Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education

PubMed Central

Fleckman, Julia M.; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C.

2015-01-01

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions. PMID:26389109

Intercultural Competency in Public Health: A Call for Action to Incorporate Training into Public Health Education.

PubMed

Fleckman, Julia M; Dal Corso, Mark; Ramirez, Shokufeh; Begalieva, Maya; Johnson, Carolyn C

2015-01-01

Due to increasing national diversity, programs addressing cultural competence have multiplied in U.S. medical training institutions. Although these programs share common goals for improving clinical care for patients and reducing health disparities, there is little standardization across programs. Furthermore, little progress has been made to translate cultural competency training from the clinical setting into the public health setting where the focus is on population-based health, preventative programming, and epidemiological and behavioral research. The need for culturally relevant public health programming and culturally sensitive public health research is more critical than ever. Awareness of differing cultures needs to be included in all processes of planning, implementation and evaluation. By focusing on community-based health program planning and research, cultural competence implies that it is possible for public health professionals to completely know another culture, whereas intercultural competence implies it is a dual-sided process. Public health professionals need a commitment toward intercultural competence and skills that demonstrate flexibility, openness, and self-reflection so that cultural learning is possible. In this article, the authors recommend a number of elements to develop, adapt, and strengthen intercultural competence education in public health educational institutions.

Bioterrorism, public health, and the law.

PubMed

Bayer, Ronald; Colgrove, James

2002-01-01

The controversy over the Model State Emergency Health Powers Act has underscored the enduring tension in public health between guarding the common welfare and respecting individual liberty. The current version of the act, crafted in response to extensive public commentary, attempts to strike a balance between these values but has failed to allay the concerns of many civil libertarians and privacy advocates. Although the debates over the model act have been triggered by the threat of bioterrorism, they illustrate broader philosophical differences, with profound implications for all realms of public health policy.

Public health decisions: Actions and consequences☆

PubMed Central

Pohl, H.R.; Jones, D.E.; Holler, J.S.; Murray, H.E.

2017-01-01

The goal of public health is to promote the best possible health for the whole population. Public health issues are numerous and can be unbelievably complex in form, scope, and possible consequence. Most public health decisions involve assessing several different options, weighing the respective benefits and risks of those options, and making difficult decisions that hopefully provide the greatest benefit to the affected populations. Many risk management decisions involve a variety of societal factors which modify risk assessment choices. The purpose of this paper is to point out difficulties in making decisions that impact public health. The intent of such decisions is to improve public health, but as illustrated in the paper, there can be unintended adverse consequences. Such unplanned issues require continued attention and efforts for responsible officials in the protection of environmental public health. This article presents examples of such events, when in the past, it was necessary to assess and regulate a number of potentially hazardous chemicals commonly used as insecticides, gasoline additives, and wood preservatives. PMID:25092130

Firearms, Youth Homicide, and Public Health

PubMed Central

Levine, Robert S.; Goldzweig, Irwin; Kilbourne, Barbara; Juarez, Paul

2012-01-01

Homicide is seven times as common among U.S. non-Hispanic Black as among non-Hispanic White youth ages 15 to 24 years. In 83% of these youth homicides, the murder weapon is a firearm. Yet, for more than a decade, the national public health position on youth violence has been largely silent about the role of firearms, and tools used by public health professionals to reduce harm from other potential hazards have been unusable where guns are concerned. This deprives already underserved populations from the full benefits public health agencies might be able to deliver. In part, political prohibitions against research about direct measures of firearm control and the absence of valid public health surveillance are responsible. More refined epidemiologic theories as well as traditional public health methods are needed if the U.S. aims to reduce disparate Black-White youth homicide rates. PMID:22643459

Obesity Stigma: Important Considerations for Public Health

PubMed Central

Heuer, Chelsea A.

2010-01-01

Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health. PMID:20075322

Harmful Algal Blooms and Public Health

PubMed Central

Grattan, Lynn M.; Holobaugh, Sailor; Morris, J. Glenn

2015-01-01

The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971

Harmful Algal Blooms and Public Health.

PubMed

Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn

2016-07-01

The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels.

