These opportunities involve significant health problems that are potentially amenable to change through law and for which an effective legal intervention is available: optimizing graduated driver licensing laws, increasing tax rates on alcoholic beverages, regulating sodium in foods, enacting laws to facilitate reversal of opioid overdoses, and improving mental health interventions in the college setting. We call for a national conversation about critical opportunities for public health law to advance evidence-based policymaking. PMID:24028265

Achieving Population Health in Accountable Care Organizations

PubMed Central

Walker, Deborah Klein

2013-01-01

Although “population health” is one of the Institute for Healthcare Improvement’s Triple Aim goals, its relationship to accountable care organizations (ACOs) remains ill-defined and lacks clarity as to how the clinical delivery system intersects with the public health system. Although defining population health as “panel” management seems to be the default definition, we called for a broader “community health” definition that could improve relationships between clinical delivery and public health systems and health outcomes for communities. We discussed this broader definition and offered recommendations for linking ACOs with the public health system toward improving health for patients and their communities. PMID:23678910

Healthy and Ready to Learn: Effects of a School-Based Public Health Insurance Outreach Program for Kindergarten-Aged Children

ERIC Educational Resources Information Center

Jenkins, Jade Marcus

2018-01-01

Background: Rates of child insurance coverage have increased due to expansions in public programs, but many eligible children remain uninsured. Uninsured children are less likely to receive preventative care, which leads to poorer health and achievement in the long term. This study is an evaluation of a school-based health insurance outreach…

Does autonomization of public hospitals and exposure to market pressure complement or debilitate social health insurance systems? Evidence from a low-income country.

PubMed

Sepehri, Ardeshir

2014-01-01

Granting public hospitals greater autonomy and creating organizational arrangements that mimic the private sector and encourage competition is often promoted as a way to increase efficiency and public accountability and to improve quality of care at these facilities. The existence of good-quality health infrastructure, in turn, encourages the population to join and support the social health insurance system and achieve universal coverage. This article provides a critical review of hospital autonomization, using Vietnam's experience to assess the influence of hospital autonomy on the sustainability of Vietnam's social health insurance. The evidence suggests that a reform process based on greater autonomy of resource mobilization and on the retention and use of own-source revenues can create perverse incentives among managers and health care providers, leading to the development of a two-tiered provision of clinical care, provider-induced supply of an inefficient service mix, a high degree of duplication, wasteful investment, and cost escalation. Rather than complementing social health insurance and helping the country to achieve universal coverage, granting public hospitals greater autonomy that mimics the private sector may indeed undermine the legitimacy and sustainability of social health insurance as health care costs escalate and higher quality of care remains elusive.

Health care financing in Nigeria: Implications for achieving universal health coverage.

PubMed

Uzochukwu, B S C; Ughasoro, M D; Etiaba, E; Okwuosa, C; Envuladu, E; Onwujekwe, O E

2015-01-01

The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

Can nurses rise to the public health challenge? How a novel solution in nurse education can address this contemporary question.

PubMed

Turner-Wilson, Angela L; Mills, Anne M; Rees, Karen

2017-10-01

This paper raises the problem of how improvements in health outcomes, a key component in many governments' strategies, can be achieved. The work highlights a novel undergraduate educational approach which offers solutions to public health challenges within nursing. Against the backdrop of one UK university institution it discusses approaches that can guide nursing students towards a deeper understanding and engagement within the principles of public health. It then proposes how nurses can use their learning to become leaders of health improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Competence necessary for Japanese public health center directors in responding to public health emergencies.

PubMed

Tachibanai, Tomoko; Takemura, Shinji; Sone, Tomofumi; Segami, Kiyotaka; Kato, Noriko

2005-11-01

To clarify the "competencies" required of public health center directors in "public health emergency responses." We selected as our subjects six major public health emergencies in Japan that accorded with a definition of a "health crisis." Their types were: (1) natural disaster; (2) exposure to toxic substances caused by individuals; (3) food poisoning; and (4) accidental hospital infection. Item analysis was conducted using the Incident Analysis Method, based on the "Medical SAFER Technique." The competencies of public health center directors required the following actions: (1) to estimate the impact on local health from the "first notification" of the occurrence and the "initial investigation"; (2) to manage a thorough investigation of causes; (3) to manage organizations undertaking countermeasures; (4) to promptly provide precise information on countermeasures, etc.; and (5) to create systems enabling effective application of countermeasures against recurrence of incidents, and to achieve social consensus. For public health preparedness, public health center directors should have the following competencies: (1) the ability to estimate the "impact" of public health emergencies that have occurred or may occur; (2) be able to establish and carry out proactive policies; (3) be persuasive; and (4) have organizational management skills.

The economic cost of measles: Healthcare, public health and societal costs of the 2012-13 outbreak in Merseyside, UK.

PubMed

Ghebrehewet, Sam; Thorrington, Dominic; Farmer, Siobhan; Kearney, James; Blissett, Deidre; McLeod, Hugh; Keenan, Alex

2016-04-04

Measles is a highly contagious vaccine-preventable infection that caused large outbreaks in England in 2012 and 2013 in areas which failed to achieve herd protection levels (95%) consistently. We sought to quantify the economic costs associated with the 2012-13 Merseyside measles outbreak, relative to the cost of extending preventative vaccination to secure herd protection. A costing model based on a critical literature review was developed. A workshop and interviews were held with key stakeholders in the Merseyside outbreak to understand the pathway of a measles case and then quantify healthcare activity and costs for the main NHS providers and public health team incurred during the initial four month period to May 2012. These data were used to model the total costs of the full outbreak to August 2013, comprising those to healthcare providers for patient treatment, public health and societal productivity losses. The modelled total cost of the full outbreak was compared to the cost of extending the preventative vaccination programme to achieve herd protection. The Merseyside outbreak included 2458 reported cases. The estimated cost of the outbreak was £ 4.4m (sensitivity analysis £ 3.9 m to £ 5.2m) comprising 15% (£ 0.7 m) NHS patient treatment costs, 40% (£ 1.8m) public health costs and 44% (£ 2.0m) for societal productivity losses. In comparison, over the previous five years in Cheshire and Merseyside a further 11,793 MMR vaccinations would have been needed to achieve herd protection at an estimated cost of £ 182,909 (4% of the total cost of the measles outbreak). Failure to consistently reach MMR uptake levels of 95% across all localities and sectors (achieve herd protection) risks comparatively higher economic costs associated with the containment (including healthcare costs) and implementation of effective public health management of outbreaks. Commissioned by the Cheshire and Merseyside Public Health England Centre. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

The public health leadership certificate: a public health and primary care interprofessional training opportunity.

PubMed

Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

2014-03-01

This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

The Irish health system: developments in strategy, structure, funding and delivery since 1980.

PubMed

Wiley, Miriam M

2005-09-01

As the Irish health system embarks upon its first major structural reorganisation in over 30 years, developments within this system over the past two decades are assessed. Real cuts in health expenditure achieved in the 1980s contrast sharply with the unprecedented increase in resources devoted to the health system in the 1990s. While successive statements of health strategy have prioritised the objectives of equity, efficiency and quality of care, questions arise regarding the return achieved with the increased investment. With higher levels of economic growth, more people have been buying private health insurance such that almost half the population are now privately insured. At the same time, the numbers with eligibility for health services without charge have decreased while those from lower socio-economic groups continue to have higher levels of utilisation. Equity issues arise, however, with regard to access to public hospitals as the rate of growth in admissions for private patients outstrips that for public patients. The establishment of a National Treatment Purchase Fund to purchase treatment in private facilities for public patients on waiting lists raises efficiency and equity questions as the treatment of private patients in public hospitals is heavily subsidised while the State pays full cost for the treatment of public patients in private facilities. Copyright (c) 2005 John Wiley & Sons, Ltd.

[Economics, politics, and public health in Porfirian Mexico (1876-1910)].

PubMed

Carrillo, Ana María

2002-01-01

The article examines the scientific, political, and economic elements that permitted the birth of modern public health in Mexico under the Porfirio Díaz administration (1876-1910). Firstly, a portion of Mexican physicians were open to the discoveries of microbiology, immunology, and epidemiology. Secondly, the State's growing concentration of power in public health matters ran parallel to its concentration of disciplinary political power and enabled this new knowledge to be placed at the service of collective health problem prevention. Lastly, both imperialism and the Porfirian elite needed to protect their business interests. The article evaluates public health achievements and limitations during the Porfirian period, abruptly interrupted by the revolution begun in 1910.

Application of VPN technique in the construction of public health information system.

PubMed

Hu, Xianming; Deng, Yongzhi; Lu, Zhuxun; Li, Shukai; Wang, Guoping; Lu, Suqin

2005-01-01

Data communication and sharing of five level network of Public Health Information System, i.e. nation, province, district (city), county, and town, as far as to the countryside level were described, and how to apply the three solutions, i.e. Access VPN, Intranet VPN, and Extranet VPN of VPN technique to achieve the appropriation of the public network was also presented.

Environmental Noise Pollution in the United States: Developing an Effective Public Health Response

PubMed Central

Hammer, Monica S.; Swinburn, Tracy K.

2013-01-01

Background: Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution. Objectives: We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure. Discussion: We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions. Conclusion: Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda. Citation: Hammer MS, Swinburn TK, Neitzel RL. 2014. Environmental noise pollution in the United States: developing an effective public health response. Environ Health Perspect 122:115–119; http://dx.doi.org/10.1289/ehp.1307272 PMID:24311120

Eminence, IQ, physical and mental health, and achievement domain : Cox's 282 Geniuses revisited.

PubMed

Simonton, Dean Keith; Song, Anna V

2009-04-01

Catharine Cox published two studies of highly eminent creators and leaders, the first in 1926 as the second volume of Terman's landmark Genetic Studies of Genius and the second in 1936 as a coauthored article. The former publication concentrated on the relation between IQ and achieved eminence, and the latter focused on early physical and mental health. Taking advantage of unpublished data from the second study, we examined, for the first time, the relationships among achieved eminence, IQ, early physical and mental health, and achievement domain. The correlation and regression analyses showed, for these 282 individuals, that eminence is a positive function of IQ and that IQ is a positive function of mental health and a negative function of physical health, implying an indirect effect of physical and mental health on eminence. Furthermore, levels of early physical and mental health vary across 10 specific domains of achievement.

Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.

PubMed

Somerville, Claire; Marteau, Theresa M; Kinmonth, Ann Louise; Cohn, Simon

2015-12-01

Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

Building national public health capacity for managing chemical events: A case study of the development of health protection services in the United Kingdom

PubMed Central

Palmer, Stephen; Coleman, Gary

2013-01-01

The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved ‘adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases. PMID:23447032

Building national public health capacity for managing chemical events: a case study of the development of health protection services in the United Kingdom.

PubMed

Palmer, Stephen; Coleman, Gary

2013-05-01

The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved 'adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases.

Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage.

PubMed

Kwon, Soonman

2009-01-01

South Korea introduced mandatory social health insurance for industrial workers in large corporations in 1977, and extended it incrementally to the self-employed until it covered the entire population in 1989. Thirty years of national health insurance in Korea can provide valuable lessons on key issues in health care financing policy which now face many low- and middle-income countries aiming to achieve universal health care coverage, such as: tax versus social health insurance; population and benefit coverage; single scheme versus multiple schemes; purchasing and provider payment method; and the role of politics and political commitment. National health insurance in Korea has been successful in mobilizing resources for health care, rapidly extending population coverage, effectively pooling public and private resources to purchase health care for the entire population, and containing health care expenditure. However, there are also challenges posed by the dominance of private providers paid by fee-for-service, the rapid aging of the population, and the public-private mix related to private health insurance.

A glossary of theories for understanding policymaking.

PubMed

Smith, Katherine Elizabeth; Katikireddi, Srinivasa Vittal

2013-02-01

Public health practitioners and researchers often seek to influence public policies in order to improve population health and/or reduce health inequalities. However, these efforts frequently appear to be uninformed by the many empirically-based theories about policymaking that have been developed within political science. This glossary provides a brief overview of some of the most popular of these theories, describing how each: frames the policymaking process; portrays the relationships and influence of specific policy actors; and depicts the potential for policy change (or inertia). Examples of their application to public health are provided to help improve understanding of the material presented. Throughout the article, the implications of the different theories for public health researchers and advocates seeking to inform policy decisions are emphasised. The glossary aims to provide an accessible overview to key theories about policy and decision-making, with a view to supporting public health efforts to achieve healthier public policies.

Public Health and Social Ideas in Modern Brazil

PubMed Central

Lima, Nísia Trindade

2007-01-01

Public health in Brazil achieved remarkable development at the turn of the 20th century thanks in part to physicians and social thinkers who made it central to their proposals for “modernizing” the country. Public health was more than a set of medical and technical measures; it was fundamental to the project of nation building. I trace the interplay between public health and social ideas in the late 19th and early 20th centuries. Physicians and social thinkers challenged the traditional belief that Brazil’s sociocultural and ethnic diversity was an obstacle to modernization, and they promoted public health as the best prescription for national unity. Public health ideas in developing countries such as Brazil may have a greater impact when they are intertwined with social thought and with the processes of nation building and construction of a modern society. PMID:17538074

Why psychopathy matters: Implications for public health and violence prevention✩

PubMed Central

Reidy, Dennis E.; Kearns, Megan C.; DeGue, Sarah; Lilienfeld, Scott O.; Massetti, Greta; Kiehl, Kent A.

2018-01-01

Psychopathy is an early-appearing risk factor for severe and chronic violence. The violence largely attributable to psychopathy constitutes a substantial portion of the societal burden to the public health and criminal justice systems, and thus necessitates significant attention from prevention experts. Yet, despite a vast base of research in psychology and criminology, the public health approach to violence has generally neglected to consider this key variable. Fundamentally, the public health approach to violence prevention is focused on achieving change at the population level to provide the most benefit to the maximum number of people. Increasing attention to the individual-level factor of psychopathy in public health could improve our ability to reduce violence at the community and societal levels. We conclude that the research literature on psychopathy points to a pressing need for a broad-based public health approach with a focus on primary prevention. Further, we consider how measuring psychopathy in public health research may benefit violence prevention, and ultimately society, in general. PMID:29593448

Towards achievement of universal health care in India by 2020: a call to action

PubMed Central

Reddy, K Srinath; Patel, Vikram; Jha, Prabhat; Paul, Vinod K; Shiva Kumar, A K; Dandona, Lalit

2016-01-01

To sustain the positive economic trajectory that India has had during the past decade, and to honour the fundamental right of all citizens to adequate health care, the health of all Indian people has to be given the highest priority in public policy. We propose the creation of the Integrated National Health System in India through provision of universal health insurance, establishment of autonomous organisations to enable accountable and evidence-based good-quality health-care practices and development of appropriately trained human resources, the restructuring of health governance to make it coordinated and decentralised, and legislation of health entitlement for all Indian people. The key characteristics of our proposal are to strengthen the public health system as the primary provider of promotive, preventive, and curative health services in India, to improve quality and reduce the out-of-pocket expenditure on health care through a well regulated integration of the private sector within the national health-care system. Dialogue and consensus building among the stakeholders in the government, civil society, and private sector are the next steps to formalise the actions needed and to monitor their achievement. In our call to action, we propose that India must achieve health care for all by 2020. PMID:21227489

Towards achievement of universal health care in India by 2020: a call to action.

PubMed

Reddy, K Srinath; Patel, Vikram; Jha, Prabhat; Paul, Vinod K; Kumar, A K Shiva; Dandona, Lalit

2011-02-26

To sustain the positive economic trajectory that India has had during the past decade, and to honour the fundamental right of all citizens to adequate health care, the health of all Indian people has to be given the highest priority in public policy. We propose the creation of the Integrated National Health System in India through provision of universal health insurance, establishment of autonomous organisations to enable accountable and evidence-based good-quality health-care practices and development of appropriately trained human resources, the restructuring of health governance to make it coordinated and decentralised, and legislation of health entitlement for all Indian people. The key characteristics of our proposal are to strengthen the public health system as the primary provider of promotive, preventive, and curative health services in India, to improve quality and reduce the out-of-pocket expenditure on health care through a well regulated integration of the private sector within the national health-care system. Dialogue and consensus building among the stakeholders in the government, civil society, and private sector are the next steps to formalise the actions needed and to monitor their achievement. In our call to action, we propose that India must achieve health care for all by 2020. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home

DTIC Science & Technology

2011-01-01

The Quadruple Aim: Working Together, Achieving Success 2011 Military Health System Conference TMA and Services Using Technology, Clinical Workflow...Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...Surgeon General Chief Medical Information Officer 1 Military Health System Conference Report Documentation Page Form ApprovedOMB No. 0704-0188 Public

[Public health and mental health: methodological tools to evaluate the Brazilian Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System].

PubMed

Onocko-Campos, Rosana Teresa; Furtado, Juarez Pereira

2006-05-01

This article presents a preliminary discussion of potential methodological tools for qualitative research on the Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System (SUS). The relevance of mental health within the field of public health is examined. The study focuses on the high prevalence of mental disorders and the disproportionate lack of studies on the interface between mental health and public health. The establishment of an interdisciplinary field between public health and mental health is proposed to meet common needs by achieving similar perspectives in knowledge and practice. A particular group of tools is proposed, emphasizing the importance of reclaiming and guaranteeing the roles of various social actors to shape the assessment process, the need for collecting and standardizing academic studies on the topic, and the importance of promoting a new research field focusing on public health policies to support policymakers, managers, and health teams in reshaping their practices.

Boosting health insurance coverage in developing countries: do conditional cash transfer programmes matter in Mexico?

PubMed

Biosca, Olga; Brown, Heather

2015-03-01

Achieving universal health insurance coverage is a goal for many developing countries. Even when universal health insurance programmes are in place, there are significant barriers to reaching the lowest socio-economic groups such as a lack of awareness of the programmes or knowledge of the benefits to participating in the insurance market. Conditional cash transfer (CCT) programmes can encourage participation through mandatory health education classes, increased contact with the health care system and cash payments to reduce costs of participating in the insurance market. To explore if participation in a CCT programme in Mexico, Oportunidades, is significantly associated with self-reported enrolment in a public health insurance programme. Cross-sectional data from 2007 collected on 29 595 Mexican households where the household head is aged between ages 15 and 60 were analysed. A logit model was used to estimate the association between Oportunidades participation and awareness of enrolment in a public health insurance programme. Participation in the Oportunidades programme is associated with a 25% higher likelihood of being actively aware of enrolment in Seguro Popular, a public health insurance scheme for the lowest socio-economic groups. Participation in the Oportunidades CCT programme is positively associated with awareness of enrolment in public health insurance. CCT programmes may be used to promote participation of the lowest socio-economic groups in universal public health insurance systems. This is crucial to achieving universal health insurance coverage in developing countries. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

40 CFR 63.43 - Maximum achievable control technology (MACT) determinations for constructed and reconstructed...

Code of Federal Regulations, 2012 CFR

2012-07-01

... achieving such emission reduction and any non-air quality health and environmental impacts and energy..., and analysis of cost and non-air quality health environmental impacts or energy requirements for the...-day period for submittal of public comment; and (iii) A notice by prominent advertisement in the area...

40 CFR 63.43 - Maximum achievable control technology (MACT) determinations for constructed and reconstructed...

Code of Federal Regulations, 2014 CFR

2014-07-01

... achieving such emission reduction and any non-air quality health and environmental impacts and energy..., and analysis of cost and non-air quality health environmental impacts or energy requirements for the...-day period for submittal of public comment; and (iii) A notice by prominent advertisement in the area...

40 CFR 63.43 - Maximum achievable control technology (MACT) determinations for constructed and reconstructed...

Code of Federal Regulations, 2013 CFR

2013-07-01

... achieving such emission reduction and any non-air quality health and environmental impacts and energy..., and analysis of cost and non-air quality health environmental impacts or energy requirements for the...-day period for submittal of public comment; and (iii) A notice by prominent advertisement in the area...

Environmental noise pollution in the United States: developing an effective public health response.

PubMed

Hammer, Monica S; Swinburn, Tracy K; Neitzel, Richard L

2014-02-01

Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution. We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure. We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions. Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda.

A unique funding opportunity for public health in Texas.

PubMed

Schlenker, Thomas; Huber, Carol A

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.

Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

PubMed

McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

2011-07-01

Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

Disentangling patient and public involvement in healthcare decisions: why the difference matters.

PubMed

Fredriksson, Mio; Tritter, Jonathan Q

2017-01-01

Patient and public involvement has become an integral aspect of many developed health systems and is judged to be an essential driver for reform. However, little attention has been paid to the distinctions between patients and the public, and the views of patients are often seen to encompass those of the general public. Using an ideal-type approach, we analyse crucial distinctions between patient involvement and public involvement using examples from Sweden and England. We highlight that patients have sectional interests as health service users in contrast to citizens who engage as a public policy agent reflecting societal interests. Patients draw on experiential knowledge and focus on output legitimacy and performance accountability, aim at typical representativeness, and a direct responsiveness to individual needs and preferences. In contrast, the public contributes with collective perspectives generated from diversity, centres on input legitimacy achieved through statistical representativeness, democratic accountability and indirect responsiveness to general citizen preferences. Thus, using patients as proxies for the public fails to achieve intended goals and benefits of involvement. We conclude that understanding and measuring the impact of patient and public involvement can only develop with the application of a clearer comprehension of the differences. © 2016 Foundation for the Sociology of Health & Illness.

Strengthening the public health workforce: An estimation of the long-term requirements for public health specialists in Serbia.

PubMed

Santric Milicevic, Milena; Vasic, Milena; Edwards, Matt; Sanchez, Cristina; Fellows, John

2018-06-01

At the beginning of the 21st century, planning the public health workforce requirements came into the focus of policy makers. The need for improved provision of essential public health services, driven by a challenging non-communicable disease and causes of death and disability within Serbia, calls for a much needed estimation of the requirements of the public health professionals. Mid and long-term public health specialists' supply and demand estimations out to 2025were developed based on national staffing standards and regional distribution of the workforce in public health institutes of Serbia. By 2025, the supply of specialists, taking into account attrition rate of -1% reaches the staffing standard. However, a slight increase in attrition rates has the impact of revealing supply shortage risks. Demand side projections show that public health institutes require an annual input of 10 specialists or 2.1% annual growth rate in order for the four public health fields to achieve a headcount of 487 by 2025 as well as counteract workforce attrition rates. Shortage and poor distribution of public health specialists underline the urgent need for workforce recruitment and retention in public health institutes in order to ensure the coordination, management, surveillance and provision of essential public health services over the next decade. Copyright © 2018 Elsevier B.V. All rights reserved.

[Public policies of research].

PubMed

Ruiz Cantero, M T; Alvarez-Dardet, C

1995-01-01

With its present configuration, the Spanish public device of research in health sciences has limited possibilities to achieve properly the aims of the Ley General de Sanidad, due to its reduced financial importance as well as its thematic and lack of mechanisms of interterritorial compensation. These limitations are effective according to its small capacity to provide information for the development of a health system, oriented to the overcoming of territorial and social imbalance as well as the promotion of health and prevention of diseases. The capacity of public policies of research in Spain to affect the work of researchers is very small due to the importance of the widespread practice of not using funds which are not specifically dedicated to research of the institutions employing the researchers, among other reasons. Most of the public resources of research are concentrated in Madrid and Barcelona. This situation can seriously jeopardize in a near future the development and quality of the attention given in Regional Health Services transferred to Autonomic Communities without big cities. The funds are mostly used to finance researches of basic sciences, medical specialties and clinic laboratories. Investigation in Public Health is only 0.8% of the research budgets, and the funds dedicated to research in Health Primary Care are also very small. The present predominant thematic and methodological orientation of health research in our country, with medicalized research aims, subindividual observation units, experimental designs, and analysis which are basically quantitative, can endanger the possibilities of Spain to achieve the health aims established by the OMS.

[Public Health as an Applied, Multidisciplinary Subject: Is Research-Based Learning the Answer to Challenges in Learning and Teaching?

PubMed

Gerhardus, A; Schilling, I; Voss, M

2017-03-01

Public health education aims at enabling students to deal with complex health-related challenges using appropriate methods based on sound theoretical understanding. Virtually all health-related problems in science and practice require the involvement of different disciplines. However, the necessary interdisciplinarity is only partly reflected in the curricula of public health courses. Also theories, methods, health topics, and their application are often taught side-by-side and not together. For students, it can become an insurmountable challenge to integrate the different disciplines ("horizontal integration") and theories, methods, health topics, and their application ("vertical integration"). This situation is specific for education in public health but is representative for other interdisciplinary fields as well. Several approaches are available to achieve the horizontal integration of different disciplines and vertical integration of theories, methods, health topics, and their application. A curriculum that is structured by topics, rather than disciplines might be more successful in integrating different disciplines. Vertical integration can be achieved by research-based learning. Research-based learning places a student-led research project at the centre of teaching. Students choose a topic and a research question, raise their own questions for theories and methods and will hopefully cross the seeming chasm between science and practice. Challenges of research-based learning are enhanced demands on students, teachers and curriculum design. © Georg Thieme Verlag KG Stuttgart · New York.

Same description, different values. How service users and providers define patient and public involvement in health care.

PubMed

Rise, Marit By; Solbjør, Marit; Lara, Mariela C; Westerlund, Heidi; Grimstad, Hilde; Steinsbekk, Aslak

2013-09-01

Patient and public involvement in health care is important, but the existing definitions of the concept do not integrate the stakeholders' own perceptions. To investigate and compare service users' and service providers' own definitions of patient and public involvement and their implications. Qualitative study with mainly individual in-depth semi-structured interviews conducted between June 2007 and June 2009. Data were analysed using a grounded theory approach. A total of 20 patients, 13 public representatives and 44 health service providers/managers in both somatic and mental health care were interviewed. A common definition of patient and public involvement emerged: It is founded on mutual respect, carried out through dialogue aiming at achieving shared decision making. Nevertheless, users and providers assigned different values to the core aspects: Respect was imperative for service users and implied for providers, dialogue was a way to gain respect for service users and to achieve good outcome for providers, and both worried that the other party wanted to make sole decisions. Users and providers need to consider that although they have a common definition of involvement in health care, they assign different values to its aspects. Increasing and improving patient and public involvement therefore requires knowledge on and dialogue between the parties about these differences. © 2011 John Wiley & Sons Ltd.

Adolescent Immunization: Challenges and Opportunities

ERIC Educational Resources Information Center

Grace, Judith A.

2006-01-01

Immunization is one of the greatest public health achievements of the past century. Vaccines are responsible for the worldwide eradication of smallpox, the elimination of polio in the western hemisphere, and most recently the elimination of rubella as a public health threat in the United States. Childhood vaccination rates are at an all-time high,…

Health Care Provider Initiative Strategic Plan

ERIC Educational Resources Information Center

National Environmental Education & Training Foundation, 2012

2012-01-01

This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

Public spending on health care in Africa: do the poor benefit?

PubMed Central

Castro-Leal, F.; Dayton, J.; Demery, L.; Mehra, K.

2000-01-01

Health care is a basic service essential in any effort to combat poverty, and is often subsidized with public funds to help achieve that aim. This paper examines public spending on curative health care in several African countries and finds that this spending favours mostly the better-off rather than the poor. It concludes that this targeting problem cannot be solved simply by adjusting the subsidy allocations. The constraints that prevent the poor from taking advantage of these services must also be addressed if the public subsidies are to be effective in reaching the poor. PMID:10686734

Making it without losing it: Type A, achievement motivation, and scientific attainment revisited.

PubMed

Helmreich, R L; Spence, J T; Pred, R S

1988-09-01

In a study by Matthews, Helmreich, Beane, and Lucker (1980), responses by academic psychologists to the Jenkins Activity Survey for Health Prediction (JAS), a measure of the Type A construct, were found to be significantly, positively correlated with two measures of attainment, citations by others to published work and number of publications. In the present study, JAS responses from the Matthews et al. sample were subjected to a factor analysis with oblique rotation and two new subscales were developed on the basis of this analysis. The first, Achievement Strivings (AS) was found to be significantly correlated with both the publication and citation measures. The second scale, Impatience and Irritability (I/I), was uncorrelated with the achievement criteria. Data from other samples indicate that I/I is related to a number of health symptoms. The results suggest that the current formulation of the Type A construct may contain two components, one associated with positive achievement and the other with poor health.

Making it without losing it: Type A, achievement motivation, and scientific attainment revisited

NASA Technical Reports Server (NTRS)

Helmreich, R. L.; Spence, J. T.; Pred, R. S.

1988-01-01

In a study by Matthews, Helmreich, Beane, and Lucker (1980), responses by academic psychologists to the Jenkins Activity Survey for Health Prediction (JAS), a measure of the Type A construct, were found to be significantly, positively correlated with two measures of attainment, citations by others to published work and number of publications. In the present study, JAS responses from the Matthews et al. sample were subjected to a factor analysis with oblique rotation and two new subscales were developed on the basis of this analysis. The first, Achievement Strivings (AS) was found to be significantly correlated with both the publication and citation measures. The second scale, Impatience and Irritability (I/I), was uncorrelated with the achievement criteria. Data from other samples indicate that I/I is related to a number of health symptoms. The results suggest that the current formulation of the Type A construct may contain two components, one associated with positive achievement and the other with poor health.

Making it without losing it: Type A, achievement motivation, and scientific attainment revisited

NASA Technical Reports Server (NTRS)

Helmreich, Robert L.; Spence, Janet T.; Pred, Robert S.

1987-01-01

In a study by Matthews et al. (1980), responses by academic psychologists to the Jenkins Activity Survey for Health Prediction, a measure of the Type A construct, were found to be significantly, positively correlated with two measures of attainment, citations by others to published work and number of publications. In the present study, JAS responses from the Matthews et al. sample were subjected to a factor analysis with oblique rotation and two new subscales were developed on the basis of this analysis. The first, Achievement Strivings (AS) was found to be significantly correlated with both the publication and citation measures. The second scale, Impatience and Irritability (I/I), was uncorrelated with the achievement criteria. Data from other samples indicate that I/I is related to a number of health symptoms. The results suggest that the current formulation of the Type A construct may contain two components, one associated with positive achievement and the other with poor health.

US Centers for Disease Control and Prevention and Its Partners’ Contributions to Global Health Security

PubMed Central

Cassell, Cynthia H.; Bunnell, Rebecca E.; Angulo, Frederick J.; Craig, Allen; Pesik, Nicki; Dahl, Benjamin A.; Ijaz, Kashef; Jafari, Hamid; Martin, Rebecca

2017-01-01

To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world. PMID:29155656

A national research agenda for public health services and systems.

PubMed

2012-05-01

The field of public health services and systems research (PHSSR) has emerged over the past decade to produce the evidence needed to address critical uncertainties about how best to organize, finance, and deliver effective public health strategies to all Americans. To advance these efforts, a national PHSSR research agenda-setting process was used to identify a broad inventory of information needs and uncertainties that public health stakeholders face in the domains of public health workforce, public health system structure and performance, public health financing, and public health information and technology. This paper presents the results of an expert review process used to transform the identified information needs into a concise set of research questions that can be pursued through new scientific inquiry in PHSSR. Established research frameworks were used to specify the contexts, mechanisms of action, and outcomes within the public health system that require further study. A total of 72 research questions were developed from the 113 original items in the PHSSR inventory of information needs. The questions include both persistent problems and newly emerging needs in public health practice and policy. The resulting research agenda provides a starting point for mobilizing the public health scientific enterprise around contemporary, high-priority uncertainties identified by broad cross sections of public health stakeholders. Regular updates to this agenda will be required to achieve continuous improvements in both the science and practice of public health. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.

Toward a Healthy High Schools Movement: Strategies for Mobilizing Public Health for Educational Reform

PubMed Central

Ruglis, Jessica

2010-01-01

Although research shows that education and health are closely intertwined, health professionals have difficulty using this evidence to improve health and educational outcomes and reduce inequities. We call for a social movement for healthy high schools in the United States that would improve school achievement and graduation rates; create school environments that promote lifelong individual, family, and community health and prevent chronic illness, violence, and problems of sexual health; and engage youths in creating health-promoting environments. Achieving these goals will require strengthening and better linking often uncoordinated efforts to improve child health and education. Only a broad social movement has the power and vision to mobilize the forces that can transform educational and health systems to better achieve health and educational equity. PMID:20634448

Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel.

PubMed

Parker, Cindy L; Everly, George S; Barnett, Daniel J; Links, Jonathan M

2006-01-01

A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.

[Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013].

PubMed

Roth-Deubel, André N; Molina-Marín, Gloria

2013-01-01

Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

Machine-Learning Algorithms to Code Public Health Spending Accounts

PubMed Central

Leider, Jonathon P.; Resnick, Beth A.; Alfonso, Y. Natalia; Bishai, David

2017-01-01

Objectives: Government public health expenditure data sets require time- and labor-intensive manipulation to summarize results that public health policy makers can use. Our objective was to compare the performances of machine-learning algorithms with manual classification of public health expenditures to determine if machines could provide a faster, cheaper alternative to manual classification. Methods: We used machine-learning algorithms to replicate the process of manually classifying state public health expenditures, using the standardized public health spending categories from the Foundational Public Health Services model and a large data set from the US Census Bureau. We obtained a data set of 1.9 million individual expenditure items from 2000 to 2013. We collapsed these data into 147 280 summary expenditure records, and we followed a standardized method of manually classifying each expenditure record as public health, maybe public health, or not public health. We then trained 9 machine-learning algorithms to replicate the manual process. We calculated recall, precision, and coverage rates to measure the performance of individual and ensembled algorithms. Results: Compared with manual classification, the machine-learning random forests algorithm produced 84% recall and 91% precision. With algorithm ensembling, we achieved our target criterion of 90% recall by using a consensus ensemble of ≥6 algorithms while still retaining 93% coverage, leaving only 7% of the summary expenditure records unclassified. Conclusions: Machine learning can be a time- and cost-saving tool for estimating public health spending in the United States. It can be used with standardized public health spending categories based on the Foundational Public Health Services model to help parse public health expenditure information from other types of health-related spending, provide data that are more comparable across public health organizations, and evaluate the impact of evidence-based public health resource allocation. PMID:28363034

Machine-Learning Algorithms to Code Public Health Spending Accounts.

PubMed

Brady, Eoghan S; Leider, Jonathon P; Resnick, Beth A; Alfonso, Y Natalia; Bishai, David

Government public health expenditure data sets require time- and labor-intensive manipulation to summarize results that public health policy makers can use. Our objective was to compare the performances of machine-learning algorithms with manual classification of public health expenditures to determine if machines could provide a faster, cheaper alternative to manual classification. We used machine-learning algorithms to replicate the process of manually classifying state public health expenditures, using the standardized public health spending categories from the Foundational Public Health Services model and a large data set from the US Census Bureau. We obtained a data set of 1.9 million individual expenditure items from 2000 to 2013. We collapsed these data into 147 280 summary expenditure records, and we followed a standardized method of manually classifying each expenditure record as public health, maybe public health, or not public health. We then trained 9 machine-learning algorithms to replicate the manual process. We calculated recall, precision, and coverage rates to measure the performance of individual and ensembled algorithms. Compared with manual classification, the machine-learning random forests algorithm produced 84% recall and 91% precision. With algorithm ensembling, we achieved our target criterion of 90% recall by using a consensus ensemble of ≥6 algorithms while still retaining 93% coverage, leaving only 7% of the summary expenditure records unclassified. Machine learning can be a time- and cost-saving tool for estimating public health spending in the United States. It can be used with standardized public health spending categories based on the Foundational Public Health Services model to help parse public health expenditure information from other types of health-related spending, provide data that are more comparable across public health organizations, and evaluate the impact of evidence-based public health resource allocation.

Cancer surveillance and information: balancing public health with privacy and confidentiality concerns (United States).

PubMed

Deapen, Dennis

2006-06-01

Rapid advances in informatics and communication technologies are greatly expanding the capacity for information capture and transportation. While these tools can be used for great good, they also offer new opportunities for those who seek to obtain and use information for improper purposes. While issues related to identity theft for financial gain garner the most attention, protection of privacy in public health endeavors such as cancer surveillance is also a significant concern. Some efforts to protect health-related information have had unintended consequences detrimental to health research and public health practice. Achieving a proper balance between measures to protect privacy and the ability to guard and improve public health requires careful consideration and development of appropriate policies, regulations and use of technology.

Postgraduate and research programmes in Medicine and Public Health in Rwanda: an exciting experience about training of human resources for health in a limited resources country.

PubMed

Kakoma, Jean Baptiste

2016-01-01

The area of Human Resources for Health (HRH) is the most critical challenge for the achievement of health related development goals in countries with limited resources. This is even exacerbated in a post conflict environment like Rwanda. The aim of this commentary is to report and share the genesis and outcomes of an exciting experience about training of qualified health workers in medicine and public health as well as setting - up of a research culture for the last nine years (2006 - 2014) in Rwanda. Many initiatives have been taken and concerned among others training of qualified health workers in medicine and public health. From 2006 to 2014, achievements were as follows: launching and organization of 8 Master of Medicine programmes (anesthesiology, family and community medicine, internal medicine, obstetrics & gynecology, otorhinolaryngology, pediatrics, psychiatry and surgery) and 4 Master programmes in public health (MPH, MSc Epidemiology, MSc Field Epidemiology & Laboratory Management, and Master in Hospital and Healthcare Administration); training to completion of more than 120 specialists in medicine, and 200 MPH, MSc Epidemiology, and MSc Field Epidemiology holders; revival of the Rwanda Medical Journal; organization of graduate research training (MPhil and PhD); 3 Master programmes in the pipeline (Global Health, Health Financing, and Supply Chain Management); partnerships with research institutions of great renown, which contributed to the reinforcement of the institutional research capacity and visibility towards excellence in leadership, accountability, and self sustainability. Even though there is still more to be achieved, the Rwanda experience about postgraduate and research programmes is inspiring through close interactions between main stakeholders. This is a must and could allow Rwanda to become one of the rare examples to other more well-to-do Sub - Saharan countries, should Rwanda carry on doing that.

A Public Health Achievement Under Adversity: The Eradication of Poliomyelitis From Peru, 1991

PubMed Central

Cueto, Marcos

2014-01-01

The fight to achieve global eradication of poliomyelitis continues. Although native transmission of poliovirus was halted in the Western Hemisphere by the early 1990s, and only a few cases have been imported in the past few years, much of Latin America’s story remains to be told. Peru conducted a successful flexible, or flattened, vertical campaign in 1991. The initial disease-oriented programs began to collaborate with community-oriented primary health care systems, thus strengthening public–private partnerships and enabling the common goal of poliomyelitis eradication to prevail despite rampant terrorism, economic instability, and political turmoil. Committed leaders in Peru’s Ministry of Health, the Pan American Health Organization, and Rotary International, as well as dedicated health workers who acted with missionary zeal, facilitated acquisition of adequate technologies, coordinated work at the local level, and increased community engagement, despite sometimes being unable to institutionalize public health improvements. PMID:25322297

A Performance Analysis of Public Expenditure on Maternal Health in Mexico.

PubMed

Servan-Mori, Edson; Avila-Burgos, Leticia; Nigenda, Gustavo; Lozano, Rafael

2016-01-01

We explore the relationship between public expenditure, coverage of adequate ANC (including timing, frequent and content), and the maternal mortality ratio--adjusted by coverage of adequate ANC--observed in Mexico in 2012 at the State level. Additionally, we examine the inequalities and concentration of public expenditure between populations with and without Social Security. Results suggest that in the 2003-2011 period, the public expenditure gap between women with and without Social Security decreased 74%, however, the distribution is less equitable among women without Social Security, across the States. Despite high levels of coverage on each dimension of ANC explored, coverage of adequate ANC was lower among Social Security than non-Social Security women. This variability results in differences up to 1.5 times in State-adjusted maternal mortality rate at the same level of expense and maternal mortality rate, respectively. The increase in the economic resources is only a necessary condition for achieving improved health outcomes. Providing adequate health services and achieving efficient, effective and transparent use of resources in health, are critical elements for health systems performance. The attainment of universal effective coverage of maternal health and reducing maternal mortality in Mexico, requires the adjustment of policy innovations including the rules of allocation and execution of health resources. Health policies should be designed on a more holistic view promoting a balance between accessibility, effective implementation and rigorous stewardship.

A Performance Analysis of Public Expenditure on Maternal Health in Mexico

PubMed Central

Servan-Mori, Edson; Avila-Burgos, Leticia; Nigenda, Gustavo; Lozano, Rafael

2016-01-01

We explore the relationship between public expenditure, coverage of adequate ANC (including timing, frequent and content), and the maternal mortality ratio -adjusted by coverage of adequate ANC- observed in Mexico in 2012 at the State level. Additionally, we examine the inequalities and concentration of public expenditure between populations with and without Social Security. Results suggest that in the 2003–2011 period, the public expenditure gap between women with and without Social Security decreased 74%, however, the distribution is less equitable among women without Social Security, across the States. Despite high levels of coverage on each dimension of ANC explored, coverage of adequate ANC was lower among Social Security than non-Social Security women. This variability results in differences up to 1.5 times in State-adjusted maternal mortality rate at the same level of expense and maternal mortality rate, respectively. The increase in the economic resources is only a necessary condition for achieving improved health outcomes. Providing adequate health services and achieving efficient, effective and transparent use of resources in health, are critical elements for health systems performance. The attainment of universal effective coverage of maternal health and reducing maternal mortality in Mexico, requires the adjustment of policy innovations including the rules of allocation and execution of health resources. Health policies should be designed on a more holistic view promoting a balance between accessibility, effective implementation and rigorous stewardship. PMID:27043819

The Component Model of Infrastructure: A Practical Approach to Understanding Public Health Program Infrastructure

PubMed Central

Snyder, Kimberly; Rieker, Patricia P.

2014-01-01

Functioning program infrastructure is necessary for achieving public health outcomes. It is what supports program capacity, implementation, and sustainability. The public health program infrastructure model presented in this article is grounded in data from a broader evaluation of 18 state tobacco control programs and previous work. The newly developed Component Model of Infrastructure (CMI) addresses the limitations of a previous model and contains 5 core components (multilevel leadership, managed resources, engaged data, responsive plans and planning, networked partnerships) and 3 supporting components (strategic understanding, operations, contextual influences). The CMI is a practical, implementation-focused model applicable across public health programs, enabling linkages to capacity, sustainability, and outcome measurement. PMID:24922125

Multinational Alcohol Market Development and Public Health: Diageo in India.

PubMed

Esser, Marissa B; Jernigan, David H

2015-11-01

Alcohol is a risk factor for communicable and noncommunicable diseases, and alcohol consumption is rising steadily in India. The growth of multinational alcohol corporations, such as Diageo, contributes to India's changing alcohol environment. We provide a brief history of India's alcohol regulation for context and examine Diageo's strategies for expansion in India in 2013 and 2014. Diageo is attracted to India's younger generation, women, and emerging middle class for growth opportunities. Components of Diageo's responsibility strategy conflict with evidence-based public health recommendations for reducing harmful alcohol consumption. Diageo's strategies for achieving market dominance in India are at odds with public health evidence. We conclude with recommendations for protecting public health in emerging markets.

The Longitudinal Link between Student Health and Math Achievement Scores

ERIC Educational Resources Information Center

Garcy, Anthony M.

2009-01-01

This study investigated the relationship between health conditions suffered over time and student scores on the Stanford Achievement Test 9 in Yuma County, Arizona, public grade schools. The majority of children in Yuma County were of Hispanic origin. The poverty and low income status of most of these children placed them at greater risk for…

A Model for Training Public Health Workers in Health Policy: the Nebraska Health Policy Academy

PubMed Central

Brandert, Kathleen; McCarthy, Claudine; Grimm, Brandon; Svoboda, Colleen; Palm, David

2014-01-01

There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska’s state and local public health staff and their community partners to use public health policy and law as a public health tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state’s public health workforce. Challenges and lessons learned when offering workforce development on public health policy efforts are discussed. PMID:24831286

Psychology Doctoral Training in Work and Health.

ERIC Educational Resources Information Center

Raymond, Jonathan S.; And Others

1990-01-01

Suggests that psychology has an obligation to help achieve healthy work environments. This will require the development of a new doctoral-level specialty that combines the perspective of health psychology with those of occupational health and public health. The new field might be called occupational health psychology. (EVL)

Meeting the challenge: using policy to improve children's health.

PubMed

Brush, Charles Adam; Kelly, Maggie M; Green, Denise; Gaffney, Marcus; Kattwinkel, John; French, Molly

2005-11-01

We reflect on the proceedings of a symposium at a conference of the Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities. We present examples of bridging the gap between science and policy to achieve improvements in children's health through case studies in early hearing detection and intervention, folic acid fortification to prevent birth defects, sleep positioning recommendations to reduce infant mortality, and workplace lactation support programs. We discuss case studies that present different policy strategies (public health law and voluntary practices) for improving public health. These case studies demonstrate both the power of policy as a tool for improving children's health and the challenges of communicating public health research to policy decisionmakers.

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

PubMed Central

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-01-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

PubMed

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-02-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version.

What is policy and where do we look for it when we want to research it?

PubMed

Crammond, Brad; Carey, Gemma

2017-04-01

Public health researchers are increasingly concerned with achieving 'upstream' change to achieve reductions in the global burden of disease and health inequalities. Consequently, understanding policy and how to change it has become a central goal of public health. Yet conceptualisation of what constitutes policy and where it can be found is very limited within this field. Our glossary demonstrates that policy is many headed. It is located in a vast array of documents, discussions dialogues and actions which can be captured variously by formal and informal forms of documentation and observation. Effectively understanding policy and its relevance for public health requires an awareness of the full range of places and contexts in which policy work happens and policy documents are produced. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A Unique Funding Opportunity for Public Health in Texas

PubMed Central

Schlenker, Thomas; Huber, Carol A.

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the “Triple Aim” goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation. PMID:25423061

Water availability and quality in the Gulf Cooperation Council countries: implications for public health.