The interrelationships of wellness, public health, and chiropractic

PubMed Central

Hawk, Cheryl

2005-01-01

Abstract Objectives To explicate the relationships among the definitions and practices of chiropractic, wellness and public health and to make recommendations for strengthening these relationships. Background Public health-related topics comprise less than 2% of chiropractic coursework at most chiropractic colleges, and few connections currently exist between chiropractic and public health practice. The concept of well-ness is common to both, and might serve to bridge the gap between the individual health services provided by chiropractors and the community health services provided by public health agencies. Conclusion It is time for chiropractic to join the public health movement to improve the health and promote wellness not just in their patient populations, but in their communities, and demonstrate their commitment to patient wellness by integrating their efforts with the healthcare mainstream. PMID:19674661

Eugenics and public health in American history.

PubMed

Pernick, M S

1997-11-01

Supporters of eugenics, the powerful early 20th-century movement for improving human heredity, often attacked that era's dramatic improvements in public health and medicine for preserving the lives of people they considered hereditarily unfit. Eugenics and public health also battled over whether heredity played a significant role in infectious diseases. However, American public health and eugenics had much in common as well. Eugenic methods often were modeled on the infection control techniques of public health. The goals, values, and concepts of disease of these two movements also often overlapped. This paper sketches some of the key similarities and differences between eugenics and public health in the United States, and it examines how their relationship was shaped by the interaction of science and culture. The results demonstrate that eugenics was not an isolated movement whose significance is confined to the histories of genetics and pseudoscience, but was instead an important and cautionary part of past public health and a general medical history as well.

Eugenics and public health in American history.

PubMed Central

Pernick, M S

1997-01-01

Supporters of eugenics, the powerful early 20th-century movement for improving human heredity, often attacked that era's dramatic improvements in public health and medicine for preserving the lives of people they considered hereditarily unfit. Eugenics and public health also battled over whether heredity played a significant role in infectious diseases. However, American public health and eugenics had much in common as well. Eugenic methods often were modeled on the infection control techniques of public health. The goals, values, and concepts of disease of these two movements also often overlapped. This paper sketches some of the key similarities and differences between eugenics and public health in the United States, and it examines how their relationship was shaped by the interaction of science and culture. The results demonstrate that eugenics was not an isolated movement whose significance is confined to the histories of genetics and pseudoscience, but was instead an important and cautionary part of past public health and a general medical history as well. PMID:9366633

Public health insurance under a nonbenevolent state.

PubMed

Lemieux, Pierre

2008-10-01

This paper explores the consequences of the oft ignored fact that public health insurance must actually be supplied by the state. Depending how the state is modeled, different health insurance outcomes are expected. The benevolent model of the state does not account for many actual features of public health insurance systems. One alternative is to use a standard public choice model, where state action is determined by interaction between self-interested actors. Another alternative--related to a strand in public choice theory--is to model the state as Leviathan. Interestingly, some proponents of public health insurance use an implicit Leviathan model, but not consistently. The Leviathan model of the state explains many features of public health insurance: its uncontrolled growth, its tendency toward monopoly, its capacity to buy trust and loyalty from the common people, its surveillance ability, its controlling nature, and even the persistence of its inefficiencies and waiting lines.

Targeted marketing and public health.

PubMed

Grier, Sonya A; Kumanyika, Shiriki

2010-01-01

Targeted marketing techniques, which identify consumers who share common needs or characteristics and position products or services to appeal to and reach these consumers, are now the core of all marketing and facilitate its effectiveness. However, targeted marketing, particularly of products with proven or potential adverse effects (e.g., tobacco, alcohol, entertainment violence, or unhealthful foods) to consumer segments defined as vulnerable raises complex concerns for public health. It is critical that practitioners, academics, and policy makers in marketing, public health, and other fields recognize and understand targeted marketing as a specific contextual influence on the health of children and adolescents and, for different reasons, ethnic minority populations and other populations who may benefit from public health protections. For beneficial products, such understanding can foster more socially productive targeting. For potentially harmful products, understanding the nature and scope of targeted marketing influences will support identification and implementation of corrective policies.

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 Public Health Responsibility Deal: brokering a deal for public health, but on whose terms?

PubMed

Panjwani, Clare; Caraher, Martin

2014-02-01

Coalitions of multinational food and drink businesses have pledged to reformulate their products and to market them responsibly. Largely business-led and self-regulated, the integrity of these voluntary initiatives has been questioned. The Public Health Responsibility Deal in England is an example of a voluntary initiative that is government-led. Does this approach provide evidence that with public leadership there is potential for voluntary actions to deliver meaningful results for public health? The subject of the research is the calorie reduction initiative of the Responsibility Deal. Source material was obtained primarily through a series of UK Freedom of Information requests and comprises previously unpublished Department of Health documentation relating to relevant meetings held during 2011 and 2012. The Responsibility Deal approach to calorie reduction deliberately involves the food industry in the specification of the measures it is to implement (reformulation and portion control). Finding the common ground between private and public interests has resulted in the deflection of public health objectives and the preclusion of adequate monitoring and evaluation. The Responsibility Deal approach is fundamentally flawed in its expectation that industry will take voluntary actions that prioritise public health interests above its own. Being government-led counts for little in the absence of sanctions to drive compliance. Instead the initiative affords private interests the opportunity to influence in their favour the public health policies and strategies that affect their products. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Re-visioning public health ethics: a relational perspective.

PubMed

Kenny, Nuala P; Sherwin, Susan B; Baylis, Françoise E

2010-01-01

Canada is in the forefront of thinking about the unique and complex issues of contemporary public health ethics. However, an inordinate focus on the urgent issues of emergency preparedness in pandemic and reliance on bioethical analysis steeped in the autonomy and individual rights tradition of health care and research do not serve adequately as the basis for an ethic of public health with its focus on populations, communities and the common good. This paper describes some concerns regarding the focus on pandemic ethics in isolation from public health ethics; identifies inadequacies in the dominant individualistic ethics framework; and summarizes nascent work on the concepts of relational autonomy, relational social justice and relational solidarity that can inform a re-visioning of public health ethics. While there is still much work to be done to further refine these principles, they can help to reclaim and centre the common and collective good at risk in pandemic and other emergency situations. Minimally, these principles require a policy-making process that is truly transparent, fair and inclusive; is sensitive and responsive to the workings of systemic inequalities; and requires public recognition of the fact that we enter any crisis with varying degrees of inequity. Public policy response to crisis must not forseeably increase existing inequities.

Public policy involvement by health commissioners.

PubMed

Thompson, Amy; Boardley, Debra; Kerr, Dianne; Greene, Tiffany; Jenkins, Melissa

2009-08-01

The purpose of this national study was to determine advocacy activities and level of involvement of health commissioners regarding public policy. Benefits, barriers, and perceived outcomes of advocacy efforts were also explored. A previously validated (Holtrop et al., Am J Health Behav 24(2):132-142, 2000) four-page survey was mailed to 700 health commissioners, who were randomly selected from the National Association of County and City Health Officials (NACCHO) database. A three-wave mailing was performed which yielded a 50% response rate. Of these respondents, the majority (70%) were female and (88%) Caucasian. Overall, 31% of health commissioners reported being involved in influencing public policy in the last 4 years. The most common reported activities engaged in by health commissioners included voting (84%), and providing policy information to consumers or other professionals (77%). Perceived barriers to influencing policy were time, (64%), and other priorities (46%). Perceived benefits to influencing policy included improving the health of the public (94%) and making a difference in others' lives (87%). Only 15% perceived their knowledge regarding the process of changing public policy was excellent. Although health commissioners are often spokespersons for health agencies and communities, their public policy involvement is marginal. Professional preparation programs and continuing education opportunities should focus on advocacy, public policy development, and removing barriers to action.

Commonalities of nurse-designed models of health care.

PubMed

Mason, Diana J; Jones, Dorothy A; Roy, Callista; Sullivan, Cheryl G; Wood, Laura J

2015-01-01

The American Academy of Nursing has identified examples of care redesign developed by nurses who address the health needs of diverse populations. These models show important clinical and financial outcomes as summarized in the Select Edge Runner Models of Care table included in this article. A study team appointed by the Academy explored the commonalities across these models. Four commonalities emerged: health holistically defined; individual-, family-, and community-centric approaches to care; relationship-based care that enables partnerships and builds patient engagement and activation; and a shift from episodic individual care to continuous group and public health approaches. The policy implications include examining measures of an expanded definition of health, paying for visionary care, and transparency and rewards for community-level engagement. Copyright © 2015 Elsevier Inc. All rights reserved.

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

Public health ethics. Public justification and public trust.