PubMed

Sherif, Mohsen

2010-07-01

Environmental problems and their potential impacts on public health vary in scale and time depending on the level and nature of pollutants. Although water is regarded as the source of all kinds of life on earth, it also acts as an efficient carrier of pollutants. Contamination of drinking water, agricultural water, or recreational water by infectious pathogens, chemical pollutants, or others can have significant impacts on public health. During the past few decades, waterborne diseases continued to spread and the health risks continued to increase. The correlation between water resources and public health is more evident in arid regions. This article discusses the availability of water resources in the Gulf Cooperation Council countries and elaborates on the possible impacts of water resources on public health. It emphasizes the importance of preservation of water quality and prevention of waterborne diseases, which could be achieved through a coordinated effort from diverse groups and disciplines.

[The implementation of innovations in public health].

PubMed

Systerova, A A; Totskaia, E G

2012-01-01

Nowadays, the innovative activities are considered as the mechanism of implementation of public policy to increase effectiveness of public health system on the basis of achievements of modern medicine and technical sciences. The development, elaboration and implementation of products being in line with corresponding to criteria of innovation, promote the concurrency of medical institutions at the medical services market. The administrators of health departments and medical science professionals are to become aware about the problems of implementation of innovations into medical practice to develop the mechanisms of overcoming these issues.

Formulating Employability Skills for Graduates of Public Health Study Program

ERIC Educational Resources Information Center

Qomariyah, Nurul; Savitri, Titi; Hadianto, Tridjoko; Claramita, Mora

2016-01-01

Employability skills (ES) are important for effective and successful individual participation in the workplace. The main aims of the research were to identify important ES needed by graduates of Public Health Study Program Universitas Ahmad Dahlan (PHSP UAD) and to assess the achievement of the ES development that has been carried out by PHSP UAD.…

An Integrated Approach to Diabetes Prevention: Anthropology, Public Health, and Community Engagement.

PubMed

Page-Reeves, Janet; Mishra, Shiraz I; Niforatos, Joshua; Regino, Lidia; Bulten, Robert

2013-01-01

Diabetes is an enormous public health problem with particular concern within Hispanic communities and among individuals with low wealth. However, attempts to expand the public health paradigm to include social determinants of health rarely include analysis of social and contextual factors considered outside the purview of health research. As a result, conceptualization of the dynamics of diabetes health disparities remains shallow. We argue that using a holistic anthropological lens has the potential to offer insights regarding the nature of the interface between broader social determinants, health outcomes and health disparity. In a primarily Hispanic, immigrant community in Albuquerque, New Mexico, we conducted a mixed methods study that integrates an anthropological lens with a community engaged research design. Our data from focus groups, interviews, a survey and blood sampling demonstrate the need to conceptualize social determinants more broadly, more affectively and more dynamically than often considered. These results highlight a need to include, in addition to individual-level factors that are traditionally the focus of public health and more innovative structural factors that are currently in vogue, an in-depth, qualitative exploration of local context, social environment, and culture, and their interactions and intersectionality, as key factors when considering how to achieve change. The discussion presented here offers a model for culturally situated and contextually relevant scientific research. This model achieves the objectives and goals of both public health and anthropology while providing valuable insights and mechanisms for addressing health disparity such as that which exists in relation to diabetes among Hispanic immigrants in New Mexico. Such an approach has implications for how research projects are designed and conceptualizing social determinants more broadly. The discussion presented provides insights with relevance for both disciplines.

A Framework for Public Health Action: The Health Impact Pyramid

PubMed Central

2010-01-01

A 5-tier pyramid best describes the impact of different types of public health interventions and provides a framework to improve health. At the base of this pyramid, indicating interventions with the greatest potential impact, are efforts to address socioeconomic determinants of health. In ascending order are interventions that change the context to make individuals' default decisions healthy, clinical interventions that require limited contact but confer long-term protection, ongoing direct clinical care, and health education and counseling. Interventions focusing on lower levels of the pyramid tend to be more effective because they reach broader segments of society and require less individual effort. Implementing interventions at each of the levels can achieve the maximum possible sustained public health benefit. PMID:20167880

Social participation in health in Brazil and England: inclusion, representation and authority

PubMed Central

Barnes, Marian; Coelho, Vera Schattan

2009-01-01

Abstract Aim  This article offers a brief description and analysis of public participation in health in Brazil and England in order to highlight different motivators and tensions within an acceptance of participation as official policy. Sources/methods  The article draws on a range of research in both countries and an analysis of official documents relating to participation. It is based on collaboration between researchers deriving from broad programmes of work on public participation in which the authors are involved. Argument  There is a tension between different principles underpinning collective public involvement in health both within and between countries. Different aspirations or claims have been made about what such participation will achieve and there are trade‐offs between design principles that have consequences for issues such as who takes part and thus also for what can be achieved. The democratic origins of public participation are more evident in the Brazilian situation than in England, but there are still questions about the inclusivity of the practices through which this is achieved. The English picture is both more diverse and dynamic, but formal decision‐making power of participatory forums is less than in Brazil. Whilst social justice claims for participation have been made in both countries, there is as yet limited evidence that these have been realized. PMID:19754687

Social participation in health in Brazil and England: inclusion, representation and authority.

PubMed

Barnes, Marian; Coelho, Vera Schattan

2009-09-01

This article offers a brief description and analysis of public participation in health in Brazil and England in order to highlight different motivators and tensions within an acceptance of participation as official policy. The article draws on a range of research in both countries and an analysis of official documents relating to participation. It is based on collaboration between researchers deriving from broad programmes of work on public participation in which the authors are involved. There is a tension between different principles underpinning collective public involvement in health both within and between countries. Different aspirations or claims have been made about what such participation will achieve and there are trade-offs between design principles that have consequences for issues such as who takes part and thus also for what can be achieved. The democratic origins of public participation are more evident in the Brazilian situation than in England, but there are still questions about the inclusivity of the practices through which this is achieved. The English picture is both more diverse and dynamic, but formal decision-making power of participatory forums is less than in Brazil. Whilst social justice claims for participation have been made in both countries, there is as yet limited evidence that these have been realized.

The public health response to 'do-it-yourself' urbanism.

PubMed

Sibbald, Shannon L; Graham, Ross; Gilliland, Jason

2017-09-01

Greater understanding of the important and complex relationship between the built environment and human health has made 'healthy places' a focus of public health and health promotion. While current literature concentrates on creating healthy places through traditional decision-making pathways (namely, municipal land use planning and urban design processes), this paper explores do-it-yourself (DIY) urbanism: a movement circumventing traditional pathways to, arguably, create healthy places and advance social justice. Despite being aligned with several health promotion goals, DIY urbanism interventions are typically illegal and have been categorized as a type of civil disobedience. This is challenging for public health officials who may value DIY urbanism outcomes, but do not necessarily support the means by which it is achieved. Based on the literature, we present a preliminary approach to health promotion decision-making in this area. Public health officials can voice support for DIY urbanism interventions in some instances, but should proceed cautiously.

Wanted: interdisciplinary, multidisciplinary, and knowledge translation and exchange training for students of public health.

PubMed

Mishra, Lipi; Banerjee, Ananya T; MacLennan, Mary E; Gorczynski, Paul F; Zinszer, Kate A

2011-01-01

Students vocalized their concern with public health training programs in Canada at the 2010 CPHA Centennial Conference. Given these concerns, we reviewed the objectives and curricula of public health graduate (master's) programs in Canada. Our objective was to understand to what extent public and population health graduate programs in Canada support interdisciplinary, multidisciplinary and knowledge translation and exchange (KTE) training. This was achieved through a review of all public and population health master's programs in Canada identified from the public health graduate programs listed on the Public Health Agency of Canada website (n = 33) plus an additional four programs that were not originally captured on the list. Of the 37 programs reviewed, 28 (76%) stated that interdisciplinary, multidisciplinary or cross-disciplinary training opportunities are of value to their program, with 12 programs (32%) providing multidisciplinary or interdisciplinary training opportunities in their curriculum. Only 14 (38%) of the 37 programs provided value statements of KTE activities in their program goals or course objectives, with 10 (27%) programs offering KTE training in their curriculum. This review provides a glimpse into how public health programs in Canada value and support interdisciplinary and multidisciplinary collaboration as well as KTE activities.

The Turning Point Social Marketing National Excellence Collaborative: integrating social marketing into routine public health practice.

PubMed

Pirani, Sylvia; Reizes, Tom

2005-01-01

Social marketing can be an effective tool for achieving public health goals. Social marketing uses concepts from commercial marketing to plan and implement programs designed to bring about behavior change that will benefit individuals and society. Although social marketing principles have been used to address public health problems, efforts have been dominated by message-based, promotion-only strategies, and effective implementation has been hampered by both lack of understanding of and use of all of the components of a social marketing approach and lack of training. The Turning Point initiative's Social Marketing National Excellence Collaborative (SMNEC) was established to promote social marketing principles and practices to improve public health across the nation. After 4 years, the Collaborative's work has resulted in improved understanding of social marketing among participating members and the development of new tools to strengthen the social marketing skills among public health practitioners. The Collaborative has also made advances in incorporating and institutionalizing the practice of social marketing within public health in participating states.

[The Caribbean origins of the National Public Health System in the USA: a global approach to the history of medicine and public health in Latin America].

PubMed

Espinosa, Mariola

2015-01-01

This article defines global history in relation to the history of medicine and public health. It argues that a global approach to history opens up a space for examining the reverberations transmitted from the geographic periphery towards western regions, which have traditionally dominated modern historiography. It analyzes two medical interventions in the Caribbean in the late nineteenth and early twentieth century, showing how these events had profound consequences in the USA. The successes achieved in the Caribbean in terms of yellow fever and ancylostoma control, as well as providing a model for health campaigns in the southern USA, inspired the centralization of public health in North America under the centralizing control of the federal government.

Public health agencies' obligations and the case of Zika.

PubMed

Luna, Florencia

2017-10-01

This article focuses on the initial reactions to the Zika epidemic by national and international public health agencies. It presents and analyzes some responses public officials made about sexual and reproductive health at the inception of the epidemic. It also describes the different challenges and obligations faced by local and international public health agencies, as these have not been clearly outlined. The article argues that these agencies have different obligations and should fulfill them despite existing obstacles. While international agencies should honor their leadership role and make recommendations at a meta-level, local agencies should provide, in the case of Zika, a framework for empowerment and grant women the freedom to achieve sexual and reproductive health so that they can avoid the consequences of this epidemic. © 2017 John Wiley & Sons Ltd.

Levels, Trends and Disparities in Public-Health-Related Indicators among Reproductive-Age Women in Bangladesh by Urban-Rural and Richest-Poorest Groups, 1993-2011

PubMed Central

Khan, Md. Mobarak Hossain; Zanuzdana, Arina; Kraemer, Alexander

2013-01-01

Background And Objectives Although Bangladesh has already achieved noticeable progress in the field of development and health, disparities in public health indicators for several markers are still reported. To assess public health development in Bangladesh during the last two decades, firstly, we analysed levels, trends and disparities in public-health-related indicators by rural versus urban as well as by the richest versus poorest group of women who have ever been married. Secondly, using the most recent data set we performed multiple analyses to check whether urban-rural and richest-poorest disparities were still significant. Methods The analysis was based on six nationally representative data sets from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 1993-94 (n=9,640), 1996-1997 (n=9,127), 1999-2000 (n=10,544), 2004 (n=11,440), 2007 (n=10,996) and 2011 (n=17,749). The outcome variables were six selected public-health-related indicators. We performed various types of analyses, including multiple logistic regressions. Results The trend of all indicators except being overweight (1993-2011) displayed gradual improvements for both markers. However, the urban and richest groups revealed a better situation than their counterparts in both simple and multiple analyses. Disparities between richest-poorest groups were more pronounced than urban-rural disparities. For instance, the prevalence of delivery at any healthcare facility in 2011 was 20.4% in rural areas and 46.5% in urban areas, whereas it was 9.1% in the poorest group and 57.6% in the richest group. Conclusion The public health sector in Bangladesh has achieved some successes over the last two decades. However, urban-rural and richest-poorest disparities are still considerable and therefore more public health strategies and efforts are clearly needed for the rural and poorest groups of women in order to reduce these gaps further. PMID:24086485

Health-Related Behaviors and Academic Achievement Among High School Students - United States, 2015.

PubMed

Rasberry, Catherine N; Tiu, Georgianne F; Kann, Laura; McManus, Tim; Michael, Shannon L; Merlo, Caitlin L; Lee, Sarah M; Bohm, Michele K; Annor, Francis; Ethier, Kathleen A

2017-09-08

Studies have shown links between educational outcomes such as letter grades, test scores, or other measures of academic achievement, and health-related behaviors (1-4). However, as reported in a 2013 systematic review, many of these studies have used samples that are not nationally representative, and quite a few studies are now at least 2 decades old (1). To update the relevant data, CDC analyzed results from the 2015 national Youth Risk Behavior Survey (YRBS), a biennial, cross-sectional, school-based survey measuring health-related behaviors among U.S. students in grades 9-12. Analyses assessed relationships between academic achievement (i.e., self-reported letter grades in school) and 30 health-related behaviors (categorized as dietary behaviors, physical activity, sedentary behaviors, substance use, sexual risk behaviors, violence-related behaviors, and suicide-related behaviors) that contribute to leading causes of morbidity and mortality among adolescents in the United States (5). Logistic regression models controlling for sex, race/ethnicity, and grade in school found that students who earned mostly A's, mostly B's, or mostly C's had statistically significantly higher prevalence estimates for most protective health-related behaviors and significantly lower prevalence estimates for most health-related risk behaviors than did students with mostly D's/F's. These findings highlight the link between health-related behaviors and education outcomes, suggesting that education and public health professionals can find their respective education and health improvement goals to be mutually beneficial. Education and public health professionals might benefit from collaborating to achieve both improved education and health outcomes for youths.

Achieving universal health coverage in small island states: could importing health services provide a solution?

PubMed Central

Walls, Helen; Smith, Richard

2018-01-01

Background Universal health coverage (UHC) is difficult to achieve in settings short of medicines, health workers and health facilities. These characteristics define the majority of the small island developing states (SIDS), where population size negates the benefits of economies of scale. One option to alleviate this constraint is to import health services, rather than focus on domestic production. This paper provides empirical analysis of the potential impact of this option. Methods Analysis was based on publicly accessible data for 14 SIDS, covering health-related travel and health indicators for the period 2003–2013, together with in-depth review of medical travel schemes for the two highest importing SIDS—the Maldives and Tuvalu. Findings Medical travel from SIDS is accelerating. The SIDS studied generally lacked health infrastructure and technologies, and the majority of them had lower than the recommended number of physicians in a country, which limits their capacity for achieving UHC. Tuvalu and the Maldives were the highest importers of healthcare and notably have public schemes that facilitate medical travel and help lower the out-of-pocket expenditure on medical travel. Although different in approach, design and performance, the medical travel schemes in Tuvalu and the Maldives are both examples of measures used to increase access to health services that cannot feasibly be provided in SIDS. Interpretation Our findings suggest that importing health services (through schemes to facilitate medical travel) is a potential mechanism to help achieve universal healthcare for SIDS but requires due diligence over cost, equity and quality control. PMID:29527349

A Child's Health Is the Public's Health: Progress and Gaps in Addressing Pediatric Needs in Public Health Emergencies.

PubMed

Dziuban, Eric J; Peacock, Georgina; Frogel, Michael

2017-09-01

Children are the most prevalent vulnerable population in US society and have unique needs during the response to and recovery from public health emergencies. The physiological, behavioral, developmental, social, and mental health differences of children require specific attention in preparedness efforts. Despite often being more severely affected in disasters, children's needs are historically underrepresented in preparedness. Since 2001, much progress has been made in addressing this disparity through better pediatric incorporation in preparedness planning from national to local levels. Innovative approaches, policies, and collaborations contribute to these advances. However, many gaps remain in the appropriate and proportional inclusion of children in planning for public health emergencies. Successful models of pediatric planning can be developed, evaluated, and widely disseminated to ensure that further progress can be achieved.

Canada's universal health-care system: achieving its potential.

PubMed

Martin, Danielle; Miller, Ashley P; Quesnel-Vallée, Amélie; Caron, Nadine R; Vissandjée, Bilkis; Marchildon, Gregory P

2018-04-28

Access to health care based on need rather than ability to pay was the founding principle of the Canadian health-care system. Medicare was born in one province in 1947. It spread across the country through federal cost sharing, and eventually was harmonised through standards in a federal law, the Canada Health Act of 1984. The health-care system is less a true national system than a decentralised collection of provincial and territorial insurance plans covering a narrow basket of services, which are free at the point of care. Administration and service delivery are highly decentralised, although coverage is portable across the country. In the setting of geographical and population diversity, long waits for elective care demand the capacity and commitment to scale up effective and sustainable models of care delivery across the country. Profound health inequities experienced by Indigenous populations and some vulnerable groups also require coordinated action on the social determinants of health if these inequities are to be effectively addressed. Achievement of the high aspirations of Medicare's founders requires a renewal of the tripartite social contract between governments, health-care providers, and the public. Expansion of the publicly funded basket of services and coordinated effort to reduce variation in outcomes will hinge on more engaged roles for the federal government and the physician community than have existed in previous decades. Public engagement in system stewardship will also be crucial to achieve a high-quality system grounded in both evidence and the Canadian values of equity and solidarity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Achieving public and global health competencies: A teaching case study of Botswana's cervical cancer screening program.

PubMed

Okatch, Harriet; Sowicz, Timothy Joseph; Teng, Helen; Ramogola-Masire, Doreen; Buttenheim, Alison M

2018-05-01

To design and implement a case study on the cervical cancer screening program in Botswana to teach public and global health competencies to undergraduate nursing students. The case study was developed following a review of the literature on the epidemiology and health policies of cervical cancer in Botswana, and an interview with an obstetrician/gynecologist engaged in both clinical practice and research in Botswana. The case study has been implemented over seven semesters to students enrolled in the Nursing in the Community course at the University of Pennsylvania. Approximately 75-100 students are enrolled each semester. Student's perceptions of epidemiologic skills gained and group functioning. Students responded to an open-ended question about lessons learned and offered suggestions to improve the learning experience. Faculty assessment of student deliverables demonstrated that students achieved the learning objectives and mastered necessary competencies. More than 70% (n = 69) of the students indicated that they acquired relevant skills at greater than a satisfactory level. Generally, students had great experiences working in groups measured across five dimensions: engagement/contribution, creativity/resilience, on task/works independently, social interaction/communication, and preparedness. However, isolated cases of poor group functioning were reported for engagement/contribution, and creativity/resilience. The case study, which has been revised with respect to length, content and group processes, has been valuable in educating undergraduate nursing students in a more engaging way that mimics real life public health nursing scenarios. Students achieved both public and global health competencies through participation in the case study. © 2018 Wiley Periodicals, Inc.

Ethics, economics, and public financing of health care.

PubMed

Hurley, J

2001-08-01

There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services.

Vaccinating Health Care Workers Against Influenza: The Ethical and Legal Rationale for a Mandate

PubMed Central

Wu, Joel T.; Poland, Gregory A.; Jacobson, Robert M.; Koenig, Barbara A.; Tilburt, Jon C.

2011-01-01

Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety. When public health is jeopardized, and a safe, low-cost, and effective method to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent. The recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce. PMID:21228284

Vaccinating health care workers against influenza: the ethical and legal rationale for a mandate.

PubMed

Ottenberg, Abigale L; Wu, Joel T; Poland, Gregory A; Jacobson, Robert M; Koenig, Barbara A; Tilburt, Jon C

2011-02-01

Despite improvements in clinician education, symptom awareness, and respiratory precautions, influenza vaccination rates for health care workers have remained unacceptably low for more than three decades, adversely affecting patient safety. When public health is jeopardized, and a safe, low-cost, and effective method to achieve patient safety exists, health care organizations and public health authorities have a responsibility to take action and change the status quo. Mandatory influenza vaccination for health care workers is supported not only by scientific data but also by ethical principles and legal precedent. The recent influenza pandemic provides an opportunity for policymakers to reconsider the benefits of mandating influenza vaccination for health care workers, including building public trust, enhancing patient safety, and strengthening the health care workforce.

China's health care system reform: Progress and prospects.

PubMed

Li, Ling; Fu, Hongqiao

2017-07-01

This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system. Recently, China issued the 13th 5-year plan for medical reform, setting forth the goals, policy priorities, and strategies for health reform in the following 5 years. Moreover, the Chinese government announced the "Healthy China 2030" blueprint in October 2016, which has the goals of providing universal health security for all citizens by 2030. By examining these policy priorities against the existing gaps and challenges, we conclude that China's health care reform is heading in the right direction. To effectively implement these policies, we recommend that China should take advantage of policy experimentation to mobilize bottom-up initiatives and encourage innovations. Copyright © 2017 John Wiley & Sons, Ltd.

Multinational Alcohol Market Development and Public Health: Diageo in India

PubMed Central

Jernigan, David H.

2015-01-01

Alcohol is a risk factor for communicable and noncommunicable diseases, and alcohol consumption is rising steadily in India. The growth of multinational alcohol corporations, such as Diageo, contributes to India’s changing alcohol environment. We provide a brief history of India’s alcohol regulation for context and examine Diageo’s strategies for expansion in India in 2013 and 2014. Diageo is attracted to India’s younger generation, women, and emerging middle class for growth opportunities. Components of Diageo’s responsibility strategy conflict with evidence-based public health recommendations for reducing harmful alcohol consumption. Diageo’s strategies for achieving market dominance in India are at odds with public health evidence. We conclude with recommendations for protecting public health in emerging markets. PMID:26378848

Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

PubMed

Eby, Chas

2014-01-01

The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

Responding to Communicable Diseases in Internationally Mobile Populations at Points of Entry and along Porous Borders, Nigeria, Benin, and Togo

PubMed Central

Rogers, Kimberly; Ward, Sarah; Ojo, Olubumni; Kakaī, Clement Glele; Agbeko, Tamekloe Tsidi; Garba, Hassan; MacGurn, Amanda; Oppert, Marydale; Kone, Idrissa; Bamsa, Olutola; Schneider, Dana; Brown, Clive

2017-01-01

Recent multinational disease outbreaks demonstrate the risk of disease spreading globally before public health systems can respond to an event. To ensure global health security, countries need robust multisectoral systems to rapidly detect and respond to domestic or imported communicable diseases. The US Centers for Disease Control and Prevention International Border Team works with the governments of Nigeria, Togo, and Benin, along with Pro-Health International and the Abidjan-Lagos Corridor Organization, to build sustainable International Health Regulations capacities at points of entry (POEs) and along border regions. Together, we strengthen comprehensive national and regional border health systems by developing public health emergency response plans for POEs, conducting qualitative assessments of public health preparedness and response capacities at ground crossings, integrating internationally mobile populations into national health surveillance systems, and formalizing cross-border public health coordination. Achieving comprehensive national and regional border health capacity, which advances overall global health security, necessitates multisectoral dedication to the aforementioned components. PMID:29155668

Responding to Communicable Diseases in Internationally Mobile Populations at Points of Entry and along Porous Borders, Nigeria, Benin, and Togo.

PubMed

Merrill, Rebecca D; Rogers, Kimberly; Ward, Sarah; Ojo, Olubumni; Kakaī, Clement Glele; Agbeko, Tamekloe Tsidi; Garba, Hassan; MacGurn, Amanda; Oppert, Marydale; Kone, Idrissa; Bamsa, Olutola; Schneider, Dana; Brown, Clive

2017-12-01

Recent multinational disease outbreaks demonstrate the risk of disease spreading globally before public health systems can respond to an event. To ensure global health security, countries need robust multisectoral systems to rapidly detect and respond to domestic or imported communicable diseases. The US Centers for Disease Control and Prevention International Border Team works with the governments of Nigeria, Togo, and Benin, along with Pro-Health International and the Abidjan-Lagos Corridor Organization, to build sustainable International Health Regulations capacities at points of entry (POEs) and along border regions. Together, we strengthen comprehensive national and regional border health systems by developing public health emergency response plans for POEs, conducting qualitative assessments of public health preparedness and response capacities at ground crossings, integrating internationally mobile populations into national health surveillance systems, and formalizing cross-border public health coordination. Achieving comprehensive national and regional border health capacity, which advances overall global health security, necessitates multisectoral dedication to the aforementioned components.

The relevance of public health research for practice: A 30-year perspective.

PubMed

Diderichsen, Finn

2018-06-01

The Nordic context where public health responsibility is strongly devolved to municipalities raises specific demands on public health research. The demands for causal inference of disease aetiology and intervention efficacy is not different, but in addition there is a need for population health science that describes local prevalence, distribution and clustering of determinants. Knowledge of what interventions and policies work, for whom and under what conditions is essential, but instead of assuming context independence and demanding high external validity it is important to understand how contextual factors linked to groups and places modify both effects and implementation. More implementation studies are needed, but the infrastructure for that research in terms of theories and instruments for monitoring implementation is needed. Much of this was true also 30 years ago, but with increasing spending on both public health research and practice, the demands are increasing that major improvement of population health and health equity are actually achieved.

A state policy framework for integrating health and social services.

PubMed

McGinnis, Tricia; Crawford, Maia; Somers, Stephen A

2014-07-01

Recognizing that health is determined by a variety of interrelated factors, states are looking to connect health care, public health, and social services to help achieve improved population health, better care, and reduced cost of care. This issue brief describes three essential components for integrating health, including physical and behavioral health services and public health, and social services: (1) a coordinating mechanism, (2) quality measurement and data-sharing tools, and (3) aligned financing and payment. It also presents a five-step policy framework to help states move beyond isolated pilot efforts and establish the infrastructure necessary to support ongoing integration of health and social services, particularly for Medicaid beneficiaries.

Consideration of an Applied Model of Public Health Program Infrastructure

PubMed Central

Lavinghouze, Rene; Snyder, Kimberly; Rieker, Patricia; Ottoson, Judith

2015-01-01

Systemic infrastructure is key to public health achievements. Individual public health program infrastructure feeds into this larger system. Although program infrastructure is rarely defined, it needs to be operationalized for effective implementation and evaluation. The Ecological Model of Infrastructure (EMI) is one approach to defining program infrastructure. The EMI consists of 5 core (Leadership, Partnerships, State Plans, Engaged Data, and Managed Resources) and 2 supporting (Strategic Understanding and Tactical Action) elements that are enveloped in a program’s context. We conducted a literature search across public health programs to determine support for the EMI. Four of the core elements were consistently addressed, and the other EMI elements were intermittently addressed. The EMI provides an initial and partial model for understanding program infrastructure, but additional work is needed to identify evidence-based indicators of infrastructure elements that can be used to measure success and link infrastructure to public health outcomes, capacity, and sustainability. PMID:23411417

Development and use of the generic WHO/CDC logic model for vitamin and mineral interventions in public health programmes

PubMed Central

De-Regil, Luz Maria; Peña-Rosas, Juan Pablo; Flores-Ayala, Rafael; del Socorro Jefferds, Maria Elena

2015-01-01

Objective Nutrition interventions are critical to achieve the Millennium Development Goals; among them, micronutrient interventions are considered cost-effective and programmatically feasible to scale up, but there are limited tools to communicate the programme components and their relationships. The WHO/CDC (Centers for Disease Control and Prevention) logic model for micronutrient interventions in public health programmes is a useful resource for planning, implementation, monitoring and evaluation of these interventions, which depicts the programme theory and expected relationships between inputs and expected Millennium Development Goals. Design The model was developed by applying principles of programme evaluation, public health nutrition theory and programmatic expertise. The multifaceted and iterative structure validation included feedback from potential users and adaptation by national stakeholders involved in public health programmes' design and implementation. Results In addition to the inputs, main activity domains identified as essential for programme development, implementation and performance include: (i) policy; (ii) products and supply; (iii) delivery systems; (iv) quality control; and (v) behaviour change communication. Outputs encompass the access to and coverage of interventions. Outcomes include knowledge and appropriate use of the intervention, as well as effects on micronutrient intake, nutritional status and health of target populations, for ultimate achievement of the Millennium Development Goals. Conclusions The WHO/CDC logic model simplifies the process of developing a logic model by providing a tool that has identified high-priority areas and concepts that apply to virtually all public health micronutrient interventions. Countries can adapt it to their context in order to support programme design, implementation, monitoring and evaluation for the successful scale-up of nutrition interventions in public health. PMID:23507463

Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study

PubMed Central

Marteau, Theresa M.; Kinmonth, Ann Louise; Cohn, Simon

2015-01-01

Background: Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Methods: Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300 000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Results: Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. Conclusions: The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. PMID:25983329

Global health and the global economic crisis.

PubMed

Benatar, Solomon R; Gill, Stephen; Bakker, Isabella

2011-04-01

Although the resources and knowledge for achieving improved global health exist, a new, critical paradigm on health as an aspect of human development, human security, and human rights is needed. Such a shift is required to sufficiently modify and credibly reduce the present dominance of perverse market forces on global health. New scientific discoveries can make wide-ranging contributions to improved health; however, improved global health depends on achieving greater social justice, economic redistribution, and enhanced democratization of production, caring social institutions for essential health care, education, and other public goods. As with the quest for an HIV vaccine, the challenge of improved global health requires an ambitious multidisciplinary research program.

Public Value Mapping of Equity in Emerging Nanomedicine

ERIC Educational Resources Information Center

Slade, Catherine P.

2011-01-01

Public values failure occurs when the market and the public sector fail to provide goods and services required to achieve the core values of society such as equity (Bozeman 2007). That public policy for emerging health technologies should address intrinsic societal values such as equity is not a novel concept. However, the ways that the public…

Education for public health in Europe and its global outreach.

PubMed

Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert

2014-01-01

At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice.

Promoting the Health of Young Adults in Urban Public Universities: A Case Study from City University of New York

ERIC Educational Resources Information Center

Freudenberg, Nicholas; Manzo, Luis; Mongiello, Lorraine; Jones, Hollie; Boeri, Natascia; Lamberson, Patricia

2013-01-01

Changing demographics of college students and new insights into the developmental trajectory of chronic diseases present universities with opportunities to improve population health and reduce health inequalities. The reciprocal relationships between better health and improved educational achievement also offer university health programs a chance…

45 CFR 158.162 - Reporting of Federal and State taxes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... designed to cover the costs of providing indigent care or other access to health care throughout the State... expenditures for activities or programs that seek to achieve the objectives of improving access to health... Federal, State or local public health priorities such as advancing health care knowledge through education...

45 CFR 158.162 - Reporting of Federal and State taxes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... designed to cover the costs of providing indigent care or other access to health care throughout the State... expenditures for activities or programs that seek to achieve the objectives of improving access to health... Federal, State or local public health priorities such as advancing health care knowledge through education...

Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe

PubMed Central

Jones, Donna S; Tshimanga, Mufuta; Woelk, Godfrey; Nsubuga, Peter; Sunderland, Nadine L; Hader, Shannon L; St Louis, Michael E

2009-01-01

Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes. PMID:19664268

The politics of managed competition: public abuse of the private interest.

PubMed

Robinson, James C

2003-01-01

The doctrine of managed competition in health care sought to achieve the social goals of access and efficiency using market incentives and consumer choice rather than governmental regulation and public administration. In retrospect, it demanded too much from both the public and the private sectors. Rather than develop choice-supporting rules and institutions, the public sector has promoted process regulation and benefit mandates. The private health insurance sector has pursued short-term profitability rather than cooperate in the development of fair competition and informed consumer choice. Purchasers have subsidized inefficient insurance designs in order to exploit tax and regulatory loopholes and to retain an image of corporate paternalism. America's health care system suffers from the public abuse of private interests and the private abuse of the public interest.

Integrating epidemiology, psychology, and economics to achieve HPV vaccination targets.

PubMed

Basu, Sanjay; Chapman, Gretchen B; Galvani, Alison P

2008-12-02

Human papillomavirus (HPV) vaccines provide an opportunity to reduce the incidence of cervical cancer. Optimization of cervical cancer prevention programs requires anticipation of the degree to which the public will adhere to vaccination recommendations. To compare vaccination levels driven by public perceptions with levels that are optimal for maximizing the community's overall utility, we develop an epidemiological game-theoretic model of HPV vaccination. The model is parameterized with survey data on actual perceptions regarding cervical cancer, genital warts, and HPV vaccination collected from parents of vaccine-eligible children in the United States. The results suggest that perceptions of survey respondents generate vaccination levels far lower than those that maximize overall health-related utility for the population. Vaccination goals may be achieved by addressing concerns about vaccine risk, particularly those related to sexual activity among adolescent vaccine recipients. In addition, cost subsidizations and shifts in federal coverage plans may compensate for perceived and real costs of HPV vaccination to achieve public health vaccination targets.

Key-phrase based classification of public health web pages.

PubMed

Dolamic, Ljiljana; Boyer, Célia

2013-01-01

This paper describes and evaluates the public health web pages classification model based on key phrase extraction and matching. Easily extendible both in terms of new classes as well as the new language this method proves to be a good solution for text classification faced with the total lack of training data. To evaluate the proposed solution we have used a small collection of public health related web pages created by a double blind manual classification. Our experiments have shown that by choosing the adequate threshold value the desired value for either precision or recall can be achieved.

Reframing school dropout as a public health issue.

PubMed

Freudenberg, Nicholas; Ruglis, Jessica

2007-10-01

Good education predicts good health, and disparities in health and in educational achievement are closely linked. Despite these connections, public health professionals rarely make reducing the number of students who drop out of school a priority, although nearly one-third of all students in the United States and half of black, Latino, and American Indian students do not graduate from high school on time. In this article, we summarize knowledge on the health benefits of high school graduation and discuss the pathways by which graduating from high school contributes to good health. We examine strategies for reducing school dropout rates with a focus on interventions that improve school completion rates by improving students' health. Finally, we recommend actions health professionals can take to reframe the school dropout rate as a public health issue and to improve school completion rates in the United States.

[Crisis and the independence of public health policies. SESPAS report 2014].

PubMed

Hernández Aguado, Ildefonso; Lumbreras Lacarra, Blanca

2014-06-01

Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations have influenced the formulation of certain policies with an impact on health, such as those related to the tobacco industry, the chemical industry, nutrition, alcohol, pharmaceuticals, and health technology. The main areas in which these companies can influence policies are science, education, politics, and society in general. In this scenario, public health associations should take an active role in ensuring the independence of political decisions via actions such as the following: supporting strategies that guarantee the independence of public health policies and apply criteria of impartiality and transparency; rejecting those public-private partnerships launched to prevent health problems partly caused by these corporations; establishing partnerships to achieve independent training of health professionals and an institution with scientific authority in order to improve public health communication and counteract the lack of sound public health information; promoting a critical analysis of the definition of health problems and their solutions, and establishing related agendas (scientific, political and media) and alliances, so that continuing training for health professionals is independent. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

China's rural public health system performance: a cross-sectional study.

PubMed

Tian, Miaomiao; Feng, Da; Chen, Xi; Chen, Yingchun; Sun, Xi; Xiang, Yuanxi; Yuan, Fang; Feng, Zhanchun

2013-01-01

In the past three years, the Government of China initiated health reform with rural public health system construction to achieve equal access to public health services for rural residents. The study assessed trends of public health services accessibility in rural China from 2008 to 2010, as well as the current situation about the China's rural public health system performance. The data were collected from a cross-sectional survey conducted in 2011, which used a multistage stratified random sampling method to select 12 counties and 118 villages from China. Three sets of indicators were chosen to measure the trends in access to coverage, equality and effectiveness of rural public health services. Data were disaggregated by provinces and by participants: hypertension patients, children, elderly and women. We examined the changes in equality across and within region. China's rural public health system did well in safe drinking water, children vaccinations and women hospital delivery. But more hypertension patients with low income could not receive regular healthcare from primary health institutions than those with middle and high income. In 2010, hypertension treatment rate of Qinghai in Western China was just 53.22% which was much lower than that of Zhejiang in Eastern China (97.27%). Meanwhile, low performance was showed in effectiveness of rural public health services. The rate of effective treatment for controlling their blood pressure within normal range was just 39.7%. The implementation of health reform since 2009 has led the public health development towards the right direction. Physical access to public health services had increased from 2008 to 2010. But, inter- and intra-regional inequalities in public health system coverage still exist. Strategies to improve the quality and equality of public health services in rural China need to be considered.

Assessment of public health impact of work-related asthma.

PubMed

Jaakkola, Maritta S; Jaakkola, Jouni J K

2012-03-05

Asthma is among the most common chronic diseases in working-aged populations and occupational exposures are important causal agents. Our aims were to evaluate the best methods to assess occurrence, public health impact, and burden to society related to occupational or work-related asthma and to achieve comparable estimates for different populations. We addressed three central questions: 1: What is the best method to assess the occurrence of occupational asthma? We evaluated: 1) assessment of the occurrence of occupational asthma per se, and 2) assessment of adult-onset asthma and the population attributable fractions due to specific occupational exposures. 2: What are the best methods to assess public health impact and burden to society related to occupational or work-related asthma? We evaluated methods based on assessment of excess burden of disease due to specific occupational exposures. 3: How to achieve comparable estimates for different populations? We evaluated comparability of estimates of occurrence and burden attributable to occupational asthma based on different methods. Assessment of the occurrence of occupational asthma per se can be used in countries with good coverage of the identification system for occupational asthma, i.e. countries with well-functioning occupational health services. Assessment based on adult-onset asthma and population attributable fractions due to specific occupational exposures is a good approach to estimate the occurrence of occupational asthma at the population level. For assessment of public health impact from work-related asthma we recommend assessing excess burden of disease due to specific occupational exposures, including excess incidence of asthma complemented by an assessment of disability from it. International comparability of estimates can be best achieved by methods based on population attributable fractions. Public health impact assessment for occupational asthma is central in prevention and health policy planning and could be improved by purposeful development of methods for assessing health benefits from preventive actions. Registry-based methods are suitable for evaluating time-trends of occurrence at a given population but for international comparisons they face serious limitations. Assessment of excess burden of disease due to specific occupational exposure is a useful measure, when there is valid information on population exposure and attributable fractions.

7 CFR 1739.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... transmission service that fosters economic growth and delivers enhanced educational, health care, and public... transmission services that improve economic development and provide enhanced educational and health care... the advanced technologies that are necessary to achieve these goals. ...

NYC Epi Scholars program: promoting applied health disparities research in an urban public health department-a program model.

PubMed

Blake, Janice; Choden, Tsering; Hemans-Henry, Calaine; Koppaka, Ram; Greene, Carolyn

2011-01-01

Although health disparities research has already contributed to decreased mortality and morbidity in underserved communities, more work is needed. The NYC Epi Scholars program of the New York City Department of Health and Mental Hygiene (NYC DOHMH) aims to address gaps in critical public health needs and to train future public health leaders in epidemiology. The program is designed to increase racial/ethnic and socioeconomic diversity in the public health workforce, to provide fieldwork and practica opportunities, and to cultivate future leaders in epidemiology and public health. Since its inception in 2007, the NYC Epi Scholars program of the NYC DOHMH has sought talented epidemiology students interested in gaining practical experience in applied health disparities research. NYC Epi Scholars is open to graduate epidemiology students who have demonstrated achievement and leadership potential and gives them an opportunity to provide high-quality research assistance to projects that identify and address health disparities of public health significance. Many of the program's 32 alumni have made notable contributions to public health: publishing articles in peer-reviewed journals; making presentations at national and international conferences; and after graduating, pursuing careers at the DOHMH, Centers for Disease Control and Prevention, the Environmental Protection Agency, and the National Institutes of Health. Because of its noted success, the NYC Epi Scholars program may serve as a "best-practice" model for expansion in other urban health departments.

Implications of the 2017 Tax Cuts and Jobs Act for Public Health.

PubMed

Glied, Sherry

2018-06-01

The recently passed Tax Cuts and Jobs Act will reduce total federal revenues by about 4% between 2018 and 2027. The law makes multiple changes to the taxation of individuals and corporations. It also repeals the Affordable Care Act's (ACA's) individual mandate penalties, which will erase some of the gains in insurance coverage achieved since implementation of the ACA's coverage expansions. The resulting increases in rates of uninsurance will likely lead to increased uncompensated care and deflect hospitals and health departments from addressing other prevention and public health needs. In addition, the law is expected to lead to substantial increases in the federal debt and, consequently, to calls for reductions in spending on entitlement programs, particularly Medicare, and on discretionary programs, including public health. Many other provisions of the law could also have second-order effects on public health.

Public and private sector interactions: an economic perspective.

PubMed

Maynard, A

1986-01-01

The debate about the public-private mix for health care has been dominated by rhetoric and the failure to evaluate the characteristics of the outcomes of public and private health care systems and to relate these to policy targets. After a brief analysis of the competing, liberal (conservative) and collectivist (socialist), objectives, the nature of the private health care sector in Britain is described and it is shown that growth has faltered due to cost containment problems. This outcome is the product of characteristics of the private health care system, paralleled precisely in the NHS: asymmetry information, monopoly power, moral hazard and third party pays. The final section discusses briefly some remedies for the inefficient and inequitable outcomes which are seen in all health care markets and it is argued that competition within public and private health care systems may enable each system type to achieve its own particular objectives more efficiently.

Universal Health Coverage for India by 2022: A Utopia or Reality?

PubMed Central

Singh, Zile

2013-01-01

It is the obligation of the state to provide free and universal access to quality health-care services to its citizens. India continues to be among the countries of the world that have a high burden of diseases. The various health program and policies in the past have not been able to achieve the desired goals and objectives. 65th World Health Assembly in Geneva identified universal health coverage (UHC) as the key imperative for all countries to consolidate the public health advances. Accordingly, Planning Commission of India constituted a high level expert group (HLEG) on UHC in October 2010. HLEG submitted its report in Nov 2011 to Planning Commission on UHC for India by 2022. The recommendations for the provision of UHC pertain to the critical areas such as health financing, health infrastructure, health services norms, skilled human resources, access to medicines and vaccines, management and institutional reforms, and community participation. India faces enormous challenges to achieve UHC by 2022 such as high disease prevalence, issues of gender equality, unregulated and fragmented health-care delivery system, non-availability of adequate skilled human resource, vast social determinants of health, inadequate finances, lack of inter-sectoral co-ordination and various political pull and push of different forces, and interests. These challenges can be met by a paradigm shift in health policies and programs in favor of vulnerable population groups, restructuring of public health cadres, reorientation of undergraduate medical education, more emphasis on public health research, and extensive education campaigns. There are still areas of concern in fulfilling the objectives of achieving UHC by 2022 regarding financing model for health-care delivery, entitlement package, cost of health-care interventions and declining state budgets. However, the Government's commitment to provide adequate finances, recent bold social policy initiatives and enactments such as food security bill, enhanced participation by civil society in all health matters, major initiative by some states such as Tamil Nadu to improve health, water, and sanitation services are good enough reasons for hope that UHC can be achieved by 2022. However, in the absence of sustained financial support, strong political will and leadership, dedicated involvement of all stakeholders and community participation, attainment of UHC by 2022 will remain a Utopia. PMID:23878417

Universal health coverage for India by 2022: a utopia or reality?

PubMed

Singh, Zile

2013-04-01

It is the obligation of the state to provide free and universal access to quality health-care services to its citizens. India continues to be among the countries of the world that have a high burden of diseases. The various health program and policies in the past have not been able to achieve the desired goals and objectives. 65(th) World Health Assembly in Geneva identified universal health coverage (UHC) as the key imperative for all countries to consolidate the public health advances. Accordingly, Planning Commission of India constituted a high level expert group (HLEG) on UHC in October 2010. HLEG submitted its report in Nov 2011 to Planning Commission on UHC for India by 2022. The recommendations for the provision of UHC pertain to the critical areas such as health financing, health infrastructure, health services norms, skilled human resources, access to medicines and vaccines, management and institutional reforms, and community participation. India faces enormous challenges to achieve UHC by 2022 such as high disease prevalence, issues of gender equality, unregulated and fragmented health-care delivery system, non-availability of adequate skilled human resource, vast social determinants of health, inadequate finances, lack of inter-sectoral co-ordination and various political pull and push of different forces, and interests. These challenges can be met by a paradigm shift in health policies and programs in favor of vulnerable population groups, restructuring of public health cadres, reorientation of undergraduate medical education, more emphasis on public health research, and extensive education campaigns. There are still areas of concern in fulfilling the objectives of achieving UHC by 2022 regarding financing model for health-care delivery, entitlement package, cost of health-care interventions and declining state budgets. However, the Government's commitment to provide adequate finances, recent bold social policy initiatives and enactments such as food security bill, enhanced participation by civil society in all health matters, major initiative by some states such as Tamil Nadu to improve health, water, and sanitation services are good enough reasons for hope that UHC can be achieved by 2022. However, in the absence of sustained financial support, strong political will and leadership, dedicated involvement of all stakeholders and community participation, attainment of UHC by 2022 will remain a Utopia.

Cultivating Hygiene as a Science: The Welch-Rose Report's Influence at Johns Hopkins and Beyond.

PubMed

Thomas, Karen Kruse

2016-03-01

In 1915, William Henry Welch and Wickliffe Rose submitted a report to the Rockefeller Foundation that became the template for public health professional education in the United States and abroad. Based on the Welch-Rose Report's recommendations, the Foundation awarded a grant to Johns Hopkins University in 1916 to establish the first independent graduate school of public health, with Welch serving as the founding dean. The Welch-Rose Report and, by extension, the Johns Hopkins School of Hygiene and Public Health established and transmitted a new model of scientific training that wove the laboratory mindset together with the methods of public health administration and epidemiologic fieldwork. During the School's first quarter-century, faculty and alumni were remarkably active in frontline public health problem-solving, as well as launching public health agencies and schools of all types and sizes. The most lasting contribution of the Welch-Rose Report and the Johns Hopkins School of Hygiene and Public Health, now the Johns Hopkins Bloomberg School of Public Health, has been to "cultivate the science of hygiene" to bring about exponential growth in the evidence base for public health. The schools that have adopted the Johns Hopkins model of public health education worldwide have produced professionals who have worked to achieve wide-ranging reforms dedicated to preserving life, protecting health, and preventing injury across populations and continents. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Public Policy on Smoking and Health: Toward a Smoke-Free Generation by the Year 2000. Volume 73, No. 2.