PubMed

Childress, J F; Bernheim, R Gaare

2008-02-01

Viewing public health as a political and social undertaking as well as a goal of this activity, the authors develop some key elements in a framework for public health ethics, with particular attention to the formation of public health policies and to decisions by public health officials that are not fully determined by established public policies. They concentrate on ways to approach ethical conflicts about public health interventions. These conflicts arise because, in addition to the value of public health, societies have a wide range of other values that sometimes constrain the selection of means to achieve public health goals. The authors analyze three approaches for resolving these conflicts (absolutist, contextualist, and presumptivist), argue for the superiority of the presumptivist approach, and briefly explicate five conditions for rebutting presumptions in a process of public justification. In a liberal, pluralistic, democratic society, a presumptivist approach that engages the public in the context of a variety of relationships can provide a foundation for public trust, which is essential to public health as a political and social practice as well as to achieving public health goals.

Ethical Issues in Public Health Practice in Michigan

PubMed Central

Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

2009-01-01

Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

[Health services research for the public health service (PHS) and the public health system].

PubMed

Hollederer, A; Wildner, M

2015-03-01

There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

Public Health and Budget Impact of Probiotics on Common Respiratory Tract Infections: A Modelling Study

PubMed Central

Lenoir-Wijnkoop, Irene; Gerlier, Laetitia; Bresson, Jean-Louis; Le Pen, Claude; Berdeaux, Gilles

2015-01-01

Objectives Two recent meta-analyses by the York Health Economics Consortium (YHEC) and Cochrane demonstrated probiotic efficacy in reducing the duration and number of common respiratory tract infections (CRTI) and associated antibiotic prescriptions. A health-economic analysis was undertaken to estimate the public health and budget consequences of a generalized probiotic consumption in France. Methods A virtual age- and gender-standardized population was generated using a Markov microsimulation model. CRTI risk factors incorporated into this model were age, active/passive smoking and living in a community setting. Incidence rates and resource utilization were based on the 2011-2012 flu season and retrieved from the French GPs Sentinelles network. Results of both meta-analyses were independently applied to the French population to estimate CRTI events, assuming a generalized probiotic use compared to no probiotics during winter months: -0.77 days/CRTI episode (YHEC scenario) or odds-ratio 0.58 for ≥1 CRTI episode (Cochrane scenario) with vs. without probiotics. Economic perspectives were National Health System (NHS), society, family. Outcomes included cost savings related to the reduced numbers of CRTI episodes, days of illness, number of antibiotic courses, sick leave days, medical and indirect costs. Results For France, generalized probiotic use would save 2.4 million CRTI-days, 291,000 antibiotic courses and 581,000 sick leave days, based on YHEC data. Applying the Cochrane data, reductions were 6.6 million CRTI days, 473,000 antibiotic courses and 1.5 million sick days. From the NHS perspective, probiotics’ economic impact was about €14.6 million saved according to YHEC and €37.7 million according to Cochrane. Higher savings were observed in children, active smokers and people with more frequent human contacts. Conclusions Public health and budget impact of probiotics are substantial, whether they reduce CRTI episodes frequency or duration. Noteworthy

Global public health today: connecting the dots.

PubMed

Lomazzi, Marta; Jenkins, Christopher; Borisch, Bettina

2016-01-01

Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the global level and should lead to a serious rethinking of education

A Public Health Approach to Addressing Arthritis in Older Adults: The Most Common Cause of Disability

PubMed Central

Helmick, Charles G.; Brady, Teresa J.

2012-01-01

Arthritis is highly prevalent and is the leading cause of disability among older adults in the United States owing to the aging of the population and increases in the prevalence of risk factors (e.g., obesity). Arthritis will play a large role in the health-related quality of life, functional independence, and disability of older adults in the upcoming decades. We have emphasized the role of the public health system in reducing the impact of this large and growing public health problem, and we have presented priority public health actions. PMID:22390506

Policy, politics and public health.

PubMed

Greer, Scott L; Bekker, Marleen; de Leeuw, Evelyne; Wismar, Matthias; Helderman, Jan-Kees; Ribeiro, Sofia; Stuckler, David

2017-10-01

If public health is the field that diagnoses and strives to cure social ills, then understanding political causes and cures for health problems should be an intrinsic part of the field. In this article, we argue that there is no support for the simple and common, implicit model of politics in which scientific evidence plus political will produces healthy policies. Efforts to improve the translation of evidence into policy such as knowledge transfer work only under certain circumstances. These circumstances are frequently political, and to be understood through systematic inquiry into basic features of the political economy such as institutions, partisanship and the organization of labour markets. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Public health emergencies and the public health/managed care challenge.