ERIC Educational Resources Information Center

Warner, Kenneth E.; And Others

This policy statement on smoking and health was written by a working group of experts commissioned by the American Heart Association's Subcommittee on Smoking to study relevant issues and recommend appropriate policies for achieving a smoke-free society by the year 2000. To aid in developing and implementing public policies designed to facilitate…

Daring to dream: reactions to tobacco endgame ideas among policy-makers, media and public health practitioners

PubMed Central

2011-01-01

Background Tobacco control strategies have mainly targeted reducing demand. Supply-side focused measures, though less familiar, deserve consideration, particularly to achieve 'endgame' tobacco control aims (e.g. achieving close to zero smoking prevalence). We explored attitudes towards supply-side focused 'endgame' tobacco control approaches and how they can be best communicated with senior policymakers, journalists, and public health practitioners. Methods We identified five supply-side focused approaches which could potentially lead to the tobacco endgame: two structural models and three discrete actions. The structural models were: (i) a Nicotine Authority to coordinate tobacco control activities and regulate the nicotine/tobacco market for public health aims; and (ii) a Tobacco Supply Agency acting as a monopoly purchaser of tobacco products and controlling the tobacco supply for public health aims. The actions were: (a) allocating progressively reducing tobacco product import quotas (the 'sinking lid') until importation and commercial sale of tobacco products ceased; (b) making tobacco companies responsible for reducing smoking prevalence with stringent financial penalties if targets were missed; and (c) new laws to facilitate litigation against tobacco companies. These approaches were presented as means to achieve a tobacco free New Zealand by 2020 to 19 senior policymakers, journalists, and public health physicians in two focus groups and eight interviews, and their reactions sought. Results The tobacco-free vision was widely supported. Participants engaged fully with the proposed tobacco control approaches, which were viewed as interesting or even intriguing. Most supported increasing the focus on supply-side measures. Views differed greatly about the desirability, feasibility and likely effectiveness of each approach. Participants identified a range of potential barriers to implementation and challenges to successfully advocating and communicating these approaches. The current framing of tobacco as a risky but legal commodity was noted as an important potential barrier to implementing endgame approaches. Conclusions Endgame tobacco control approaches were considered to be viable policy options. Further policy analysis, research and public discussion are needed to develop endgame approaches. A significant change in the public framing of tobacco may be a prerequisite for implementing endgame solutions. PMID:21774829

Daring to dream: reactions to tobacco endgame ideas among policy-makers, media and public health practitioners.

PubMed

Edwards, Richard; Russell, Marie; Thomson, George; Wilson, Nick; Gifford, Heather

2011-07-20

Tobacco control strategies have mainly targeted reducing demand. Supply-side focused measures, though less familiar, deserve consideration, particularly to achieve 'endgame' tobacco control aims (e.g. achieving close to zero smoking prevalence). We explored attitudes towards supply-side focused 'endgame' tobacco control approaches and how they can be best communicated with senior policymakers, journalists, and public health practitioners. We identified five supply-side focused approaches which could potentially lead to the tobacco endgame: two structural models and three discrete actions. The structural models were: (i) a Nicotine Authority to coordinate tobacco control activities and regulate the nicotine/tobacco market for public health aims; and (ii) a Tobacco Supply Agency acting as a monopoly purchaser of tobacco products and controlling the tobacco supply for public health aims. The actions were: (a) allocating progressively reducing tobacco product import quotas (the 'sinking lid') until importation and commercial sale of tobacco products ceased; (b) making tobacco companies responsible for reducing smoking prevalence with stringent financial penalties if targets were missed; and (c) new laws to facilitate litigation against tobacco companies. These approaches were presented as means to achieve a tobacco free New Zealand by 2020 to 19 senior policymakers, journalists, and public health physicians in two focus groups and eight interviews, and their reactions sought. The tobacco-free vision was widely supported. Participants engaged fully with the proposed tobacco control approaches, which were viewed as interesting or even intriguing. Most supported increasing the focus on supply-side measures. Views differed greatly about the desirability, feasibility and likely effectiveness of each approach. Participants identified a range of potential barriers to implementation and challenges to successfully advocating and communicating these approaches. The current framing of tobacco as a risky but legal commodity was noted as an important potential barrier to implementing endgame approaches. Endgame tobacco control approaches were considered to be viable policy options. Further policy analysis, research and public discussion are needed to develop endgame approaches. A significant change in the public framing of tobacco may be a prerequisite for implementing endgame solutions.

Ethics, economics, and public financing of health care

PubMed Central

Hurley, J.

2001-01-01

There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services. Key Words: Ethics • economics • health care financing PMID:11479353

Analysis of Health Sector Budget of Nepal.

PubMed

Dulal, R K; Magar, A; Karki, S D; Khatiwada, D; Hamal, P K

2014-01-01

Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.

Evaluating community and campus environmental public health programs.

PubMed

Pettibone, Kristianna G; Parras, Juan; Croisant, Sharon Petronella; Drew, Christina H

2014-01-01

The National Institute of Environmental Health Sciences' (NIEHS) Partnerships for Environmental Public Health (PEPH) program created the Evaluation Metrics Manual as a tool to help grantees understand how to map out their programs using a logic model, and to identify measures for documenting their achievements in environmental public health research. This article provides an overview of the manual, describing how grantees and community partners contributed to the manual, and how the basic components of a logic model can be used to identify metrics. We illustrate how the approach can be implemented, using a real-world case study from the University of Texas Medical Branch, where researchers worked with community partners to develop a network to address environmental justice issues.

Public-private partnerships in practice: collaborating to improve health finance policy in Ghana and Kenya.

PubMed

Suchman, Lauren; Hart, Elizabeth; Montagu, Dominic

2018-06-13

Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public-private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why. Drawing on semi-structured interviews conducted with National Health Insurance (NHI) officials in Kenya and Ghana, as well as with staff from several international NGOs (INGOs) representing social franchise networks that are partnering to increase private provider accreditation into the NHIs, this article examines one example of public-private collaboration in practice. We found that interviewees initially had incomplete knowledge about the potential for cross-sector synergy, but both sides were motivated to work together around shared goals and the potential for mutual benefit. The public-private relationship then evolved over time through regular face-to-face interactions, reciprocal feedback, and iterative workplan development. This process led to a collegial relationship that also has given small private providers more voice in the health system. In order to sustain this relationship, we recommend that both public and private sector representatives develop formalized protocols for working together, as well as less formal open channels for communication. Models for aggregating small private providers and delivering them to government programmes as a package have potential to facilitate public-private partnerships as well, but there is little evidence on how these models work in LMICs thus far.

An Examination of Two Policy Networks Involved in Advancing Smokefree Policy Initiatives.

PubMed

Moreland-Russell, Sarah; Carothers, Bobbi J

2015-09-08

This study examines smokefree policy networks in two cities—Kansas City and St. Louis, Missouri—one that was successful in achieving widespread policy success, and one that was not. Descriptive social network analyses and visual network mapping were used to compare importance and contact relationships among actors involved in the smokefree policy initiatives. In Kansas City, where policy adoption was achieved, there was a higher level of connectivity among members, with network members being in contact with an average of more than five people, compared to just over two people for the St. Louis network. For both cities, despite being recognized as important, politicians were in contact with the fewest number of people. Results highlight the critical need to actively engage a variety of stakeholders when attempting city wide public health policy change. As evident by the success in smokefree policy adoption throughout Kansas City compared to St. Louis, closer linkages and continued communication among stakeholders including the media, coalitions, public health agencies, policymakers, and other partners are essential if we are to advance and broaden the impact of public health policy. Results indicate that the presence of champions, or those that play leadership roles in actively promoting policy by linking individuals and organizations, play an important role in advancing public health policy. Those working in public health should examine their level of engagement with the policy process and implement strategies for improving that engagement through relationship building and ongoing interactions with a variety of stakeholders, including policymakers.

Assessing the Public Health Impact and Effectiveness of Interventions To Prevent Salmonella Contamination of Sprouts.

PubMed

Ding, Hongliu; Fu, Tong-Jen

2016-01-01

Sprouts have been a recurring public health challenge due to microbiological contamination, and Salmonella has been the major cause of sprout-associated outbreaks. Although seed treatment and microbiological testing have been applied as risk reduction measures during sprout production, the extent to which their effectiveness in reducing the public health risks associated with sprouts has not been well investigated. We conducted a quantitative risk assessment to measure the risk posed by Salmonella contamination in sprouts and to determine whether and how mitigation strategies can achieve a satisfactory risk reduction based on the assumption that the risk reduction achieved by a microbiological sampling and testing program at a given sensitivity is equivalent to that achieved by direct inactivation of pathogens. Our results indicated that if the sprouts were produced without any risk interventions, the health impact caused by sprouts contaminated with Salmonella would be very high, with a median annual estimated loss of disability-adjusted life years (DALYs) of 691,412. Seed treatment (with 20,000 ppm of calcium hypochlorite) or microbiological sampling and testing of spent irrigation water (SIW) alone could reduce the median annual impact to 734 or 4,856 DALYs, respectively. Combining seed treatment with testing of the SIW would further decrease the risk to 58 DALYs. This number could be dramatically lowered to 3.99 DALYs if sprouts were produced under conditions that included treating seeds with 20,000 ppm of calcium hypochlorite plus microbiological testing of seeds, SIW, and finished products. Our analysis shows that the public health impact due to Salmonella contamination in sprouts could be controlled if seeds are treated to reduce pathogens and microbiological sampling and testing is implemented. Future advances in intervention strategies would be important to improve sprout safety further.

Health inequalities as a foundation for embodying knowledge within public health teaching: a qualitative study.

PubMed

Mabhala, Mzwandile A

2013-06-28

Recent U.K. health policies identified nurses as key contributors to the social justice agenda of reducing health inequalities, on the assumption that all nurses understand and wish to contribute to public health. Following this policy shift, public health content within pre-registration nursing curricula increased. However, public health nurse educators (PHNEs) had various backgrounds, and some had limited formal public health training, or involvement in or understanding of policy required to contribute effectively to it. Their knowledge of this subject, their understanding and interpretation of how it could be taught, was not fully understood. This research aimed to understand how public health nurse educators' professional knowledge could be conceptualised and to develop a substantive theory of their knowledge of teaching public health, using a qualitative data analysis approach. Qualitative in-depth semi-structured interviews (n=26) were conducted with eleven university-based PHNEs. Integrating public health into all aspects of life was seen as central to the knowing and teaching of public health; this was conceptualised as 'embodying knowledge'. Participants identified the meaning of embodying knowledge for teaching public health as: (a) possessing a wider vision of health; (b) reflecting and learning from experience; and (c) engaging in appropriate pedagogical practices. The concept of public health can mean different things to different people. The variations of meaning ascribed to public health reflect the various backgrounds from which the public health workforce is drawn. The analysis indicates that PHNEs are embodying knowledge for teaching through critical pedagogy, which involves them engaging in transformative, interpretive and integrative processes to refashion public health concepts; this requires PHNEs who possess a vision of what to teach, know how to teach, and are able to learn from experience. Their vision of public health is influenced by social justice principles in that health inequalities, socioeconomic determinants of health, epidemiology, and policy and politics are seen as essential areas of the public health curriculum. They believe in forms of teaching that achieve social transformation at individual, behavioural and societal levels, while also enabling learners to recognise their capacity to effect change.

Health inequalities as a foundation for embodying knowledge within public health teaching: a qualitative study

PubMed Central

2013-01-01

Introduction Recent UK health policies identified nurses as key contributors to the social justice agenda of reducing health inequalities, on the assumption that all nurses understand and wish to contribute to public health. Following this policy shift, public health content within pre-registration nursing curricula increased. However, public health nurse educators (PHNEs) had various backgrounds, and some had limited formal public health training, or involvement in or understanding of policy required to contribute effectively to it. Their knowledge of this subject, their understanding and interpretation of how it could be taught, was not fully understood. Methodology This research aimed to understand how public health nurse educators’ professional knowledge could be conceptualised and to develop a substantive theory of their knowledge of teaching public health, using a qualitative data analysis approach. Qualitative in-depth semi-structured interviews (n=26) were conducted with eleven university-based PHNEs. Results Integrating public health into all aspects of life was seen as central to the knowing and teaching of public health; this was conceptualised as ‘embodying knowledge’. Participants identified the meaning of embodying knowledge for teaching public health as: (a) possessing a wider vision of health; (b) reflecting and learning from experience; and (c) engaging in appropriate pedagogical practices. Conclusion The concept of public health can mean different things to different people. The variations of meaning ascribed to public health reflect the various backgrounds from which the public health workforce is drawn. The analysis indicates that PHNEs are embodying knowledge for teaching through critical pedagogy, which involves them engaging in transformative, interpretive and integrative processes to refashion public health concepts; this requires PHNEs who possess a vision of what to teach, know how to teach, and are able to learn from experience. Their vision of public health is influenced by social justice principles in that health inequalities, socioeconomic determinants of health, epidemiology, and policy and politics are seen as essential areas of the public health curriculum. They believe in forms of teaching that achieve social transformation at individual, behavioural and societal levels, while also enabling learners to recognise their capacity to effect change. PMID:23809694

Pathways to Program Success: A Qualitative Comparative Analysis (QCA) of Communities Putting Prevention to Work Case Study Programs

PubMed Central

Kane, Heather; Hinnant, Laurie; Day, Kristine; Council, Mary; Tzeng, Janice; Soler, Robin; Chambard, Megan; Roussel, Amy; Heirendt, Wendy

2016-01-01

Objective To examine the elements of capacity, a measure of organizational resources supporting program implementation that result in successful completion of public health program objectives in a public health initiative serving 50 communities. Design We used crisp set Qualitative Comparative Analysis (QCA) to analyze case study and quantitative data collected during the evaluation of the Communities Putting Prevention to Work (CPPW) program. Setting CPPW awardee program staff and partners implemented evidence-based public health improvements in counties, cities, and organizations (eg, worksites, schools). Participants Data came from case studies of 22 CPPW awardee programs that implemented evidence-based, community-and organizational-level public health improvements. Intervention Program staff implemented a range of evidence-based public health improvements related to tobacco control and obesity prevention. Main Outcome Measure The outcome measure was completion of approximately 60% of work plan objectives. Results Analysis of the capacity conditions revealed 2 combinations for completing most work plan objectives: (1) having experience implementing public health improvements in combination with having a history of collaboration with partners; and (2) not having experience implementing public health improvements in combination with having leadership support. Conclusion Awardees have varying levels of capacity. The combinations identified in this analysis provide important insights into how awardees with different combinations of elements of capacity achieved most of their work plan objectives. Even when awardees lack some elements of capacity, they can build it through strategies such as hiring staff and engaging new partners with expertise. In some instances, lacking 1 or more elements of capacity did not prevent an awardee from successfully completing objectives. Implications for Policy & Practice These findings can help funders and practitioners recognize and assemble different aspects of capacity to achieve more successful programs; awardees can draw on extant organizational strengths to compensate when other aspects of capacity are absent. PMID:27598714

Building health research systems to achieve better health

PubMed Central

Hanney, Stephen R; González Block, Miguel A

2006-01-01

Health research systems can link knowledge generation with practical concerns to improve health and health equity. Interest in health research, and in how health research systems should best be organised, is moving up the agenda of bodies such as the World Health Organisation. Pioneering health research systems, for example those in Canada and the UK, show that progress is possible. However, radical steps are required to achieve this. Such steps should be based on evidence not anecdotes. Health Research Policy and Systems (HARPS) provides a vehicle for the publication of research, and informed opinion, on a range of topics related to the organisation of health research systems and the enormous benefits that can be achieved. Following the Mexico ministerial summit on health research, WHO has been identifying ways in which it could itself improve the use of research evidence. The results from this activity are soon to be published as a series of articles in HARPS. This editorial provides an account of some of these recent key developments in health research systems but places them in the context of a distinguished tradition of debate about the role of science in society. It also identifies some of the main issues on which 'research on health research' has already been conducted and published, in some cases in HARPS. Finding and retaining adequate financial and human resources to conduct health research is a major problem, especially in low and middle income countries where the need is often greatest. Research ethics and agenda-setting that responds to the demands of the public are issues of growing concern. Innovative and collaborative ways are being found to organise the conduct and utilisation of research so as to inform policy, and improve health and health equity. This is crucial, not least to achieve the health-related Millennium Development Goals. But much more progress is needed. The editorial ends by listing a wide range of topics related to the above priorities on which we hope to feature further articles in HARPS and thus contribute to an informed debate on how best to achieve such progress. PMID:17087830

Challenges and strategies in applying performance measurement to federal public health programs.

PubMed

DeGroff, Amy; Schooley, Michael; Chapel, Thomas; Poister, Theodore H

2010-11-01

Performance measurement is widely accepted in public health as an important management tool supporting program improvement and accountability. However, several challenges impede developing and implementing performance measurement systems at the federal level, including the complexity of public health problems that reflect multiple determinants and involve outcomes that may take years to achieve, the decentralized and networked nature of public health program implementation, and the lack of reliable and consistent data sources and other issues related to measurement. All three of these challenges hinder the ability to attribute program results to specific public health program efforts. The purpose of this paper is to explore these issues in detail and offer potential solutions that support the development of robust and practical performance measures to meet the needs for program improvement and accountability. Adapting performance measurement to public health programs is both an evolving science and art. Through the strategies presented here, appropriate systems can be developed and monitored to support the production of meaningful data that will inform effective decision making at multiple levels. Published by Elsevier Ltd.

Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

PubMed Central

Stoto, Michael A.

2014-01-01

Introduction: Whether the focus of population-health improvement efforts, the measurement of health outcomes, risk factors, and interventions to improve them are central to achieving collective impact in the population health perspective. And because of the importance of a shared measurement system, appropriate measures can help to ensure the accountability of and ultimately integrate the efforts of public health, the health care delivery sector, and other public and private entities in the community to improve population health. Yet despite its importance, population health measurement efforts in the United States are poorly developed and uncoordinated. Collaborative Measurement Development: To achieve the potential of the population health perspective, public health officials, health system leaders, and others must work together to develop sets of population health measures that are suitable for different purposes yet are harmonized so that together they can help to improve a community’s health. This begins with clearly defining the purpose of a set of measures, distinguishing between outcomes for which all share responsibility and actions to improve health for which the health care sector, public health agencies, and others should be held accountable. Framework for Population Health Measurement: Depending on the purpose of the analysis, then, measurement systems should clearly specify what to measure—in particular the population served (the denominator), what the critical health dimensions are in a measurement framework, and how the measures can be used to ensure accountability. Building on a clear understanding of the purpose and dimensions of population health that must be measured, developers can then choose specific measures using existing data or developing new data sources if necessary, with established validity, reliability, and other scientific characteristics. Rather than indiscriminately choosing among the proliferating data streams, this systematic approach to measure development can yield measurement systems that are more appropriate and useful for improving population health. PMID:25995988

Global Health and the Global Economic Crisis

PubMed Central

Gill, Stephen; Bakker, Isabella

2011-01-01

Although the resources and knowledge for achieving improved global health exist, a new, critical paradigm on health as an aspect of human development, human security, and human rights is needed. Such a shift is required to sufficiently modify and credibly reduce the present dominance of perverse market forces on global health. New scientific discoveries can make wide-ranging contributions to improved health; however, improved global health depends on achieving greater social justice, economic redistribution, and enhanced democratization of production, caring social institutions for essential health care, education, and other public goods. As with the quest for an HIV vaccine, the challenge of improved global health requires an ambitious multidisciplinary research program. PMID:21330597

A process evaluation of the 'Aware' and 'Supportive Communities' gambling harm-minimisation programmes in New Zealand.

PubMed

Kolandai-Matchett, Komathi; Bellringer, Maria; Landon, Jason; Abbott, Max

2018-04-01

The Gambling Act 2003 mandated a public health strategy for preventing and minimising gambling harm in New Zealand. Aware Communities and Supportive Communities are two public health programmes subsequently implemented nationwide. These programmes differed from common health promotion initiatives such as media or education campaigns as they were community-action based (requiring community involvement in programme planning and delivery). We carried out a process evaluation to determine their implementation effectiveness and inform improvement and future programme planning. Our qualitative dominant mixed methods design comprised analysis of over a hundred implementer progress reports (submitted July 2010 - June 2013), a staff survey and a staff focus group interview. The programmes demonstrated capacity to not only achieve expected outcomes (e.g. enhanced community awareness about harmful gambling), but also to enhance social sustainability at the community level (e.g. established trustful relationships) and achieve some programme sustainability (e.g. community ownership over ongoing programme delivery). The evaluation noted the potential for a sustainable gambling harm-minimisation model. Community-action based harm-minimisation programmes offer programme sustainability potential which in turn offers funding cost-effectiveness when there are continual public health outcomes beyond initial funding. Although resource intensive, the community-action based approach enables culturally appropriate public health programmes suitable for societies where specific ethnic groups have higher gambling risk. Recognition of such harm-minimisation programmes' contribution to social sustainability is important considering the potential for broader public health outcomes (e.g. better life quality, lesser social problems) within socially sustainable societies.

Education for public health in Europe and its global outreach

PubMed Central

Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert

2014-01-01

Introduction At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice. PMID:24560263

Lost Dollars Threaten Research in Public Academic Health Centers.

PubMed

Bourne, Henry R; Vermillion, Eric B

2017-03-01

The decrease of federal and state support threatens long-term sustainability of research in publicly supported academic health centers. In weathering these financial threats, research at the University of California, San Francisco (UCSF), has undergone 3 substantial changes: institutional salary support goes preferentially to senior faculty, whereas the young increasingly depend on grants; private and government support for research grows apace in clinical departments but declines in basic science departments; and research is judged more on its quantity (numbers of investigators and federal and private dollars) than on its goals, achievements, or scientific quality. We propose specific measures to alleviate these problems. Other large public academic health centers probably confront similar issues, but-except for UCSF-such centers have not been subjected to detailed public analysis.-Bourne, H. R., Vermillion, E. B. Lost dollars threaten research in public academic health centers. © FASEB.

Evidence based communication for health promotion: Indian lessons of last decade.

PubMed

Suresh, K

2011-01-01

Good health promotion programs which help achieve public health goals are derived from using a mix of epidemiological and social and behavioral science research information. Social data informed by behavioral theories provides a lens of understanding how recommended behaviors are adopted by different individuals within the population over a period of time. In addition to social and epidemiological data, evidence based and scientifically planned and monitored strategic communication interventions have to be linked to available service components of the program. Communication is increasingly understood as an enabler of individual and social level change to achieve established developmental goals including health. Democratization movements and the advent of the internet have changed the environment around any program communication from top-down, expert-to-consumer (vertical) communication towards non-hierarchical, dialogue-based (horizontal) communication, through which the public increasingly questions recommendations of experts and public institutions on the basis of their own, often web based, research. The amount of information available has increased greatly, including scientifically valid data and evidence-based recommendations alongside poor quality data, personal opinions, and misinformation. Evidence-based approaches include engagement with and listening to stakeholders, and being transparent about decision making, and honest and open about uncertainty and risks. Decision and policy makers cannot assume what the public wants without undertaking social science and decision science research. The Global Polio Eradication Initiative and Integrated Disease Surveillance Projects (IDSP) in India haves shown that monitoring of public concerns needs to be continuous and responsive, and hand in hand with the monitoring of technical strategies and appropriate Information Technology support for, not only data transmission but also for videoconferencing and community involvement through toll free 24 × 7 call service with universal access. This article elucidates the vital role of Health Promotion, a research based communication process, in achieving developmental, particularly health goals. It underscores that communication is as much a science as an art, as much process as it is about outcomes. It advocates for increased linkages between epidemiological research and social science research in planning effective health promotion interventions with quality service delivery.

Physician training rotations in a large urban health department.

PubMed

Alkon, Ellen; Kim-Farley, Robert; Gunzenhauser, Jeffrey

2014-01-01

Hospitals are the normal setting for physician residency training within the United States. When a hospital cannot provide the specific training needed, a special rotation for that experience is arranged. Linkages between clinical and public health systems are vital to achieving improvements in overall health status in the United States. Nevertheless, most physicians in postgraduate residency programs receive neither training nor practical experience in the practice of public health. For many years, public health rotations have been available within the Los Angeles County Department of Public Health (and its antecedent organizations). Arrangements that existed with local medical schools for residents to rotate with Los Angeles County Department of Health hospitals were extended to include a public health rotation. A general model for the rotation ensured that each resident received education and training relevant to the clinician in practice. Some parts of the model for experience have changed over time while others have not. Also, the challenges and opportunities for both trainees and preceptors have evolved and varied over time. A logic model demonstrates the components and changes with the public health rotation. Changes included alterations in recruitment, expectations, evaluation, formal education, and concepts related to the experience. Changes in the rotation model occurred in the context of other major environmental changes such as new electronic technology, changing expectations for residents, and evolving health services and public health systems. Each impacted the public health rotation. The evaluation method developed included content tests, assessment of competencies by residents and preceptors, and satisfaction measures. Results from the evaluation showed increases in competency and a high level of satisfaction after a public health rotation. The article includes examples of challenges and benefits to a local health department in providing a public health rotation for physicians-in-training and how these challenges were overcome.

Attitudes and values expected of public health nursing students at graduation: A delphi study.

PubMed

Okura, Mika; Takizawa, Hiroko

2018-06-01

The skills and knowledge of the competencies expected of public health nursing (PHN) students at graduation have been clarified; however, the attitudes and values have not yet been studied in Japan. The objective of this study was to identify and reach a consensus among experts on the attitudes and values expected of PHN students at graduation. This survey was conducted as a two-stage Delphi study. We selected the following experts: 248 teachers in the faculty of public health nursing at a university as academic experts, and 250 public health nurses who were also experienced clinical instructors as clinical experts. The round 1 mailed survey was conducted using a questionnaire about the necessity and importance of attitudes and values, and 211 experts responded (42.4%, clinical; n = 124, academic; n = 87). In the Round 2 survey, the experts consisted of 60.2% of the round 1 participants (clinical; n = 73, academic; n = 54). Descriptive statistics were used for multiple imputation. We identified a total of 13 attitudes and values expected of PHN students, and reached ≥90% consensus for most items (except for one). Regarding the expected achievement level at graduation, there was no difference between clinical and academic experts except for one item. Consensus was clearly achieved for 13 attitudes and values expected of PHN students, as well as importance and expected achievement level at graduation. In the future, it is important to examine strategies that can effectively develop these attitudes and values through basic and continuous education. Copyright © 2018 Elsevier Ltd. All rights reserved.

Case study of early detection and intervention of infectious disease outbreaks in an institution using Nursery School Absenteeism Surveillance Systems (NSASSy) of the Public Health Center.

PubMed

Matsumoto, Kayo; Hirayama, Chifumi; Sakuma, Yoko; Itoi, Yoichi; Sunadori, Asami; Kitamura, Junko; Nakahashi, Takeshi; Sugawara, Tamie; Ohkusa, Yasushi

2016-01-01

Objectives Detecting outbreaks early and then activating countermeasures based on such information is extremely important for infection control at childcare facilities. The Sumida ward began operating the Nursery School Absenteeism Surveillance System (NSASSy) in August 2013, and has since conducted real-time monitoring at nursery schools. The Public Health Center can detect outbreaks early and support appropriate intervention. This paper describes the experiences of Sumida Public Health Center related to early detection and intervention since the initiation of the system.Methods In this study, we investigated infectious disease outbreaks detected at 62 nursery schools in the Sumida ward, which were equipped with NSASSy from early November 2013 through late March 2015. We classified the information sources of the detected outbreak and responses of the public health center. The sources were (1) direct contact from some nursery schools, (2) messages from public officers with jurisdiction over nursery schools, (3) automatic detection by NSASSy, and (4) manual detection by public health center officers using NSASSy. The responses made by the health center were described and classified into 11 categories including verification of outbreak and advice for caregivers.Results The number of outbreaks detected by the aforementioned four information sources was zero, 25, 15, and 7 events, respectively, during the first 5 months after beginning NSASSy. These numbers became 5, 7, 53, and 25 events, respectively, during the subsequent 12 months. The number of outbreaks detected increased by 47% during the first 5 months, and by 87% in the following 12 months. The responses were primarily confirming the situation and offering advice to caregivers.Conclusion The Sumida Public Health Center ward could achieve early detection with automatic or manual detection of NSASSy. This system recently has become an important detection resource, and has contributed greatly to early detection. Because the Public Health Center can use it to achieve real-time monitoring, they can recognize emergent situations and intervene earlier, and thereby give feedback to the nursery schools. The system can contribute to providing effective countermeasures in these settings.

Are public health professionals prepared for public health genomics? A cross-sectional survey in Italy

PubMed Central

2014-01-01

Background Public health genomics is an emerging multidisciplinary approach, which aims to integrate genome-based knowledge in a responsible and effective way into public health. Despite several surveys performed to evaluate knowledge, attitudes and professional behaviors of physicians towards predictive genetic testing, similar surveys have not been carried out for public health practitioners. This study is the first to assess knowledge, attitudes and training needs of public health professionals in the field of predictive genetic testing for chronic diseases. Methods A self-administered questionnaire was used to carry out a cross-sectional survey of a random sample of Italian public health professionals. Results A response rate of 67.4% (797 questionnaires) was achieved. Italian public health professionals have the necessary attitudinal background to contribute to the proper use of predictive genetic testing for chronic diseases, but they need additional training to increase their methodological knowledge. Knowledge significantly increases with exposure to predictive genetic testing during postgraduate training (odds ratio (OR) = 1.74, 95% confidence interval (CI) = 1.05–2.88), time dedicated to continuing medical education (OR = 1.53, 95% CI = 1.14–2.04) and level of English language knowledge (OR = 1.36, 95% CI = 1.07–1.72). Adequate knowledge is the strongest predictor of positive attitudes from a public health perspective (OR = 3.98, 95% CI = 2.44–6.50). Physicians show a lower level of knowledge and more public health attitudes than other public health professionals do. About 80% of public health professionals considered their knowledge inadequate and 86.0% believed that it should be improved through specific postgraduate training courses. Conclusions Specific and targeted training initiatives are needed to develop a skilled public health workforce competent in identifying genomic technology that is ready for use in population health and in modeling public health genomic programs and primary care services that need to be developed, implemented and evaluated. PMID:24885316

International cooperation and health. Part I: Issues and concepts.

PubMed

McKee, Martin; Gilmore, Anna B; Schwalbe, Nina

2005-08-01

The world is increasingly shaped by powerful global forces, many of which have consequences for human health and the social, economic, and environmental factors that influence health are increasingly determined at a supranational level. As a result, local or national level efforts to influence health determinants can have only a limited impact and it is all too easy for the individual public health practitioner to feel powerless. Yet while public health practitioners, on their own, may indeed be comparatively powerless, together they can achieve a great deal. Part I of this glossary explores a range of issues that arise as they seek to make a difference.

International cooperation and health. Part I: issues and concepts

PubMed Central

McKee, M.; Gilmore, A.; Schwalbe, N.

2005-01-01

The world is increasingly shaped by powerful global forces, many of which have consequences for human health and the social, economic, and environmental factors that influence health are increasingly determined at a supranational level. As a result, local or national level efforts to influence health determinants can have only a limited impact and it is all too easy for the individual public health practitioner to feel powerless. Yet while public health practitioners, on their own, may indeed be comparatively powerless, together they can achieve a great deal. Part I of this glossary explores a range of issues that arise as they seek to make a difference. PMID:16020637

Program Description | Cancer Prevention Fellowship Program

Cancer.gov

Preventing cancer is one of the most important scientific and public health aims for the 21st Century. To achieve that goal, the Nation needs leaders: scientists and health professionals trained in the principles and practice of cancer prevention and control.

Time for Transformation: Public Policy Must Change to Achieve Health Equity for LGBT Older Adults

PubMed Central

Fredriksen-Goldsen, Karen I.; Espinoza, Robert

2015-01-01

The marriage equality movement and the Affordable Care Act have enormous potential to reduce health disparities in LGBT elders, but more data and additional policy changes are sorely needed. PMID:25960600

Health benefits of a low carbon economy.

PubMed

Haines, A

2012-09-01

This article summarizes a presentation given at 'Health and Well-being: the 21st Century Agenda', which focused on the potential to make progress by making appropriate connections between activity to promote health and respond to the threat of climate change. It argues that a transition to a low carbon economy would bring together two of our greatest public health challenges, supporting action to improve public health within resource constraints and action to avert climate change as far as possible. Deep cuts in emissions are needed to prevent dangerous consequences arising from climate change. In addition, many of the policies to reduce greenhouse gas emissions will, in themselves, have beneficial effects on public health. This article provides an overview of several modelling studies which demonstrate that well-designed initiatives that curb greenhouse gas emissions in energy, residential construction, urban transport and agricultural systems can enhance global public health, including improving health among poor populations. Some of these health co-benefits can be achieved in a relatively short time frame, and they can help offset the costs of climate change mitigation policies. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Dental public health in India: An insight

PubMed Central

Gambhir, Ramandeep Singh; Kaur, Amanpreet; Singh, Arshdeep; Sandhu, Anmol Rattan Singh; Dhaliwal, Angad Prakash Singh

2016-01-01

Oral diseases are a major public health problem, and their burden is on increase in many low- and middle-income countries. Dental public health (DPH) aims to improve the oral health of the population through preventive and curative services. However, its achievements in India are being questioned probably because of lack of proficiency and skill among DPH personnel. The literature search for the present study was conducted utilizing various search engines and electronic databases such as PubMed and MEDLINE. Documents related to the Central and State Governments of India were also considered. Finally, 26 articles were selected for the present study from which relevant information can be extracted. The present study focuses on some of the important aspects relating to DPH in India such as priority for oral health, DPH workforce and curriculum, utilization of DPH personnel in providing primary oral health care, role of mobile dental vans, and research in DPH. It was concluded that more attention should be given toward preventive oral health care by employing more number of public health dentists in public sector, strengthening DPH education and research, and combining oral health programs with general health-care programs. PMID:28348984

The Impact of Policy, Environmental, and Educational Interventions: A Synthesis of the Evidence from Two Public Health Success Stories

ERIC Educational Resources Information Center

Gielen, Andrea C.; Green, Lawrence W.

2015-01-01

Motor vehicle safety and tobacco control are among the greatest public health achievements of the 20th century, according to the Centers for Disease Control and Prevention. As the number of miles traveled in the United States multiplied 10 times from the 1920s to the 1990s, the annual motor vehicle crash death rate per vehicle mile traveled…

Implications of the 2017 Tax Cuts and Jobs Act for Public Health

PubMed Central

2018-01-01

The recently passed Tax Cuts and Jobs Act will reduce total federal revenues by about 4% between 2018 and 2027. The law makes multiple changes to the taxation of individuals and corporations. It also repeals the Affordable Care Act’s (ACA’s) individual mandate penalties, which will erase some of the gains in insurance coverage achieved since implementation of the ACA’s coverage expansions. The resulting increases in rates of uninsurance will likely lead to increased uncompensated care and deflect hospitals and health departments from addressing other prevention and public health needs. In addition, the law is expected to lead to substantial increases in the federal debt and, consequently, to calls for reductions in spending on entitlement programs, particularly Medicare, and on discretionary programs, including public health. Many other provisions of the law could also have second-order effects on public health. PMID:29565668

From making pamphlets to making policies: results from a collaborative training to increase knowledge, motivation, and self-efficacy for achieving public health policy and systems change.

PubMed

Dilley, Julia A; Reuer, Jennifer R; Colman, Victor; Norman, Robbi Kay

2009-04-01

Steps to a Healthier Washington, in collaboration with other programs in the Washington State Department of Health and external partners, has implemented training to improve public health practice and create greater organizational and staff capacity for promoting effective policy and systems changes, including reducing disparities. The training is grounded in behavior change and adult learning theories. A comprehensive post training evaluation found long-term improvements in self-efficacy, reported changes in work, and attribution of those changes to the training. Organizations working to refocus public health work on policy and systems change should consider providing skills-based policy training to their staff. This study suggests that an integrated training, using adult learning theory, has led to long-term improvements in capacity among public health staff and partners.

Fat stigma and public health: a theoretical framework and ethical analysis.

PubMed

Abu-Odeh, Desiree

2014-09-01

This paper proposes a theoretical framework for understanding fat stigma and its impact on people's well-being. It argues that stigma should never be used as a tool to achieve public health ends. Drawing on Bruce Link and Jo Phelan's 2001 conceptualization of stigma as well as the works of Hilde Lindemann, Paul Benson, and Margaret Urban Walker on identity, positionality, and agency, this paper clarifies the mechanisms by which stigmatizing, oppressive conceptions of overweight and obesity damage identities and diminish moral agency, arguing that the use of obesity-related stigma for public health ends violates the bioethics principles of nonmaleficence, autonomy, and justice.

Physical Education Teacher Effectiveness in a Public Health Context

ERIC Educational Resources Information Center

McKenzie, Thomas L.; Lounsbery, Monica A. F.

2013-01-01

The health benefits of physical activity are well documented, and the important role that schools and physical education (PE) can play in reducing sedentary behavior and contributing to population health has been identified. Although effective teaching is ultimately judged by student achievement, a major component of teacher and school…

42 CFR 52.7 - Use of funds; changes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR RESEARCH PROJECTS... project shall be limited to changes in methodology, approach or other aspects of the project to expedite achievement of the project's research objectives, including changes that grow out of the approved project and...

Zoonoses and marginalised infectious diseases of poverty: where do we stand?

PubMed

Molyneux, David; Hallaj, Zuhair; Keusch, Gerald T; McManus, Donald P; Ngowi, Helena; Cleaveland, Sarah; Ramos-Jimenez, Pilar; Gotuzzo, Eduardo; Kar, Kamal; Sanchez, Ana; Garba, Amadou; Carabin, Helene; Bassili, Amal; Chaignat, Claire L; Meslin, Francois-Xavier; Abushama, Hind M; Willingham, Arve L; Kioy, Deborah

2011-06-14

Despite growing awareness of the importance of controlling neglected tropical diseases as a contribution to poverty alleviation and achieving the Millennium Development Goals, there is a need to up-scale programmes to achieve wider public health benefits. This implementation deficit is attributable to several factors but one often overlooked is the specific difficulty in tackling diseases that involve both people and animals - the zoonoses. A Disease Reference Group on Zoonoses and Marginalised Infectious Diseases (DRG6) was convened by the Special Programme for Research and Training in Tropical Diseases (TDR), a programme executed by the World Health Organization and co-sponsored by UNICEF, UNDP, the World Bank and WHO. The key considerations included: (a) the general lack of reliable quantitative data on their public health burden; (b) the need to evaluate livestock production losses and their additional impacts on health and poverty; (c) the relevance of cross-sectoral issues essential to designing and implementing public health interventions for zoonotic diseases; and (d) identifying priority areas for research and interventions to harness resources most effectively. Beyond disease specific research issues, a set of common macro-priorities and interventions were identified which, if implemented through a more integrated approach by countries, would have a significant impact on human health of the most marginalised populations characteristically dependent on livestock.

Zoonoses and marginalised infectious diseases of poverty: Where do we stand?

PubMed Central

2011-01-01

Despite growing awareness of the importance of controlling neglected tropical diseases as a contribution to poverty alleviation and achieving the Millennium Development Goals, there is a need to up-scale programmes to achieve wider public health benefits. This implementation deficit is attributable to several factors but one often overlooked is the specific difficulty in tackling diseases that involve both people and animals - the zoonoses. A Disease Reference Group on Zoonoses and Marginalised Infectious Diseases (DRG6) was convened by the Special Programme for Research and Training in Tropical Diseases (TDR), a programme executed by the World Health Organization and co-sponsored by UNICEF, UNDP, the World Bank and WHO. The key considerations included: (a) the general lack of reliable quantitative data on their public health burden; (b) the need to evaluate livestock production losses and their additional impacts on health and poverty; (c) the relevance of cross-sectoral issues essential to designing and implementing public health interventions for zoonotic diseases; and (d) identifying priority areas for research and interventions to harness resources most effectively. Beyond disease specific research issues, a set of common macro-priorities and interventions were identified which, if implemented through a more integrated approach by countries, would have a significant impact on human health of the most marginalised populations characteristically dependent on livestock. PMID:21672216

Equity in public health standards: a qualitative document analysis of policies from two Canadian provinces

PubMed Central

2012-01-01

Introduction Promoting health equity is a key goal of many public health systems. However, little is known about how equity is conceptualized in such systems, particularly as standards of public health practice are established. As part of a larger study examining the renewal of public health in two Canadian provinces, Ontario and British Columbia (BC), we undertook an analysis of relevant public health documents related to equity. The aim of this paper is to discuss how equity is considered within documents that outline standards for public health. Methods A research team consisting of policymakers and academics identified key documents related to the public health renewal process in each province. The documents were analyzed using constant comparative analysis to identify key themes related to the conceptualization and integration of health equity as part of public health renewal in Ontario and BC. Documents were coded inductively with higher levels of abstraction achieved through multiple readings. Sets of questions were developed to guide the analysis throughout the process. Results In both sets of provincial documents health inequities were defined in a similar fashion, as the consequence of unfair or unjust structural conditions. Reducing health inequities was an explicit goal of the public health renewal process. In Ontario, addressing “priority populations” was used as a proxy term for health equity and the focus was on existing programs. In BC, the incorporation of an equity lens enhanced the identification of health inequities, with a particular emphasis on the social determinants of health. In both, priority was given to reducing barriers to public health services and to forming partnerships with other sectors to reduce health inequities. Limits to the accountability of public health to reduce health inequities were identified in both provinces. Conclusion This study contributes to understanding how health equity is conceptualized and incorporated into standards for local public health. As reflected in their policies, both provinces have embraced the importance of reducing health inequities. Both concepualized this process as rooted in structural injustices and the social determinants of health. Differences in the conceptualization of health equity likely reflect contextual influences on the public health renewal processes in each jurisdiction. PMID:22632097

[Framework for the strengthening of health information systems in Peru].

PubMed

Curioso, Walter H; Espinoza-Portilla, Elizabeth

2015-01-01

In this article we present the essential components and policies that are most relevant regarding the conceptual framework to strengthen the health information systems in Peru. The article also presents the main policies, actions and strategies made in the field of electronic health in Peru that are most significant. The health information systems in Peru play a key role and are expected to achieve an integrated and interoperable information system. This will allow health information to be complete, efficient, of good quality and available in a timely manner to achieve better quality of life for people and allow meaningful modernization of public health in the context of health reform in Peru.

Zika Virus -10 Public Health Achievements in 2016 and Future Priorities.

PubMed

Oussayef, Nadia L; Pillai, Satish K; Honein, Margaret A; Ben Beard, C; Bell, Beth; Boyle, Coleen A; Eisen, Lars M; Kohl, Katrin; Kuehnert, Matthew J; Lathrop, Eva; Martin, Stacey W; Martin, Rebecca; McAllister, Janet C; McClune, Elizabeth Pantino; Mead, Paul; Meaney-Delman, Dana; Petersen, Brett; Petersen, Lyle R; Polen, Kara N D; Powers, Ann M; Redd, Stephen C; Sejvar, James J; Sharp, Tyler; Villanueva, Julie; Jamieson, Denise J

2017-01-06

The introduction of Zika virus into the Region of the Americas (Americas) and the subsequent increase in cases of congenital microcephaly resulted in activation of CDC's Emergency Operations Center on January 22, 2016, to ensure a coordinated response and timely dissemination of information, and led the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. During the past year, public health agencies and researchers worldwide have collaborated to protect pregnant women, inform clinicians and the public, and advance knowledge about Zika virus (Figure 1). This report summarizes 10 important contributions toward addressing the threat posed by Zika virus in 2016. To protect pregnant women and their fetuses and infants from the effects of Zika virus infection during pregnancy, public health activities must focus on preventing mosquito-borne transmission through vector control and personal protective practices, preventing sexual transmission by advising abstention from sex or consistent and correct use of condoms, and preventing unintended pregnancies by reducing barriers to access to highly effective reversible contraception.

THE VISUAL BEACH NUMERICAL MODEL: A DIAGNOSTIC AND PROGNOSTIC MODELING APPROACH TO ACHIEVING US BEACHES AESTHETIC AND PUBLIC HEALTH PROTECTION

EPA Science Inventory

Under the BEACH Act of 2000, EPA has committed to a program to monitor beach water quality and develop strategies, including modeling, for timely notification of the public when bacterial contamination poses a risk to bathers. EPA's goal is to manage 100% of significant public be...

Big Data’s Role in Precision Public Health

PubMed Central

Dolley, Shawn

2018-01-01

Precision public health is an emerging practice to more granularly predict and understand public health risks and customize treatments for more specific and homogeneous subpopulations, often using new data, technologies, and methods. Big data is one element that has consistently helped to achieve these goals, through its ability to deliver to practitioners a volume and variety of structured or unstructured data not previously possible. Big data has enabled more widespread and specific research and trials of stratifying and segmenting populations at risk for a variety of health problems. Examples of success using big data are surveyed in surveillance and signal detection, predicting future risk, targeted interventions, and understanding disease. Using novel big data or big data approaches has risks that remain to be resolved. The continued growth in volume and variety of available data, decreased costs of data capture, and emerging computational methods mean big data success will likely be a required pillar of precision public health into the future. This review article aims to identify the precision public health use cases where big data has added value, identify classes of value that big data may bring, and outline the risks inherent in using big data in precision public health efforts. PMID:29594091

Big Data's Role in Precision Public Health.

PubMed

Dolley, Shawn

2018-01-01

Precision public health is an emerging practice to more granularly predict and understand public health risks and customize treatments for more specific and homogeneous subpopulations, often using new data, technologies, and methods. Big data is one element that has consistently helped to achieve these goals, through its ability to deliver to practitioners a volume and variety of structured or unstructured data not previously possible. Big data has enabled more widespread and specific research and trials of stratifying and segmenting populations at risk for a variety of health problems. Examples of success using big data are surveyed in surveillance and signal detection, predicting future risk, targeted interventions, and understanding disease. Using novel big data or big data approaches has risks that remain to be resolved. The continued growth in volume and variety of available data, decreased costs of data capture, and emerging computational methods mean big data success will likely be a required pillar of precision public health into the future. This review article aims to identify the precision public health use cases where big data has added value, identify classes of value that big data may bring, and outline the risks inherent in using big data in precision public health efforts.

[Jan Pilecki (1821-1878) and achievements his Druskieninkai].

PubMed

Kierzek, Andrzej; Kuciel-Lewandowska, Jadwiga; Pozowski, Andrzej; Borowicz-Paprocka, Małgorzata

2012-01-01

The history of development of health resort Druskieniki basing on Adam Wrzosek, an eminent Polish historian of medicine pointed out. The beauty and advantages of this health resort is depicted widely. The living and professional achievements of Jan Pilecki (1821-1878), an eminent physician of health resort, his significance for development and of Druskieninkai are presented in more detail. The medical indications and contraindications in Druskieniki basing on his own experiences have been reported. Pilecki was a author of many medical publications in Polish medical magazines. His papers contained interested medical observations and description of social life and entertainments in this health resort.

Clinical Preventive Services for Older Adults: The Interface Between Personal Health Care and Public Health Services

PubMed Central

Richards, Chesley L.; Shenson, Douglas

2012-01-01

Healthy aging must become a priority objective for both population and personal health services, and will require innovative prevention programming to span those systems. Uptake of essential clinical preventive services is currently suboptimal among adults, owing to a number of system- and office-based care barriers. To achieve maximum health results, prevention must be integrated across community and clinical settings. Many preventive services are portable, deliverable in either clinical or community settings. Capitalizing on that flexibility can improve uptake and health outcomes. Significant reductions in health disparities, mortality, and morbidity, along with decreases in health spending, are achievable through improved collaboration and synergy between population health and personal health systems. PMID:22390505

Core competency model for the family planning public health nurse.

PubMed

Hewitt, Caroline M; Roye, Carol; Gebbie, Kristine M

2014-01-01

A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance. © 2014 Wiley Periodicals, Inc.

Partnerships for Environmental and Occupational Justice: Contributions to Research, Capacity and Public Health

PubMed Central

Sinclair, Raymond; Payne-Sturges, Devon; Phelps, Jerry; Zenick, Harold; Collman, Gwen W.; O'Fallon, Liam R.

2009-01-01

In 1994, the National Institute of Environmental Health Sciences (NIEHS) initiated a program to address communication gaps between community residents, researchers and health care providers in the context of disproportionate environmental exposures. Over 13 years, together with the Environmental Protection Agency and National Institute for Occupational Health and Safety, NIEHS funded 54 environmental justice projects. Here we examine the methods used and outcomes produced based on data gathered from summaries submitted for annual grantees' meetings. Data highlight how projects fulfilled program objectives of improving community awareness and capacity and the positive public health and public policy outcomes achieved. Our findings underscore the importance of community participation in developing effective, culturally sensitive interventions and emphasize the importance of systematic program planning and evaluation. PMID:19890151

Vaccinations: A public health triumph and a public relations tragedy.

PubMed

Jacobson, Robert M

2012-08-01

Routine vaccination has been hailed as one of the top public health achievements of the last century. However, despite the reduced number of cases of and deaths from vaccine-preventable diseases such as pertussis and measles, outbreaks continue to occur as more parents fail to adequately vaccinate their children because of misinformation about immunizations. This article describes the challenges of making sure all children in the United States are fully immunized and what physicians need to know to effectively work with parents who may be hesitant to vaccinate their children.

A Child’s Health Is the Public’s Health: Progress and Gaps in Addressing Pediatric Needs in Public Health Emergencies

PubMed Central

Peacock, Georgina; Frogel, Michael

2017-01-01

Children are the most prevalent vulnerable population in US society and have unique needs during the response to and recovery from public health emergencies. The physiological, behavioral, developmental, social, and mental health differences of children require specific attention in preparedness efforts. Despite often being more severely affected in disasters, children’s needs are historically underrepresented in preparedness. Since 2001, much progress has been made in addressing this disparity through better pediatric incorporation in preparedness planning from national to local levels. Innovative approaches, policies, and collaborations contribute to these advances. However, many gaps remain in the appropriate and proportional inclusion of children in planning for public health emergencies. Successful models of pediatric planning can be developed, evaluated, and widely disseminated to ensure that further progress can be achieved. PMID:28892439

Meeting the millennium development goals in Sub-saharan Africa: what about mental health?

PubMed

Skeen, Sarah; Lund, Crick; Kleintjes, Sharon; Flisher, Alan

2010-01-01

Mental health is a crucial public health and development issue in sub-Saharan Africa (SSA), a region where little progress has been made towards achieving the Millennium Development Goals (MDGs). In this paper we argue that not only will limited progress in achieving these targets have a significant impact on mental health, but it will be impossible to achieve some of these aspirations in the absence of addressing mental health concerns. We consider the strong relationship of mental health with dimensions of human development represented in the MDGs, including reducing poverty, achieving universal primary education, decreasing child mortality rates, improving maternal health, HIV, environmental factors and improving the lives of those living in informal settlements. With these links in mind, we examine the mental health context in SSA settings and provide some specific examples of best practice for addressing mental health and the MDGs. It is recommended that the role of mental health interventions in accelerating the realization of the MDGs is investigated; further efforts are dedicated to probing the impact of different development projects upon mental health outcomes, and that mental health is declared a global development priority for the remainder of the MDG period and beyond.

Strengthening the public health system.

PubMed

Roper, W L; Baker, E L; Dyal, W W; Nicola, R M

1992-01-01

Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capacity, particularly in local and State public health agencies. To strengthen the public health system, concerted action is needed to meet these five critical needs: First, the knowledge base of public health workers needs to be supplemented through on-the-job training and continuing education programs. To this end, self-study courses will be expanded, and a network of regional training centers will be established throughout the country. Second, communities need dynamic leadership from public health officials and their agencies. To enhance leadership skills and expand the leadership role of public health agencies, focused personal leadership development activities, including a Public Health Leadership Institute, and national conferences will provide a vision of the future role of public health agencies. Third, local and State public health agencies need access to data on the current health status of the people in their communities and guidance from the nation's public health experts. To improve access to information resources, state-of-the-art technologies will be deployed to create integrated information and communication systems linking all components of the public health system. Fourth, local and State agencies need disease prevention and health promotion plans that target problems and develop strategies and the capacity to address them. To provide communities with structured approaches to this process, planning tools have been developed and distributed, and technical assistance will be provided to local and State health agencies to involve each community in planning,priority setting, and constituency building.Finally, public health agencies need adequate resources to fund prevention programs. To improve the use of existing Federal support and enhance the availability of new community resources, grant programs will be modified, and innovative approaches to local resource enhancement will be developed and shared.Activities in these five key areas are designed to improve the infrastructure of the public health system and its capacity to carry out effectively the core functions of public health assessment, policy development, and assurance of the availability of the benefits of public health. If the nation is to achieve the health objectives for the year 2000, the public health system-the individuals and institutions that, when working effectively together, promote and protect the health of the people-must be strengthened.

Reducing health inequities: the contribution of core public health services in BC

PubMed Central

2013-01-01

Background Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens. Methods/design This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory. Discussion An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences in health among population groups. As a collaborative effort between public health practitioners/decision makers and university researchers, this research will provide important understanding and insights about the implementation of the changes in public health with a specific focus on health equity, the promotion of mental health and the prevention of harms of substance use. PMID:23738840

Window of opportunity--positioning food and nutrition policy within a sustainability agenda.

PubMed

Yeatman, Heather

2008-04-01

Public health professionals have an opportunity to refocus national attention on food and nutrition policy, within a sustainability agenda. A broadly based national Food and Nutrition Policy was developed in 1992. However, its implementation has been selective and primarily based within the health sector. Other major policy areas, for example; industry, agriculture and trade, have dominated Australian nutrition and health policy. A broad, whole-of-government commitment to a comprehensive food and nutrition policy that engages with the community is required to achieve outcomes in terms of public health, a sustainable environment and viable food production for future generations.

The Public Health Responsibility Deal: making the workplace healthier?

PubMed

Knai, Cécile; Scott, Courtney; D'Souza, Preethy; James, Lesley; Mehrotra, Anushka; Petticrew, Mark; Eastmure, Elizabeth; Durand, Mary Alison; Mays, Nicholas

2017-06-01

The Public Health Responsibility Deal (RD) in England is a public-private partnership which aims to improve public health by addressing issues such as health at work. This paper analyses the RD health at work pledges in terms of their likely effectiveness and added value. A review of evidence on the effectiveness of the RD 'health at work' pledges to improve health in the workplace; analysis of publically available data on signatory organizations' plans and progress towards achieving the pledges; and assessment of the likelihood that workplace activities pledged by signatories were brought about by participating in the RD. The 'health at work' pledges mostly consist of information sharing activities, and could be more effective if made part of integrated environmental change at the workplace. The evaluation of organizations' plans and progress suggests that very few actions (7%) were motivated by participation in the RD, with most organizations likely (57%) or probably (36%) already engaged in the activities they listed before joining the RD. The RD's 'health at work' pledges are likely to contribute little to improving workplace health as they stand but could contribute more if they were incorporated into broader, coherent workplace health strategies. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

PubMed

Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

2006-04-01

Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

Criteria for Drug Reimbursement Decision-Making: An Emerging Public Health Challenge in Bulgaria

PubMed Central

Iskrov, Georgi; Stefanov, Rumen

2016-01-01

Background: During times of fiscal austerity, means of reimbursement decision-making are of particular interest for public health theory and practice. Introduction of advanced health technologies, growing health expenditures and increased public scrutiny over drug reimbursement decisions have pushed governments to consider mechanisms that promote the use of effective health technologies, while constraining costs. Aims: The study’s aim was to explore the current rationale of the drug reimbursement decision-making framework in Bulgaria. Our pilot research focused on one particular component of this process – the criteria used – because of the critical role that criteria are known to have in setting budgets and priorities in the field of public health. The analysis pursued two objectives: to identify important criteria relevant to drug reimbursement decision-making and to unveil relationships between theory and practice. Study Design: Cross-sectional study. Methods: The study was realized through a closed-ended survey on reimbursement criteria among four major public health stakeholders – medical professionals, patients, health authorities, and industry. Empirical outcomes were then cross-compared with the theoretical framework, as defined by current Bulgarian public health legislation. Analysis outlined what is done and what needs to be done in the field of public health reimbursement decision-making. Results: Bulgarian public health stakeholders agreed on 15 criteria to form a tentative optimal framework for drug reimbursement decision-making. The most apparent gap between the empirically found preferences and the official legislation is the lack of consideration for the strength of evidence in reimbursement decisions. Conclusion: Bulgarian policy makers need to address specific gaps, such as formal consideration for strength of evidence, explicit role of efficiency criteria, and means to effectively empower patient and citizen involvement in public health decision-making. Drug reimbursement criteria have to be integrated into legitimate public health decision support tools that ensure the achievement of national public health objectives. These recommendations could be expanded to all Eastern European countries who share common public health problems. PMID:26966615

The effect of a public health card program on the supply of health care.

PubMed

Johar, Meliyanni

2010-05-01

The supply-side responsiveness to public programs targeted to consumers is not widely studied. However, it is unlikely that supply variables remain constant, particularly when their link to the demand initiative is weak. The aim of this study is to provide such analysis, using the experience of the Indonesian health card program, which is a demand-sided program. Without an increase in staff or an appropriate salary revision, the salary payment system of the public sector may not adequately reward the existing health workers, lowering their incentives to maintain their public position. Using data from the Indonesian Family Life Surveys on public health centres, the leading providers of outpatient services in the public sector, this study found some evidence that the health card program resulted in a reduction in the number of full-time GPs working in these facilities. Other conditions not related to workers' compensation, such as infrastructure conditions and registration fees, were not adversely affected. Identification of this program's effect is achieved by variations in time and the intensity of health card distribution across communities. The findings highlight the importance of public policy management in general, and sheds light on physicians' behaviour in developing countries, about which we know very little. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

OA11 Public health and hospices: what is really possible?

PubMed

Hartley, Nigel; Richardson, Heather

2015-04-01

Whilst a growing number of hospices are proactively engaging in the public health agenda, questions remain about whether this is an approach that hospices can adopt successfully. (Sallnow et al . 2014). The experience of St Christopher's in the development of its social hub (The Anniversary Centre) offers insights into the challenges and how these are best addressed. The Anniversary Centre was established to provide a more open and flexible approach to end of life care and to challenge and change public attitudes towards death and dying. It sought, also, to contest an existing culture of care, shifting from professional management of problems to one in which people take a lead in their own care and wellbeing. A review of the progress of the Centre in achieving these aims has been undertaken five years after its establishment. Questions focus on: The degree to which the centre has engaged more of the local communities How much its users are able to determine their own priorities, care and wellbeing through attendance at the centre What evidence of a public health approach exists in the support it provides. The Centre offers a new and alternative way of supporting people living with a life threatening condition. Although successes have been achieved, organisational and historical cultural barriers continue to limit progress. Hospice culture can prohibit public health approaches to palliative care. However, related innovation is possible when clear values and stories are shared, champions are identified and professional assumptions are challenged. Sallnow L, Paul S. Understanding community engagement in end-of-life care: developing conceptual clarity. Crit Public Health 2015;25(2):231-8. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Career Satisfaction Among Dental Public Health Specialists in India - A Cross-sectional Survey.

PubMed

Janakiram, Chandrashekar; Joseph, Joe; Antony, Bobby

2017-01-01

The satisfaction in career is an important indicator for the growth of the discipline and the profession. An empirical investigation of satisfaction in career and amendments needed in course and profession may help in growth of discipline. To assess career satisfaction among Dental Public Health (DPH) specialists working in India and analyze their perspective on changes required in the profession. Questionnaire for this cross-sectional survey was adapted from Minnesota Job Satisfaction Survey which included 40 enquiries to understand the reasons for choosing public health dentistry as career, competencies of public health dentists, satisfaction as a public health dentist and changes required in the profession. The questions were both open and closed end type. Updated electronic mail details of all registered public health dentists were collected from the head office of Indian Association of Public Health Dentistry. Each participant was contacted by electronic mail and consent to participate were sought. Reminders were e-mailed thrice during three months. A total of 580 participants were contacted. A total of 183 responses were received, among which 179 consented. Nearly half of the respondents felt they are yet to achieve the accomplishment from the present career as public health dentist. Only 46.9% felt that there is advancement in the profession as career. Nearly three-fourth of respondents could not attain recognition as a public health dentist. A 45.8% of respondents were of the opinion that career in public health dentistry would provide them a steady employment and 53.1% of public health dentists would envision as satisfied in their career in next 10 years. Nearly 85% felt public health dentistry training needs a major course correction. There has been some reservation or skepticism about the future of the specialty as the jobs are in declining stage. This information provides insight about success and failures of public health dentistry as profession which would be needed for planning the dental manpower.

Public Health Innovation and Research in Europe: introduction to the supplement.

PubMed

McCarthy, Mark; Zeegers Paget, Dineke

2013-11-01

PHIRE (Public Health Innovation and Research in Europe) was developed for the national member associations and individual researchers of the European Public Health Association (EUPHA) to engage collectively with the health research agenda in Europe. It was co-funded by the European Commission's Directorate for Health and Consumers within the EU Health Programme. It was coordinated by EUPHA in a partnership of eight organizations. This article introduces the Supplement in the European Journal of Public Health presenting the results of PHIRE. PHIRE used mixed methods to collect data across 30 European countries (European Union 27 plus Iceland, Norway and Switzerland). Seven thematic Sections of EUPHA identified eight cross-national public health innovation projects, and Country Informants to report on national uptake and impact of these innovations. Public health was considered broadly--health determinants and interventions, health services and practice. Through EUPHA's member national public health associations, and by direct country contacts, PHIRE described country public health research strategies and structures, reviewed calls and programmes for research in 1 year and organized stakeholder workshops. PHIRE was reported to the European Commission, and the component reports placed on the EUPHA web page. A draft of the Final Summary Report was sent by email for commentary by selected experts. PHIRE data from the work packages were organized into eight themes for the Supplement. Through the EUPHA thematic Sections, experts described the uptake and impact of eight innovation projects from the EU Health Programme. National reports indicated a positive impact of the innovations in public health 'markets'. Through national public health associations, 75 programmes and calls for public health research were found for 2010, but systems are not comparable and nor is information exchanged or coordinated. Only a few countries have public health research strategies. Having competitive research funding through Ministries of Health is potentially beneficial. There is limited contact between national and European public health research programmes and calls. Experts who were sent the draft PHIRE Summary Report gave generally positive responses on the validity and usefulness of the results. Dissemination has been achieved through meetings during the study and by electronic means thereafter. PHIRE has increased knowledge about public health innovation at national and European levels. Strengthening the public health research system, and demonstrating innovation in public health markets will maximize benefits to Europe's citizens.

Influenza as an issue on the agenda of policy makers and government representatives. What can we do? What do we need?

PubMed

2006-11-10

Influenza vaccinations and antiviral drugs are the foundation of epidemic and pandemic preparedness, but only close collaboration between public health authorities and industry can achieve the necessary production levels and ensure the smooth distribution necessary to protect European citizens from this public health scourge. To focus the minds of all public health stakeholders, ESWI has translated these simple facts into clear achievable goals: it recommends that EU governments vaccinate one-third of their populations by 2010 and stockpile antiviral drugs for 20% of their citizens while promoting public-private partnerships. The scientific justification behind this objective is easily understood namely that while the annual flu shot protects against three viral strains,the pandemic vaccine will focus on only the one highly lethal virus. As a result if countries succeed in meeting the target to vaccine one-third of the EU-25 population with a trivalent vaccine, sufficient monovalent pandemic vaccine could be produced to vaccinate almost the entire EU-25 population at least once. Achieving these objectives would go far to containing the pandemic and ensuring necessary treatment to avoid needless deaths and social and economic disruption. It would also signal that influenza preparedness had become part of the European mindset. Relying on the technique of force-field analysis organised by professional facilitators the session asked government representatives and policy makers to identify existing factors that either provide support for the objectives or hinder progress.

Healthcare financing: approaches and trends in India.

PubMed

Bajpai, Vikas; Saraya, Anoop

2010-01-01

Despite the importance of healthcare for the well-being of society, there is little public debate in India on issues relating to it. The 'human capital approach' to finance healthcare largely relies on private investment in health, while the 'human development approach' envisages the State as the guarantorof preventive as well as curative care to achieve universalization of healthcare. The prevailing health indices of India and challenges in the field of public health require a human developmentapproach to healthcare. On the eve of independence, India adopted the human development approach, with the report of the Bhore Committee emphasizing the role of the State in the development and provision of healthcare. However, more recently, successive governments have moved towards the human capital approach. Instead of increasing state spending on health and expanding the public health infrastructure, the government has been relying more and more on the private sector. The public-private partnership has been touted as the new-age panacea for the ills of the Indian healthcare system. This approach has led to a stagnation of public health indices and a decrease in the access of the poor to healthcare.

Terrorism: a public health threat with a trauma system response.

PubMed

Jacobs, Lenworth M; Burns, Karyl J; Gross, Ronald I

2003-12-01

The threat of mass casualties and widespread infectious disease caused by terrorism is now a challenge for our government and public health system. Funds have been granted to the states by the Centers for Disease Control and Prevention and the Health Resources and Services Administration to establish bioterrorism preparedness and response capabilities. Hartford Hospital has been designated as a Center of Excellence for Bioterrorism Preparedness by the Commissioner of the Connecticut Department of Public Health. The Center of Excellence has implemented strategies to prepare for a possible bioterrorist attack. A unique model that combines epidemiology and traumatology is being used to guide the preparedness activities. Although the focus of the grant from the Connecticut Department of Public Health is bioterrorism, the application of the model can apply to preparation for all terrorist events. Implementation of strategies indicates that bioterrorism preparedness is well underway. Similar initiatives should be achievable by other trauma systems throughout the country. A Center of Excellence for Bioterrorism Preparedness in Connecticut is successfully modifying a trauma system to meet the challenge of a new public health threat, terrorism.

What Does it Mean to be Genomically Literate? National Human Genome Research Institute Meeting Report

PubMed Central

Hurle, Belen; Citrin, Toby; Jenkins, Jean F.; Kaphingst, Kimberly A.; Lamb, Neil; Roseman, Jo Ellen; Bonham, Vence L.

2014-01-01

Genomic discoveries will increasingly advance the science of medicine. Limited genomic literacy may adversely impact the public’s understanding and use of the power of genetics and genomics in health care and public health. In November 2011, a meeting was held by the National Human Genome Research Institute to examine the challenge of achieving genomic literacy for the general public, from K-12 to adult education. The role of the media in disseminating scientific messages and in perpetuating, or reducing, misconceptions was also discussed. Workshop participants agreed that genomic literacy will only be achieved through active engagement between genomics experts and the varied constituencies that comprise the public. This report summarizes the background, content, and outcomes from this meeting, including recommendations for a research agenda to inform decisions about how to advance genomic literacy in our society. PMID:23448722

45 CFR 400.1 - Basis and purpose of the program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 400.1 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM... resettlement of refugees and to assist them to achieve economic self-sufficiency as quickly as possible. (c...

Drinking Water State Revolving Fund: EPA Funding for ...

EPA Pesticide Factsheets

2017-07-06

The Safe Drinking Water Act (SDWA) Amendments of 1996 (Pub. L. 104-182) authorize a Drinking Water State Revolving Fund (DWSRF) program to assist public water systems to finance the costs of infrastructure needed to achieve or maintain compliance with SDWA requirements and to protect public health.

42 CFR 423.2420 - Calculation of medical loss ratio.

Code of Federal Regulations, 2013 CFR

2013-10-01

... improve health care quality, as defined in § 423.2430; (2) Incurred claims for prescription drug costs... expenditures for activities or programs that seek to achieve the objectives of improving access to health... 42 Public Health 3 2013-10-01 2013-10-01 false Calculation of medical loss ratio. 423.2420 Section...

42 CFR 423.2420 - Calculation of medical loss ratio.

Code of Federal Regulations, 2014 CFR

2014-10-01

... improve health care quality, as defined in § 423.2430; (2) Incurred claims for prescription drug costs... expenditures for activities or programs that seek to achieve the objectives of improving access to health... 42 Public Health 3 2014-10-01 2014-10-01 false Calculation of medical loss ratio. 423.2420 Section...

75 FR 62323 - Pesticide Management and Disposal; Standards for Pesticide Containers and Containment; Change to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

... reduce the likelihood of unreasonable adverse effects on human health and the environment. The container... significant number of pesticides important to the protection of public health and the nation's food supply... achieve the environmental and human health protection goals of the statute and the Agency. EPA solicits...

[Public policy, structures of the State and the advocacy of the right to health protection].

PubMed

Ruelas-Barajas, Enrique; Gay-Molina, Juan Gabriel

2008-01-01

Not always public policies for the advocacy of citizen rights meet their goal, among other things, because between their formulation and their implementation there is a lack of appropriate structures to generate, articulate and execute these policies. This has been the case of Mexico regarding the advocacy of the rights of non smokers. Very few has been achieved in this matter in the past. This article lists some of the potential causes of the lack of implementation of public policies. At the same time, explores the highly dynamic nature of the health care system at the present and towards the future. The magnitude of the challenges faced by the health care system requires concerted actions of many actors, not only from the very health care system but also from outside. Thus, public policies have to be considered not just at the governmental level but at the state level. Therefore, the main argument of this paper is that given the need to respond to complex challenges to protect the health of the population and their rights in a very complex context, there is a need to formulate and implement state policies that require the intervention of the appropriate state structures to make sure that the design and execution leads to the expected achievements. One such structure at the state level, among others, is the General Health Council, an organization established in 1841, that was incorporated within the Mexican Constitution in 1917, depending directly from the President of Mexico as Head of State. This Council has been reinforced to improve its assigned role to better participate, along other state structures, in the formulation and implementation of public policies such as those for the advocacy of citizen rights.

Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

PubMed Central

Jin, Yinzi; Hou, Zhiyuan; Zhang, Donglan

2016-01-01

Background China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. Methods We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. Results In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. Conclusion The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance. PMID:27564320

Establishing undergraduate public health education: process, challenges, and achievements in a case study in Israel.

PubMed

Bashkin, Osnat; Tulchinsky, Theodore Herzl

2017-01-01

In this paper, we describe the development process of the first undergraduate public health baccalaureate program, in the Ashkelon Academic College in Israel. Expansion of degree-granting colleges in Israel is part of the democratization of higher education providing access to and increasing educational opportunities for groups underrepresented in universities. The main objectives of the program at Ashkelon Academic College have been to open accessible and affordable career opportunities for current workers in the health system and for new entries to health careers for academic advancement in a peripheral and relatively poor region of the country. The program focuses on well-established and literature-based learning goals of public health education but also includes basic medical sciences, incorporation of arts and sciences into public health, development of critical thinking and quantitative skills, experiential field learning, and integrative learning for facing global health challenges. The curricula of the program is composed of seven modules including introductory courses, methodology courses, health organization courses, epidemiology courses, courses related to core content of public health, elective courses and practicum. The first class will graduate in 2017; this will allow for final approval of the Council of Higher Education of Israel and possible revision of curriculum. A second BA program is now seeking approval in Israel and cooperation with post-graduate schools of public health is developing. Our program is in keeping with trends in Europe and the USA to broaden public health education, to reduce inequality of career opportunity, to expand the workforce, and to promote public health.

Ethical tensions associated with the promotion of public health policy in health visiting: a qualitative investigation of health visitors' views.

PubMed

Greenway, Julie Catherine; Entwistle, Vikki Ann; terMeulen, Ruud

2013-04-01

To explore whether and how health visitors experience ethical tensions between the public health agenda and the need to be responsive to individual clients. Current health policy in England gives health visitors a key role in implementing the government's public health agenda. Health visitors are also required by their Professional Code to respond to the health-related concerns and preferences of their individual clients. This may generate tensions. A total of 17 semi-structured individual interviews covering participants' experiences of implementing public health interventions and perceptions of the ethical tensions involved were conducted. Interviews were audio-recorded, transcribed and analysed thematically using a Framework approach. Health visitors raised a number of ethical concerns, which they attributed to organisational resource allocation and the introduction of protocols and targets relating to public health goals. They did not always regard it as appropriate to raise topics that employing organisations had identified as public health priorities with particular clients for whom they were not priorities, or who had other more pressing needs. They noted that resources that were allocated towards reaching public health targets were unavailable for clients who needed support in other areas. Organisational protocols designed to monitor performance put pressure on health visitors to prioritise achieving targets and undermined their ability to exercise professional judgement when supporting individual clients. This had implications for health visitors' sense of professionalism. Health visitors saw trusting relationships as key to effective health visiting practice, but the requirement to implement public health priorities, combined with a lack of resources in health visiting, eroded their ability to form these. Policies need to be evaluated with regard to their impact upon a broader range of processes and outcomes than public health goals. The erosion of health visitors' professional values and ability to develop relationships with clients could have numerous adverse implications.

Imagining Global Health with Justice: In Defense of the Right to Health.

PubMed

Friedman, Eric A; Gostin, Lawrence O

2015-12-01

The singular message in Global Health Law is that we must strive to achieve global health with justice--improved population health, with a fairer distribution of benefits of good health. Global health entails ensuring the conditions of good health--public health, universal health coverage, and the social determinants of health--while justice requires closing today’s vast domestic and global health inequities. These conditions for good health should be incorporated into public policy, supplemented by specific actions to overcome barriers to equity. A new global health treaty grounded in the right to health and aimed at health equity--a Framework Convention on Global Health (FCGH)--stands out for its possibilities in helping to achieve global health with justice. This far-reaching legal instrument would establish minimum standards for universal health coverage and public health measures, with an accompanying national and international financing framework, require a constant focus on health equity, promote Health in All Policies and global governance for health, and advance the principles of good governance, including accountability. While achieving an FCGH is certainly ambitious, it is a struggle worth the efforts of us all. The treaty’s basis in the right to health, which has been agreed to by all governments, has powerful potential to form the foundation of global governance for health. From interpretations of UN treaty bodies to judgments of national courts, the right to health is now sufficiently articulated to serve this role, with the individual’s right to health best understood as a function of a social, political, and economic environment aimed at equity. However great the political challenge of securing state agreement to the FCGH, it is possible. States have joined other treaties with significant resource requirements and limitations on their sovereignty without significant reciprocal benefits from other states, while important state interests would benefit from the FCGH. And from integrating the FCGH into the existing human rights system to creative forms of compliance and enforcement and strengthened domestic legal and political accountability mechanisms, the treaty stands to improve right to health compliance. The potential for the FCGH to bring the right to health nearer universal reality calls for us to embark on the journey towards securing this global treaty.

A Modelling Approach to Estimate the Impact of Sodium Reduction in Soups on Cardiovascular Health in the Netherlands

PubMed Central

Bruins, Maaike J.; Dötsch-Klerk, Mariska; Matthee, Joep; Kearney, Mary; van Elk, Kathelijn; Weber, Peter; Eggersdorfer, Manfred

2015-01-01

Hypertension is a major modifiable risk factor for cardiovascular disease and mortality, which could be lowered by reducing dietary sodium. The potential health impact of a product reformulation in the Netherlands was modelled, selecting packaged soups containing on average 25% less sodium as an example of an achievable product reformulation when implemented gradually. First, the blood pressure lowering resulting from sodium intake reduction was modelled. Second, the predicted blood pressure lowering was translated into potentially preventable incidence and mortality cases from stroke, acute myocardial infarction (AMI), angina pectoris, and heart failure (HF) implementing one year salt reduction. Finally, the potentially preventable subsequent lifetime Disability-Adjusted Life Years (DALYs) were calculated. The sodium reduction in soups might potentially reduce the incidence and mortality of stroke by approximately 0.5%, AMI and angina by 0.3%, and HF by 0.2%. The related burden of disease could be reduced by approximately 800 lifetime DALYs. This modelling approach can be used to provide insight into the potential public health impact of sodium reduction in specific food products. The data demonstrate that an achievable food product reformulation to reduce sodium can potentially benefit public health, albeit modest. When implemented across multiple product categories and countries, a significant health impact could be achieved. PMID:26393647

An analysis of structural incentives in the Arizona Health Care Cost-Containment System

PubMed Central

Vogel, Ronald J.

1984-01-01

This article analyzes the financial structures of the prevailing public and private health insurance mechanisms. Based on this analysis, it was concluded that the financial structures of health insurance mechanisms are deficient in that they neither produce efficiency in the consumption of health services, nor generate efficiency in the production of health services. On the other hand, closed-end systems of finance, such as the health maintenance organization (HMO) or the new Arizona Health Care Cost-Containment System (AHCCCS), give more promise of achieving such efficiencies. The AHCCCS represents an important innovation in the public financing of health care, and, for policy purposes, should be considered a viable national alternative for the reform of Medicare and Medicaid. PMID:10310943

The changing global context of public health.

PubMed

McMichael, A J; Beaglehole, R

2000-08-05

Future health prospects depend increasingly on globalisation processes and on the impact of global environmental change. Economic globalisation--entailng deregulated trade and investment--is a mixed blessing for health. Economic growth and the dissemination of technologies have widely enhanced life expectancy. However, aspects of globalisation are jeopardising health by eroding social and environmental conditions, exacerbating the rich-poor gap, and disseminating consumerism. Global environmental changes reflect the growth of populations and the intensity of economic activity. These changes include altered composition of the atmosphere, land degradation, depletion of terrestrial aquifers and ocean fisheries, and loss of biodiversity. This weakening of life-supporting systems poses health risks. Contemporary public health must therefore encompass the interrelated tasks of reducing social and health inequalities and achieving health-sustaining environments.

Democracy and power in alcohol premises licensing: A qualitative interview study of the Scottish public health objective.

PubMed

Fitzgerald, Niamh; Winterbottom, Jo; Nicholls, James

2018-06-11

There is international interest in how the availability of alcohol can be controlled to reduce harms. An objective of 'protecting and improving public health' was introduced to alcohol premises licensing in Scotland in 2005, resulting in public health actors engaging with licensing in new ways. We aimed to explore their experiences, including perceptions of the distribution of power, and constraints on their influence and that of the general public within the licensing system. In-depth, semi-structured interviews were conducted with 13 public health actors who had recent and extensive experience of involvement in local licensing in 20 Scottish licensing jurisdictions. Interviews were audio-recorded and analysed using an inductive framework approach. Public health actors reported experiencing the licensing process as inherently unfair, with structures and traditions that were largely unhelpful to their efforts to support the public health objective. These included influence exerted by local officials, the formal and quasi-judicial conduct of licensing meetings, and the disparity in resources available to public health actors versus licence applicants-with many larger applicants engaging specialist lawyers to represent their interests. The influence of public opinion-through, for instance, elected representatives' perceptions of public attitudes, consultation exercises and local 'licensing forums'-was seen as having a limited effect on decision-making. Changes to Scottish alcohol licensing ostensibly designed to enhance democratic engagement and promote public health, were as yet insufficient to change the system, or empower stakeholders, to fully achieve those goals. © 2018 Australasian Professional Society on Alcohol and other Drugs.

An Ethical Justification for Expanding the Notion of Effectiveness in Vaccine Post-Market Monitoring: Insights from the HPV Vaccine in Canada.

PubMed

Komparic, Ana; Smith, Maxwell J; Thompson, Alison

2016-04-01

Health regulators must carefully monitor the real-world safety and effectiveness of marketed vaccines through post-market monitoring in order to protect the public's health and promote those vaccines that best achieve public health goals. Yet, despite the fact that vaccines used in collective immunization programmes should be assessed in the context of a public health response, post-market effectiveness monitoring is often limited to assessing immunogenicity or limited programmatic features, rather than assessing effectiveness across populations. We argue that post-market monitoring ought to be expanded in two ways to reflect a 'public health notion of post-market effectiveness', which incorporates normative public health considerations: (i) effectiveness monitoring should yield higher quality data and grant special attention to underrepresented and vulnerable populations; and (ii) the scope of effectiveness should be expanded to include a consideration of the various social factors that maximize (and minimize) a vaccine's effectiveness at the population level, paying particular attention to how immunization programmes impact related health gradients. We use the case of the human papillomavirus vaccine in Canada to elucidate how expanding post-market effectiveness monitoring is necessary to close the gap between clinical practice and public health, and to ensure that vaccines are effective in a morally relevant sense.

Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience

PubMed Central

Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

2015-01-01

Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies. PMID:26673477

A strategic approach to workforce development for local public health.

PubMed

Bryant, Beverley; Ward, Megan

2017-11-09

In 2009, Peel Public Health set a vision to transform the work of public health from efficient delivery of public health services as defined by provincial mandate to the robust analysis of the health status of the local population and selection and implementation of programming to achieve best health outcomes. A strategic approach to the workforce was a key enabler. PPH is a public health unit in Ontario that serves 1.4 million people. An organization-wide strategic workforce development program was instituted. It is theory-based, evidence-informed and data-driven. A first step was a conceptual framework, followed by interventions in workforce planning, human resources management, and capacity development. The program was built on evidence reviews, theory, and public health core competencies. Interventions spread across the employee work-life span. Capacity development based on the public health core competencies is a main focus, particularly analytical capacity to support decision-making. Employees gain skill and knowledge in comprehensive population health. Leadership evolves as work shifts to the analysis of health status and development of interventions. Effective human resource processes ensure appropriate job design, recruitment and orientation. Analysis of the workforce leads to vigorous employee development to ensure a strong pool of potential leadership successors. Theory, research evidence, and data provide a robust foundation for workforce development. Competencies are important inputs to job descriptions, recruitment, training, and human resource processes. A comprehensive workforce development strategy enables the development of a skilled workforce capable of responding to the needs of the population it serves.

Implications of health as 'the ability to adapt and self-manage' for public health policy: a qualitative study.

PubMed

Jambroes, Marielle; Nederland, Trudi; Kaljouw, Marian; van Vliet, Katja; Essink-Bot, Marie-Louise; Ruwaard, Dirk

2016-06-01

To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Secondary qualitative data analysis of 28 focus group interviews, with 277 participants involved in public health and healthcare, on the future of the Dutch healthcare system. WHO's essential public health operations (EPHOs) were used as a framework for analysis. Starting from the new concept of health, participants perceived health as an individual asset, requiring an active approach in the Dutch population towards health promotion and adaptation to a healthy lifestyle. Sectors outside healthcare and public health were considered as resources to support individual lifestyle improvement. Integrating prevention and health promotion in healthcare is also expected to stimulate individuals to comply with a healthy lifestyle. Attention should be paid to persons less skilled to self-manage their own health, as this group may require a healthcare safety net. The relationship between individual and population health was not addressed, resulting in little focus on collective prevention to achieve health. The new concept of health as a basis for changes in the healthcare system offers opportunities to create a health-promoting societal context. However, inequalities in health within the general population may increase when using the new concept as an operationalisation of health. For public health, the main challenge is to maintain focus on the collective socioeconomic and environmental determinants of health and disease and, thereby, preserve collective prevention. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

[Pedagogical training in stricto sensu graduate programs in public health].

PubMed

Corrêa, Guilherme Torres; Ribeiro, Victoria Maria Brant

2013-06-01

The scope of this research is to discuss the relevance and need for pedagogical training of university lecturers in the Public Health field. The contention is that college teaching is a practice that requires specific training, since it is characterized by complex elements that transcend the mastery of given content. Considering stricto sensu graduate studies as an important stage in the training of future university lecturers, an attempt was made to identify and analyze the subjects and practices of pedagogical training in academic masters and doctorate programs in Public Health. To achieve the research aim, this work was based on Pierre Bourdieu's field theory and on Tomaz Tadeu da Silva's curriculum theory. Results indicate that the programs do not consider the aspect of teacher training as a major issue. With regard to the Public Health field approximately 61% of masters and 38% of doctorate programs have pedagogical training subjects/practices. Furthermore, there is a tendency for technical-instrumental training, which is in line with the history of the Public Health field. The conclusion is that there is a need to develop a culture that values college and graduate Public Health teaching, considering the complexity of pedagogical practice in all its dimensions.

Blueprint for a deliberative public forum on biobanking policy: were theoretical principles achievable in practice?

PubMed

Molster, Caron; Maxwell, Susannah; Youngs, Leanne; Kyne, Gaenor; Hope, Fiona; Dawkins, Hugh; O'Leary, Peter

2013-06-01

Public deliberation is recommended for obtaining citizen input to policy development when policies involve contested ethical dimensions, diverse perspectives on how to trade-off competing public interests and low public awareness of these perspectives. Several norms have been proposed for the design of deliberative methods. Evidence is scarce regarding whether such norms are achievable in practice. This paper refers to principles of deliberative democracy theory to describe a deliberative public forum on biobanking. Practical challenges and contextual facilitators of achieving deliberative ideals are discussed, along with factors that influenced use of the forum output in policy development. The forum ran for 4 days over two weekends in Perth, Western Australia. Key methodological features were socio-demographic stratification to randomly recruit a mini-public of citizens for discursive representation, provision of information inclusive of diverse perspectives and framed for difference, provision of a fair way for reasoning and collective decision making and adoption of processes to achieve publicity, accountability and independence from undue institutional influence. Most design principles were achieved in practice, with the fundamental exception of representativeness. Factors influencing these outcomes, and the use of deliberated outputs to develop policy, included institutional characteristics, the design involvement of deliberative experts and quality of the outputs when compared to other consultation methods. Public deliberations can achieve design ideals and influence (ethics-based) public health policy. The representation of 'hard to reach' citizens and their views needs further consideration, particularly as this relates to the procedural legitimacy of ethical analyses and the just inclusion of deliberative citizen advice within the broader policy-making process. © 2011 John Wiley & Sons Ltd.

Blueprint for a deliberative public forum on biobanking policy: were theoretical principles achievable in practice?

PubMed Central

Molster, Caron; Maxwell, Susannah; Youngs, Leanne; Kyne, Gaenor; Hope, Fiona; Dawkins, Hugh; O’Leary, Peter

2011-01-01

Abstract Background:  Public deliberation is recommended for obtaining citizen input to policy development when policies involve contested ethical dimensions, diverse perspectives on how to trade‐off competing public interests and low public awareness of these perspectives. Several norms have been proposed for the design of deliberative methods. Evidence is scarce regarding whether such norms are achievable in practice. Purpose:  This paper refers to principles of deliberative democracy theory to describe a deliberative public forum on biobanking. Practical challenges and contextual facilitators of achieving deliberative ideals are discussed, along with factors that influenced use of the forum output in policy development. Method:  The forum ran for 4 days over two weekends in Perth, Western Australia. Key methodological features were socio‐demographic stratification to randomly recruit a mini‐public of citizens for discursive representation, provision of information inclusive of diverse perspectives and framed for difference, provision of a fair way for reasoning and collective decision making and adoption of processes to achieve publicity, accountability and independence from undue institutional influence. Results:  Most design principles were achieved in practice, with the fundamental exception of representativeness. Factors influencing these outcomes, and the use of deliberated outputs to develop policy, included institutional characteristics, the design involvement of deliberative experts and quality of the outputs when compared to other consultation methods. Conclusions:  Public deliberations can achieve design ideals and influence (ethics‐based) public health policy. The representation of ‘hard to reach’ citizens and their views needs further consideration, particularly as this relates to the procedural legitimacy of ethical analyses and the just inclusion of deliberative citizen advice within the broader policy‐making process. PMID:21645188

Why culture matters in health interventions: lessons from HIV/AIDS stigma and NCDs.

PubMed

Airhihenbuwa, Collins O; Ford, Chandra L; Iwelunmor, Juliet I

2014-02-01

Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. We argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. We conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.

Public health education for midwives and midwifery students: a mixed methods study.

PubMed

McNeill, Jenny; Doran, Jackie; Lynn, Fiona; Anderson, Gail; Alderdice, Fiona

2012-12-07

Current national and international maternity policy supports the importance of addressing public health goals and investing in early years. Health care providers for women during the reproductive and early postnatal period have the opportunity to encourage women to make choices that will impact positively on maternal and fetal health. Midwives are in a unique position, given the emphasis of the philosophy of midwifery care on building relationships and incorporating a holistic approach, to support women to make healthy choices with the aim of promoting health and preventing ill health. However, exploration of the educational preparation of midwives to facilitate public health interventions has been relatively limited. The aim of the study was to identify the scope of current midwifery pre registration educational provision in relation to public health and to explore the perspectives of midwives and midwifery students about the public health role of the midwife. This was a mixed methods study incorporating a survey of Higher Educational Institutions providing pre registration midwifery education across the UK and focus groups with midwifery students and registered midwives. Twenty nine institutions (53% response) participated in the survey and nine focus groups were conducted (59 participants). Public health education was generally integrated into pre registration midwifery curricula as opposed to taught as a discrete subject. There was considerable variation in the provision of public health topics within midwifery curricula and the hours of teaching allocated to them. Focus group data indicated that it was consistently difficult for both midwifery students and midwives to articulate clearly their understanding and definition of public health in relation to midwifery. There is a unique opportunity to impact on maternal and infant health throughout the reproductive period; however the current approach to public health within midwifery education should be reviewed to capitalise on the role of the midwife in delivering public health interventions. It is clear that better understanding of midwifery public health roles and the visibility of public health within midwifery is required in order to maximise the potential contribution of midwives to achieving short and long term public health population goals.

Tobacco control, stigma, and public health: rethinking the relations.

PubMed

Bayer, Ronald; Stuber, Jennifer

2006-01-01

The AIDS epidemic has borne witness to the terrible burdens imposed by stigmatization and to the way in which marginalization could subvert the goals of HIV prevention. Out of that experience, and propelled by the linkage of public health and human rights, came the commonplace assertion that stigmatization was a retrograde force.Yet, strikingly, the antitobacco movement has fostered a social transformation that involves the stigmatization of smokers. Does this transformation represent a troubling outcome of efforts to limit tobacco use and its associated morbidity and mortality; an ineffective, counterproductive, and moralizing approach that leads to a dead end; or a signal of public health achievement? If the latter is the case, are there unacknowledged costs?

Putting the Law Into Practice: A Comparison of Isolation and Quarantine As Tools to Control Tuberculosis and Ebola.

PubMed

Hershey, Tina Batra; Pryde, Julie A; Mwaungulu, Geoffrey S; Phifer, Victoria I; Roszak, Andrew R

The recent Ebola epidemic has put the words "isolation and quarantine" in the spotlight. Isolation and quarantine are tools that are often utilized by public health officials around the United States to address various types of infectious disease, including tuberculosis. While voluntary compliance is preferred, it can be difficult to achieve. In cases where an individual chooses not to voluntarily comply with an isolation or quarantine request, public health officials require assistance from the judiciary and law enforcement to effectuate the order. This article compares 2 recent court cases with different outcomes where public health officials sought assistance from the courts to enforce an isolation or quarantine order.

Taking Stock of Parent Education in the Family Courts: Envisioning a Public Health Model

PubMed Central

Salem, Peter; Sandler, Irwin; Wolchik, Sharlene

2012-01-01

The paper reviewed the development and current status of the parent education movement in the Family Courts. Parent education programs are now being implemented in courts throughout the United States and have a high level of public acceptance; however, a stronger research methodology to evaluate the effects and continued work to align the goals with the content and teaching strategies of these programs are needed. A new conceptual framework is proposed for parent education, which views divorce as a public health problem for children as well as a legal issue. The three-level framework uses concepts from public health to align the goals, content and format of parent education programs and to enable rigorous evaluations of the outcomes achieved by these programs. PMID:23641191

[Desperately seeking decentralisation: Mexican health policies in two periods of reform: the 1920s-30s and the 1980s].