PubMed

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Training public health superheroes: five talents for public health leadership.

PubMed

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Human rights in patient care and public health-a common ground.

PubMed

Peled-Raz, Maya

2017-01-01

Medical law and public health law have both served extensively as instruments of health protection and promotion-yet both are limited in their effect and scope and do not sufficiently cover nor supply a remedy to systematic, rather than anecdotal, mistreatments in the health care system. A possible solution to this deficiency may be found in the human rights in patient care legal approach. The concept of human rights in patient care is a reframing of international human rights law, as well as constitutional thought and tools, into a coherent approach aimed at the protection and furthering of both personal and communal health. It applies human rights discourse and human rights law onto the patient care setting while moving away from the narrow consumeristic view of health care delivery. By applying human rights in patient care approach, both national and international courts may and should serve as policy influencing instruments, protecting the rights of the most vulnerable and prejudiced against groups, which are want of a remedy through traditional patients' rights legal schemes.

[Utilitarianism or communitarianism as the foundation of public health ethics?].

PubMed

Rauprich, O

2008-02-01

The goal of public health is to maximise health, and to promote the common good. These two assumptions frequently give rise to claims that public health is founded on utilitarian or communitarian ethics, respectively. In this paper, these claims are critically examined and rejected. It is neither plausible to assume utilitarian goals in public health nor to propose a utilitarian account of public health ethics. The idea of public health as health-related utilitarianism rests on a misconception of utilitarian ethics. Once this misconception is realised, the seeming appeal of public health to utilitarianism quickly fades. Communitarianism, in turn, fails to serve as a comprehensive and systematic ethical account. Some moderate appeals to more communal spirit for public health are well taken, although not exclusive communitarian. Other more extreme proposals of communitarians, e.g. to exercise public-health police power and public-health paternalism, are to be taken with great care. Thus, it is concluded that there is a need for an ethical foundation of public health different from both utilitarianism and communitarianism.

Global public health today: connecting the dots

PubMed Central

Lomazzi, Marta; Jenkins, Christopher; Borisch, Bettina

2016-01-01

Background Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the global level and should lead

Articles Published and Downloaded by Public Health Scientists: Analysis of Data From the CDC Public Health Library, 2011-2013.

PubMed

Iskander, John; Bang, Gail; Stupp, Emma; Connick, Kathy; Gomez, Onnalee; Gidudu, Jane

2016-01-01

To describe scientific information usage and publication patterns of the Centers for Disease Control and Prevention (CDC) Public Health Library and Information Center patrons. Administratively collected patron usage data and aggregate data on CDC-authored publications from the CDC Library for 3 consecutive years were analyzed. The CDC Public Health Library and Information Center, which serves CDC employees nationally and internationally. Internal patrons and external users of the CDC Library. Three-year trends in full-text article publication and downloads including most common journals used for each purpose, systematic literature searches requested and completed, and subscriptions to a weekly public health current literature awareness service. From 2011 to 2013, CDC scientists published a total of 7718 articles in the peer-reviewed literature. During the same period, article downloads from the CDC Library increased 25% to more than 1.1 million, completed requests for reviews of the scientific literature increased by 34%, and electronic subscriptions to literature compilation services increased by 23%. CDC's scientific output and information use via the CDC Library are both increasing. Researchers and field staff are making greater use of literature review services and other customized information content delivery. Virtual public health library access is an increasingly important resource for the scientific practice of public health.

Pooling academic resources for public health.