PubMed

Birn, Anne-Emannuelle

2005-01-01

This article compares public health policy reforms in Mexico during the 1920s and 1930s with subsequent reforms initiated in the 1980s. The attempts at decentralization in the 1920s-30s were supported by the Rockefeller Foundation, which was interested in the formation of local cooperative health units. In the 1980s, the aim of the Mexican government and international financial agencies, such as the Inter-American Development Bank, was to reduce public spending (as part of "structural adjustment" policies). One of the hypotheses of this article is that, in the end, the public health reforms were unable to overcome the limitations imposed by Mexico's political centralization and longstanding inequities in public spending. At the same time, one of the unforeseen achievements of these reforms was an increase in local capabilities to demand a better distribution of social services.

The role of public-private partnerships in addressing the biomedical innovation challenge.

PubMed

Said, Maya; Zerhouni, Elias

2014-11-01

Without a step change in the productivity of pharmaceutical research and development, it will be difficult to tackle the public health challenges facing societies worldwide. Public–private partnerships could play a key role in achieving this step change, but they need to be well designed and led.

Structured Mentoring for Workforce Engagement and Professional Development in Public Health Settings.

PubMed

Dopson, Stephanie A; Griffey, Sue; Ghiya, Neelam; Laird, Susan; Cyphert, Aubrey; Iskander, John

2017-05-01

Mentoring is commonly used to facilitate professional growth and workforce development in a variety of settings. Organizations can use mentoring to help achieve broader personnel goals including leadership development and succession planning. While mentorship can be incorporated into training programs in public health, there are other examples of structured mentoring, with time commitments ranging from minutes to months or longer. Based on a review of the literature in public health and aggregated personal subject matter expertise of existing programs at the Centers for Disease Control and Prevention, we summarize selected mentoring models that vary primarily by time commitments and meeting frequency and identify specific work situations to which they may be applicable, primarily from the federal job experience point of view. We also suggest specific tasks that mentor-mentee pairs can undertake, including review of writing samples, practice interviews, and development of the mentee's social media presence. The mentor-mentee relationship should be viewed as a reciprocally beneficial one that can be a source of learning and personal growth for individuals at all levels of professional achievement and across the span of their careers.

[Hygiene and Infection Prevention in Medical Institutions, Kindergartens and Schools - Statutory Basis, Infection Control Practice and Experiences of the Public Health Services].

PubMed

Heudorf, U

2015-07-01

Infection prevention is one of the main tasks of the public health services. The "Protection against infection act" places all medical institutions and facilities for children (kindergartens and schools) under the obligation to assume responsibility and to cooperate. Duties of the institutions are described, and public health services are obliged to perform hygiene control visits.Regarding medical institutions, the guidelines of the German Commission on Hospital Hygiene and Infection Control have to be observed, and the counties were obliged to publish hygiene enactments. Subsequently, good improvements in hygiene management in medical institutions were achieved. In schools, however, severe hygienic problems (i.e. sanitary hygiene, indoor air hygiene) are detected, without any improvement - obviously due to a missing sense of responsibility in the school community. Causes for poor behaviour prevention (hand hygiene, ventilation) and missing situational prevention (i.e. cleaning) are discussed. Without reversion to the obviously needed but nearly forgotten subject school hygiene, obligatory guidelines and the assuming of responsibility, permanent improvements cannot be achieved. © Georg Thieme Verlag KG Stuttgart · New York.

Insights in public health: systems thinking: basic constructs, application challenges, misuse in health, and how public health leaders can pave the way forward.

PubMed

Canyon, Deon V

2013-12-01

The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in Public Health, the World Health Organization, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. This paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and public health to achieve the reason it was adopted in the first place.

A new entity for the negotiation of public procurement prices for patented medicines in Mexico.

PubMed

Gómez-Dantés, Octavio; Wirtz, Veronika J; Reich, Michael R; Terrazas, Paulina; Ortiz, Maki

2012-10-01

As countries expand health insurance coverage, their expenditures on medicines increase. To address this problem, WHO has recommended that every country draw up a list of essential medicines. Although most medicines on the list are generics, in many countries patented medicines represent a substantial portion of pharmaceutical expenditure. To help control expenditure on patented medicines, in 2008 the Mexican Government created the Coordinating Commission for Negotiating the Price of Medicines and other Health Inputs (CCPNM), whose role, as the name suggests, is to enter into price negotiations with drug manufacturers for patented drugs on Mexico's list of essential medicines. Mexico's public expenditure on pharmaceuticals has increased substantially in the past decade owing to government efforts to achieve universal health-care coverage through Seguro Popular, an insurance programme introduced in 2004 that guarantees access to a comprehensive package of health services and medicines. Since 2008, the CCPNM has improved procurement practices in Mexico's public health institutions and has achieved significant price reductions resulting in substantial savings in public pharmaceutical expenditure. The CCPNM has successfully changed the landscape of price negotiation for patented medicines in Mexico. However, it is also facing challenges, including a lack of explicit indicators to assess CCPNM performance; a shortage of permanent staff with sufficient technical expertise; poor coordination among institutions in preparing background materials for the annual negotiation process in a timely manner; insufficient communication among committees and institutions; and a lack of political support to ensure the sustainability of the CCPNM.

Doing patient-centredness versus achieving public health targets: A critical review of interactional dilemmas in ART adherence support.

PubMed

de Kok, B C; Widdicombe, S; Pilnick, A; Laurier, E

2018-05-01

Anti-retroviral Therapy (ART) transformed HIV into a chronic disease but its individual and public health benefits depend on high levels of adherence. The large and rising number of people on ART, now also used as prevention, puts considerable strain on health systems and providers in low and middle as well as high-income countries, which are our focus here. Delivering effective adherence support is thus crucial but challenging, especially given the promotion of patient-centredness and shared decision making in HIV care. To illuminate the complexities of ART adherence support delivered in and through clinical encounters, we conducted a multi-disciplinary interpretative literature review. We reviewed and synthesized 82 papers published post 1997 (when ART was introduced) belonging to three bodies of literature: public health and psychological studies of ART communication; anthropological and sociological studies of ART; and conversation analytic studies of patient-centredness and shared decision-making. We propose three inter-related tensions which make patient-centredness particularly complex in this infectious disease context: achieving trust versus probing about adherence; patient-centredness versus reaching public health targets; and empowerment versus responsibilisation as 'therapeutic citizens'. However, there is a dearth of evidence concerning how precisely ART providers implement patient-centredness, shared-decision making in practice, and enact trust and therapeutic citizenship. We show how conversation analysis could lead to new, actionable insights in this respect. Copyright © 2018 Elsevier Ltd. All rights reserved.

Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era.

PubMed

Desai, Sachin N; Pezzoli, Lorenzo; Alberti, Kathryn P; Martin, Stephen; Costa, Alejandro; Perea, William; Legros, Dominique

2017-03-04

Cholera remains an important but neglected public health threat, affecting the health of the poorest populations and imposing substantial costs on public health systems. Cholera can be eliminated where access to clean water, sanitation, and satisfactory hygiene practices are sustained, but major improvements in infrastructure continue to be a distant goal. New developments and trends of cholera disease burden, the creation of affordable oral cholera vaccines (OCVs) for use in developing countries, as well as recent evidence of vaccination impact has created an increased demand for cholera vaccines. The global OCV stockpile was established in 2013 and with support from Gavi, has assisted in achieving rapid access to vaccine in emergencies. Recent WHO prequalification of a second affordable OCV supports the stockpile goals of increased availability and distribution to affected populations. It serves as an essential step toward an integrated cholera control and prevention strategy in emergency and endemic settings.

Scale-up of HIV treatment through PEPFAR: a historic public health achievement.

PubMed

El-Sadr, Wafaa M; Holmes, Charles B; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

2012-08-15

Since its inception in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems.

Primary care in Cuba: a public health approach.

PubMed

Swanson, K A; Swanson, J M; Gill, A E; Walter, C

1995-01-01

Cuba's primary health care model is presented. Unlike ambulatory care services, which are but one component of primary care, Cuba's model is a comprehensive public health approach that meets the World Health Organization's definition of primary care. The history of the development of Cuba's model is presented, including an update on the innovative neighborhood/home clinics. Achievements in health outcomes as a result of Cuba's model and the consequences for women's health care are discussed. Examples are presented of the effects on health care delivery of the economic hardship that Cuba has experienced since 1991 as a result of the loss of 85% of its trade with the former Soviet Union and the intensified U.S. embargo. A critique of Cuba's model concludes the article.

A public health approach to eating disorders prevention: it's time for public health professionals to take a seat at the table.

PubMed

Austin, S Bryn

2012-10-09

The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders.

A public health approach to eating disorders prevention: It’s time for public health professionals to take a seat at the table

PubMed Central

2012-01-01

Background The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. Discussion The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. Summary There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders. PMID:23043459

Public support for bicycling and transport policies in inner Sydney, Australia: a cross-sectional survey.

PubMed

Rissel, Chris; Crane, Melanie; Standen, Chris; Wen, Li Ming; Ellison, Richard; Greaves, Stephen

2018-06-01

To describe the degree of community support - and factors associated with this support - for a number of potential transport policy options among an inner-city sample of residents in Sydney, Australia. This study analysed data collected from a cross-sectional online survey: Wave 3 of the Sydney Transport and Health Study, conducted in September-October 2015 (n=418). There was a high level of overall support for policies to make public transport cheaper (85%), have more bicycle paths separated from motor vehicles (82%) and have a public bike-share program (72%), with similar levels of support across usual commute mode, age and sex. Despite a natural tendency for respondents to support transport policies that were of most relevance to themselves, it appeared that, in this sample, public support for public transport and bicycling policies remained strong across all respondents. Implications for public health: Policies that support public transport and active travel and achieve positive health outcomes would be well received by inner-Sydney residents. © 2018 The Authors.

Journal of Special Operations Medicine. Volume 10, Edition 4, Fall 2010

DTIC Science & Technology

2010-01-01

Prior To Ascent? ● Scapula Fracture Secondary to Static Line Injury in a 22 year-old Active Duty Soldier ● Public Health Foodborne Illness Case Study...Scapula Fracture Secondary to Static Line Injury in a 22 year-old Active Duty Soldier LTC K. David Thompson, MPAS, PA-C Public Health Foodborne Illness...consistent measurements were achieved. Predicted lung vol- ume and an appropriate densitometry equation were used to calculate percent body fat (% BF

Medicine and public health in a multiethnic world.

PubMed

Bhopal, Raj

2009-09-01

Achievement of medical and public health goals requires mutual understanding between professionals and the public, a challenge in diverse societies. Despite their massive diversity humans belong to one species, with race and ethnicity used to subgroup/classify humans and manage diversity. Classifications are contextual and vary by time, place and classifier. As classifications show major variations in health status, and risk factors, research using race and ethnicity has accelerated. Medical sciences, including epidemiology, are learning fast to extract value from such data. Among the debatable issues is the value of the relative risk versus absolute risk approaches (the latter is gaining ground), and how to assess ethnicity and race (self-assignment is favoured in the UK and North America, country of birth in continental Europe). Racial and ethnic variations in disease and risk factors are often large and usually unexplained. There is a compelling case for ethnic monitoring, despite its difficulties, for tackling inequalities and as a foundation for research. Medical and public health goals require good data collected in a racism-free social environment. Health professionals need to find the benefits of exploring differences while avoiding social division. Advances in health care, public health and medical science will follow.

[Development of an instrument for the surveillance of quality indicators in specialized training in Preventive Medicine and Public Health].

PubMed

Gil-Borrelli, Christian Carlo; Latasa, Pello; Reques, Laura; Alemán, Guadalupe

2015-01-01

This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Conflict and compromise in public health policy: analysis of changes made to five competitive food legislative proposals prior to adoption.

PubMed

Dinour, Lauren M

2015-04-01

Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an important strategy for reducing childhood obesity. Yet little is known about the decision-making processes by which such legislation is formed and adopted. Using a comparative case study design, this study describes and analyzes the policy formation processes surrounding five state-level competitive food bills introduced in 2009-2010. Data for each case were drawn from multiple key informant interviews and document reviews. Case studies were conducted, analyzed, and written independently using a standard protocol and were subsequently compared for recurring and unique themes. Abbreviated case studies and summary tables are provided. Results indicate that bill cost is a major barrier to achieving strong, health-promoting policy change. Additionally, findings reveal that supporters of stronger competitive food policies often concede to changes that weaken a bill in order to neutralize opposition and achieve stakeholder buy-in. These challenges suggest that continued research on the development, implementation, and evaluation of public health policies can contribute to the advancement of new strategies for effective health promotion. © 2015 Society for Public Health Education.

AEGIS: a robust and scalable real-time public health surveillance system.

PubMed

Reis, Ben Y; Kirby, Chaim; Hadden, Lucy E; Olson, Karen; McMurry, Andrew J; Daniel, James B; Mandl, Kenneth D

2007-01-01

In this report, we describe the Automated Epidemiological Geotemporal Integrated Surveillance system (AEGIS), developed for real-time population health monitoring in the state of Massachusetts. AEGIS provides public health personnel with automated near-real-time situational awareness of utilization patterns at participating healthcare institutions, supporting surveillance of bioterrorism and naturally occurring outbreaks. As real-time public health surveillance systems become integrated into regional and national surveillance initiatives, the challenges of scalability, robustness, and data security become increasingly prominent. A modular and fault tolerant design helps AEGIS achieve scalability and robustness, while a distributed storage model with local autonomy helps to minimize risk of unauthorized disclosure. The report includes a description of the evolution of the design over time in response to the challenges of a regional and national integration environment.

Strong tobacco control program requirements and secure funding are not enough: lessons from Florida.

PubMed

Kennedy, Allison; Sullivan, Sarah; Hendlin, Yogi; Barnes, Richard; Glantz, Stanton

2012-05-01

Florida's Tobacco Pilot Program (TPP; 1998-2003), with its edgy Truth media campaign, achieved unprecedented youth smoking reductions and became a model for tobacco control programming. In 2006, 3 years after the TPP was defunded, public health groups restored funding for tobacco control programming by convincing Florida voters to amend their constitution. Despite the new program's strong legal structure, Governor Charlie Crist's Department of Health implemented a low-impact program. Although they secured the program's strong structure and funding, Florida's nongovernmental public health organizations did not mobilize to demand a high-impact program. Implementation of Florida's Amendment 4 demonstrates that a strong programmatic structure and secure funding are insufficient to ensure a successful public health program, without external pressure from nongovernmental groups.

An assessment of interactions between global health initiatives and country health systems.

PubMed

Samb, Badara; Evans, Tim; Dybul, Mark; Atun, Rifat; Moatti, Jean-Paul; Nishtar, Sania; Wright, Anna; Celletti, Francesca; Hsu, Justine; Kim, Jim Yong; Brugha, Ruairi; Russell, Asia; Etienne, Carissa

2009-06-20

Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.

Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed?

PubMed

Gadsby, E W; Peckham, S; Coleman, A; Bramwell, D; Perkins, N; Jenkins, L M

2017-02-17

The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reforms have altered public health commissioning. We conducted multi-methods research over 33 months, incorporating national surveys of Directors of Public Health and local council elected members at two time-points, and in-depth case studies in five purposively selected geographical areas. Public health commissioning responsibilities have changed and become more fragmented, being split amongst a range of different organisations, most of which were newly created in 2013. There is much change in the way public health commissioning is done, in who is doing it, and in what is commissioned, since the reforms. There is wider consultation on decisions in the local council setting than in the NHS, and elected members now have a strong influence on public health prioritisation. There is more (and different) scrutiny being applied to public health contracts, and most councils have embarked on wide-ranging changes to the health improvement services they commission. Public health money is being used in different ways as councils are adapting to increasing financial constraint. Our findings suggest that, while some of the intended opportunities to improve population health and create a more joined-up system with clearer leadership have been achieved, fragmentation, dispersed decision-making and uncertainties regarding funding remain significant challenges. There have been profound changes in commissioning processes, with consequences for what health improvement services are ultimately commissioned. Time (and further research) will tell if any of these changes lead to improved population health outcomes and reduced health inequalities, but many of the opportunities brought about by the reforms are threatened by the continued flux in the system.

Soil and public health: invisible bridges

NASA Astrophysics Data System (ADS)

Pachepsky, Yakov

2017-04-01

Public health institutions, as ancient as civilizations itself, are intrinsically connected with soils. The massive body of the empirical knowledge about this connection has been accumulated. Recently unraveling the underlying mechanisms of this link has begun, and many of them appear to have the microbiological origin. The impressive progress in understanding the nexus between soil and health has been achieved by experimentation with preserved soil microbial systems functioning along with the metagenomic characterization. The objective of this work is to present an overview of some recent onsets. In the food safety arena, survival of human pathogens in soils has been related to the degree of soil eutrophication and/or related structure of soil microbial communities. Soil microbial systems affect the affinity of plants to internalizing pathogenic organisms. Pharmaceutical arsenals benefit from using field soil environment for developing antibiotics. Enzyme production by soil bacteria is used as the signal source for drug activation. Sanitary functions of sols are dependent on soil microbial system workings. The healthy living can be enhanced by the human immune system training received from direct contact with soils. The hygiene hypothesis considers the microbial input due to exposure to soil as the essential ecosystem service. The invisible links between soil and public health result in large-scale consequences. Examples of concurrent degradation of soil and public health are worth scrutinizing. Public health records can provide valuable sources of 'soil-public health' interactions. It may be worthwhile to examine current assessments of soil health from the public health standpoint. Soil management can be an efficient instrument of public health control.

Food Science for the Public Good

NASA Astrophysics Data System (ADS)

Miller, Cassandra

If you are interested in food science, looking for a meaningful career path, and are motivated by the desire to make a difference, you may find that a career working for the public good can be very rewarding. Often, such opportunities address issues of social responsibility, sustainability, public health, and/or economic development. Food scientists who choose this path typically have an interest in social and public health issues, and are usually driven by the achievement of some sort of social, health, or societal gain. As food science in itself is a very broad discipline, applying this knowledge for the public good can also take a variety of paths. Whether you're interested in manufacturing, food safety, nutrition, food policy, product development, quality control, marketing and sales, or any other discipline that makes up the diverse field of food science, various opportunities exist to make a difference to society.

Communications in public health emergency preparedness: a systematic review of the literature.

PubMed

Savoia, Elena; Lin, Leesa; Viswanath, Kasisomayajula

2013-09-01

During a public health crisis, public health agencies engage in a variety of public communication efforts to inform the population, encourage the adoption of preventive behaviors, and limit the impact of adverse events. Given the importance of communication to the public in public health emergency preparedness, it is critical to examine the extent to which this field of study has received attention from the scientific community. We conducted a systematic literature review to describe current research in the area of communication to the public in public health emergency preparedness, focusing on the association between sociodemographic and behavioral factors and communication as well as preparedness outcomes. Articles were searched in PubMed and Embase and reviewed by 2 independent reviewers. A total of 131 articles were included for final review. Fifty-three percent of the articles were empirical, of which 74% were population-based studies, and 26% used information environment analysis techniques. None had an experimental study design. Population-based studies were rarely supported by theoretical models and mostly relied on a cross-sectional study design. Consistent results were reported on the association between population socioeconomic factors and public health emergency preparedness communication and preparedness outcomes. Our findings show the need for empirical research to determine what type of communication messages can be effective in achieving preparedness outcomes across various population groups. They suggest that a real-time analysis of the information environment is valuable in knowing what is being communicated to the public and could be used for course correction of public health messages during a crisis.

Communications in Public Health Emergency Preparedness: A Systematic Review of the Literature

PubMed Central

Savoia, Elena; Viswanath, Kasisomayajula

2013-01-01

During a public health crisis, public health agencies engage in a variety of public communication efforts to inform the population, encourage the adoption of preventive behaviors, and limit the impact of adverse events. Given the importance of communication to the public in public health emergency preparedness, it is critical to examine the extent to which this field of study has received attention from the scientific community. We conducted a systematic literature review to describe current research in the area of communication to the public in public health emergency preparedness, focusing on the association between sociodemographic and behavioral factors and communication as well as preparedness outcomes. Articles were searched in PubMed and Embase and reviewed by 2 independent reviewers. A total of 131 articles were included for final review. Fifty-three percent of the articles were empirical, of which 74% were population-based studies, and 26% used information environment analysis techniques. None had an experimental study design. Population-based studies were rarely supported by theoretical models and mostly relied on a cross-sectional study design. Consistent results were reported on the association between population socioeconomic factors and public health emergency preparedness communication and preparedness outcomes. Our findings show the need for empirical research to determine what type of communication messages can be effective in achieving preparedness outcomes across various population groups. They suggest that a real-time analysis of the information environment is valuable in knowing what is being communicated to the public and could be used for course correction of public health messages during a crisis. PMID:24041193

Assessing the Contributions of Private Health Facilities in a Pioneer Private-Public Partnership in Childhood Immunization in Nigeria

PubMed Central

Oluoha, Chukwuemeka; Ahaneku, Hycienth

2014-01-01

The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria. PMID:28299112

Studies in Adolescent Health: Research to Improve Health Services for Mothers and Children.

ERIC Educational Resources Information Center

California Univ., Los Angeles. School of Public Health.

This publication is one in a series summarizing final reports of research projects concerned with improving health services for mothers, children and physically handicapped youth. Topics of the 10 reports include: (1) ambulatory care patterns of urban adolescents in New York City, (2) selected parameters of school achievement among New York City…

An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities

PubMed Central

Mukherjee, Sutapa; Patel, Sanjay R.; Kales, Stefanos N.; Ayas, Najib T.; Strohl, Kingman P.; Gozal, David; Malhotra, Atul

2015-01-01

Rationale: Despite substantial public interest, few recommendations on the promotion of good sleep health exist to educate health care providers and the general public on the importance of sleep for overall health. Objectives: The aim of this American Thoracic Society (ATS) statement is to provide a review of the current scientific literature to assist health care providers, especially pulmonologists and sleep physicians, in making recommendations to patients and the general public about the importance of achieving good quality and adequate quantity of sleep. Methods: ATS members were invited, based on their expertise in sleep medicine, and their conclusions were based on both empirical evidence identified after comprehensive literature review and clinical experience. Main Results: We focus on sleep health in both children and adults, including the impact of occupation on sleep, the public health implications of drowsy driving, and the common sleep disorders of obstructive sleep apnea and insomnia. This ATS statement also delineates gaps in research and knowledge that should be addressed and lead to new focused research priorities to advance knowledge in sleep and sleep health. Conclusions: Good quality and quantity of sleep are essential for good health and overall quality of life; therefore a strong recommendation was made for the implementation of public education programs on the importance of sleep health. PMID:26075423

[Extreme types - a comparison of public health systems in Thuringia and the Warthegau].

PubMed

Vossen, J

2013-11-01

Special policing measures in Nazi Germany required centralisation in the public health service which was mainly achieved through the Law for the Unification of Municipal and State Health Administration in 1934. The long-term aim for public health officers was now hereditary and racial welfare. Several following legal regulations contributed to the implementation of a specific national-socialist health and social policy on the basis of racial hygiene and gave immense power to the health officers. Especially with the Law for the Prevention of Hereditarily Sick Offspring, compulsory sterilisation was legalised and resulted in about 400,000 victims up to 1945. The central force in this new system was the public health office. The most extreme variation of public health administration was launched in Thuringia, where professional powers and state authority implemented an extensive institutional machinery which managed to reinforce Nazi population policy almost to perfection. After the invasion of western Poland the Germans built up an inhumane regime in the annexed and occupied regions, persecuted and murdered the Polish population and tried to exterminate the Jewish people. Here the health officers of the Warthegau could promote a rigorously racial dominated population policy of segregation. © Georg Thieme Verlag KG Stuttgart · New York.

Prioritising public health: a qualitative study of decision making to reduce health inequalities.

PubMed

Orton, Lois C; Lloyd-Williams, Ffion; Taylor-Robinson, David C; Moonan, May; O'Flaherty, Martin; Capewell, Simon

2011-10-20

The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health and health inequalities. Researchers have a vital role to play in providing the complex evidence required to compare different models of prevention and service delivery. Those working in public health must develop leadership to raise the profile of health inequalities as an issue that merits attention, resources and workforce capacity; and advocate for central government to play a key role in shifting social norms.

[Evaluation of scientific production in different subareas of Public Health: limits of the current model and contributions to the debate].

PubMed

Iriart, Jorge Alberto Bernstein; Deslandes, Suely Ferreira; Martin, Denise; Camargo, Kenneth Rochel de; Carvalho, Marilia Sá; Coeli, Cláudia Medina

2015-10-01

The aim of this study was to discuss the limits of the quantitative evaluation model for scientific production in Public Health. An analysis of the scientific production of professors from the various subareas of Public Health was performed for 2010-2012. Distributions of the mean annual score for professors were compared according to subareas. The study estimated the likelihood that 60% of the professors in the graduate studies programs scored P50 (Very Good) or higher in their area. Professors of Epidemiology showed a significantly higher median annual score. Graduate studies programs whose faculty included at least 60% of Epidemiology professors and fewer than 10% from the subarea Social and Human Sciences in Health were significantly more likely to achieve a "Very Good" classification. The observed inequalities in scientific production between different subareas of Public Health point to the need to rethink their evaluation in order to avoid reproducing iniquities that have harmful consequences for the field's diversity.

A new paradigm for quarantine and public health activities at land borders: opportunities and challenges.

PubMed

Waterman, Stephen H; Escobedo, Miguel; Wilson, Todd; Edelson, Paul J; Bethel, Jeffrey W; Fishbein, Daniel B

2009-01-01

The Institute of Medicine (IOM) report Quarantine Stations at Ports of Entry: Protecting the Public's Health focused almost exclusively on U.S. airports and seaports, which served 106 million entries in 2005. IOM concluded that the primary function of these quarantine stations (QSs) should shift from providing inspection to providing strategic national public health leadership. The large expanse of our national borders, large number of crossings, sparse federal resources, and decreased regulation regarding conveyances crossing these borders make land borders more permeable to a variety of threats. To address the health challenges related to land borders, the QSs serving such borders must assume unique roles and partnerships to achieve the strategic leadership and public health research roles envisioned by the IOM. In this article, we examine how the IOM recommendations apply to the QSs that serve the land borders through which more than 319 million travelers, immigrants, and refugees entered the U.S. in 2005.

Legal and regulatory capacity to support the global health security agenda.

PubMed

Morhard, Ryan; Katz, Rebecca

2014-01-01

On February 13, 2014, 27 nations, along with 3 international organizations, launched the Global Health Security Agenda (GHSA). The intent of GHSA is to accelerate progress in enabling countries around the world to prevent, detect, and respond to public health emergencies-capacities to be achieved through 9 core objectives. Building national, regional, and international capacity includes creating strong legal and regulatory regimes to support national and international capacities to prevent, detect, and respond to public health emergencies. Accordingly, establishing and reinforcing international and national-level legal preparedness is central to advancing elements of each of the 9 objectives of the GHSA.

Technological and social innovation: a unifying new paradigm for global health.

PubMed

Gardner, Charles A; Acharya, Tara; Yach, Derek

2007-01-01

This paper highlights the growing capacity for innovation in some developing countries. To maximize the potential of this phenomenon for global health, countries and donors need to link two disparate schools of thought: (1) a search for technological solutions exemplified by global public-private product development partnerships, and (2) a focus on systemic solutions exemplified by health policy and systems research. A strong capacity for both technological and social innovation in developing countries represents the only truly sustainable means of improving the effectiveness of health systems. Local public-private research and development partnerships, implementation research, and individual leadership are needed to achieve this goal.

Availability and affordability of antimalarial and antibiotic medicines in Malawi

PubMed Central

Khuluza, Felix

2017-01-01

Background Availability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. We here present an analysis of availability and prices of antimalarial and antibiotic medicines in public, faith-based and private health facilities in Malawi. Medicines are provided free of charge in the public health care system of Malawi. In contrast, facilities of the Christian Health Association of Malawi (CHAM) usually charge their patients for medicines, as do private for-profit facilities. Methods As part of a study on medicine quality, samples of six antimalarial and six antibiotic medicines were collected in 31 health facilities in four districts of southern Malawi. These included 15 public facilities (i.e. health centres, district hospitals and central hospitals), eight CHAM and eight private facilities. Random selection was used in choosing the included health facilities. The availability of medicines was recorded, including the number of units which could be collected of each medicine, as well as the prices of medicines which were charged in CHAM and private facilities. These data were analyzed using the standard methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Results Availability of the antimalarials artemether/lumefantrine and sulfadoxine/pyrimethamine, which are provided with financial support from international donors, was high in public and CHAM facilities (93% and 100%, respectively). However, availability of antibiotics was much lower (e.g. 40% availability of amoxicillin tablets/capsules in public health centres). Medicine prices were lower than reported from many other countries. The median price ratio (MPR) to a wholesale international procurement price was 2.8 in CHAM facilities and even lower in the private sector (MPR 2.3). Nevertheless, for 10 of the 12 investigated medicines the cost for one course of treatment exceeded the daily wage of a low-paid government worker in Malawi and therefore had to be considered as unaffordable for a major part of the population. Conclusions Continued efforts are required to improve the availability of essential medicines in Malawi. The free provision of medicines in the public health care system remains important in order to achieve universal health coverage, due to the low income in this country. PMID:28419126

What's good for the goose is good for the gander. Guiding principles for the use of financial incentives in health behaviour change.

PubMed

Lynagh, Marita C; Sanson-Fisher, Rob W; Bonevski, Billie

2013-03-01

The use of financial incentives or pay-for-performance programs for health care providers has triggered emerging interest in the use of financial incentives for encouraging health behaviour change. This paper aims to identify key conditions under which the use of financial incentives for improvements in public health outcomes is most likely to be effective and appropriate. We review recent systematic reviews on their effectiveness in changing health behaviour and identify existing moral concerns concerning personal financial incentives. Current evidence indicates that incentives can be effective in driving health behaviour change under certain provisos, while a number of misgivings continue to be deliberated on. We outline a number of key principles for consideration in decisions about the potential use of incentives in leading to public health improvements. These key principles can assist policy makers in making decisions on the use of financial incentives directed at achieving improvements in public health.

Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia

PubMed Central

Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

2017-01-01

Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked. PMID:28196113

Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia.

PubMed

Lim, Huy Ming; Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

2017-01-01

Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71-0.96). Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked.

Evaluating the role of public health in implementation of genomics-related recommendations: a case study of hereditary cancers using the CDC Science Impact Framework.

PubMed

Green, Ridgely Fisk; Ari, Mary; Kolor, Katherine; Dotson, W David; Bowen, Scott; Habarta, Nancy; Rodriguez, Juan L; Richardson, Lisa C; Khoury, Muin J

2018-06-15

Public health plays an important role in ensuring access to interventions that can prevent disease, including the implementation of evidence-based genomic recommendations. We used the Centers for Disease Control and Prevention (CDC) Science Impact Framework to trace the impact of public health activities and partnerships on the implementation of the 2009 Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Lynch Syndrome screening recommendation and the 2005 and 2013 United States Preventive Services Task Force (USPSTF) BRCA1 and BRCA2 testing recommendations.The EGAPP and USPSTF recommendations have each been cited by >300 peer-reviewed publications. CDC funds selected states to build capacity to integrate these recommendations into public health programs, through education, policy, surveillance, and partnerships. Most state cancer control plans include genomics-related goals, objectives, or strategies. Since the EGAPP recommendation, major public and private payers now provide coverage for Lynch Syndrome screening for all newly diagnosed colorectal cancers. National guidelines and initiatives, including Healthy People 2020, included similar recommendations and cited the EGAPP and USPSTF recommendations. However, disparities in implementation based on race, ethnicity, and rural residence remain challenges. Public health achievements in promoting the evidence-based use of genomics for the prevention of hereditary cancers can inform future applications of genomics in public health.

No more business as usual: enticing companies to sharply lower the public health costs of the products they sell.

PubMed

Sugarman, S

2009-03-01

Cigarettes, alcohol, junk food and motor vehicles cause a staggeringly high level of death, injury and disease. Business leaders from the industries that make these products currently try to frame these negative outcomes as 'collateral damage' that is someone else's problem. That framing is not only morally objectionable, but also overlooks the possibility that, with proper prodding, industry could substantially mitigate these public health disasters. A promising regulatory tool called 'performance-based regulation' is a new approach to combating the problem. Simply put, performance-based regulation would impose a legal obligation on manufacturers to reduce their negative social costs. Rather than suing the firms for damages, or telling them how they should run their businesses differently (as typical 'command and control' regimes do), performance-based regulation allows the firms to determine how best to decrease today's negative public health consequences. Like other public health strategies, performance-based regulation shifts the focus away from individual consumers on to those who are far more likely to achieve real public health gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good.

Hospital physician payment mechanisms in Austria: do they provide gateways to institutional corruption?

PubMed

Sommersguter-Reichmann, Margit; Stepan, Adolf

2017-12-01

Institutional corruption in the health care sector has gained considerable attention during recent years, as it acknowledges the fact that service providers who are acting in accordance with the institutional and environmental settings can nevertheless undermine a health care system's purposes as a result of the (financial) conflicts of interest to which the service providers are exposed. The present analysis aims to contribute to the examination of institutional corruption in the health sector by analyzing whether the current payment mechanism of separately remunerating salaried hospital physicians for treating supplementary insured patients in public hospitals, in combination with the public hospital physician's possibility of taking up dual practice as a self-employed physician with a private practice and/or as an attending physician in private hospitals, has the potential to undermine the primary purposes of the Austrian public health care system. Based on the analysis of the institutional design of the Austrian public hospital sector, legal provisions and directives have been identified, which have the potential to promote conduct on the part of the public hospital physician that systematically undermines the achievement of the Austrian public health system's primary purposes.

Tackling overweight and obesity: does the public health message match the science?

PubMed

Hafekost, Katherine; Lawrence, David; Mitrou, Francis; O'Sullivan, Therese A; Zubrick, Stephen R

2013-02-18

Despite the increasing understanding of the mechanisms relating to weight loss and maintenance, there are currently no validated public health interventions that are able to achieve sustained long-term weight loss or to stem the increasing prevalence of obesity in the population. We aimed to examine the models of energy balance underpinning current research about weight-loss intervention from the field of public health, and to determine whether they are consistent with the model provided by basic science. EMBASE was searched for papers published in 2011 on weight-loss interventions. We extracted details of the population, nature of the intervention, and key findings for 27 articles. Most public health interventions identified were based on a simple model of energy balance, and thus attempted to reduce caloric consumption and/or increase physical activity in order to create a negative energy balance. There appeared to be little consideration of homeostatic feedback mechanisms and their effect on weight-loss success. It seems that there has been a lack of translation between recent advances in understanding of the basic science behind weight loss, and the concepts underpinning the increasingly urgent efforts to reduce excess weight in the population. Public health weight-loss interventions seem to be based on an outdated understanding of the science. Their continued failure to achieve any meaningful, long-term results reflects the need to develop intervention science that is integrated with knowledge from basic science. Instead of asking why people persist in eating too much and exercising too little, the key questions of obesity research should address those factors (environmental, behavioral or otherwise) that lead to dysregulation of the homeostatic mechanism of energy regulation. There is a need for a multidisciplinary approach in the design of future weight-loss interventions in order to improve long-term weight-loss success.

Urban planning and health equity.

PubMed

Northridge, Mary Evelyn; Freeman, Lance

2011-06-01

Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability. Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions. Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public health professionals have once again become convinced of the need for inclusive approaches to improve population health and achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide.

Use of a public-private partnership in malaria elimination efforts in Sri Lanka; a case study.

PubMed

Fernando, Deepika; Wijeyaratne, Pandu; Wickremasinghe, Rajitha; Abeyasinghe, Rabindra R; Galappaththy, Gawrie N L; Wickremasinghe, Renu; Hapugoda, M; Abeywickrema, W A; Rodrigo, Chaturaka

2018-03-23

In special circumstances, establishing public private partnerships for malaria elimination may achieve targets faster than the state sector acting by itself. Following the end of the separatist war in Sri Lanka in 2009, the Anti Malaria Campaign (AMC) of Sri Lanka intensified malaria surveillance jointly with a private sector partner, Tropical and Environmental Diseases and Health Associates Private Limited (TEDHA) with a view to achieving malaria elimination targets by 2014. This is a case study on how public private partnerships can be effectively utilized to achieve malaria elimination goals. TEDHA established 50 Malaria Diagnostic Laboratories and 17 entomology surveillance sentinel sites in consultation with the AMC in areas difficult to access by government officials (five districts in two provinces affected by war). TEDHA screened 994,448 individuals for malaria, of which 243,867 were screened at mobile malaria clinics as compared to 1,102,054 screened by the AMC. Nine malaria positives were diagnosed by TEDHA, while the AMC diagnosed 103 malaria cases in the same districts in parallel. Over 13,000 entomological activity days were completed. Relevant information was shared with AMC and the data recorded in the health information system. A successful public-private partnership model for malaria elimination was initiated at a time when the health system was in disarray in war ravaged areas of Sri Lanka. This ensured a high annual blood examination rate and screening of vulnerable people in receptive areas. These were important for certification of malaria-free status which Sri Lanka eventually received in 2016.

Strengthening of partnerships between the public sector and faith-based groups.

PubMed

Duff, Jean F; Buckingham, Warren W

2015-10-31

The sharpening focus on global health and the growing recognition of the capacities and scope of faith-based groups for improving community health outcomes suggest an intentional and systematic approach to forging strong, sustained partnerships between public sector agencies and faith-based organisations. Drawing from both development and faith perspectives, this Series paper examines trends that could ground powerful, more sustainable partnerships and identifies new opportunities for collaboration based on respective strengths and existing models. This paper concludes with five areas of recommendations for more effective collaboration to achieve health goals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Community Reinforcement and the Dissemination of Evidence-Based Practice: Implications for Public Policy

ERIC Educational Resources Information Center

Milford, Jaime L.; Austin, Julia L.; Smith, Jane Ellen

2007-01-01

The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are both highly effective and empirically validated psychosocial approaches to the treatment of addictions whose unique designs may help achieve certain public health objectives. Literature will be reviewed to examine the potential impact of CRA and…

The future of public hospitals in a globalized world: corporate governance, corporatization or privatization?

PubMed

Mordelet, Patrick

2008-01-01

This paper contributes to research in health systems and hospitals governance by examining the reasons and expected outcomes of the generalization of corporate governance rules in both public and private non-profit hospitals, all over the world, in order to achieve its clinical, quality and financial objectives.

45 CFR 261.20 - How will we hold a State accountable for achieving the work objectives of TANF?

Code of Federal Regulations, 2010 CFR

2010-10-01

... the work objectives of TANF? 261.20 Section 261.20 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK What Are the Provisions Addressing...

Pharmacist contributions to the ten essential services of public health in three National Association of Boards of Pharmacy regions.

PubMed

Strand, Mark A; Scott, David M; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

Pharmacists have contributed to improved population health through the delivery of public health services, but their contributions often go unrecognized within the larger health care system. To determine pharmacist perceptions of their contributions to the 10 essential services of public health and to compare those contributions among pharmacists in Iowa, North Dakota, and Manitoba. Licensed pharmacists in Iowa, North Dakota, and Manitoba were sent an online survey of their perceived level of achievement of the 10 essential services of public health. A total of 649 pharmacists completed the survey. The 3 essential services that scored the highest overall were enforce laws and regulations that protect health and ensure safety, inform and educate people about health issues, and participate in ongoing training beyond continuing education requirements. Contributions of pharmacists to the 10 essential services of public health were previously evaluated by frequency of citation in the published literature. There was relative agreement between what was reported in the literature and what was determined by survey. One exception was "enforce laws and regulations that protect health and ensure safety," which was rarely reported in the literature but was reported in the survey to be the most frequently delivered service. Pharmacist contributions to improved population health should be reported with the use of the 10 essential services of public health. This will increase recognition of pharmacist contributions and better align the disciplines of pharmacy and public health. In particular, pharmacists should consider ways to increase their level of involvement in the community and in partnership with other health care professionals. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Public Careers and Private Sexuality: Some Gay and Lesbian Lives in the History of Medicine and Public Health

PubMed Central

Hansen, Bert

2002-01-01

This study explores the careers of 5 physicians active in public health and medicine during the first half of the 20th century to illustrate interactions between private and professional life. An examination of these individuals, who might today be variously designated as gay, lesbian, bisexual, transgender, or queer, suggests how historical understanding can be enriched by a greater willingness to investigate intimacy and sexual life as potentially relevant to career and achievements. Further, the narratives support a plea for all historians to provide readers with a more frank acknowledgment of the possible relevance of personal life to intellectual work, even in the sciences. Additionally, this historical exploration of ways that careers and achievements may have been affected by a person's homosexuality (even when the person did not publicly embrace a gay identity) opens up a new area of research through biographical sketches based on historical sources combined with generalizations that are intentionally provisional. Included are the stories of Sara Josephine Baker, Harry Stack Sullivan, Ethel Collins Dunham, Martha May Eliot, and Alan L. Hart. PMID:11772756

Evaluating Cross-Cutting Approaches to Chronic Disease Prevention and Management: Developing a Comprehensive Evaluation

PubMed Central

Jernigan, Jan; Barnes, Seraphine Pitt; Shea, Pat; Davis, Rachel; Rutledge, Stephanie

2017-01-01

We provide an overview of the comprehensive evaluation of State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (State Public Health Actions). State Public Health Actions is a program funded by the Centers for Disease Control and Prevention to support the statewide implementation of cross-cutting approaches to promote health and prevent and control chronic diseases. The evaluation addresses the relevance, quality, and impact of the program by using 4 components: a national evaluation, performance measures, state evaluations, and evaluation technical assistance to states. Challenges of the evaluation included assessing the extent to which the program contributed to changes in the outcomes of interest and the variability in the states’ capacity to conduct evaluations and track performance measures. Given the investment in implementing collaborative approaches at both the state and national level, achieving meaningful findings from the evaluation is critical. PMID:29215974

The EXODUS of public health. What history can tell us about the future.

PubMed

Fairchild, Amy L; Rosner, David; Colgrove, James; Bayer, Ronald; Fried, Linda P

2010-01-01

We trace the shifting definitions of the American public health profession's mission as a social reform and science-based endeavor. Its authority coalesced in the late nineteenth and early twentieth centuries as public health identified itself with housing, sanitation, and labor reform efforts. The field ceded that authority to medicine and other professions as it jettisoned its social mission in favor of a science-based identity. Understanding the potential for achieving progressive social change as it moves forward will require careful consideration of the industrial, structural, and intellectual forces that oppose radical reform and the identification of constituencies with which professionals can align to bring science to bear on the most pressing challenges of the day.

The EXODUS of Public Health What History Can Tell Us About the Future

PubMed Central

Rosner, David; Colgrove, James; Bayer, Ronald; Fried, Linda P.

2010-01-01

We trace the shifting definitions of the American public health profession's mission as a social reform and science-based endeavor. Its authority coalesced in the late nineteenth and early twentieth centuries as public health identified itself with housing, sanitation, and labor reform efforts. The field ceded that authority to medicine and other professions as it jettisoned its social mission in favor of a science-based identity. Understanding the potential for achieving progressive social change as it moves forward will require careful consideration of the industrial, structural, and intellectual forces that oppose radical reform and the identification of constituencies with which professionals can align to bring science to bear on the most pressing challenges of the day. PMID:19965565

The nationalization of a disease: a paradigm?

PubMed

Soviero, D J

1986-01-01

The early history of the Federal involvement in Hansen's Disease reflects the history of the Public Health Service itself. As a young and aggressive institution, the Public Health Service sought out contagious, infectious diseases that threatened the public health. National resources and national coordination were needed to fight the likes of malaria, hookworm, or smallpox. The customary attack would consist of a field study, determination of the etiology, the method of transmission, and, then, perhaps, preventive measures. An eradication campaign would follow. Leprosy fit perfectly into the model--a disease of unknown etiology, an unknown method of transmission, thought to be highly contagious, and no known cure. The United States launched a major investigation in Hawaii, where the disease was prevalent and its victims conveniently segregated. The investigation failed. The Public Health Service then turned toward segregation and isolation as a way to fulfill its public health role. A bureaucracy was established around the idea that victims of leprosy must be incarcerated for the good of the public. The institutionalization of the Public Health Service and the philosophy upon which its treatment of leprosy was based proved difficult to change when researchers in the field made major scientific breakthroughs in the 1940s. The realization that the disease was only feebly contagious, activities of patient organizations, and pressure from the media and the Congress did not achieve as dramatic results as the sulfone drugs did. The Public Health Service moved, but slowly. What are the lessons in all of this?.

Prevalence of obesity: A public health problem poorly understood

USDA-ARS?s Scientific Manuscript database

This review article discusses the Dietary Guidelines for Americans in support of a total diet approach to achieving diet and health goals, especially as they relate to the obesity epidemic. However, some scientists and organizations have identified one food, food group, or nutrient as the cause of t...

77 FR 15761 - Office of the Assistant Secretary for Health, Statement of Organization, Functions, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... hepatitis, other infectious diseases of public health significance, and blood safety and availability. The..., including viral hepatitis and HIV/AIDS, across HHS and monitors progress toward achieving established goals... to promote effective prevention and advancement of research for HIV/AIDS, viral hepatitis, and other...

A Public Health Approach to Addressing Lead

EPA Pesticide Factsheets

Describes EPA’s achievements in reducing childhood lead exposures and emphasizes the need to continue actions to further reduce lead exposures, especially in those communities where exposures remain high.

Expenditure tracking and review of reproductive maternal, newborn and child health policy in Pakistan.