PubMed

Michael, J M; Hayakawa, J M

1994-01-01

In January 1984, the Asia-Pacific Academic Consortium for Public Health (APACPH) was established, bringing together 5 schools of public health with the objectives: to raise the quality of professional education in public health; to enhance the knowledge and skills of health workers through joint projects; to solve health problems through closer links with each other and with ministries of health; to increase opportunities for graduate students through curriculum development; and to make child survival a major priority. The Consortium now comprises 31 academic institutions or units in 16 countries, and is supported by UNICEF, The World Health Organization, the China Medical Board of New York, and the governments of Japan and Malaysia. During 1985-1992, it also received major support from the United States through the US Agency for International Development and the University of Hawaii. During the past 10 years, APACPH has carried out such activities as setting up a data bank on the programs of its members, assessing public health problems, designing new curriculum and systems for service delivery, facilitating information and faculty exchanges, and running workshops for academic administrators. It has also organized conferences on the impact of urbanization on health, aging, child survival, AIDS, and occupational health. Since 1987 it has published the Asia-Pacific Journal of Public Health, the only English language journal on public health issues in the Asia and Pacific region, which will feature work being done by non-English-speaking researchers. Emphasis in the coming years will be placed on setting common standards for teaching and research, so that members can make more use of each other's programs. It is hoped that membership of the Consortium will continue to expand. A particular concern will be to focus more resources on preventive care rather than curative.

Public Libraries As Partners for Health

PubMed Central

Dupuis, Roxanne; Morgan, Anna U.; D’Alonzo, Bernadette; Epstein, Caleb; Klusaritz, Heather; Cannuscio, Carolyn C.

2018-01-01

Introduction Public libraries are free and accessible to all and are centers of community engagement and education, making them logical choices as partners for improving population health. Library staff members routinely assist patrons with unmet health and social needs. Methods We used a 100-question, self-administered web survey sent to all library directors listed in the Pennsylvania Library Association database (N = 621), to investigate staff interactions with library patrons to address social determinants of health. We conducted statistical comparisons of quantitative responses and a content analysis of open-ended responses. Results Respondents (N = 262) reported frequently interacting with patrons around health and social concerns — well beyond those related to literacy and education — including help with employment (94%), nutrition (70%), exercise (66%), and social welfare benefits (51%). Acute emergencies were not uncommon in Pennsylvania’s public libraries, with nearly 12% of respondents having witnessed a drug overdose at the library in the past year. Most respondents felt that their professional training left them inadequately prepared to assist patrons with health and social issues. Although at least 40% of respondents offered some health programming at their library branch, their offerings did not meet the high level of need reflected in common patron inquiries. Conclusion The challenges library staff members experience in meeting their patrons’ information needs suggest opportunities for public libraries to advance population health. Library staff members need additional training and resources and collaboration with public health and health care institutions to respond to community needs through effective, evidence-based public health programming. PMID:29806580

Public Libraries As Partners for Health.

PubMed

Whiteman, Eliza D; Dupuis, Roxanne; Morgan, Anna U; D'Alonzo, Bernadette; Epstein, Caleb; Klusaritz, Heather; Cannuscio, Carolyn C

2018-05-24

Public libraries are free and accessible to all and are centers of community engagement and education, making them logical choices as partners for improving population health. Library staff members routinely assist patrons with unmet health and social needs. We used a 100-question, self-administered web survey sent to all library directors listed in the Pennsylvania Library Association database (N = 621), to investigate staff interactions with library patrons to address social determinants of health. We conducted statistical comparisons of quantitative responses and a content analysis of open-ended responses. Respondents (N = 262) reported frequently interacting with patrons around health and social concerns - well beyond those related to literacy and education - including help with employment (94%), nutrition (70%), exercise (66%), and social welfare benefits (51%). Acute emergencies were not uncommon in Pennsylvania's public libraries, with nearly 12% of respondents having witnessed a drug overdose at the library in the past year. Most respondents felt that their professional training left them inadequately prepared to assist patrons with health and social issues. Although at least 40% of respondents offered some health programming at their library branch, their offerings did not meet the high level of need reflected in common patron inquiries. The challenges library staff members experience in meeting their patrons' information needs suggest opportunities for public libraries to advance population health. Library staff members need additional training and resources and collaboration with public health and health care institutions to respond to community needs through effective, evidence-based public health programming.

Sexual and reproductive health and rights in public health education.