PubMed

Malik, Muhammad Ashar; Nahyoun, Abdul Sattar; Rizvi, Arjumand; Bhatti, Zaid Ahmad; Bhutta, Zulfiqar Ahmad

2017-07-01

Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals (MDGs) 4 and 5 were not achieved (2000-15). Maternal Mortality Ratio was reduced to 170 per 100 000 live births (target 100) by 2013 at an annual reduction rate of 3.6% (1990-2013). Against the target of 46 per 1000 live births, the Under Five Mortality Rate was reduced to 81 per 1000 live births by 2015 at an annual reduction rate of 2.1% (1990-2015). We evaluated the comparative expenditures for the RMNCH sector and analysed impact of public expenditures on the use of the public facilities for the RMNCH services. Expenditure on RMNCH increased by 181% (2000-10), reaching PKR 628.79 billion (US$9.67 billion). The Share of the RMNCH expenditure in the total health expenditure increased from 16 to 21% (2005-10). The share of official development assistance for the RMNCH increased from 36 to 51% (2003-10). Equity was modestly achieved with a greater proportion of the poor using public facilities for the childhood diarrhoea (Concentration Index -0.06 in 2001-02 to - 0.11 in 2010-11) and reduction in the proportion of the rich using the public health facilities for institutional births (Concentration Index 0.30 in 2001-02 to 0.25 in 2010-11). Overall the RMNCH disease control programmes focused on vertical primary health approach and targeted the district health system in the un-served areas. Our findings confirm that diseconomies of scale, donor dependence and supply side perspective could only result in a modest progress towards achieving the MDGs. We call for urgent attention of the policy makers for the integration of the vertical and the routine primary health care and reliance on indigenous sustainable healthcare financing. We also recommend acknowledging economic perspective on health policy and health programmes. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Good Life: A Holistic Approach to the Health of the Population

PubMed Central

Shahtahmasebi, Said

2006-01-01

The idea of a holistic approach towards public health planning presented itself through a food-related and trivial curiosity. It is, however, emphasized that food and nutrition are only one aspect of public health. The aim is to reintroduce a holistic approach to achieve sustainable public health with emphasis on the interpretation of the term “holistic”. Holistic decision making is not a new phenomenon and has historical basis. In line with shifts in social norms, decision making has evolved. In particular, various complex models for public health have been proposed to respond to ever-increasing health issues. The advancement in mathematical sciences and technology has led to the quantification of health models. However, mathematical representations pose a major limitation on the holistic approach. Due to its evolutionary nature, human health is dynamically related to social, environmental, and other processes. With the current knowledge, it is difficult to quantify the evolution and feedback effects in holistic models. In this paper, the individual's and public's health is viewed as a dynamic process, but not independent of other dynamic processes (e.g., agriculture, economy, politics) that are all part of a much bigger process. Furthermore, it is argued that it is not merely sufficient to account for all known factors to be holistic. In this paper, the holistic conceptual model is illustrated, using public health as the central issue. The application of the conceptual model is also discussed using two practical examples. PMID:17370007

NGOs and government partnership for health systems strengthening: A qualitative study presenting viewpoints of government, NGOs and donors in Pakistan

PubMed Central

2011-01-01

Background Health systems are expected to serve the population needs in an effective, efficient and equitable manner. Therefore, the importance of strengthening of public, private and community health systems has been emphasized time and again. In most of the developing countries, certain weaknesses and gaps in the government health systems have been hampering the achievement of improved health outcomes. Public sector in Pakistan has been deficient in the capacity to deliver equitable and quality health services and thus has been grossly underutilized. Methods A qualitative study comprising in-depth interviews was conducted capturing the perceptions of the government functionaries, NGO representatives and donor community about the role and position of NGOs in health systems strengthening in Pakistan's context. Analysis of the data was done manually to generate nodes, sub-nodes and themes. Results Since many years, international and local non-governmental organizations (NGOs) have endeavored to fill the gaps in health service delivery, research and advocacy. NGOs have relatively performed better and achieved the results because of the flexible planning and the ability to design population based projects on health education, health promotion, social marketing, community development and advocacy. This paper captures the need and the opportunity of public private partnership in Pakistan and presents a framework for a meaningful engagement of the government and the private and nonprofit NGOs. Conclusion Involving the NGOs for health system strengthening may eventually contribute to create a healthcare system reflecting an increased efficiency, more equity and good governance in the wake of the Millennium Development Goals. Nevertheless, few questions need to be answered and pre-requisites have to be fulfilled before moving on. PMID:21609480

Strong Tobacco Control Program Requirements and Secure Funding Are Not Enough: Lessons From Florida

PubMed Central

Kennedy, Allison; Sullivan, Sarah; Hendlin, Yogi; Barnes, Richard

2012-01-01

Florida’s Tobacco Pilot Program (TPP; 1998–2003), with its edgy Truth media campaign, achieved unprecedented youth smoking reductions and became a model for tobacco control programming. In 2006, 3 years after the TPP was defunded, public health groups restored funding for tobacco control programming by convincing Florida voters to amend their constitution. Despite the new program’s strong legal structure, Governor Charlie Crist’s Department of Health implemented a low-impact program. Although they secured the program’s strong structure and funding, Florida’s nongovernmental public health organizations did not mobilize to demand a high-impact program. Implementation of Florida’s Amendment 4 demonstrates that a strong programmatic structure and secure funding are insufficient to ensure a successful public health program, without external pressure from nongovernmental groups. PMID:22420813

Achieving Consensus on Principles of Good Practice for School Health in Independent Schools: A Delphi Study

ERIC Educational Resources Information Center

Marshall, Miguel G.; Allegrante, John P.

2017-01-01

Background: Although the 8 components of the coordinated school health (CSH) framework have been implemented to various degrees in the nation's public schools, principles of good practice (PGPs) to guide health promotion efforts in independent schools do not exist. The purpose of this study was to generate PGPs and rate their feasibility of…

Public behavioral health care reform in North Carolina: will we get it right this time around?

PubMed

Swartz, Marvin; Morrissey, Joseph

2012-01-01

North Carolina seeks to provide affordable and high-quality care for people with mental health, developmental disabilities and substance abuse conditions by reforming its behavioral health care system. This article presents an overview of current efforts to achieve that goal and discusses the challenges that must be overcome if reform is to be effective.

The Intersection of Infant Mental Health and Reproductive Health and Justice: The Pioneering Voice of Irving Harris

ERIC Educational Resources Information Center

Lauen, Joanna; Henderson, Dorothy; White, Barbara; Kohchi, Joaniko

2017-01-01

Achieving reproductive health and justice matters to family and child well-being. These two ideals are, however, often put at odds in public policies and discourse that shape the systems and programs that affect pregnant women and families. This article describes the Irving Harris Foundation's historic approach to investing in early childhood and…

Expert Consensus Statement on achieving self-sufficiency in safe blood and blood products, based on voluntary non-remunerated blood donation (VNRBD).

PubMed

2012-11-01

All countries face challenges in making sufficient supplies of blood and blood products available and sustainable, while also ensuring the quality and safety of these products in the face of known and emerging threats to public health. Since 1975, the World Health Assembly (WHA) has highlighted the global need for blood safety and availability. WHA resolutions 63·12, 58·13 and 28·72, The Melbourne Declaration on 100% Voluntary Non-Remunerated Donation of Blood and Blood Components and WHO Global Blood Safety Network recommendations have reaffirmed the achievement of 'Self-sufficiency in blood and blood products based on voluntary non-remunerated blood donation (VNRBD)' as the important national policy direction for ensuring a safe, secure and sufficient supply of blood and blood products, including labile blood components and plasma-derived medicinal products. Despite some successes, self-sufficiency is not yet a reality in many countries. A consultation of experts, convened by the World Health Organization (WHO) in September 2011 in Geneva, Switzerland, addressed the urgent need to establish strategies and mechanisms for achieving self-sufficiency. Information on the current situation, and country perspectives and experiences were shared. Factors influencing the global implementation of self-sufficiency, including safety, ethics, security and sustainability of supply, trade and its potential impact on public health, availability and access for patients, were analysed to define strategies and mechanisms and provide practical guidance on achieving self-sufficiency. Experts developed a consensus statement outlining the rationale and definition of self-sufficiency in safe blood and blood products based on VNRBD and made recommendations to national health authorities and WHO. © 2012 World Health Organization. Vox Sanguinis © 2012 International Society of Blood Transfusion.

Evolution of the ART approach: highlights and achievements

PubMed Central

FRENCKEN, Jo E.

2009-01-01

ABSTRACT Atraumatic Restorative Treatment (ART) was initiated in the mid-eighties in Tanzania in response to an inappropriately functioning community oral health programme that was based on western health care models and western technology. The approach has evolved to its present standing as an effective minimal intervention approach mainly because the originators anticipated the great potential of ART to alleviate inequality in oral health care, and because they recognised the need to carry out research to investigate its effectiveness and applicability. Twenty-five years later, ART was accepted by the World Health Organisation (1994) and the FDI World Dental Federation (2002). It is included in textbooks on cariology, restorative dentistry and minimal intervention dentistry. It is being systematically introduced into public oral health service systems in a number of low- and middle income countries. Private practitioners use it. Many publications related to aspects of ART have been published and many more will follow. To achieve quality results with ART one has to attend well-conducted and sufficiently long training courses, preferably in combination with other caries preventive strategies. ART should, therefore, not be considered in isolation and must be part of an evidence-based approach to oral health with a strong foundation based on prevention. PMID:21499660

Using the Theory of Normative Social Behavior to Understand Compliance with a Smoke-Free Law in a Middle-Income Country

ERIC Educational Resources Information Center

Byron, M. J.; Cohen, J. E.; Frattaroli, S.; Gittelsohn, J.; Jernigan, D. H.

2016-01-01

Smoke-free laws, which ban smoking in public venues, can be effective in protecting public health, but it has been difficult to achieve compliance with these laws in low- and middle-income countries. This study was conducted to understand the social norms around public smoking and learn how to improve compliance in Bogor, the first Indonesian city…

Building and Rebuilding: The National Public Health Laboratory Systems and Services Before and After the Earthquake and Cholera Epidemic, Haiti, 2009-2015.

PubMed

Jean Louis, Frantz; Buteau, Josiane; Boncy, Jacques; Anselme, Renette; Stanislas, Magalie; Nagel, Mary C; Juin, Stanley; Charles, Macarthur; Burris, Robert; Antoine, Eva; Yang, Chunfu; Kalou, Mireille; Vertefeuille, John; Marston, Barbara J; Lowrance, David W; Deyde, Varough

2017-10-01

Before the 2010 devastating earthquake and cholera outbreak, Haiti's public health laboratory systems were weak and services were limited. There was no national laboratory strategic plan and only minimal coordination across the laboratory network. Laboratory capacity was further weakened by the destruction of over 25 laboratories and testing sites at the departmental and peripheral levels and the loss of life among the laboratory health-care workers. However, since 2010, tremendous progress has been made in building stronger laboratory infrastructure and training a qualified public health laboratory workforce across the country, allowing for decentralization of access to quality-assured services. Major achievements include development and implementation of a national laboratory strategic plan with a formalized and strengthened laboratory network; introduction of automation of testing to ensure better quality of results and diversify the menu of tests to effectively respond to outbreaks; expansion of molecular testing for tuberculosis, human immunodeficiency virus, malaria, diarrheal and respiratory diseases; establishment of laboratory-based surveillance of epidemic-prone diseases; and improvement of the overall quality of testing. Nonetheless, the progress and gains made remain fragile and require the full ownership and continuous investment from the Haitian government to sustain these successes and achievements.

Building and Rebuilding: The National Public Health Laboratory Systems and Services Before and After the Earthquake and Cholera Epidemic, Haiti, 2009–2015

PubMed Central

Jean Louis, Frantz; Buteau, Josiane; Boncy, Jacques; Anselme, Renette; Stanislas, Magalie; Nagel, Mary C.; Juin, Stanley; Charles, Macarthur; Burris, Robert; Antoine, Eva; Yang, Chunfu; Kalou, Mireille; Vertefeuille, John; Marston, Barbara J.; Lowrance, David W.; Deyde, Varough

2017-01-01

Abstract. Before the 2010 devastating earthquake and cholera outbreak, Haiti’s public health laboratory systems were weak and services were limited. There was no national laboratory strategic plan and only minimal coordination across the laboratory network. Laboratory capacity was further weakened by the destruction of over 25 laboratories and testing sites at the departmental and peripheral levels and the loss of life among the laboratory health-care workers. However, since 2010, tremendous progress has been made in building stronger laboratory infrastructure and training a qualified public health laboratory workforce across the country, allowing for decentralization of access to quality-assured services. Major achievements include development and implementation of a national laboratory strategic plan with a formalized and strengthened laboratory network; introduction of automation of testing to ensure better quality of results and diversify the menu of tests to effectively respond to outbreaks; expansion of molecular testing for tuberculosis, human immunodeficiency virus, malaria, diarrheal and respiratory diseases; establishment of laboratory-based surveillance of epidemic-prone diseases; and improvement of the overall quality of testing. Nonetheless, the progress and gains made remain fragile and require the full ownership and continuous investment from the Haitian government to sustain these successes and achievements. PMID:29064354

Assessing the Impact of School-Based Health Centers on Academic Achievement and College Preparation Efforts: Using Propensity Score Matching to Assess School-Level Data in California.

PubMed

Bersamin, Melina; Garbers, Samantha; Gaarde, Jenna; Santelli, John

2016-08-01

This study examines the association between school-based health center (SBHC) presence and school-wide measures of academic achievement and college preparation efforts. Publicly available educational and demographic data from 810 California public high schools were linked to a list of schools with an SBHC. Propensity score matching, a method to reduce bias inherent in nonrandomized control studies, was used to select comparison schools. Regression analyses, controlling for proportion of English-language learners, were conducted for each outcome including proportion of students participating in three College Board exams, graduation rates, and meeting university graduation requirements. Findings suggest that SBHC presence is positively associated with college preparation outcomes but not with academic achievement outcomes (graduation rates or meeting state graduation requirements). Future research must examine underlying mechanisms supporting this association, such as school connectedness. Additional research should explore the role that SBHC staff could have in supporting college preparation efforts. © The Author(s) 2016.

Reinventing vital statistics. The impact of changes in information technology, welfare policy, and health care.

PubMed

Starr, P; Starr, S

1995-01-01

Vital statistics offers a case study in the potential of new information technology and reengineering to achieve better public sector performance. New technology--notably the shift from a paper to an electronic process for recording vital events and transmitting the data to public agencies--is creating opportunities to produce more timely, accurate, and useful information. The furthest advanced innovation is the electronic birth certificate. At the same time, changes in welfare policy and health care--including efforts to establish paternity at the time of birth and to improve health care outcomes--are creating pressures for more policy-relevant data about vital events. In addition, the rise of integrated health plans and health information networks is radically altering the organizational context of vital statistics. On the basis of a State-by-State survey of vital statistics officials, the authors estimate that at the end of 1994, 58 percent of all births in the United States were being recorded on an electronic birth certificate and communicated to a public agency electronically. Nearly all respondents reported that the electronic birth certificate brought improvements in both timeliness and accuracy of data. Achieving the full promise of the new technology, however, will require more fundamental changes in institutions and policies and a reconceptualization of the birth certificate as part of a broader perinatal information system.

The health sector reforms and the efficiency of public hospitals in Turkey: provincial markets.

PubMed

Sulku, Seher Nur

2012-10-01

Turkey initiated the 'Health Transformation Programme' (HTP) in 2003 to align its health care system with the European Union and OECD countries. This study investigates the impact of these reforms on the efficiency of public hospitals. Our study would contribute to the existing literature with a comprehensive analysis of the health system in a developing country. We employ the data envelopment approach and the Malmquist index to comparatively examine before and after the reform years. Our analyses compare the performances of public hospitals served in provincial markets. Inputs of number of beds, number of primary care physician, and number of specialists, and how they are used to produce outputs of inpatient discharges, outpatient visits and surgical operations are investigated. Indeed, as the performance indicators dead rate, hospital bed occupation rate and average length of stay are considered. The HTP was generally successful in boosting productivity due to advancements in technology and technical efficiency but in the socio-economically disadvantaged provinces productivity gains have not been achieved. The average technical efficiency gains took place because of the significantly improved scale efficiencies, as the average pure technical efficiency slightly improved. Lastly, the hospital performance indicators have not improved in the short run. It appears that the expected benefits from the health reforms in Turkey have been partially achieved in the short run.

A new entity for the negotiation of public procurement prices for patented medicines in Mexico

PubMed Central

Wirtz, Veronika J; Reich, Michael R; Terrazas, Paulina; Ortiz, Maki

2012-01-01

Abstract Problem As countries expand health insurance coverage, their expenditures on medicines increase. To address this problem, WHO has recommended that every country draw up a list of essential medicines. Although most medicines on the list are generics, in many countries patented medicines represent a substantial portion of pharmaceutical expenditure. Approach To help control expenditure on patented medicines, in 2008 the Mexican Government created the Coordinating Commission for Negotiating the Price of Medicines and other Health Inputs (CCPNM), whose role, as the name suggests, is to enter into price negotiations with drug manufacturers for patented drugs on Mexico’s list of essential medicines. Local setting Mexico’s public expenditure on pharmaceuticals has increased substantially in the past decade owing to government efforts to achieve universal health-care coverage through Seguro Popular, an insurance programme introduced in 2004 that guarantees access to a comprehensive package of health services and medicines. Relevant changes Since 2008, the CCPNM has improved procurement practices in Mexico’s public health institutions and has achieved significant price reductions resulting in substantial savings in public pharmaceutical expenditure. Lessons learnt The CCPNM has successfully changed the landscape of price negotiation for patented medicines in Mexico. However, it is also facing challenges, including a lack of explicit indicators to assess CCPNM performance; a shortage of permanent staff with sufficient technical expertise; poor coordination among institutions in preparing background materials for the annual negotiation process in a timely manner; insufficient communication among committees and institutions; and a lack of political support to ensure the sustainability of the CCPNM. PMID:23109747

Collaborative leadership and the implementation of community-based fall prevention initiatives: a multiple case study of public health practice within community groups.

PubMed

Markle-Reid, Maureen; Dykeman, Cathy; Ploeg, Jenny; Kelly Stradiotto, Caralyn; Andrews, Angela; Bonomo, Susan; Orr-Shaw, Sarah; Salker, Niyati

2017-02-16

Falls among community-dwelling older adults are a serious public health concern. While evidence-based fall prevention strategies are available, their effective implementation requires broad cross-sector coordination that is beyond the capacity of any single institution or organization. Community groups comprised of diverse stakeholders that include public health, care providers from the public and private sectors and citizen volunteers are working to deliver locally-based fall prevention. These groups are examples of collective impact and are important venues for public health professionals (PHPs) to deliver their mandate to work collaboratively towards achieving improved health outcomes. This study explores the process of community-based group work directed towards fall prevention, and it focuses particular attention on the collaborative leadership practices of PHPs, in order to advance understanding of the competencies required for collective impact. Four community groups, located in Ontario, Canada, were studied using an exploratory, retrospective, multiple case study design. The criteria for inclusion were presence of a PHP, a diverse membership and the completion of an initiative that fit within the scope of the World Health Organization Fall Prevention Model. Data were collected using interviews (n = 26), focus groups (n = 4), and documents. Cross-case synthesis was conducted by a collaborative team of researchers. The community groups differed by membership, the role of the PHP and the type of fall prevention initiatives. Seven practice themes emerged: (1) tailoring to address context; (2) making connections; (3) enabling communication; (4) shaping a vision; (5) skill-building to mobilize and take action; (6) orchestrating people and projects; and (7) contributing information and experience. The value of recognized leadership competencies was underscored and the vital role of institutional supports was highlighted. To align stakeholders working towards fall prevention for community-dwelling older adults and establish a foundation for collective impact, public health professionals employed practices that reflected a collaborative leadership style. Looking ahead, public health professionals will want to shift their focus to evaluating the effectiveness of their group work within communities. They will also need to assess outcomes and evaluate whether the anticipated reductions in fall rates among community-dwelling older adults is being achieved.

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

PubMed

Martineau, F P; Graff, H; Mitchell, C; Lock, K

2014-09-01

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

Local leadership in public health: the role of the medical officer of health in Britain, 1872–1974

PubMed Central

Gorsky, Martin

2007-01-01

The recent policy focus in British public health on the importance of local action invites consideration of historical precedent. The role and achievements of the medical officer of health (MOH), the local government official charged with public health responsibilities, is discussed. The gradual accretion of duties is traced in the first section: the mid‐Victorian concern with urban sanitation; the preventive strategies adopted after the bacteriological revolution; the extension of personal health services in the early 20th century; and the more diminished role under the National Health Service (NHS), when infectious diseases retreated. The historical verdicts passed on the MOsH are reviewed in the second section. The leading role of the MOsH in the late 19th‐century mortality decline has been reasserted, and although there is some justification in the argument that in the 20th century public health lost its focus, it is important to recall that the extension of personal health services under MOH direction signified a major extension of access to care. Similarly, the charge that MOsH did not redefine their role in the period before their final demise in 1974 is not entirely justified. The emphasis of the NHS on curative rather than preventive medicine, and the economic constraints on local authority health service expansion limited their room for manoeuvre. The history of local leadership in public health may offer some enduring lessons. These include the importance of monitoring local population health, acting as a public interface between medicine and the community, facilitating joined‐up working and confronting vested interests. PMID:17496253

Perceived School and Neighborhood Safety, Neighborhood Violence and Academic Achievement in Urban School Children

ERIC Educational Resources Information Center

Milam, A. J.; Furr-Holden, C. D. M.; Leaf, P. J.

2010-01-01

Community and school violence continue to be a major public health problem, especially among urban children and adolescents. Little research has focused on the effect of school safety and neighborhood violence on academic performance. This study examines the effect of the school and neighborhood climate on academic achievement among a population…

Achieving recognition that mental health is part of the mission of CDC.

PubMed

Safran, Marc A

2009-11-01

For much of its history the U.S. Centers for Disease Control and Prevention (CDC) considered mental health to be outside of its mission. That assumption persisted even after CDC became a leading public health agency and began to face important mental health issues. This narrative describes how the organizational paradigm indicating that mental health was not mission related was challenged and superseded by a new paradigm recognizing mental health as part of CDC's public health mission. Even after the CDC Mental Health Work Group's establishment in 2000, CDC took eight more years to overcome powerful remnants of the old paradigm that had for so long excluded, minimized, or discouraged attention to mental health. The CDC Mental Health Work Group led the agency's mental health efforts without funding or dedicated staffing but with more than 100 CDC professionals from multiple disciplines and centers serving as voluntary members, in addition to their other CDC responsibilities.

Healthy people with nature in mind.

PubMed

Annerstedt van den Bosch, Matilda; Depledge, Michael H

2015-12-11

The global disease burden resulting from climate change is likely to be substantial and will put further strain on public health systems that are already struggling to cope with demand. An up- stream solution, that of preventing climate change and associated adverse health effects, is a promising approach, which would create win-win-situations where both the environment and human health benefit. One such solution would be to apply methods of behaviour change to prompt pro-environmentalism, which in turn benefits health and wellbeing. Based on evidence from the behavioural sciences, we suggest that, like many social behaviours, pro- environmental behaviour can be automatically induced by internal or external stimuli. A potential trigger for such automatic pro-environmental behaviour would be natural environments themselves. Previous research has demonstrated that natural environments evoke specific psychological and physiological reactions, as demonstrated by self-reports, epidemiological studies, brain imaging techniques, and various biomarkers. This suggests that exposure to natural environments could have automatic behavioural effects, potentially in a pro-environmental direction, mediated by physiological reactions. Providing access and fostering exposure to natural environments could then serve as a public health tool, together with other measures, by mitigating climate change and achieving sustainable health in sustainable ecosystems. However, before such actions are implemented basic research is required to elucidate the mechanisms involved, and applied investigations are needed to explore real world impacts and effect magnitudes. As environmental research is still not sufficiently integrated within medical or public health studies there is an urgent need to promote interdisciplinary methods and investigations in this critical field. Health risks posed by anthropogenic climate change are large, unevenly distributed, and unpredictable. To ameliorate negative impacts, pro-environmental behaviours should be fostered. Potentially this could be achieved automatically through exposure to favourable natural environments, with an opportunity for cost-efficient nature-based solutions that provide benefits for both the environment and public health.

Application of Ethical Principles to Research using Public Health Data in The Global South: Perspectives from Africa.

PubMed

Anane-Sarpong, Evelyn; Wangmo, Tenzin; Sankoh, Osman; Tanner, Marcel; Elger, Bernice Simone

2018-06-01

Existing ethics guidelines, influential literature and policies on ethical research generally focus on real-time data collection from humans. They enforce individual rights and liberties, thereby lowering need for aggregate protections. Although dependable, emerging public health research paradigms like research using public health data (RUPD) raise new challenges to their application. Unlike traditional research, RUPD is population-based, aligned to public health activities, and often reliant on pre-collected longitudinal data. These characteristics, when considered in relation to the generally lower protective ethico-legal frameworks of the Global South, including Africa, highlight ethical gaps. Health and demographic surveillance systems are examples of public health programs that accommodate RUPD in these contexts. We set out to explore the perspectives of professionals with a working knowledge of these systems to determine practical ways of appropriating the foundational principles of health research to advance the ever growing opportunities in RUPD. We present their perspectives and in relation to the literature and our ethical analysis, make context relevant recommendations. We further argue for the development of a framework founded on the discussions and recommendations as a minimum base for achieving optimal ethics for optimal RUPD in the Global South. © 2016 John Wiley & Sons Ltd.

Realising social justice in public health law.

PubMed

Fox, Marie; Thomson, Michael

2013-03-01

Law has played an important, but largely constitutive, role in the development of the public health enterprise. Thus, law has been central to setting up the institutions and offices of public health. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women's interests which we see as crucial to a fully realised vision of social justice. We argue that, aside from particular interventions in the field of reproduction, public health practice tends to marginalise women-a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalisation of women's interests, this article argues that Amartya Sen's capabilities approach has much to contribute to the framing of public health law and policy. Sen's approach provides an evaluative and normative framework which recognises the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice.

Fluorides and Other Preventive Strategies for Tooth Decay.

PubMed

Horst, Jeremy A; Tanzer, Jason M; Milgrom, Peter M

2018-04-01

We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity. Copyright © 2017 Elsevier Inc. All rights reserved.

Privilege, power, and public health programs: a student perspective on deconstructing institutional racism in community service learning.

PubMed

Taboada, Arianna

2011-01-01

The Association of Schools of Public Health has identified "diversity and culture" as 1 of 7 crosscutting competencies that public health students are expected to achieve. This competency is traditionally incorporated into the curriculum through a community service-learning (CSL) component that aims to expose students to racial/ethnic health disparities. However, this model of CSL is problematic because although students are directly engaging with community members, it does not ensure long-term sustainable changes or benefits for the host community. Moreover, academic institutions have developed significant critiques of traditional CSL models where white middle-class students engage with low-income clients and communities of color, potentially reinforcing Eurocentric power and privilege. As such, public health programs require a shift in both pedagogy and curricula that more directly addresses underlying institutional racism in health disparities. Consistent with the principles of public health, a social justice framework is imperative in teaching cultural competency and should facilitate discussion of racial injustice and privilege in the students' own lives. This brief presents an autobiographical personal narrative of my experiences with CSL as a racial/ethnic minority student in a California graduate school of public health. Although autoethnography is inherently limited, this brief highlights my observations of the limitations of the service-learning model to adequately educate students on the intersection of racism and health outcomes. In addition, the brief includes suggestions for creating inclusive curricula that critically examine issues of privilege, oppression, and power dynamics related to race/ethnicity.

Building capacity for evidence informed decision making in public health: a case study of organizational change.

PubMed

Peirson, Leslea; Ciliska, Donna; Dobbins, Maureen; Mowat, David

2012-02-20

Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

[Prioritizing prescriptions in a ambulatory care setting: a tool to achieve appropriateness of care in public health management].

PubMed

Semeraro, V; Zantedeschi, E; Pasquarella, A; Guerrera, C; Guasticchi, G

2012-01-01

Waiting lists are one of the main Public Health issues within developed countries. To promote appropriateness about General Practitioners' (GPs) prescriptions, during 2009 the project "Priority setting in outpatient prescriptions" in Latium Region has been approved. Regional referees, Latium Public Health Agency managers and advisors, managers and advisors of three Local Public Health Units (LPHUs) within the Latium region and some voluntarily recruited General Practitioners (each one with more than 800 patients enrolled) were included in a team work with the duty to develop the project. During two selected months of 2010, 46 GPs have forwarded overall 2.229 medical prescriptions. The six most numerous prescriptions were picked out and analyzed by the team work. 42% of these prescriptions were identified as belonging to category D of the priority level--"standard", while 42% and 41% of prescriptions bore the expressions of "control" and "diagnostic purpose" respectively. Among these ones, 75% were represented by bilateral mammography, prescribed to women aged between 50 and 69 years: but for those people bilateral mammography is already provided free of charge within the regional program of breast cancer screening, making the routine prescription by their physician a useless duplication, unacceptable in a healthcare system of good quality. Therefore at the conclusion of the project, the team work suggests proper standards be applied by healthcare professionals and GPs to achieve a significant objective: mammography appropriateness prescriptions.

Hospital Community Benefit in the Context of the Larger Public Health System: A State-Level Analysis of Hospital and Governmental Public Health Spending Across the United States.

PubMed

Singh, Simone R; Bakken, Erik; Kindig, David A; Young, Gary J

2016-01-01

Achieving meaningful population health improvements has become a priority for communities across the United States, yet funding to sustain multisector initiatives is frequently not available. One potential source of funding for population health initiatives is the community benefit expenditures that are required of nonprofit hospitals to maintain their tax-exempt status. In this article, we explore the importance of nonprofit hospitals' community benefit dollars as a funding source for population health. Hospitals' community benefit expenditures were obtained from their 2009 IRS (Internal Revenue Service) Form 990 Schedule H and complemented with data on state and local public health spending from the Association of State and Territorial Health Officials and the National Association of County & City Health Officials. Key measures included indicators of hospitals' community health spending and governmental public health spending, all aggregated to the state level. Univariate and bivariate statistics were used to describe how much hospitals spent on programs and activities for the community at large and to understand the relationship between hospitals' spending and the expenditures of state and local health departments. Tax-exempt hospitals spent a median of $130 per capita on community benefit activities, of which almost $11 went toward community health improvement and community-building activities. In comparison, median state and local health department spending amounted to $82 and $48 per capita, respectively. Hospitals' spending thus contributed an additional 9% to the resources available for population health to state and local health departments. Spending, however, varied widely by state and was unrelated to governmental public health spending. Moreover, adding hospitals' spending to the financial resources available to governmental public health agencies did not reduce existing inequalities in population health funding across states. Hospitals' community health investments represent an important source for public health activities, yet inequalities in the availability of funding across communities remain.

Correlates of Achieving the Guidelines of Four Forms of Physical Activity, and the Relationship between Guidelines Achievement and Academic Performance: Undergraduate Students in Finland.

PubMed

El Ansari, Walid; Suominen, Sakari; Draper, Steve

2017-06-01

We surveyed and compared, by gender, the levels and correlates of achieving the international guidelines of four forms of physical activity (PA): moderate PA (MPA), vigorous PA (VPA), moderate or vigorous PA (MVPA), and muscle strengthening PA (MSPA). The study assessed the associations between achieving the guidelines of the four PA forms and a range of socio-demographic, health and academic performance variables. Data was collected across the seven faculties of the University of Turku (2013-2014 from a representative sample of 1,189 undergraduates). An English language online self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. We employed cut-offs for the guidelines in accordance with the American Heart Association. Chi-square statistic tested the differences in PA, socio-demographic variables and academic performance between males and females. Binary logistic regression examined the factors associated with achieving the four PA guidelines and linear regression examined the association between the frequency of PA and academic performance. Achievement of PA guidelines was relatively low across the sample. Female students were less likely to achieve the VPA or MSPA guidelines, but were more health conscious and in generally exhibited better academic performace than males. High health awareness and excellent/very good self-rated health were the strongest predictors of achieving all forms of PA. Parents' education level was positively related to likelihood of achieving the VPA, MVPA and MSPA guidelines. Achieving the MPA guidelines (but not VPA or MSPA) was positively associated with subjective perceptions of better academic performance. Achievement of PA guidelines was generally low for this sample of Finnish students, and was associated with positive health status and high health awareness. Universities need a holistic approach to improve awareness of health and promote PA in students' lifestyles. Copyright© by the National Institute of Public Health, Prague 2017

Insights in Public Health

PubMed Central

Canyon, Deon V

2013-01-01

The strengthening of health systems is fundamental to improving health outcomes, crisis preparedness, and our capacity to meet global challenges, such as accelerating progress towards the Millennium Development Goals, reducing maternal and child mortality, combating HIV, malaria and other diseases, limiting the effects of a new influenza pandemic, and responding appropriately to climate change. To meet these complex needs, the Association of Schools and Programs in Public Health, the World Health Organization, and the Institute of Medicine promote systems thinking as the only sensible means to respond to issues that greatly exceed the normal capacity of health and medical services. This paper agrees with the application of systems thinking but argues that health organizations have misunderstood and misapplied systems thinking to the extent that the term has become meaningless. This paper presents the basic constructs of systems thinking, explains why systems thinking has been misapplied, examines some misapplications of systems thinking in health, and suggests how the concept can be applied correctly to medicine and public health to achieve the reason it was adopted in the first place. PMID:24377080

A 10-year retrospective of research in health mass media campaigns: where do we go from here?

PubMed

Noar, Seth M

2006-01-01

Mass media campaigns have long been a tool for promoting public health. How effective are such campaigns in changing health-related attitudes and behaviors, however, and how has the literature in this area progressed over the past decade? The purpose of the current article is threefold. First, I discuss the importance of health mass media campaigns and raise the question of whether they are capable of effectively impacting public health. Second, I review the literature and discuss what we have learned about the effectiveness of campaigns over the past 10 years. Finally, I conclude with a discussion of possible avenues for the health campaign literature over the next 10 years. The overriding conclusion is the following: The literature is beginning to amass evidence that targeted, well-executed health mass media campaigns can have small-to-moderate effects not only on health knowledge, beliefs, and attitudes, but on behaviors as well, which can translate into major public health impact given the wide reach of mass media. Such impact can only be achieved, however, if principles of effective campaign design are carefully followed.

Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST).

PubMed

Wyrick, David L; Rulison, Kelly L; Fearnow-Kenney, Melodie; Milroy, Jeffrey J; Collins, Linda M

2014-09-01

Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions.

Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment.

PubMed

Honda, Ayako; Ryan, Mandy; van Niekerk, Robert; McIntyre, Diane

2015-06-01

The introduction of national health insurance (NHI), aimed at achieving universal coverage, is the most important issue currently on the South African health policy agenda. Improvement in public sector health-care provision is crucial for the successful implementation of NHI as, regardless of whether health-care services become more affordable and available, if the quality of the services provided is not acceptable, people will not use the services. Although there has been criticism of the quality of public sector health services, limited research is available to identify what communities regard as the greatest problems with the services. A discrete choice experiment (DCE) was undertaken to elicit public preferences on key dimensions of quality of care when selecting public health facilities in South Africa. Qualitative methods were applied to establish attributes and levels for the DCE. To elicit preferences, interviews with community members were held in two South African provinces: 491 in Western Cape and 499 in Eastern Cape. The availability of necessary medicine at health facilities has the greatest impact on the probability of attending public health facilities. Other clinical quality attributes (i.e. provision of expert advice and provision of a thorough examination) are more valued than non-clinical quality of care attributes (i.e. staff attitude, treatment by doctors or nurses, and waiting time). Treatment by a doctor was less valued than all other attributes. Communities are prepared to tolerate public sector health service characteristics such as a long waiting time, poor staff attitudes and lack of direct access to doctors if they receive the medicine they need, a thorough examination and a clear explanation of the diagnosis and prescribed treatment from health professionals. These findings prioritize issues that the South African government must address in order to meet their commitment to improve public sector health-care service provision. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

The democratization of health in Mexico: financial innovations for universal coverage

PubMed Central

Frenk, Julio; Knaul, Felicia Marie

2009-01-01

Abstract In 2003, the Mexican Congress approved a reform establishing the Sistema de Protección Social en Salud [System of Social Protection in Health], whereby public funding for health is being increased by one percent of the 2003 gross domestic product over seven years to guarantee universal health insurance. Poor families that had been excluded from traditional social security can now enrol in a new public insurance scheme known as Seguro Popular [People’s Insurance], which assures legislated access to a comprehensive set of health-care entitlements. This paper describes the financial innovations behind the expansion of health-care coverage in Mexico to everyone and their effects. Evidence shows improvements in mobilization of additional public resources; availability of health infrastructure and drugs; service utilization; effective coverage; and financial protection. Future challenges are discussed, among them the need for additional public funding to extend access to costly interventions for non-communicable diseases not yet covered by the new insurance scheme, and to improve the technical quality of care and the responsiveness of the health system. Eventually, the progress achieved so far will have to be reflected in health outcomes, which will continue to be evaluated so that Mexico can meet the ultimate criterion of reform success: better health through equity, quality and fair financing. PMID:19649369

The democratization of health in Mexico: financial innovations for universal coverage.

PubMed

Frenk, Julio; Gómez-Dantés, Octavio; Knaul, Felicia Marie

2009-07-01

In 2003, the Mexican Congress approved a reform establishing the Sistema de Protección Social en Salud [System of Social Protection in Health], whereby public funding for health is being increased by one percent of the 2003 gross domestic product over seven years to guarantee universal health insurance. Poor families that had been excluded from traditional social security can now enrol in a new public insurance scheme known as Seguro Popular [People's Insurance], which assures legislated access to a comprehensive set of health-care entitlements. This paper describes the financial innovations behind the expansion of health-care coverage in Mexico to everyone and their effects. Evidence shows improvements in mobilization of additional public resources; availability of health infrastructure and drugs; service utilization; effective coverage; and financial protection. Future challenges are discussed, among them the need for additional public funding to extend access to costly interventions for non-communicable diseases not yet covered by the new insurance scheme, and to improve the technical quality of care and the responsiveness of the health system. Eventually, the progress achieved so far will have to be reflected in health outcomes, which will continue to be evaluated so that Mexico can meet the ultimate criterion of reform success: better health through equity, quality and fair financing.

Global Oral Health Inequalities

PubMed Central

Pitts, N.; Amaechi, B.; Niederman, R.; Acevedo, A.-M.; Vianna, R.; Ganss, C.; Ismail, A.; Honkala, E.

2011-01-01

The IADR Global Oral Health Inequalities Task Group on Dental Caries has synthesized current evidence and opinion to identify a five-year implementation and research agenda which should lead to improvements in global oral health, with particular reference to the implementation of current best evidence as well as integrated action to reduce caries and health inequalities between and within countries. The Group determined that research should: integrate health and oral health wherever possible, using common risk factors; be able to respond to and influence international developments in health, healthcare, and health payment systems as well as dental prevention and materials; and exploit the potential for novel funding partnerships with industry and foundations. More effective communication between and among the basic science, clinical science, and health promotion/public health research communities is needed. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. Recommendations are made for both clinical and public health implementation of existing research and for caries-related research agendas in clinical science, health promotion/public health, and basic science. PMID:21490233

Global oral health inequalities: dental caries task group--research agenda.

PubMed

Pitts, N; Amaechi, B; Niederman, R; Acevedo, A-M; Vianna, R; Ganss, C; Ismail, A; Honkala, E

2011-05-01

The IADR Global Oral Health Inequalities Task Group on Dental Caries has synthesized current evidence and opinion to identify a five-year implementation and research agenda which should lead to improvements in global oral health, with particular reference to the implementation of current best evidence as well as integrated action to reduce caries and health inequalities between and within countries. The Group determined that research should: integrate health and oral health wherever possible, using common risk factors; be able to respond to and influence international developments in health, healthcare, and health payment systems as well as dental prevention and materials; and exploit the potential for novel funding partnerships with industry and foundations. More effective communication between and among the basic science, clinical science, and health promotion/public health research communities is needed. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. Recommendations are made for both clinical and public health implementation of existing research and for caries-related research agendas in clinical science, health promotion/public health, and basic science.

Trends in Testing for Mycobacterium tuberculosis Complex From US Public Health Laboratories, 2009-2013.

PubMed

Tyrrell, Frances; Stafford, Cortney; Yakrus, Mitchell; Youngblood, Monica; Hill, Andrew; Johnston, Stephanie

We investigated data from US public health laboratories funded through the Centers for Disease Control and Prevention's Tuberculosis Elimination and Laboratory Cooperative Agreement to document trends and challenges in meeting national objectives in tuberculosis (TB) laboratory diagnoses. We examined data on workload and turnaround time from public health laboratories' progress reports during 2009-2013. We reviewed methodologies, laboratory roles, and progress toward rapid detection of Mycobacterium tuberculosis complex through nucleic acid amplification (NAA) testing. We compared selected data with TB surveillance reports to estimate public health laboratories' contribution to national diagnostic services. During the study period, culture and drug susceptibility tests decreased, but NAA testing increased. Public health laboratories achieved turnaround time benchmarks for drug susceptibility tests at lower levels than for acid-fast bacilli smear and identification from culture. NAA positivity in laboratories among surveillance-reported culture-positive TB cases increased from 26.6% (2355 of 8876) in 2009 to 40.0% (2948 of 7358) in 2013. Public health laboratories provided an estimated 50.9% (4285 of 8413 in 2010) to 57.2% (4210 of 7358 in 2013) of culture testing and 88.3% (6822 of 7727 in 2011) to 94.4% (6845 of 7250 in 2012) of drug susceptibility tests for all US TB cases. Public health laboratories contribute substantially to TB diagnoses in the United States. Although testing volumes mostly decreased, the increase in NAA testing indicates continued progress in rapid M tuberculosis complex detection.

Estimating the Cost of Providing Foundational Public Health Services.

PubMed

Mamaril, Cezar Brian C; Mays, Glen P; Branham, Douglas Keith; Bekemeier, Betty; Marlowe, Justin; Timsina, Lava

2017-12-28

To estimate the cost of resources required to implement a set of Foundational Public Health Services (FPHS) as recommended by the Institute of Medicine. A stochastic simulation model was used to generate probability distributions of input and output costs across 11 FPHS domains. We used an implementation attainment scale to estimate costs of fully implementing FPHS. We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the FPHS cost estimation methodology in their agencies during 2014-2015. The average agency incurred costs of $48 per capita implementing FPHS at their current attainment levels with a coefficient of variation (CV) of 16 percent. Achieving full FPHS implementation would require $82 per capita (CV=19 percent), indicating an estimated resource gap of $34 per capita. Substantial variation in costs exists across communities in resources currently devoted to implementing FPHS, with even larger variation in resources needed for full attainment. Reducing geographic inequities in FPHS may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation. © Health Research and Educational Trust.

Prioritising public health: a qualitative study of decision making to reduce health inequalities

PubMed Central

2011-01-01

Background The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. Methods We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. Results The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. Conclusions It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health and health inequalities. Researchers have a vital role to play in providing the complex evidence required to compare different models of prevention and service delivery. Those working in public health must develop leadership to raise the profile of health inequalities as an issue that merits attention, resources and workforce capacity; and advocate for central government to play a key role in shifting social norms. PMID:22014291

Emotional intelligence as a predictor of self-efficacy among students with different levels of academic achievement at Kermanshah University of Medical Sciences

PubMed Central

GHARETEPEH, AMENEH; SAFARI, YAHYA; PASHAEI, TAHEREH; RAZAEI, MANSOUR; BAGHER KAJBAF, MOHAMMAD

2015-01-01

Introduction studies have indicated that emotional intelligence is positively related to self-efficacy and can predict the academic achievement. The present study aimed to investigate the role of emotional intelligence in identifying self-efficacy among the students of Public Health School with different levels of academic achievement. Methods This correlational study was conducted on all the students of Public Health School. 129 students were included in the study through census method. Data were collected using Emotional Intelligence and self-efficacy questionnaires and analyzed using descriptive statistics and regression analysis by SPSS 14. Results The average score of students with high academic achievement was higher in self-efficacy (39.78±5.82) and emotional intelligence (117.07±10.33) variables and their components than that of students with low academic achievement (39.17±5.91, 112.07±13.23). The overall emotional intelligence score to predict self-efficacy explanation was different among students with different levels of academic achievement (p<0.001). Self-efficacy structure was explained through self-awareness and self-motivation components in students with low academic achievement (r=0.571). In students with high academic achievement, self-awareness, self-motivation and social consciousness played an effective role in explaining self-efficacy (r=0.677, p<0.001). Conclusion Emotional intelligence and self-efficacy play an important role in achieving academic success and emotional intelligence can explain self-efficacy. Therefore, it is recommended to teach emotional intelligence skills to students with low academic achievement through training workshops. PMID:25927067

Communication models in environmental health.

PubMed

Guidotti, Tee L

2013-01-01

Communication models common in environmental health are not well represented in the literature on health communication. Risk communication is a systematic approach to conveying essential information about a specific environmental issue and a framework for thinking about community risk and the alternatives for dealing with it. Crisis communication is intended to provide essential information to people facing an emergency in order to mitigate its effects and to enable them to make appropriate decisions, and it is primarily used in emergency management. Corporate communication is intended to achieve a change in attitude or perception of an organization, and its role in environmental health is usually public relations or to rehabilitate a damaged reputation. Environmental health education is a more didactic approach to science education with respect to health and the environment. Social marketing uses conventional marketing methods to achieve a socially desirable purpose but is more heavily used in health promotion generally. Communication models and styles in environmental health are specialized to serve the needs of the field in communicating with the community. They are highly structured and executed in different ways but have in common a relative lack of emphasis on changing personal or lifestyle behavior compared with health promotion and public health in general and a tendency to emphasize content on specific environmental issues and decision frameworks for protecting oneself or the community through collective action.

Implementing Comprehensive School Physical Activity Programs: A Wayne State University Case Study

ERIC Educational Resources Information Center

Centeio, Erin E.; McCaughtry, Nate

2017-01-01

Comprehensive school physical activity programs (CSPAPs) have been highlighted by numerous public health and education agencies for their potential to improve the health and academic achievement of American youth. A CSPAP integrates physical activity throughout the school environment before, during and after school by engaging educators, children,…

Learning Laboratories for Unemployed, Out-of-School Youth. Health Education, Part 2.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Continuing Education Curriculum Development.