PubMed

Allotey, Pascale A; Diniz, Simone; Dejong, Jocelyn; Delvaux, Thérèse; Gruskin, Sofia; Fonn, Sharon

2011-11-01

This paper addresses the challenges faced in mainstreaming the teaching of sexual and reproductive health and rights into public health education. For this paper, we define sexual and reproductive health and rights education as including not only its biomedical aspects but also an understanding of its history, values and politics, grounded in gender politics and social justice, addressing sexuality, and placed within a broader context of health systems and global health. Using a case study approach with an opportunistically selected sample of schools of public health within our regional contexts, we examine the status of sexual and reproductive health and rights education and some of the drivers and obstacles to the development and delivery of sexual and reproductive health and rights curricula. Despite diverse national and institutional contexts, there are many commonalities. Teaching of sexual and reproductive health and rights is not fully integrated into core curricula. Existing initiatives rely on personal faculty interest or short-term courses, neither of which are truly sustainable or replicable. We call for a multidisciplinary and more comprehensive integration of sexual and reproductive health and rights in public health education. The education of tomorrow's public health leaders is critical, and a strategy is needed to ensure that they understand and are prepared to engage with the range of sexual and reproductive health and rights issues within their historical and political contexts. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

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

Using Written Narratives in Public Health Practice: A Creative Writing Perspective

PubMed Central

Kreuter, Matthew W.

2014-01-01

Narratives have become an increasingly common health communication tool in recent years. Vivid, engaging writing can help audiences identify with storytellers and understand health messages, but few public health practitioners are trained to create such stories. A transdisciplinary perspective, informed by both creative writing advice and evidence-based public health practices, can help public health professionals use stories more effectively in their work. This article provides techniques for creating written narratives that communicate health information for chronic disease prevention. We guide public health professionals through the process of soliciting, writing, and revising such stories, and we discuss challenges and potential solutions. PMID:24901794

Harmful algal blooms and public health.

PubMed

Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn

2016-07-01

The five most commonly recognized Harmful Algal Bloom-related illnesses are ciguatera poisoning, paralytic shellfish poisoning, neurotoxic shellfish poisoning (NSP), amnesic shellfish poisoning, and diarrhetic shellfish poisoning. Although these exposures result from exposure to different toxins or toxin congeners, these clinical syndromes have much in common. Exposure occurs through the consumption of fish, shellfish, or through exposure to aerosolized NSP toxins. Routine clinical tests are not available for the diagnosis of harmful algal bloom related illnesses, there is no known antidote for exposure, and the risk of these illnesses can negatively impact local fishing and tourism industries. The absence of exposure risk or diagnostic certainty can also precipitate a chain of events that results in considerable psychological distress for coastal populations. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, further transdisciplinary research, close communication and collaboration are needed among HAB scientists, public health researchers, and local, state and tribal health departments at academic, community outreach, and policy levels. Copyright © 2016. Published by Elsevier B.V.

'Only connect': the case for public health humanities.

PubMed

Saffran, Lise

2014-12-01

Humanities in health has until now been primarily understood to mean humanities in medicine and has generally failed to include public health. I will argue in this paper that the common justifications for the former--including increased empathy among practitioners--are at least as applicable, if not more, to the latter. Growing emphasis on the social determinants of health and cultural competency in public health require public health students and professionals to develop a nuanced understanding of the influence of social context on health behaviour and to empathise with people in difficult circumstances. Literary fiction has been demonstrated to have an impact on skills related to empathy and social intelligence. Further, translating epidemiological evidence into public policy is a core task of public health and there is a growing body of research to indicate that statistical evidence is more persuasive when combined with narrative evidence. In this article I explore similarities and differences between proposed humanities in public health and programmes in humanities in medicine and highlight research gaps and possible implications of a more expansive view of humanities in health. 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.

The genesis of public health ethics.

PubMed

Bayer, Ronald; Fairchild, Amy L

2004-11-01

As bioethics emerged in the 1960s and 1970s and began to have enormous impacts on the practice of medicine and research--fuelled, by broad socio-political changes that gave rise to the struggles of women, African Americans, gay men and lesbians, and the antiauthoritarianism impulse that characterised the New Left in democratic capitalist societies--little attention was given to the question of the ethics of public health. This was all the more striking since the core values and practices of public health, often entailing the subordination of the individual for the common good, seemed opposed to the ideological impulses of bioethics. Of what relevance is autonomy-focused bioethics for public health, with its mix of justifications including those that are either implicitly or explicitly paternalistic or that seek to impose strictures on individuals and communities in the name of collective welfare? To examine the deep divide between the central commitments of bioethics and the values that animate the practice of public health, we focus on a series of controversies implicating the concepts of privacy, liberty, and paternalism. Recognising the role of moral values in decision-making was a signal contribution of bioethics in its formative period. Over the past three decades a broad array of perspectives emerged under the rubric of bioethics but individualism remains central. As we commence the process of shaping an ethics of public health, it is clear that bioethics is the wrong place to start when thinking about the balances required in defence of the public's health.