The learning activities suggested in this publication supplement those found in the curriculum resource handbook "Learning Laboratories for Unemployed Out-of-School Youth." This phase of the program deals on a practical level with various health problems in short, achievable units. Activities keyed to the curriculum resource handbook and followed…

Scale-up of HIV Treatment Through PEPFAR: A Historic Public Health Achievement

PubMed Central

El-Sadr, Wafaa M.; Holmes, Charles B.; Mugyenyi, Peter; Thirumurthy, Harsha; Ellerbrock, Tedd; Ferris, Robert; Sanne, Ian; Asiimwe, Anita; Hirnschall, Gottfried; Nkambule, Rejoice N.; Stabinski, Lara; Affrunti, Megan; Teasdale, Chloe; Zulu, Isaac; Whiteside, Alan

2012-01-01

Since its inception in 2003, the US President’s Emergency Plan for AIDS Relief (PEPFAR) has been an important driving force behind the global scale-up of HIV care and treatment services, particularly in expansion of access to antiretroviral therapy. Despite initial concerns about cost and feasibility, PEPFAR overcame challenges by leveraging and coordinating with other funders, by working in partnership with the most affected countries, by supporting local ownership, by using a public health approach, by supporting task-shifting strategies, and by paying attention to health systems strengthening. As of September 2011, PEPFAR directly supported initiation of antiretroviral therapy for 3.9 million people and provided care and support for nearly 13 million people. Benefits in terms of prevention of morbidity and mortality have been reaped by those receiving the services, with evidence of societal benefits beyond the anticipated clinical benefits. However, much remains to be accomplished to achieve universal access, to enhance the quality of programs, to ensure retention of patients in care, and to continue to strengthen health systems. PMID:22797746

Integrating pharmacies into public health program planning for pandemic influenza vaccine response.

PubMed

Fitzgerald, Thomas J; Kang, Yoonjae; Bridges, Carolyn B; Talbert, Todd; Vagi, Sara J; Lamont, Brock; Graitcer, Samuel B

2016-11-04

During an influenza pandemic, to achieve early and rapid vaccination coverage and maximize the benefit of an immunization campaign, partnerships between public health agencies and vaccine providers are essential. Immunizing pharmacists represent an important group for expanding access to pandemic vaccination. However, little is known about nationwide coordination between public health programs and pharmacies for pandemic vaccine response planning. To assess relationships and planning activities between public health programs and pharmacies, we analyzed data from Centers for Disease Control and Prevention assessments of jurisdictions that received immunization and emergency preparedness funding from 2012 to 2015. Forty-seven (88.7%) of 53 jurisdictions reported including pharmacies in pandemic vaccine distribution plans, 24 (45.3%) had processes to recruit pharmacists to vaccinate, and 16 (30.8%) of 52 established formal relationships with pharmacies. Most jurisdictions plan to allocate less than 10% of pandemic vaccine supply to pharmacies. While most jurisdictions plan to include pharmacies as pandemic vaccine providers, work is needed to establish formalized agreements between public health departments and pharmacies to improve pandemic preparedness coordination and ensure that vaccinating pharmacists are fully utilized during a pandemic. Copyright © 2016 Elsevier Ltd. All rights reserved.

Job satisfaction in rural public health nurses.

PubMed

Cole, Sandra; Ouzts, Karen; Stepans, Mary Beth

2010-01-01

The purpose of this study was to determine whether nurse managers and staff nurses in rural public health offices were satisfied with their jobs, whether managers were more satisfied than staff nurses, and whether their achieved educational level impacted their job satisfaction. A nonexperimental comparative study was conducted of currently employed public health nurses (PHNs) to determine job satisfaction levels by using Stember's Web-based 80-question job satisfaction survey. The sample consisted of 88 PHNs employed as either managers or staff nurses in county public health office settings during April 2006. In general, both nurse managers and staff nurses reported high job satisfaction. No significant differences existed between the composite job satisfaction scores of the managers and staff nurses. Significant differences existed between managers' and staff nurses' job satisfaction in the categories of "influence" and "interpersonal relationships" with managers less satisfied than staff nurses. Both staff nurses and managers in public health were satisfied with their jobs. Managers attributed any sense of decreased job satisfaction in the areas of influence and interpersonal relationships. Further study is needed to determine what contributes to satisfaction of PHNs in order to promote positive work environments conducive to retention and recruitment.

A Comprehensive Assessment of Four Options for Financing Health Care Delivery in Oregon

PubMed Central

White, Chapin; Eibner, Christine; Liu, Jodi L.; Price, Carter C.; Leibowitz, Nora; Morley, Gretchen; Smith, Jeanene; Edlund, Tina; Meyer, Jack

2017-01-01

Abstract This article describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act (ACA) Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the ACA Marketplace. The state could cover all residents under the Single Payer option with little change in overall health care costs, but doing so would require cuts to provider payment rates that could worsen access to care, and implementation hurdles may be insurmountable. The Health Care Ingenuity Plan, a state-managed plan featuring competition among private plans, would also achieve universal coverage and would sever the employer–health insurance link, but the provider payment rates would likely be set too high, so health care costs would increase. The Public Option would be the easiest of the three options to implement, but because it would not affect many people, it would be an incremental improvement to the Status Quo. Policymakers will need to weigh these options against their desire for change to balance the benefits with the trade-offs. PMID:29057151

Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era

PubMed Central

Desai, Sachin N.; Pezzoli, Lorenzo; Alberti, Kathryn P.; Martin, Stephen; Costa, Alejandro; Perea, William; Legros, Dominique

2017-01-01

ABSTRACT Cholera remains an important but neglected public health threat, affecting the health of the poorest populations and imposing substantial costs on public health systems. Cholera can be eliminated where access to clean water, sanitation, and satisfactory hygiene practices are sustained, but major improvements in infrastructure continue to be a distant goal. New developments and trends of cholera disease burden, the creation of affordable oral cholera vaccines (OCVs) for use in developing countries, as well as recent evidence of vaccination impact has created an increased demand for cholera vaccines. The global OCV stockpile was established in 2013 and with support from Gavi, has assisted in achieving rapid access to vaccine in emergencies. Recent WHO prequalification of a second affordable OCV supports the stockpile goals of increased availability and distribution to affected populations. It serves as an essential step toward an integrated cholera control and prevention strategy in emergency and endemic settings. PMID:27813703

[What Can Health Journalism Achieve? A Criterion-Based Evaluation of Print Media Coverage of the HPV Vaccine in Germany, 2006 to 2009].

PubMed

Niewald, Ann-Kristin; Oedingen, Carina; Razum, Oliver

2018-03-16

In 2006, the first human papillomavirus (HPV) vaccine was licensed in Europe and in 2007 it was included in the service catalogue of the statutory health insurance. The HPV vaccine led to a controversy in public and print media even before it was licensed. We evaluated the quality of the newspaper coverage of the HPV vaccine during the controversy in Germany. The LexisNexis print media database was scanned for health journalism articles on HPV in 4 high-circulation national newspapers and 4 magazines using pre-defined search terms for the period 2006-2009. Articles were evaluated using established indicators and were graded using a decimal grading scale. 58 articles were identified and evaluated by 2 persons independently. The indicators reflecting health journalism quality received on average a grade of 4.6 out of 6. The major quality categories which give a comprehensive overview of the HPV vaccine scored low in the majority of the articles. Only categories like simplicity of language and structure/order scored high in most of them. Compliance with established quality standards is an important basis of health journalism but seems difficult to achieve in the news coverage on the HPV vaccine. When applying the indicators to the HPV coverage, some avoidable deficiencies was identified from a public health perspective, relating in particular to the evidence base of the vaccination. Monitoring public health media can help to systematically identify information shortfalls or errors and respond with appropriate educational campaigns. © Georg Thieme Verlag KG Stuttgart · New York.

The nationalization of a disease: a paradigm?

PubMed Central

Soviero, D J

1986-01-01

The early history of the Federal involvement in Hansen's Disease reflects the history of the Public Health Service itself. As a young and aggressive institution, the Public Health Service sought out contagious, infectious diseases that threatened the public health. National resources and national coordination were needed to fight the likes of malaria, hookworm, or smallpox. The customary attack would consist of a field study, determination of the etiology, the method of transmission, and, then, perhaps, preventive measures. An eradication campaign would follow. Leprosy fit perfectly into the model--a disease of unknown etiology, an unknown method of transmission, thought to be highly contagious, and no known cure. The United States launched a major investigation in Hawaii, where the disease was prevalent and its victims conveniently segregated. The investigation failed. The Public Health Service then turned toward segregation and isolation as a way to fulfill its public health role. A bureaucracy was established around the idea that victims of leprosy must be incarcerated for the good of the public. The institutionalization of the Public Health Service and the philosophy upon which its treatment of leprosy was based proved difficult to change when researchers in the field made major scientific breakthroughs in the 1940s. The realization that the disease was only feebly contagious, activities of patient organizations, and pressure from the media and the Congress did not achieve as dramatic results as the sulfone drugs did. The Public Health Service moved, but slowly. What are the lessons in all of this?. Images p401-a p402-a p403-a PMID:3090606

Who's afraid of noncommunicable diseases? Raising awareness of the effects of noncommunicable diseases on global health.

PubMed

Alleyne, George; Basu, Sanjay; Stuckler, David

2011-08-01

Public-health priorities are in part driven by fear, yet fear has long been recognized as posing a threat to effective public health interventions. In this article, the authors review the role of fear in global health by focusing on the leading global cause of death and disability: noncommunicable diseases. Taking an historical perspective, first the authors review Samuel Adams' 1911 analysis of the role of fear in generating public health priority and his recommendations about mass educating the public. Next, they show that Adams' analysis still applies today, drawing on contemporary responses to H1N1 and HIV, while illustrating the ongoing neglect of long-term threats such as noncommunicable diseases. Then, they pose the question, "Is it possible, necessary, or useful to create a fear factor for noncommunicable diseases?" After reviewing mixed evidence about the effects of fear on social change (on individual behaviors and on building a mass movement to achieve collective action), the authors conclude by setting out an evidence-based, marketing strategy to generate a sustained, rational response to the noncommunicable disease epidemic.

[Efficiency of medical and economic activities of a sanatorium-and-spa facility in the active phase of the public health system reform under macroeconomic instability].

PubMed

Poliakov, B A; Kizeev, M V

2010-01-01

Results of a comprehensive study have demonstrated that the reform of the public health system currently underway in this country provides conditions for the extension of medical care based at sanatorium-and-spa facilities with simultaneous rise in relevant expenses. Bearing in mind the unstable macroeconomic situation, this requires thorough monitoring medical and economic activities of health resorts for the purpose of enhancing cost efficiency. The goal of optimization can be achieved by increasing competitive capacity based on strict control of expenditures and income redistribution for financing the most promising projects.

Lifestyle Vaccines and Public Health: Exploring Policy Options for a Vaccine to Stop Smoking.

PubMed

Wolters, Anna; de Wert, Guido; van Schayck, Onno C P; Horstman, Klasien

2016-07-01

Experimental vaccines are being developed for the treatment of 'unhealthy lifestyles' and associated chronic illnesses. Policymakers and other stakeholders will have to deal with the ethical issues that this innovation path raises: are there morally justified reasons to integrate these innovative biotechnologies in future health policies? Should public money be invested in further research? Focusing on the case of an experimental nicotine vaccine, this article explores the ethical aspects of 'lifestyle vaccines' for public health. Based on findings from a qualitative study into a vaccine for smoking cessation, the article articulates possible value conflicts related to nicotine vaccination as an intervention in tobacco control. The 'vaccinization' of lifestyle disease piggybacks on the achievements of classic vaccines. Contrary to expectations of simplicity and success, quitting smoking with a vaccine requires a complex supportive network. Social justice and public trust may become important ethical challenges when deciding whether to use further public funds for research or whether to implement these innovative vaccines in the future.

Health in all policies: a start in Rhode Island.

PubMed

Ritchie, Dianne; Nolan, Patricia A

2013-07-01

In Rhode Island, health care access, whether measured as having a regular source of care or as having health insurance, is better than the U.S. average. However, health care access does not necessarily translate into better health outcomes. Rhode Island has not fared better than the rest of the nation in ending or decreasing health disparities across socioeconomic and racial demographics in spite of improved access to quality health insurance products. In June 2011, law RIGL 23-64.1 directed the establishment of a Commission of Heath Advocacy and Equity. It requires a cross-section of state agency and community members to focus on the social determinants of health, and prepare biennial reports with public participation. The law will serve to remind the government and the public that objectives for the well-being of the population are best achieved when all sectors include health as a key component of policy development.

[A strategy for institutionalisation of health impact assessment in Andalusia (Spain)].

PubMed

Vela-Ríos, José; Rodríguez-Rasero, Francisco J; Moya-Ruano, Luis A; Candau-Bejarano, Ana; Ruiz-Fernández, Josefa

2016-01-01

Health impact assessment (HIA) aims to incorporate people's health and wellbeing as a key feature in policy-making. Many authors believe that HIA might be systematically integrated into all decision-making processes as a way to achieve that goal. To that end, there is need to overcome a number of challenges, including the fact that Andalusia (Spain) has made HIA compulsory by law, the need for awareness of all public sectors whose decisions might have substantial impacts on health and for a methodology that would enable a comprehensive approach to health determinants and inequalities, and the training of both the public health staff and professional sectors responsible for its application. In Andalusia, a law provides mandatory and binding health impact reports for most authorisation procedures in different areas: from sectoral plans to urban planning schemes, and especially projects subject to environmental assessment. Implementation of this law has required its integration into authorisation procedures, the training of interdisciplinary working groups in public health, the preparation of technical guidelines, and the organisation of dissemination and training seminars for developers. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Childhood lead poisoning prevention activities within Michigan local public health departments.

PubMed

Kemper, Alex R; Uren, Rebecca L; Hudson, Sharon R

2007-01-01

Local public health departments have a wide array of responsibilities, including coordinating childhood lead poisoning prevention activities. This study was conducted in an effort to understand how local public health officers prioritized lead poisoning prevention activities and the barriers to the delivery of childhood lead poisoning prevention services delivered through local health departments. A telephone survey was conducted of health officers in Michigan, a state with a high burden of environmental lead. Analysis included Spearman rank correlation and Fisher's exact test. No association was found between the local risk of lead poisoning and the priority placed by local health departments on lead poisoning prevention activities. Similarly, there was no association between the local risk of lead poisoning and the availability of services. Only 60% of local health departments offered blood lead testing, environmental investigation, and case management. Most (74%) believed that lead poisoning is inadequately addressed within the area served by their local health department. New strategies of providing lead poisoning prevention activities are needed to achieve the federal and state goals of eliminating childhood lead poisoning over the next decade.

'Decipio': examining Virchow in the context of modern 'democracy'.

PubMed

Reilly, R Gregory; McKee, Martin

2012-04-01

More than 100 years ago Rudolf Virchow advocated for enhanced democracy and socioeconomic reforms in order that the state could empower people to achieve better health. With reference to these now famous assertions this article traces the promises and pit-falls of democracy from ancient Greece to neo-liberal economies, to ascertain if the democratic state is indeed the ideal mechanism for promoting public health. In the end we conclude that contemporary western political systems are not rooted in the interest of the people, but are rather deceptive forces of branding designed to promote underlining agendas. This 'decipractic' (decipo = to deceive) system of politics demands a vigilant analysis and response from those in the health and academic communities to ensure that governments can be a mechanism for positive change in the public's interest. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Containment of Ebola and Polio in Low-Resource Settings Using Principles and Practices of Emergency Operations Centers in Public Health.

PubMed

Shuaib, Faisal M; Musa, Philip F; Muhammad, Ado; Musa, Emmanuel; Nyanti, Sara; Mkanda, Pascal; Mahoney, Frank; Corkum, Melissa; Durojaiye, Modupeoluwa; Nganda, Gatei Wa; Sani, Samuel Usman; Dieng, Boubacar; Banda, Richard; Ali Pate, Muhammad

Emergency Operations Centers (EOCs) have been credited with driving the recent successes achieved in the Nigeria polio eradication program. EOC concept was also applied to the Ebola virus disease outbreak and is applicable to a range of other public health emergencies. This article outlines the structure and functionality of a typical EOC in addressing public health emergencies in low-resource settings. It ascribes the successful polio and Ebola responses in Nigeria to several factors including political commitment, population willingness to engage, accountability, and operational and strategic changes made by the effective use of an EOC and Incident Management System. In countries such as Nigeria where the central or federal government does not directly hold states accountable, the EOC provides a means to improve performance and use data to hold health workers accountable by using innovative technologies such as geographic position systems, dashboards, and scorecards.

Enabling health systems transformation: what progress has been made in re-orienting health services?

PubMed

Wise, Marilyn; Nutbeam, Don

2007-01-01

The Ottawa Charter has been remarkably influential in guiding the development of the goals and concepts of health promotion, and in shaping global public health practice in the past 20 years. However, of the five action areas identified in the Ottawa Charter, it appears that there has been little systematic attention to the challenge of re-orienting health services, and less than optimal progress in practice. The purposes of re-orienting health services as proposed in the Ottawa Charter were to achieve a better balance in investment between prevention and treatment, and to include a focus on population health outcomes alongside the focus on individual health outcomes. However, there is little evidence that a re-orientation of health services in these terms has occurred systematically anywhere in the world. This is in spite of the fact that direct evidence of the need to re-orient health services and of the potential benefits of doing so has grown substantially since 1986. Patient education, preventive care (screening, immunisation), and organisational and environmental changes by health organisations have all been found to have positive health and environmental outcomes. However, evidence of effectiveness has not been sufficient, on its own, to sway community preferences and political decisions. The lack of progress points to the need for significant re-thinking of the approaches we have adopted to date. The paper proposes a number of ways forward. These include working effectively in partnership with the communities we want to serve to mobilise support for change, and to reinforce this by working more effectively at influencing broader public opinion through the media. The active engagement of clinical health professionals is also identified as crucial to achieving sustainable change. Finally we recognize that by working in partnership with like-minded advocacy organizations, the IUHPE could put its significant knowledge and experience to work in leading action to transform health care systems to make a major contribution to the improvement of public health.

Obtaining resources for evidence-based public health initiatives at the local level: insights from the Central Sydney Tobacco Control Plan.

PubMed

Rissel, C; McMaugh, K; O'Connor, D; Balafas, A; Ward, J

1999-02-01

In response to inquiries regarding the processes of developing a Tobacco Control Plan (TCP) for the Central Sydney Area Health Service (which in 1997 allocated dedicated funding of $ 800,000 over 2 1/2 years to implement the plan), this article describes the strengths and weaknesses of the TCP and outlines the process which contributed to its funding. Consistent with national and state priorities, the TCP recommended strategies based on best available evidence in the four action areas: reducing sales of cigarettes to minors, marketing, passive smoking and smoking cessation. Funding of this amount for a single public health issue at a local level represents a unique achievement in the application of an evidence-based approach to population health. Key elements of our advocacy methods included the involvement of all key primary health care and clinical stakeholders; comprehensive background research to identify evidence-based strategies; careful attention to budget options; strategic lobbying of senior staff and decision makers; the proposal for a multidisciplinary management structure for the TCP and specifications for funding allocation and evaluation. Early achievements and other reflections are discussed.

Civil society: the catalyst for ensuring health in the age of sustainable development.

PubMed

Smith, Julia; Buse, Kent; Gordon, Case

2016-07-16

Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

The role of public health advocacy in achieving an outright ban on commercial tanning beds in Australia.

PubMed

Sinclair, Craig A; Makin, Jennifer Kay; Tang, Anita; Brozek, Irena; Rock, Vanessa

2014-02-01

Although many countries still face opposition to the legislation of artificial tanning beds, all Australian states and territories have announced a total ban on commercial tanning beds. A combination of epidemiological and policy-centered research, powerful personal stories, and the active advocacy of prominent academics, cancer organizations, and grassroots community campaigners contributed to the decisions to first legislate standards and then ban all commercial tanning beds. We have illustrated that incremental change can be an effective pathway to securing substantial public health reforms.

The Role of Public Health Advocacy in Achieving an Outright Ban on Commercial Tanning Beds in Australia

PubMed Central

Sinclair, Craig A.; Tang, Anita; Brozek, Irena; Rock, Vanessa

2014-01-01

Although many countries still face opposition to the legislation of artificial tanning beds, all Australian states and territories have announced a total ban on commercial tanning beds. A combination of epidemiological and policy-centered research, powerful personal stories, and the active advocacy of prominent academics, cancer organizations, and grassroots community campaigners contributed to the decisions to first legislate standards and then ban all commercial tanning beds. We have illustrated that incremental change can be an effective pathway to securing substantial public health reforms. PMID:24328651

Achievements and future path of Tehran municipality in urban health domain: An Iranian experience

PubMed Central

Damari, Behzad; Riazi-Isfahani, Sahand

2016-01-01

Background: According to national laws and world experiences; provision, maintenance, and improving citizens’ health are considered to be the essential functions of municipalities as a "social institute". In order to equitably promote health conditions at urban level, particularly in marginal areas, since 2004 targeted efforts have been implemented in the municipality of Tehran metropolis. This study was intended to identify and analyze these targeted measures and tries to analyze health interventions in a conceptual framework and propose a future path. Methods: This is a qualitative study with content analysis approach. Reviewing documents and structured interviews with national health policy making and planning experts and executive managers of 22-region municipalities of Tehran metropolis were used to collect data. The data were analyzed on the basis of conceptual framework prepared for urban health in 4 domains including municipal interventions, goal achievements, drivers and obstacles of success, and the way forward. Results: From the viewpoint of interviewees, these new health actions of Tehran municipality are more based on public participation and the municipality was able to prioritize health issue in the programs and policies of Tehran city council. Tehran municipality has accomplished three types of interventions to improve health, which in orders of magnitude are: facilitative, promotional, and mandatory interventions. Development and institutionalization of public participation is the greatest achievement in health-oriented actions; and expansion of environmental and physical health-oriented facilities and promoting a healthy lifestyle are next in ranks. Conclusion: Since management alterations seriously challenges institutionalization of actions and innovations especially in the developing countries, it is suggested that mayors of metropolitan cities like Tehran document and review municipal health measures as soon as possible and while eliminating overlapping of interventions with other sectors, design and approve the charter of "health promoting municipality". The most important role of municipalities in this charter would be coordinating health improvement of citizens. This charter, when approved as a national policy could be used for other cities too. PMID:27390693

Public health impact of achieving 80% colorectal cancer screening rates in the United States by 2018.

PubMed

Meester, Reinier G S; Doubeni, Chyke A; Zauber, Ann G; Goede, S Luuk; Levin, Theodore R; Corley, Douglas A; Jemal, Ahmedin; Lansdorp-Vogelaar, Iris

2015-07-01

The National Colorectal Cancer Roundtable, a national coalition of public, private, and voluntary organizations, has recently announced an initiative to increase colorectal cancer (CRC) screening rates in the United States to 80% by 2018. The authors evaluated the potential public health benefits of achieving this goal. The authors simulated the 1980 through 2030 United States population of individuals aged 50 to 100 years using microsimulation modeling. Test-specific historical screening rates were based on National Health Interview Survey data for 1987 through 2013. The effects of increasing screening rates from approximately 58% in 2013 to 80% in 2018 were compared to a scenario in which the screening rate remained approximately constant. The outcomes were cancer incidence and mortality rates and numbers of CRC cases and deaths during short-term follow-up (2013-2020) and extended follow-up (2013-2030). Increasing CRC screening rates to 80% by 2018 would reduce CRC incidence rates by 17% and mortality rates by 19% during short-term follow-up and by 22% and 33%, respectively, during extended follow-up. These reductions would amount to a total of 277,000 averted new cancers and 203,000 averted CRC deaths from 2013 through 2030. Achieving the goal of increasing the uptake of CRC screening in the United States to 80% by 2018 may have a considerable public health impact by averting approximately 280,000 new cancer cases and 200,000 cancer deaths within <20 years. Cancer 2015;121:2281-2285. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Syria: effects of conflict and sanctions on public health.

PubMed

Sen, Kasturi; Al-Faisal, Waleed; AlSaleh, Yaser

2013-06-01

The past 18 months have witnessed considerable turmoil in countries of the MENA region. The Syrian Arab Republic (SAR) is one such country, currently in the midst of a civil war. This report draws attention to some of the recent achievements of its health services, where, despite a dearth of published materials, the country achieved remarkable declines in maternal mortality and infant mortality rates. Its health sector now faces destruction from on-going violence compounded by economic sanctions that has affected access to health care, to medicines and to basic essentials as well as the destruction of infrastructure. This paper draws attention to the achievements of the country's health services and explores some of the consequences of conflict and of sanctions on population health. Readers need to be mindful that the situation on the ground in a civil war can alter on a daily basis. This is the case for Syria with much destruction of health facilities and increasing numbers of people killed and injured. We retain however our focus on the core theme of this paper which is on conflict and on sanctions.

Analyzing the politico-moral foundations of the Iran’s health system based on theories of justice

PubMed Central

Akrami, Forouzan; Abbasi, Mahmoud; Karimi, Abbas; Shahrivari, Akbar; Majdzadeh, Reza; Zali, Alireza

2017-01-01

Public health ethics is a field that covers both factual and ethical issues in health policy and science, and has positive obligations to improve the well-being of populations and reduce social inequalities. It is obvious that various philosophies and moral theories can differently shape the framework of public health ethics. For this reason, the present study reviewed theories of justice in order to analyze and criticize Iran’s general health policies document, served in 14 Articles in 2014. Furthermore, it explored egalitarianism as the dominant theory in the political philosophy of the country’s health care system. According to recent theories of justice, however, health policies must address well-being and its basic dimensions such as health, reasoning, autonomy, and the role of the involved agencies and social institutions in order to achieve social justice beyond distributive justice. Moreover, policy-making in the field of health and biomedical sciences based on Islamic culture necessitates a theory of social justice in the light of theological ethics. Educating people about their rights and duties, increasing their knowledge on individual agency, autonomy, and the role of the government, and empowering them will help achieve social justice. It is recommended to design and implement a strategic plan following each of these policies, based on the above-mentioned values and in collaboration with other sectors, to clarify the procedures in every case. PMID:29291037

Analyzing the politico-moral foundations of the Iran's health system based on theories of justice.

PubMed

Akrami, Forouzan; Abbasi, Mahmoud; Karimi, Abbas; Shahrivari, Akbar; Majdzadeh, Reza; Zali, Alireza

2017-01-01

Public health ethics is a field that covers both factual and ethical issues in health policy and science, and has positive obligations to improve the well-being of populations and reduce social inequalities. It is obvious that various philosophies and moral theories can differently shape the framework of public health ethics. For this reason, the present study reviewed theories of justice in order to analyze and criticize Iran's general health policies document, served in 14 Articles in 2014. Furthermore, it explored egalitarianism as the dominant theory in the political philosophy of the country's health care system. According to recent theories of justice, however, health policies must address well-being and its basic dimensions such as health, reasoning, autonomy, and the role of the involved agencies and social institutions in order to achieve social justice beyond distributive justice. Moreover, policy-making in the field of health and biomedical sciences based on Islamic culture necessitates a theory of social justice in the light of theological ethics. Educating people about their rights and duties, increasing their knowledge on individual agency, autonomy, and the role of the government, and empowering them will help achieve social justice. It is recommended to design and implement a strategic plan following each of these policies, based on the above-mentioned values and in collaboration with other sectors, to clarify the procedures in every case.

Read-To-Achieve Grant Program Annual Report to the Colorado Department of Public Health and Environment.

ERIC Educational Resources Information Center

Colorado State Dept. of Education, Denver.

Colorado Senate Bill 00-71 and S.B. 00-124 established the Read-to-Achieve Grant Program. The purpose of the program is to solicit proposals from any elementary school, including a charter school, or consortium of schools, to fund research-based intensive reading programs. The funding opportunity was designed specifically for second and third…

Environmental Law Deskbook

DTIC Science & Technology

1998-06-12

public health threats posed by water pollution. (b) More effective control of polluted runoff (including a strategy for achieving a net gain of... Control Strategies for Toxic Pollutants. a. The CWA requires states to identify "impaired" water bodies within their boundaries. For water...standards. Thereafter, states must develop "individual control strategies " (ICSs) to regulate such pollutants and achieve water quality standards

In search of a common European approach to a healthy indoor environment.

PubMed

Adan, Olaf C G; Ng-A-Tham, Julie; Hanke, Wojtek; Sigsgaard, Torben; van den Hazel, Peter; Wu, Felicia

2007-06-01

Increasingly, policymakers in Europe and around the world are realizing the importance of healthy indoor environments for public health. Certain member states of the European Union (EU) have already achieved successes in improving indoor environmental quality, such as controlling certain contaminants (e.g., environmental tobacco smoke) or developing nationwide policies that address indoor air generally. However, a common European approach to achieving healthy indoor environments is desirable for several reasons including providing a broader recognition of the problem of unhealthy indoor air, setting a policy example for all 27 EU member states, and achieving greater public health equity across the different European nations. In this article we address the question "Why is it so difficult in the EU to develop a coherent approach on indoor environment?" We identify and describe four main barriers: a) the subsidiarity principle in EU policymaking, introducing decentralization of decision making to the member states; b) fragmentation of the topic of the indoor environment; c) the differences in climate and governance among different member states that make a common policy difficult; and d) economic issues. We discuss potential lessons and recommendations from EU and U.S. successes in achieving healthier indoor environments through various policy mechanisms.

The role of insurance in the achievement of universal coverage within a developing country context: South Africa as a case study.

PubMed

van den Heever, Alex M

2012-01-01

Achieving universal coverage as an objective needs to confront the reality of multiple mechanisms, with healthcare financing and provision occurring in both public and private settings. South Africa has both large and mature public and private health systems offering useful insights into how they can be effectively harmonized to optimise coverage. Private healthcare in South Africa has also gone through many phases and regulatory regimes which, through careful review, can help identify potential policy frameworks that can optimise their ability to deepen coverage in a manner that complements the basic coverage of public arrangements. Using South Africa as a case study, this review examines whether private health systems are susceptible to regulation and therefore able to support an extension and deepening of coverage when complementing a pre-existing publicly funded and delivered health system? The approach involves a review of different stages in the development of the South African private health system and its response to policy changes. The focus is on the time-bound characteristics of the health system and associated policy responses and opportunities. A distinction is consequently made between the early, largely unregulated, phases of development and more mature phases with alternative regulatory regimes. The private health system in South Africa has played an important supplementary role in achieving universal coverage throughout its history, but more especially in the post-Apartheid period. However, the quality of this role has been erratic, influenced predominantly by policy vacillation.The private system expanded rapidly during the 1980s mainly due to the pre-existence of a mature health insurance system and a weakening public hospital system which could accommodate and facilitate an increased demand for private hospital services. This growth served to expand commercial interest in health insurance, in the form of regulated medical schemes, which until this point took the form of non-commercial occupational (employer-based) schemes. During the 1980s government acquiesced to industry lobbies arguing for the deregulation of health insurance from 1989, with an extreme deregulation occurring in 1994, evidently in anticipation of the change of government associated with the democratic dispensation. Dramatic unintended consequences followed, with substantial increases in provider and funder costs coinciding with uncontrolled discrimination against poor health risks.Against significant industry opposition, including legal challenges, partial re-regulation took effect from 2000 which removed the discretion of schemes to discriminate against poor health risks. This included: the implementation of a strong regulator of health insurance; the establishment of one allowable vehicle able to provide health insurance; open enrolment, whereby schemes could not refuse membership applications; mandatory minimum benefit requirements; and a prohibition on setting contributions or premiums on the basis of health status. After a two-year lag, dramatically reduced cost trends and contributions became evident. Aside from generally tighter regulation across a range of fronts, this appears related to the need for schemes to compete more on the basis of healthcare provider costs than demographic risk profiles. Despite an incomplete reform improved equitable coverage and cost-containment was nevertheless achieved.A more complete regulatory regime is consequently likely to deepen coverage by: further stabilising and even decreasing costs; enhanced risk pooling; and access for low income groups. This would occur if South Africa: improved the quality of free public services, thereby creating competitive constraints for medical schemes; introduced risk-equalisation, increasing the pressure on schemes to compete on the cost and quality of coverage rather than their risk profile; and through the establishment of improved price regulation. The objective of universal coverage can be seen in two dimensions, horizontal extension and vertical deepening. Private systems play an important role in deepening coverage by mobilising revenue from income earners for health services over-and-above the horizontal extension role of public systems and related subsidies. South Africa provides an example of how this natural deepening occurs whether regulated or unregulated. It also demonstrates how poor regulation of mature private systems can severely undermine this role and diminish achievements below attainable levels of social protection. The mature South African system has demonstrated its sensitivity to regulatory design and responds rapidly to changes both positive and negative. When measures to enhance risk pooling are introduced, coverage is expanded and becomes increasingly fair and sustainable. When removed, however, the system becomes less stable and fair as costs rise and people with poor health status are systematically excluded from cover. This susceptibility to regulation therefore presents an opportunity to policymakers to achieve social protection objectives through the strategic management of markets rather than exclusively through less responsive systems based on tax-funded direct provision. This is especially relevant as private markets for healthcare are inevitable, with policy discretion reduced to a choice between functional or dysfunctional regimes.

The role of insurance in the achievement of universal coverage within a developing country context: South Africa as a case study

PubMed Central

2012-01-01

Background Achieving universal coverage as an objective needs to confront the reality of multiple mechanisms, with healthcare financing and provision occurring in both public and private settings. South Africa has both large and mature public and private health systems offering useful insights into how they can be effectively harmonized to optimise coverage. Private healthcare in South Africa has also gone through many phases and regulatory regimes which, through careful review, can help identify potential policy frameworks that can optimise their ability to deepen coverage in a manner that complements the basic coverage of public arrangements. Research question Using South Africa as a case study, this review examines whether private health systems are susceptible to regulation and therefore able to support an extension and deepening of coverage when complementing a pre-existing publicly funded and delivered health system? Methods The approach involves a review of different stages in the development of the South African private health system and its response to policy changes. The focus is on the time-bound characteristics of the health system and associated policy responses and opportunities. A distinction is consequently made between the early, largely unregulated, phases of development and more mature phases with alternative regulatory regimes. Results The private health system in South Africa has played an important supplementary role in achieving universal coverage throughout its history, but more especially in the post-Apartheid period. However, the quality of this role has been erratic, influenced predominantly by policy vacillation. The private system expanded rapidly during the 1980s mainly due to the pre-existence of a mature health insurance system and a weakening public hospital system which could accommodate and facilitate an increased demand for private hospital services. This growth served to expand commercial interest in health insurance, in the form of regulated medical schemes, which until this point took the form of non-commercial occupational (employer-based) schemes. During the 1980s government acquiesced to industry lobbies arguing for the deregulation of health insurance from 1989, with an extreme deregulation occurring in 1994, evidently in anticipation of the change of government associated with the democratic dispensation. Dramatic unintended consequences followed, with substantial increases in provider and funder costs coinciding with uncontrolled discrimination against poor health risks. Against significant industry opposition, including legal challenges, partial re-regulation took effect from 2000 which removed the discretion of schemes to discriminate against poor health risks. This included: the implementation of a strong regulator of health insurance; the establishment of one allowable vehicle able to provide health insurance; open enrolment, whereby schemes could not refuse membership applications; mandatory minimum benefit requirements; and a prohibition on setting contributions or premiums on the basis of health status. After a two-year lag, dramatically reduced cost trends and contributions became evident. Aside from generally tighter regulation across a range of fronts, this appears related to the need for schemes to compete more on the basis of healthcare provider costs than demographic risk profiles. Despite an incomplete reform improved equitable coverage and cost-containment was nevertheless achieved. A more complete regulatory regime is consequently likely to deepen coverage by: further stabilising and even decreasing costs; enhanced risk pooling; and access for low income groups. This would occur if South Africa: improved the quality of free public services, thereby creating competitive constraints for medical schemes; introduced risk-equalisation, increasing the pressure on schemes to compete on the cost and quality of coverage rather than their risk profile; and through the establishment of improved price regulation. Conclusions The objective of universal coverage can be seen in two dimensions, horizontal extension and vertical deepening. Private systems play an important role in deepening coverage by mobilising revenue from income earners for health services over-and-above the horizontal extension role of public systems and related subsidies. South Africa provides an example of how this natural deepening occurs whether regulated or unregulated. It also demonstrates how poor regulation of mature private systems can severely undermine this role and diminish achievements below attainable levels of social protection. The mature South African system has demonstrated its sensitivity to regulatory design and responds rapidly to changes both positive and negative. When measures to enhance risk pooling are introduced, coverage is expanded and becomes increasingly fair and sustainable. When removed, however, the system becomes less stable and fair as costs rise and people with poor health status are systematically excluded from cover. This susceptibility to regulation therefore presents an opportunity to policymakers to achieve social protection objectives through the strategic management of markets rather than exclusively through less responsive systems based on tax-funded direct provision. This is especially relevant as private markets for healthcare are inevitable, with policy discretion reduced to a choice between functional or dysfunctional regimes. PMID:22992410

[Primary health care and the millennium development goals].

PubMed

Faye, A; Bob, M; Fall, A; Fall, C

2012-01-01

Member countries of the World Health Organization (WHO) met in Alma Ata (8-12 September 1978) to define and advocate the implementation of primary health care (PHC) worldwide, above all, in developing countries, which had a real need to review their strategies for meeting the health needs of their populations. They did not suspect that 20 years later the vision they displayed would remain undeniably relevant. Here we examine the similarities and points of convergence of their declaration about PHC with the Millennium Development Goals that seek today to reduce poverty across the world. An exhaustive and analytic literature review was conducted to collect those similarities. Further analysis of the definitions, objectives, principles and recommendations of the Alma Ata Declaration and the Millennium Declaration reveals multiple dependencies and fundamental points of similarity between these two representations. Almost all states have pledged to achieve the eight MDG by 2015: to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability, and develop a global partnership for development. The Alma Ata conference defined primary health care as essential health care, based on practical methods and techniques that are both scientifically sound and socially acceptable, universally accessible to all individuals and all families of the community, through their full participation and at a cost that the community and countries can afford at all stages of their development in the spirit of self-reliance and self-determination. It is an integral part of economic and social development. The following principles are involved in the achievement of both primary health care and the MDG: social equity, community participation, and intersectorality. Public health is an essential condition of poverty eradication and MDG achievement. Public health issues are central to the problem of sustainable development and must therefore remain the focus of attention. It is increasingly urgent to break the vicious circle created by the close correlation between environmental degradation, poor health, and poverty.

Achieving the Sustainable Development Goal 06 in Brazil: the universal access to sanitation as a possible mission.

PubMed

Dias, Cintia M M; Rosa, Luiz P; Gomez, Jose M A; D'Avignon, Alexandre

2018-04-16

Sanitation (which includes national public policies for drinking water, sewage services and waste management) is precarious in Brazil and therefore poses a challenge to a range of actors. Poor sanitation impacts public health, education, the environment, and daily life. Globally, it emits increasing greenhouse gases. Universalization of any major public service appears difficult, if not impossible; however, Brazil's program to universalize access to electricity proves the opposite, as will be shown in this paper. By describing the successful implementation of electricity for everyone, we show that planned public efforts, coordinated with private initiatives and local communities, have worked, and the same can be achieved for the sanitation sector. An overview of all sectors that touch on sanitation and emissions is also provided, highlighting the challenges and possibilities for infrastructure projects.

Work environments for healthy and motivated public health nurses.

PubMed

Saito, Naoko; Yamamoto, Takeshi; Kitaike, Tadashi

2016-01-01

Objectives By defining health as mental health and productivity and performance as work motivation, the study aimed to identify work environments that promote the health and motivation of public health nurses, using the concept of a healthy work organizations, which encompasses the coexistence of excellent health for each worker and the productivity and performance of the organization.Methods Self-administered questionnaires were sent to 363 public health nurses in 41 municipal public health departments in Chiba prefecture. The questions were comprised of the 12-item General Health Questionnaire (GHQ-12) for mental health and the Morale Measurement Scale (5 items) for work motivation. Demographic data, workplace attributes, workload, and workplace environment were set as independent variables. The Comfortable Workplace Survey (35 items in 7 areas) was used to assess workers' general work environments. The "Work Environment for Public Health Nurses" scale (25 items) was developed to assess the specific situations of public health nurses. While aggregation was carried out area by area for the general work environment, factor analysis and factor-by-factor aggregation were used for public health nurse-specific work environments. Mental health and work motivation results were divided in two based on the total scores, which were then evaluated by t-tests and χ(2) tests. Items that showed a significant correlation were analyzed using logistic regression.Results The valid responses of 215 participants were analyzed (response rate: 59.2%). For the general work environment, high scores (the higher the score, the better the situation) were obtained for "contributions to society" and "human relationships" and low scores were obtained for "career building and human resource development." For public health nurse-specific work environments, high scores were obtained for "peer support," while low scores were obtained for "easy access to advice and training" and "organizational public health initiative." Mental health was found to be related to "contributions to society" (OR=2.86), "workload" (OR=3.00), and "organizational public health initiative" (OR=2.08). Work motivation was found to be related to "contributions to society" (OR=6.73) and "recognition of public health nurse's judgment and opinion" (OR=1.59).Conclusion Both mental health and work motivation were related to working environments where public health nurses can feel that their work is meaningful to society. It is therefore necessary to improve work environments so that objectives are clearly defined to raise aspirations and nurses' activities and achievements are recognized and shared.

Ends versus means: the role of markets in expanding access to contraceptives.

PubMed

Hanson, K; Kumaranayake, L; Thomas, I

2001-06-01

Achieving and sustaining universal access to contraceptives are key policy goals of interventions supplying contraceptive commodities. Donor support for contraceptive supplies is substantial and many public and national programmes rely on donated and subsidized supplies of contraceptives. Sustainability of programme benefits is a concern to both national governments and donor agencies. At the same time, market-based provision of contraceptives has become a major source of contraceptives for individuals in a number of countries. While the goals or 'ends' of policy are to increase and sustain universal access to contraceptives, there is debate about the role of markets and their negative impacts on equity and universality. There is also concern that while public programmes supplying free contraceptives may, in the medium-term, achieve high coverage, they may hamper the achievement of long-term sustainability and the development of commercial markets. This paper focuses on the tension between the public health and market paradigms, and uses economic analysis as a framework in order to examine the relative roles or 'means' for subsidized public and commercial private sector supply of contraceptives. The review of the theory and evidence focuses on the trade-offs between public sector and market provision of contraceptives, examining the role for the public sector given the potential for market failures, the impact of public provision on the development of markets, and the role of price in demand. However, because of the potential conflict between these policy objectives, we argue that strategies to deliver contraceptives should be based on the specific characteristics of the context. In particular four variables (contraceptive prevalence rates, HIV prevalence, income level of country, size and geographic spread of private sector development) are important in characterizing this context, and these are highlighted in a matrix of programme priorities. Public choices need to take into account the ways in which they will affect the potential for development of sustainable private sources of supply. Undertaking a 'market assessment' should be a key stage in the analysis of policy options. Such an assessment should address demand factors, health priorities, actual and potential sources of supply and the relationships between public and private supply. Clearly the development of markets for contraceptives is not an end in itself, but may prove an important means of improving the health of women and men.

Human Rights and the Political Economy of Universal Health Care: Designing Equitable Financing.

PubMed

Rudiger, Anja

2016-12-01

Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good.

Human Rights and the Political Economy of Universal Health Care

PubMed Central

2016-01-01

Abstract Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good. PMID:28559677

Chile's National Center for Health Information Systems: A Public-Private Partnership to Foster Health Care Information Interoperability.

PubMed

Capurro, Daniel; Echeverry, Aisen; Figueroa, Rosa; Guiñez, Sergio; Taramasco, Carla; Galindo, César; Avendaño, Angélica; García, Alejandra; Härtel, Steffen

2017-01-01

Despite the continuous technical advancements around health information standards, a critical component to their widespread adoption involves political agreement between a diverse set of stakeholders. Countries that have addressed this issue have used diverse strategies. In this vision paper we present the path that Chile is taking to establish a national program to implement health information standards and achieve interoperability. The Chilean government established an inter-agency program to define the current interoperability situation, existing gaps, barriers, and facilitators for interoperable health information systems. As an answer to the identified issues, the government decided to fund a consortium of Chilean universities to create the National Center for Health Information Systems. This consortium should encourage the interaction between all health care stakeholders, both public and private, to advance the selection of national standards and define certification procedures for software and human resources in health information technologies.

Who Benefits from Public Spending on Higher Education in South Asia and Sub-Saharan Africa?

ERIC Educational Resources Information Center

Ilie, Sonia; Rose, Pauline

2018-01-01

Most countries are far from achieving the new sustainable development target of equal access to higher education by 2030, with those in South Asia and sub-Saharan Africa furthest behind. This raises questions about the allocation of public resources across the education system to promote equity. We use data from Demographic and Health Surveys and…

Evaluating long-term effectiveness of sleeping sickness control measures in Guinea.

PubMed

Pandey, Abhishek; Atkins, Katherine E; Bucheton, Bruno; Camara, Mamadou; Aksoy, Serap; Galvani, Alison P; Ndeffo-Mbah, Martial L

2015-10-22

Human African Trypanosomiasis threatens human health across Africa. The subspecies T.b. gambiense is responsible for the vast majority of reported HAT cases. Over the past decade, expanded control efforts accomplished a substantial reduction in HAT transmission, spurring the WHO to include Gambian HAT on its roadmap for 2020 elimination. To inform the implementation of this elimination goal, we evaluated the likelihood that current control interventions will achieve the 2020 target in Boffa prefecture in Guinea, which has one of the highest prevalences for HAT in the country, and where vector control measures have been implemented in combination with the traditional screen and treat strategy. We developed a three-species mathematical model of HAT and used a Bayesian melding approach to calibrate the model to epidemiological and entomological data from Boffa. From the calibrated model, we generated the probabilistic predictions regarding the likelihood that the current HAT control programs could achieve elimination by 2020 in Boffa. Our model projections indicate that if annual vector control is implemented in combination with annual or biennial active case detection and treatment, the probability of eliminating HAT as public health problem in Boffa by 2020 is over 90%. Annual implementation of vector control alone has a significant impact but a decreased chance of reaching the objective (77%). However, if the ongoing control efforts are interrupted, HAT will continue to remain a public health problem. In the presence of a non-human animal transmission reservoir, intervention strategies must be maintained at high coverage, even after 2020 elimination, to prevent HAT reemerging as a public health problem. Complementing active screening and treatment with vector control has the potential to achieve the elimination target before 2020 in the Boffa focus. However, surveillance must continue after elimination to prevent reemergence.

An evaluation of a morphine public health programme for cancer and AIDS pain relief in Sub-Saharan Africa

PubMed Central

Logie, Dorothy E; Harding, Richard

2005-01-01

Background Despite growing HIV and cancer prevalence in Sub-Saharan Africa, and WHO advocacy for a public health approach to palliative care provision, opioid availability is severely limited. Uganda has achieved a morphine roll-out programme in partnership with the Ministry of Health. This study aimed to evaluate that programme by identifying challenges to implementation that may inform replication. Methods A multi-methods protocol appraised morphine regulation, storage, prescribing, and consumption in three phases: key informant interviews throughout the opioid supply chain, and direct observation and audit of clinical practice. Results Regulation had achieved its goal of preventing misuse and leakage from the supply chain. However, the Government felt that relaxation of regulation was now appropriate. Confusion and complexity in storage and authorisation rules led to discontinuation of opioid pain management at the patient level and also wasted service time in trying to obtain supplies to which they were entitled. Continued neglect to prescribe among clinicians and public fear of opioids led to under prescribing, and clinical skills showed some evidence of need for improvement with respect to physical assessment and follow-up. Conclusion The Ugandan programme offers a successful model for both advocacy and Governmental support in achieving opioid roll-out across health districts. Despite initial concerns, abuse of opioids has not been evident. Further work is required to ensure that available supplies of opioids are prescribed to those in need, and that clinical standards are met. However, the programme for roll-out has proved a useful model to expand opioid availability as the first step in improving patient care, and may prove a useful template for other Sub-Saharan African countries. PMID:16092958

Health Reform Redux: Learning From Experience and Politics

PubMed Central

2009-01-01

The 2008 presidential campaign season featured health care reform proposals. I discuss 3 approaches to health care reform and the tools for bringing about reform, such as insurance market reforms, tax credits, subsidies, individual and employer mandates, and public program expansions. I also discuss the politics of past and current health care reform efforts. Market-based reforms and mandates have been less successful than public program expansions at expanding coverage and controlling costs. New divisions among special interest groups increase the likelihood that reform efforts will succeed. Federal support for state efforts may be necessary to achieve national health care reform. History suggests that state-level success precedes national reform. History also suggests that an organized social movement for reform is necessary to overcome opposition from special interest groups. PMID:19299668

Public-private partnerships to improve primary healthcare surgeries: clarifying assumptions about the role of private provider activities.

PubMed

Mudyarabikwa, Oliver; Tobi, Patrick; Regmi, Krishna

2017-07-01

Aim To examine assumptions about public-private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries. PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited. A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships. Realist evaluation principles were applied in the data analysis to interpret the findings. Six thematic areas of assumed health benefits were identified: (i) quality improvement; (ii) improved risk management; (iii) reduced procurement costs; (iv) increased efficiency; (v) community involvement; and (vi) sustainable investment. Primary Care Trusts that chose to procure their surgeries through LIFT were expected to support its implementation by providing an environment conducive for the private participants to achieve these benefits. Private participant activities were found to be based on a range of explicit and tacit assumptions perceived helpful in achieving government objectives for LIFT. The success of PPPs depended upon private participants' (i) capacity to assess how PPP assumptions added value to their activities, (ii) effectiveness in interpreting assumptions in their expected activities, and (iii) preparedness to align their business principles to government objectives for PPPs. They risked missing some of the expected benefits because of some factors constraining realization of the assumptions. The ways in which private participants preferred to carry out their activities also influenced the extent to which expected benefits were achieved. Giving more discretion to public than private participants over critical decisions may help in ensuring that assumptions in PPP activities result in outcomes that match the anticipated health benefits.

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making

PubMed Central

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-01-01

Background In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Methods Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Results Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Conclusion Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health. PMID:19094194

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

PubMed

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-12-18

In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

[Public health: politics help those who help themselves [in health services

PubMed

Ortún, Vicente

2007-01-01

Poor countries health improves with the application of public health knowledge, but this requires from institutional capacity and political will, not automatically guaranteed by income growth alone. Generalized cost-benefit analysis, explicit establishment of priorities and even consensus (knowledge sharing) are suitable methods to select appropriate policies. Some problems, such as the increasing inequalities among countries or the global warming, may require a change of our institutions given than both market mechanisms and traditional policy intervention by nation-states may prove insufficient. could be the motto for the necessary conciliation between individual and collective actions on health. It has a similar importance to act upon the differences between individuals with similar exposures as diminishing the global risk of those social groups where misfortunes cluster. In a country such a Spain the aforementioned conciliation happens though a Welfare State capable of achieving social 'desirability' based upon democratic legitimacy and effective behavior, effectiveness that can not be obtained without the best combination of clinical and Public Health interventions.

Creating the Business Case for Achieving Health Equity.

PubMed

Chin, Marshall H

2016-07-01

Health care organizations have increasingly acknowledged the presence of health care disparities across race/ethnicity and socioeconomic status, but significantly fewer have made health equity for diverse patients a true priority. Lack of financial incentives is a major barrier to achieving health equity. To create a business case for equity, governmental and private payors can: 1) Require health care organizations to report clinical performance data stratified by race, ethnicity, and socioeconomic status. 2) Incentivize preventive care and primary care. Implement more aggressive shared savings plans, update physician relative value unit fee schedules, and encourage partnerships across clinical and non-clinical sectors. 3) Incentivize the reduction of health disparities with equity accountability measures in payment programs. 4) Align equity accountability measures across public and private payors. 5) Assist safety-net organizations. Provide adequate Medicaid reimbursement, risk-adjust clinical performance scores for sociodemographic characteristics of patients, provide support for quality improvement efforts, and calibrate cuts to Disproportionate Share Hospital (DSH) payments to the pace of health insurance expansion. 6) Conduct demonstration projects to test payment and delivery system reform interventions to reduce disparities. Commitment to social justice is essential to achieve health equity, but insufficient without a strong business case that makes interventions financially feasible.

Data, Staff, and Money: Leadership Reflections on the Future of Public Health Informatics.

PubMed

Leider, Jonathon P; Shah, Gulzar H; Williams, Karmen S; Gupta, Akrati; Castrucci, Brian C

Health informatics can play a critical role in supporting local health departments' (LHDs') delivery of certain essential public health services and improving evidence base for decision support. However, LHDs' informatics capacities are below an optimum level. Efforts to build such capacities face ongoing challenges. Moreover, little is known about LHD leaders' desires for the future of public health informatics. Conduct a qualitative analysis of LHDs' future informatics plans, perceived barriers to accomplishing those plans, and potential impact of future advances in public health informatics on the work of the public health enterprise. This research presents findings from 49 in-depth key informant interviews with public health leaders and informatics professionals from LHDs, representing insights from across the United States. Interviewees were selected on the basis of the size of the population their LHD serves, as well as level of informatics capacity. Interviews were transcribed, verified, and double coded. Major barriers to doing more with informatics included staff capacity and training, financial constraints, dependency on state health agency, and small LHD size/lack of regionalization. When asked about the role of leadership in expanding informatics, interviewees said that leaders could make it a priority through (1) learning more about informatics and (2) creating appropriate budgets for integrated information systems. Local health department leaders said that they desired data that were timely and geographically specific. In addition, LHD leaders said that they desired greater access to clinical data, especially around chronic disease indicators. Local health department leadership desires to have timely or even real-time data. Local health departments have a great potential to benefit from informatics, particularly electronic health records in advancing their administrative practices and service delivery, but financial and human capital represents the largest barrier. Interoperability of public health systems is highly desirable but hardly achievable in the presence of such barriers.

Achieving public health goals through Medicaid expansion: opportunities in criminal justice, homelessness, and behavioral health with the Patient Protection and Affordable Care Act.

PubMed

DiPietro, Barbara; Klingenmaier, Lisa

2013-12-01

States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system--particularly when they struggle with behavioral health diagnoses--are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care.

Health care reform in the new South Africa.

PubMed

Benatar, S R

1997-03-20

The social transition which must follow the political transition in South Africa will pose major challenges for many decades. While it clear that inequities must be reduced, it is less clear how to effectively and sustainably achieve that end, especially given current rapid population growth and minimal additional resources in an economy which is growing less rapidly than hoped for by the new government. Health care reform is one of the country's many challenges. This paper provides insight into the shift from the conventional biomedical model of health care to the primary health care approach within a fixed public health budget. Obstacles to change, threats to academic activities, the 1980s and 1990s, political and social transition, health care reform since 1994, academic medicine and medical education, choices facing society, movement from political apartheid to economic apartheid, and public awareness are described.

Culturally Responsive Wraparound Supports: Collaborating with Families to Promote Students' Behavior Regulation across Settings

ERIC Educational Resources Information Center

Fallon, Lindsay M.; Mueller, Marlana R.

2017-01-01

As public schools in the U.S. are becoming increasingly culturally and linguistically diverse (CLD), there has been an effort to generate empirical support for culturally responsive practices in schools to promote a variety of positive outcomes for children (e.g., behavioral health, mental health, academic achievement). School psychologists can…

Building capacity for evidence informed decision making in public health: a case study of organizational change

PubMed Central

2012-01-01

Background Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. Methods This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. Results The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. Conclusion With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization. PMID:22348688

Estimating the health consequences of replacing cigarettes with nicotine inhalers

PubMed Central

Sumner, W

2003-01-01

Background: A fast acting, clean nicotine delivery system might substantially displace cigarettes. Public health consequences would depend on the subsequent prevalence of nicotine use, hazards of delivery systems, and intrinsic hazards of nicotine. Methods: A spreadsheet program, DEMANDS, estimates differences in expected mortality, adjusted for nicotine delivery system features and prevalence of nicotine use, by extending the data and methods of the SAMMEC 3 software from the US Centers for Disease Control and Prevention. The user estimates disease risks attributable to nicotine, other smoke components, and risk factors that coexist with smoking. The public health consequences of a widely used clean nicotine inhaler replacing cigarettes were compared to historical observations and public health goals, using four different risk attribution scenarios and nicotine use prevalence from 0–100%. Main outcome measures: Changes in years of potential life before age 85 (YPL85). Results: If nicotine accounts for less than a third of smokers' excess risk of SAMMEC diseases, as it most likely does, then even with very widespread use of clean nicotine DEMANDS predicts public health gains, relative to current tobacco use. Public health benefits accruing from a widely used clean nicotine inhaler probably equal or exceed the benefits of achieving Healthy People 2010 goals. Conclusions: Clean nicotine inhalers might improve public health as much as any feasible tobacco control effort. Although the relevant risk estimates are somewhat uncertain, partial nicotine deregulation deserves consideration as part of a broad tobacco control policy. PMID:12773720

Ethics in American Health 2: An Ethical Framework for Health System Reform

PubMed Central

2008-01-01

I argue that an ethical vision resting on explicitly articulated values and norms is critical to ensuring comprehensive health reform. Reform requires a consensus on the public good transcending self-interest and narrow agendas and underpinning collective action for universal coverage. In what I call shared health governance, individuals, providers, and institutions all have essential roles in achieving health goals and work together to create a positive environment for health. This ethical paradigm provides (1) reasoned consensus through a joint scientific and deliberative approach to judge the value of a health care intervention; (2) a method for achieving consensus that differs from aggregate tools such as a strict majority vote; (3) combined technical and ethical rationality for collective choice; (4) a joint clinical and economic approach combining efficiency with equity, but with economic solutions following and complementing clinical progress; and (5) protection for disabled individuals from discrimination. PMID:18703448

Ethics in American health 2: an ethical framework for health system reform.

PubMed

Ruger, Jennifer Prah

2008-10-01

I argue that an ethical vision resting on explicitly articulated values and norms is critical to ensuring comprehensive health reform. Reform requires a consensus on the public good transcending self-interest and narrow agendas and underpinning collective action for universal coverage. In what I call shared health governance, individuals, providers, and institutions all have essential roles in achieving health goals and work together to create a positive environment for health. This ethical paradigm provides (1) reasoned consensus through a joint scientific and deliberative approach to judge the value of a health care intervention; (2) a method for achieving consensus that differs from aggregate tools such as a strict majority vote; (3) combined technical and ethical rationality for collective choice; (4) a joint clinical and economic approach combining efficiency with equity, but with economic solutions following and complementing clinical progress; and (5) protection for disabled individuals from discrimination.

Research for Change: the role of scientific journals publishing mental health research.

PubMed

Saxena, Shekhar; Sharan, Pratap; Saraceno, Benedetto

2004-06-01

There is an enormous gap between the burden of mental disorders and mental health resources in low- and middle-income countries. The Mental Health: Global Action Programme of the World Health Organization (WHO) envisions an active role for research in the multidimensional efforts required to change the current mental health situation in these countries (Research for Change). WHO's strategies to achieve this include developing a research policy and a priority agenda at country level with active collaboration from all stakeholders, building research capacity and infrastructure and involving scientific journals to stimulate and disseminate public health oriented research. A recently agreed joint statement by editors of prominent journals publishing mental health research and WHO sets major objectives and some possible strategies for achieving this. WHO is committed to making Research for Change a reality by working with partners who share this aim.

Research for Change: the role of scientific journals publishing mental health research

PubMed Central

Saxena, Shekhar; Sharan, Pratap; Saraceno, Benedetto

2004-01-01

There is an enormous gap between the burden of mental disorders and mental health resources in low- and middle-income countries. The Mental Health: Global Action Programme of the World Health Organization (WHO) envisions an active role for research in the multidimensional efforts required to change the current mental health situation in these countries (Research for Change). WHO's strategies to achieve this include developing a research policy and a priority agenda at country level with active collaboration from all stakeholders, building research capacity and infrastructure and involving scientific journals to stimulate and disseminate public health oriented research. A recently agreed joint statement by editors of prominent journals publishing mental health research and WHO sets major objectives and some possible strategies for achieving this. WHO is committed to making Research for Change a reality by working with partners who share this aim. PMID:16633460

[Innovating in public health: monitoring of social determinants of health and reduction of health inequities: a priority for Spanish presidency of the European union in 2010].

PubMed

Calvete Oliva, Antonio; Campos Esteban, Pilar; Catalán Matamoros, Daniel; Fernández de la Hoz, Karoline; Herrador Ortiz, Zaida; Merino Merino, Begoña; Ramírez Fernández, Rosa; Santaolaya Cesteros, María; Hernández Aguado, Ildefonso

2010-01-01

Tackling health inequalities to achieve health equity is currently one of the main challenges for developed and developing countries. Aware of this reality, and knowing how relevant for economic and social growth the inequalities in health are, the Spanish Ministry of Health and Social Policy has established "Innovation in Public Health: monitoring social determinants of health and reduction of health inequalities" as one of the priorities for the Spanish presidency of the European Union in the first semester of 2010. Furthermore, a national strategy to tackle health inequalities is being developed in the current political term. By choosing this priority, the Spanish Ministry of Health an Social Policy aims to contribute to move forward a coherent and effective agenda at both European and national level, in a new world stage more aware of the social and economic expenditure of inequity in health and its repercussions on countries welfare and development.

Occupational safety and health: progress toward the 1990 objectives for the nation.

PubMed Central

Millar, J D; Myers, M L

1983-01-01

Occupational safety and health is 1 of 15 areas addressed in the Public Health Service's Objectives for the Nation. This area represents 104 million working men and women and the deaths, diseases, and injuries that result from exposures to hazards in their work environment. Characteristics of public health practice are compared with characteristics of occupational safety and health practice. The National Institute for Occupational Safety and Health (NIOSH), created by the Occupational Safety and Health Act, is discussed. NIOSH has developed a list of 10 leading work-related diseases and injuries. The list is headed by occupational lung diseases. Twenty Objectives for the Nation in the area of occupational safety and health are reviewed, and the status of NIOSH efforts toward their attainment is discussed. Five categories of objectives are covered: (a) improved health status, (b) reduced risk factors, (c) improved public and professional awareness, (d) improved service and protection, and (e) improved surveillance and evaluation. The potential for achieving these objectives is discussed, with special attention given to the lack of a data base for monitoring progress. A major conclusion is that surveillance in occupational safety and health needs to be strengthened. PMID:6310668

Supplementing Public Health Inspection via Social Media

PubMed Central

Schomberg, John P.; Haimson, Oliver L.; Hayes, Gillian R.; Anton-Culver, Hoda

2016-01-01

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant’s likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity, 54% specificity, area under the receiver operator curve of 77%, and positive predictive value of 25% (given a prevalence of 12%). Model accuracy improved when reviews ranked highest by Yelp were utilized. Our results indicate that public health surveillance can be improved by using social media data to identify restaurants at high risk for health code violation. Additionally, using highly ranked Yelp reviews improves predictive power and limits the number of reviews needed to generate prediction. Use of this approach as an adjunct to current risk ranking of restaurants prior to inspection may enhance detection of those restaurants participating in high risk practices that may have gone previously undetected. This model represents a step forward in the integration of social media into meaningful public health interventions. PMID:27023681

Supplementing Public Health Inspection via Social Media.

PubMed

Schomberg, John P; Haimson, Oliver L; Hayes, Gillian R; Anton-Culver, Hoda

2016-01-01

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant's likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity, 54% specificity, area under the receiver operator curve of 77%, and positive predictive value of 25% (given a prevalence of 12%). Model accuracy improved when reviews ranked highest by Yelp were utilized. Our results indicate that public health surveillance can be improved by using social media data to identify restaurants at high risk for health code violation. Additionally, using highly ranked Yelp reviews improves predictive power and limits the number of reviews needed to generate prediction. Use of this approach as an adjunct to current risk ranking of restaurants prior to inspection may enhance detection of those restaurants participating in high risk practices that may have gone previously undetected. This model represents a step forward in the integration of social media into meaningful public health interventions.

Panoramic View Of Challenges And Opportunities For Primary Healthcare Systems In Pakistan.

PubMed

Sharif, Hina; Sughra, Ume; Butt, Zahid

2016-01-01

Pakistan has a broad system of primary health care facilities to achieve mission of "Health for all". Over the last seven years health expenditure by government of Pakistan has been increased to attain this goal. This study was conducted with the aim to assess all blocks of service readiness (basic equipment, basic amenities, laboratory capacity, standard precautions and essential medicines) in public-primary health care facilities of tehsil Rawalpindi, Pakistan. A cross-sectional survey was carried out utilizing two separate structured questionnaires for basic health units and rural health centres. Information was collected from administrative heads along with other staff where required, of all public-primary health care facilities of Tehsil Rawalpindi. Data were analysed by using SPSS version.17. A total of 26 health facilities were assessed; only 56% BHUs had a sign board that was available in readable form. BHUs with women medical officer as administrative head constituted 52%. Backup for electricity and toilet were the most neglected areas. Basic amenities, standard precautions and laboratory capacity of Basic Health Units (BHUs) showed a clear deviation from standards and is thus a challenge for Pakistan's Primary Health care (PHC). On the other hand for Rural Health Centres (RHCs), most were on the way to meet expectations. Pakistan's government is undoubtedly putting efforts in order to achieve targets of primary healthcare but it needs better mainstreaming of political, institutional and social commitments with modified standards for PHC.

A Public Health Preparedness Logic Model: Assessing Preparedness for Cross-border Threats in the European Region

PubMed Central

Nelson, Christopher; Savoia, Elena; Ljungqvist, Irina; Ciotti, Massimo

2017-01-01

Improving preparedness in the European region requires a clear understanding of what European Union (EU) member states should be able to do, whether acting internally or in cooperation with each other or the EU and other multilateral organizations. We have developed a preparedness logic model that specifies the aims and objectives of public health preparedness, as well as the response capabilities and preparedness capacities needed to achieve them. The capabilities, which describe the ability to effectively use capacities to identify, characterize, and respond to emergencies, are organized into 5 categories. The first 3 categories—(1) assessment; (2) policy development, adaptation, and implementation; and (3) prevention and treatment services in the health sector—represent what the public health system must accomplish to respond effectively. The fourth and fifth categories represent a series of interrelated functions needed to ensure that the system fulfills its assessment, policy development, and prevention and treatment roles: (4) coordination and communication regards information sharing within the public health system, incident management, and leadership, and (5) emergency risk communication focuses on communication with the public. This model provides a framework for identifying what to measure in capacity inventories, exercises, critical incident analyses, and other approaches to assessing public health emergency preparedness, not how to measure them. Focusing on a common set of capacities and capabilities to measure allows for comparisons both over time and between member states, which can enhance learning and sharing results and help identify both strengths and areas for improvement of public health emergency preparedness in the EU. PMID:29058967

A Public Health Preparedness Logic Model: Assessing Preparedness for Cross-border Threats in the European Region.

PubMed

Stoto, Michael A; Nelson, Christopher; Savoia, Elena; Ljungqvist, Irina; Ciotti, Massimo

Improving preparedness in the European region requires a clear understanding of what European Union (EU) member states should be able to do, whether acting internally or in cooperation with each other or the EU and other multilateral organizations. We have developed a preparedness logic model that specifies the aims and objectives of public health preparedness, as well as the response capabilities and preparedness capacities needed to achieve them. The capabilities, which describe the ability to effectively use capacities to identify, characterize, and respond to emergencies, are organized into 5 categories. The first 3 categories-(1) assessment; (2) policy development, adaptation, and implementation; and (3) prevention and treatment services in the health sector-represent what the public health system must accomplish to respond effectively. The fourth and fifth categories represent a series of interrelated functions needed to ensure that the system fulfills its assessment, policy development, and prevention and treatment roles: (4) coordination and communication regards information sharing within the public health system, incident management, and leadership, and (5) emergency risk communication focuses on communication with the public. This model provides a framework for identifying what to measure in capacity inventories, exercises, critical incident analyses, and other approaches to assessing public health emergency preparedness, not how to measure them. Focusing on a common set of capacities and capabilities to measure allows for comparisons both over time and between member states, which can enhance learning and sharing results and help identify both strengths and areas for improvement of public health emergency preparedness in the EU.

A world wide public health problem: the principal re-emerging infectious diseases.

PubMed

De Luca D'Alessandro, E; Giraldi, G

2011-01-01

The extraordinary progress in the knowledge of infectious disease, the discovery of antibiotics and effective vaccines are among the great achievement of the nineteenth and twentieth centuries. These achievement have led to a dramatic reduction in the levels of mortality from these diseases. According to the World Health Organization, the term "re-emerging infectious diseases" refers to infectious diseases, which although well known, have not been of recent public health importance. However, climate change, migration, changes in health services, antibiotic resistance, population increase, international travel, the increase in the number of immune-depressed patients ,etc have lead to the re-emergence of these diseases. The climate changes are exposing sectors of the population to inadequate fresh air, water, food and resources for survival which, in consequence, provoke increases in both internal and international migration. In this particular period in which we find ourselves, characterized by globalization, the international community has become aware that the re-emergence of these diseases poses an important risk for public health underlines the necessity to adopt appropriate strategies for their prevention and control. The re-emerging diseases of the twenty-first century are a serious problem for public health and even though there has been enormous progress in medical science and in the battle against infectious diseases, they are still a long way from being really brought under control. A well organized monitoring system would enable the epidemiological characteristics of the infectious diseases to be analyzed and the success or otherwise of preventive interventions to be precisely evaluated. For this reason, the World Health Organization and the European Union have discussed the formation of a collaborative network for the monitoring and control of re-emerging diseases and has initiated special programmes. The battle between humanity and infectious disease has a history lasting thousands of years and is destined to continue in the future emphasizing the need to adopt combined policies for the prevention and control of re-emerging diseases.

The introduction of new vaccines into developing countries. III. The role of intellectual property.

PubMed

Mahoney, Richard T; Pablos-Mendez, Ariel; Ramachandran, S

2004-01-26

The development of new vaccines that address the particular needs of developing countries has been proceeding slowly. A number of new public sector vaccine research and development initiatives have been launched to address this problem. These new initiatives find that they often wish to collaborate with the private sector and, in collaborating with the private sector, they must address issues of intellectual property (IP) management. It has not been well understood why IP management is important and how such management by public sector groups can best be conducted. IP management has become very important because vaccine research and development is driven by the regulatory process. The regulatory process has increased the cost of vaccine development to very high levels especially for the highly sophisticated new vaccines currently under development. Thus, investors seek IP protection for the required large investments. Conversely, we assert this concept as a new insight, IP rights are essential for mobilizing the significant funds necessary to meet regulatory requirements. Thus, IP rights are of value not only for investors but also for the public at large. In the absence of public sector mechanisms to carry out the functions that the private sector currently conducts, the public sector needs to increase its sophistication in IP management and needs to identify and implement strategies that will help the public sector to achieve its public health goals, especially for the poor and, among these individuals, the poor in developing countries. This paper suggests some strategies that might be used by the public sector to help achieve its public health goals, especially for the poor.

Developing Your Evaluation Plans: A Critical Component of Public Health Program Infrastructure.

PubMed

Lavinghouze, S Rene; Snyder, Kimberly

A program's infrastructure is often cited as critical to public health success. The Component Model of Infrastructure (CMI) identifies evaluation as essential under the core component of engaged data. An evaluation plan is a written document that describes how to monitor and evaluate a program, as well as how to use evaluation results for program improvement and decision making. The evaluation plan clarifies how to describe what the program did, how it worked, and why outcomes matter. We use the Centers for Disease Control and Prevention's (CDC) "Framework for Program Evaluation in Public Health" as a guide for developing an evaluation plan. Just as using a roadmap facilitates progress on a long journey, a well-written evaluation plan can clarify the direction your evaluation takes and facilitate achievement of the evaluation's objectives.

A knowledge management tool for public health: health-evidence.ca.

PubMed

Dobbins, Maureen; DeCorby, Kara; Robeson, Paula; Husson, Heather; Tirilis, Daiva; Greco, Lori

2010-08-18

The ultimate goal of knowledge translation and exchange (KTE) activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM) is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present) of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are among the largest groups of registered users, followed by librarians, dieticians, medical officers of health, and nutritionists. The majority of users (67%) access the website from direct traffic (e.g., have the health-evidence.ca webpage bookmarked, or type it directly into their browser). Consistent use of health-evidence.ca and particularly the searching for reviews that correspond with current public health priorities illustrates that health-evidence.ca may be playing an important role in achieving evidence-informed public health decision making.

What gets measured gets done: an assessment of local data uses and needs in large urban health departments.

PubMed

Castrucci, Brian C; Rhoades, Elizabeth K; Leider, Jonathon P; Hearne, Shelley

2015-01-01

The epidemiologic shift in the leading causes of mortality from infectious disease to chronic disease has created significant challenges for public health surveillance at the local level. We describe how the largest US city health departments identify and use data to inform their work and we identify the data and information that local public health leaders have specified as being necessary to help better address specific problems in their communities. We used a mixed-methods design that included key informant interviews, as well as a smaller embedded survey to quantify organizational characteristics related to data capacity. Interview data were independently coded and analyzed for major themes around data needs, barriers, and achievements. Forty-five public health leaders from each of 3 specific positions-local health official, chief of policy, and chief science or medical officer-in 16 large urban health departments. Public health leaders in large urban local health departments reported that timely data and data on chronic disease that are available at smaller geographical units are difficult to obtain without additional resources. Despite departments' successes in creating ad hoc sources of local data to effect policy change, all participants described the need for more timely data that could be geocoded at a neighborhood or census tract level to more effectively target their resources. Electronic health records, claims data, and hospital discharge data were identified as sources of data that could be used to augment the data currently available to local public health leaders. Monitoring the status of community health indicators and using the information to identify priority issues are core functions of all public health departments. Public health professionals must have access to timely "hyperlocal" data to detect trends, allocate resources to areas of greatest priority, and measure the effectiveness of interventions. Although innovations in the largest local health departments in large urban areas have established some methods to obtain local data on chronic disease, leaders recognize that there is an urgent need for more timely and more geographically specific data at the neighborhood or census tract level to efficiently and effectively address the most pressing problems in public health.

Glycaemic control and associated factors among patients with diabetes at public health clinics in Johor, Malaysia.

PubMed

Mahmood, M I; Daud, Faiz; Ismail, Aniza

2016-06-01

To determine the prevalence of glycaemic control and factors associated with poor glycaemic control [glycosylated haemoglobin (HbA1c) ≥6.5%] among patients with type 2 diabetes treated in public health clinics in Johor, Malaysia. Cross-sectional study. A review of all patients aged over 18 years and with a diagnosis of type 2 diabetes for >1 year. The National Diabetic Registry was used as the database for attendees at public health clinics in Johor Bahru between January and December 2013. A required sample of 660 was calculated, and a random sampling method was applied to acquire patient information across the 13 public health clinics in Johor Bahru. All relevant information (e.g. HbA1c, type of treatment and other parameters for glycaemic control) were abstracted from the registry. Sixty-eight percent of 706 patients had HbA1c >6.5%, and mean HbA1c was 7.8%. Younger patients (72.3%) had poorer glycaemic control than older patients (63.0%), and most patients with poor glycaemic control were obese (79.2%). Approximately 31.7% of patients did not achieve the target blood pressure <130/80 mmHg, and 58.5% did not achieve the target lipid profile. Multiple logistic regression analysis revealed that age (<60 years), sex (male), duration of diabetes (>5 years), body mass index (obese), type of treatment (diet therapy vs combination therapy) and abnormal lipid profile were significantly associated with increased odds of HbA1C >6.5%. More than half (68%) of the patients with diabetes had HbA1c >6.5%. This highlights the importance of providing organized care to manage patients with diabetes in the primary care setting, such as weight reduction programmes, proper prescribing treatment, and age- and gender-specific groups to ensure good glycaemic control. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Contributions of Onchocerciasis Control and Elimination Programs toward the Achievement of the Millennium Development Goals

PubMed Central

Dunn, Caitlin; Callahan, Kelly; Katabarwa, Moses; Richards, Frank; Hopkins, Donald; Withers, P. Craig; Buyon, Lucas E.; McFarland, Deborah

2015-01-01

In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the “big three” diseases—namely HIV, tuberculosis (TB), and malaria—has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda. PMID:25996946

The Contributions of Onchocerciasis Control and Elimination Programs toward the Achievement of the Millennium Development Goals.

PubMed

Dunn, Caitlin; Callahan, Kelly; Katabarwa, Moses; Richards, Frank; Hopkins, Donald; Withers, P Craig; Buyon, Lucas E; McFarland, Deborah

2015-05-01

In 2000, 189 member states of the United Nations (UN) developed a plan for peace and development, which resulted in eight actionable goals known as the Millennium Development Goals (MDGs). Since their inception, the MDGs have been considered the international standard for measuring development progress and have provided a blueprint for global health policy and programming. However, emphasis upon the achievement of priority benchmarks around the "big three" diseases--namely HIV, tuberculosis (TB), and malaria--has influenced global health entities to disproportionately allocate resources. Meanwhile, several tropical diseases that almost exclusively impact the poorest of the poor continue to be neglected, despite the existence of cost-effective and feasible methods of control or elimination. One such Neglected Tropical Disease (NTD), onchocerciasis, more commonly known as river blindness, is a debilitating and stigmatizing disease primarily affecting individuals living in remote and impoverished areas. Onchocerciasis control is considered to be one of the most successful and cost-effective public health campaigns ever launched. In addition to improving the health and well-being of millions of individuals, these programs also lead to improvements in education, agricultural production, and economic development in affected communities. Perhaps most pertinent to the global health community, though, is the demonstrated effectiveness of facilitating community engagement by allowing communities considerable ownership with regard to drug delivery. This paper reviews the contributions that such concentrated efforts to control and eliminate onchocerciasis make to achieving select MDGs. The authors hope to draw the attention of public policymakers and global health funders to the importance of the struggle against onchocerciasis as a model for community-directed interventions to advance health and development, and to advocate for NTDs inclusion in the post 2015 agenda.

Small Drinking Water System Variances

EPA Pesticide Factsheets

Small system variances allow a small system to install and maintain technology that can remove a contaminant to the maximum extent that is affordable and protective of public health in lieu of technology that can achieve compliance with the regulation.

[HPV vaccine implementation in Chile: an appraisal from the social determinants of health model].

PubMed

Fernández González, Loreto

2017-12-01

Cervical cancer is the fourth most common neoplasm in women worldwide and its incidence is associated with profound social inequities. In Chile, it is the second cause of death in women of reproductive age. The Chilean clinical guideline identifies the vaccine against Human Papillomavirus (HPV) as the main preventive measure. Since 2014, the Ministry of Health has implemented free immunization against HPV for girls and female adolescents. This article critically analyzes this public policy from the viewpoint of health equity, using as framework the Social Determinants of Health Model. Specifically, we address the structural determinants of income and gender, which act as material and social barriers for achieving immunization, affecting protection against cervical cancer. These barriers correspond to the high cost of the vaccine, and social attitudes/cultural beliefs towards sexual behavior in Latin America and Chile that affect the acceptability of vaccination. The Social Determinants of Health Model constitutes a useful tool for identifying health inequities and understanding public policy from an equity viewpoint that complements the biomedical and epidemiological understanding of disease. In this topic, the initiative aims to strengthen the idea of health as a human right and health promotion as an essential function of public health policy.

A new matrix for scoring the functionality of national laboratory networks in Africa: introducing the LABNET scorecard.

PubMed

Ondoa, Pascale; Datema, Tjeerd; Keita-Sow, Mah-Sere; Ndihokubwayo, Jean-Bosco; Isadore, Jocelyn; Oskam, Linda; Nkengasong, John; Lewis, Kim

2016-01-01

Functional national laboratory networks and systems are indispensable to the achievement of global health security targets according to the International Health Regulations. The lack of indicators to measure the functionality of national laboratory network has limited the efficiency of past and current interventions to enhance laboratory capacity in resource-limited-settings. We have developed a matrix for the assessment of national laboratory network functionality and progress thereof, with support from the African Society of Laboratory Medicine and the Association of Public Health Laboratories. The laboratory network (LABNET) scorecard was designed to: (1) Measure the status of nine overarching core capabilities of laboratory network required to achieve global health security targets, as recommended by the main normative standards; (2) Complement the World Health Organization joint external evaluation tool for the assessment of health system preparedness to International Health Regulations (2005) by providing detailed information on laboratory systems; and (3) Serve as a clear roadmap to guide the stepwise implementation of laboratory capability to prevent, detect and act upon infectious threats. The application of the LABNET scorecard under the coordination of the African Society of Laboratory Medicine and the Association of Public Health Laboratories could contribute to the design, monitoring and evaluation of upcoming Global Health Security Agenda-supported laboratory capacity building programmes in sub Saharan-Africa and other resource-limited settings, and inform the development of national laboratory policies and strategic plans. Endorsement by the World Health Organization Regional Office for Africa is foreseen.

The global public good concept: a means of promoting good veterinary governance.

PubMed

Eloit, M

2012-08-01

At the outset, the concept of a 'public good' was associated with economic policies. However, it has now evolved not only from a national to a global concept (global public good), but also from a concept applying solely to the production of goods to one encompassing societal issues (education, environment, etc.) and fundamental rights, including the right to health and food. Through their actions, Veterinary Services, as defined by the Terrestrial Animal Health Code (Terrestrial Code) of the World Organisation for Animal Health (OIE), help to improve animal health and reduce production losses. In this way they contribute directly and indirectly to food security and to safeguarding human health and economic resources. The organisation and operating procedures of Veterinary Services are therefore key to the efficient governance required to achieve these objectives. The OIE is a major player in global cooperation and governance in the fields of animal and public health through the implementation of its strategic standardisation mission and other programmes for the benefit of Veterinary Services and OIE Member Countries. Thus, the actions of Veterinary Services and the OIE deserve to be recognised as a global public good, backed by public investment to ensure that all Veterinary Services are in a position to apply the principles of good governance and to comply with the international standards for the quality of Veterinary Services set out in the OIE Terrestrial Code (Section 3 on Quality of Veterinary Services) and Aquatic Animal Health Code (Section 3 on Quality of Aquatic Animal Health Services).

[Investing in health: the economic case. Report of the WISH Investing in Health Forum 2016].

PubMed

Yamey, Gavin; Beyeler, Naomi; Wadge, Hester; Jamison, Dean

2017-01-01

Developing country governments and aid agencies face difficult decisions on how best to allocate their finite resources. Investments in many different sectors -including education, water and sanitation, transportation, and health- can all reap social and economic benefits. This report focuses specifically on the health sector. It presents compelling evidence of the value of scaling-up health investments. The economic case for increasing these investments in health has never been stronger. Having made progress in reducing maternal and child mortality, and deaths from infectious diseases, it is essential that policymakers do not become complacent. These gains will be quickly reversed without sustained health investments. Scaled-up investments will be needed to tackle the emerging non-communicable disease (NCD) burden and to achieve universal health coverage (UHC). The value of investment in health far beyond its performance is reflected in economic prosperity through gross domestic product (GDP). People put a high monetary value on the additional years of life that health investments can bring -an inherent value to being alive for longer, unrelated to productivity. Policymakers need to do more to ensure that spending on health reflects people's priorities. To make sure services are accessible to all, governments have a clear role to play in financing health. Without public financing, there will be some who cannot afford the care they need, and they will be forced to choose sickness -perhaps even death- and financial ruin; a devastating choice that already pushes 150 million people into poverty every year. In low-income countries (LICs) and middle-income countries (MICs), public financing should be used to achieve universal coverage with a package of highly cost-effective interventions ('best buys'). Governments failing to protect the health and wealth of their people in this way will be unable to reap the benefits of long-term economic prosperity and growth. Public financing has the benefit of being more efficient and better at controlling costs than private financing and is the only sustainable way to reach UHC. In addition, people put a high economic value on the protection against financial risk that public financing provides. This report addresses three key questions: 1) What is the economic rationale for investing in health?; 2) what is the best way to finance health?, and 3) which interventions should be prioritized?

Bridging the Silos of Service Delivery for High-Need, High-Cost Individuals.

PubMed

Sherry, Melissa; Wolff, Jennifer L; Ballreich, Jeromie; DuGoff, Eva; Davis, Karen; Anderson, Gerard

2016-12-01

Health care reform efforts that emphasize value have increased awareness of the importance of nonmedical factors in achieving better care, better health, and lower costs in the care of high-need, high-cost individuals. Programs that care for socioeconomically disadvantaged, high-need, high-cost individuals have achieved promising results in part by bridging traditional service delivery silos. This study examined 5 innovative community-oriented programs that are successfully coordinating medical and nonmedical services to identify factors that stimulate and sustain community-level collaboration and coordinated care across silos of health care, public health, and social services delivery. The authors constructed a conceptual framework depicting community health systems that highlights 4 foundational factors that facilitate community-oriented collaboration: flexible financing, shared leadership, shared data, and a strong shared vision of commitment toward delivery of person-centered care.

[Personality and work of Florence Nightingale--creator of modern nursing and public health pioneer].

PubMed

Milutinović, Dragana; Sumonja, Sanja; Maksimović, Jovan

2012-01-01

Through her "calling to service", Florence Nightingale worked as a nurse, manager, researcher, reformer, writer and teacher. The aim of this study is to present Florence Nightingale in all these roles, pointing out all complexity and multidimensionality of nursing profession. Having come from an aristocratic English family, Florence Nightingale was very educated She considered knowledge as a way, and statistical method as an instrument for discovering the rules of the world. Her work during the Crimean War was one of her most important deeds and made her a national hero. After the war, she devoted herself to reforming nursing and public health in Britain and in the world. Since she was bedbound after the Crimean War due to her illness, writing became the most powerful tool she had in achieving her goals. Florence Nightingale wrote many letters to politicians and statesmen, many newspaper and scientific articles. One of her greatest works "Notes on Nursing" was not written only for nurses, but for all women. By founding Nursing school at St. Thomas Hospital in 1860 she aspired to train and educate nurses. Her complete and lifelong devotion to the ,,calling" directed all her activities, contributions and achievements, not only towards nursing but also towards statistics, epidemiology, public health and social sciences.

When technical achievements aren't enough: Lessons learned from efforts to catalyze policy action on supply chain in Senegal.

PubMed

Dicko, Modibo; Souare, Batouo; Sarr, Lamine Cisse; Gueye, Babacar

2017-04-19

Before 2013, Senegal public health supply system was pull-based and fully public-run. Lengthy and recurrent stockouts of essential health products (incl. contraceptives) were the rule, not the exception as they used to strike more than 80% of public service delivery points (SDPs). Following a successful pilot in two districts in 2012, the Senegalese Ministry of Health and Social Action (MSAS) implemented the Informed Push Model (IPM) Project (2013-2016). In its first two years, IPM bridged key gaps and expanded the distribution of contraceptives by private third party logistics operators to all public SDPs in Senegal and nearly eliminated stockouts. However, the MSAS was slow to take ownership of the project. Understanding the roots of this reluctance, executing a range of targeted communication and advocacy efforts and preparing a strong transition plan are succeeding to push Government toward full ownership to enable the National Supply Pharmacy to distribute all health products going to SDPs, including vaccines, consistently with their Strategic Plan 2014-2018. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

International cooperation in veterinary public health curricula using web-based distance interactive education.

PubMed

Lipman, Len J; Barnier, Valérie M; de Balogh, Katalin K

2003-01-01

The expanding field of Veterinary Public Health places new demands on the knowledge and skills of veterinarians. Veterinary curricula must therefore adapt to this new profile. Through the introduction of case studies dealing with up-to-date issues, students are being trained to solve (real-life) problems and come up with realistic solutions. At the Department of Public Health and Food Safety of the Veterinary Faculty at the University of Utrecht in the Netherlands, positive experiences have resulted from the new opportunities offered by the use of information and communication technology (ICT) in education. The possibility of creating a virtual classroom on the Internet through the use of WebCT software has enabled teachers and students to tackle emerging issues by working together with students in other countries and across disciplines. This article presents some of these experiences, through which international exchange of ideas and realities were stimulated, in addition to consolidating relations between universities in different countries. Long-distance education methodologies provide an important tool to achieve the increasing need for international cooperation in Veterinary Public Health curricula.

[Dr Stockmann and Dr Snow--two heroes of public health].

PubMed

Nylenna, Magne

2003-12-23

Dr Thomas Stockmann, the main character of An enemy of the people by Henrik Ibsen (1828-1906), has been described as a hero of public health. In spite of his idealism and high principles, he was, however, not able to do anything about the contaminated water supply of the baths in the town where he lived. Important differences may be noticed if we compare the fictional Dr Stockmann with Dr John Snow (1813-58), a real hero of public health famous for his handling of a cholera epidemic in London in 1854. While Dr Snow carried out extensive investigations of the relation between water supply and illness and still was humble when presenting his findings, the fictional Dr Stockmann took only one sample of water for examination and was bombastic in his conclusion. And while Dr Snow had a simple suggestion for solving the problem, Dr Stockmann seemed more eager to dramatize the situation. Scientific documentation and a practical attitude to problem solving continue to be important in order to achieve results in the field of public health.

Declaration of Education: Toward a Culture of Achievement in D.C. Public Schools. Hearing before the Committee on Government Reform, House of Representatives, One Hundred Ninth Congress, First Session (May 20, 2005) Serial No. 109-30

ERIC Educational Resources Information Center

US House of Representatives, 2005

2005-01-01

In this hearing on the District of Columbia's public school system (DCPS), the Honorable Tom Davis, chairman of the Committee on Government Reform, says in his opening statement that the District's improved health cannot be sustained without a better public school system, and that the lack of performance improvement threatens future growth and…

From smallpox eradication to contemporary global health initiatives: enhancing human capacity towards a global public health goal.

PubMed

Tarantola, Daniel; Foster, Stanley O

2011-12-30

The eradication of smallpox owes its success first and foremost to the thousands of lay health workers and community members who, throughout the campaign and across continents, took on the roles of advocates, educators, vaccinators, care providers and contributors to epidemic surveillance and containment. Bangladesh provides a good example where smallpox eradication and the capacity enhancement needed to achieve this goal resulted in a two-way mutually beneficial process. Smallpox-dedicated staff provided community members with information guidance, support and tools. In turn, communities not only created the enabling environment for smallpox program staff to perform their work but acquired the capacity to perform essential eradication tasks. Contemporary global health programmes can learn much from these core lessons including: the pivotal importance of supporting community aspirations, capacity and resilience; the critical need to enhance commitment, capacity and accountability across the workforce; and the high value of attentive human resources management and support. We owe to subsequent global disease control, elimination and eradication ventures recognition of the need for social and behavioural science to inform public health strategies; the essential roles that civil society organizations and public-private partnerships can play in public health discourse and action; the overall necessity of investing in broad-based health system strengthening; and the utility of applying human rights principles, norms and standards to public health policy and practice. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Toward a Fourth Generation of Disparities Research to Achieve Health Equity

PubMed Central

Thomas, Stephen B.; Quinn, Sandra Crouse; Butler, James; Fryer, Craig S.; Garza, Mary A.

2011-01-01

Achieving health equity, driven by the elimination of health disparities, is a goal of Healthy People 2020. In recent decades, the improvement in health status has been remarkable for the U.S. population as a whole. However, racial and ethnic minority populations continue to lag behind whites with a quality of life diminished by illness from preventable chronic diseases and a life span cut short by premature death. We examine a conceptual framework of three generations of health disparities research to understand (a) data trends, (b) factors driving disparities, and (c) solutions for closing the gap. We propose a new, fourth generation of research grounded in public health critical race praxis, utilizing comprehensive interventions to address race, racism, and structural inequalities and advancing evaluation methods to foster our ability to eliminate disparities. This new generation demands that we address the researcher’s own biases as part of the research process. PMID:21219164