Public health in England in 2016-the health of the public and the public health system: a review.

PubMed

Middleton, John

2017-01-01

This article describes the current state of the health of the public in England and the state of the public health professional service and systems. Data sources are wide ranging including the Global Burden of Disease, the Commonwealth Fund and Public Health England reports. There is a high burden of preventable disease and unacceptable inequalities in England. There is considerable expectation that there are gains to be made in preventing ill health and disability and so relieving demand on healthcare. Despite agreement on the need for prevention, the Government has cut public health budgets by a cumulative 10% to 2020. Public health professionals broadly supportive of remaining in the EU face an uphill battle to retain health, workplace and environmental protections following the 'Leave' vote. There is revitalized interest in air pollution. Extreme weather events are testing response and organizational skills of public health professionals and indicating the need for greater advocacy around climate change, biodiversity and protection of ecological systems. Planetary health and ecological public health are ideas whose time has certainly come. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The common risk factor approach: a rational basis for promoting oral health.

PubMed

Sheiham, A; Watt, R G

2000-12-01

Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio-political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio-environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.

Patterns in PARTNERing across Public Health Collaboratives.

PubMed

Bevc, Christine A; Retrum, Jessica H; Varda, Danielle M

2015-10-05

Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

Islamophobia and Public Health in the United States.

PubMed

Samari, Goleen

2016-11-01

Anti-Muslim sentiments are increasingly common globally and in the United States. The recent rise in Islamophobia calls for a public health perspective that considers the stigmatized identity of Muslim Americans and health implications of Islamophobic discrimination. Drawing on a stigma, discrimination, and health framework, I expand the dialogue on the rise of Islamophobia to a discussion of how Islamophobia affects the health of Muslim Americans. Islamophobia can negatively influence health by disrupting several systems-individual (stress reactivity and identity concealment), interpersonal (social relationships and socialization processes), and structural (institutional policies and media coverage). Islamophobia deserves attention as a source of negative health outcomes and health disparities. Future public health research should explore the multilevel and multidimensional pathways between Islamophobia and population health.

Islamophobia and Public Health in the United States

PubMed Central

2016-01-01

Anti-Muslim sentiments are increasingly common globally and in the United States. The recent rise in Islamophobia calls for a public health perspective that considers the stigmatized identity of Muslim Americans and health implications of Islamophobic discrimination. Drawing on a stigma, discrimination, and health framework, I expand the dialogue on the rise of Islamophobia to a discussion of how Islamophobia affects the health of Muslim Americans. Islamophobia can negatively influence health by disrupting several systems—individual (stress reactivity and identity concealment), interpersonal (social relationships and socialization processes), and structural (institutional policies and media coverage). Islamophobia deserves attention as a source of negative health outcomes and health disparities. Future public health research should explore the multilevel and multidimensional pathways between Islamophobia and population health. PMID:27631738

Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

ERIC Educational Resources Information Center

Hilton, Warren

2013-01-01

This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

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

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.

Dental Public Health In Action: Putting Oral Health on the Local Public Health Agenda.

PubMed

Walker, I F; Eapen-Simon, S; Gibson, S

2018-04-18

Oral health is a key public health issue across England. In Wakefield in the north of England, local data suggested the oral health of local children was significantly worse than the national average. This paper describes the work undertaken by Wakefield Council to strategically address this issue. A structured process was adopted. Key lessons include; having senior ownership from the Director of Public Health, partnership working across all key stakeholders, utilising dental public health expertise from Public Health England and the use of extensive engagement with stakeholders. Through this work, oral health is now identified with greater importance in Wakefield as a public health issue. Actions are now strategically co-ordinated across stakeholders to improve oral health in local children. Copyright© 2018 Dennis Barber Ltd.

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.

Funding formulas for public health allocations: federal and state strategies.

PubMed

Ogden, Lydia L; Sellers, Katie; Sammartino, Cara; Buehler, James W; Bernet, Patrick M

2012-01-01

Public health funding formulas have received less scrutiny than those used in other government sectors, particularly health services and public health insurance. We surveyed states about their use of funding formulas for specific public health activities; sources of funding; formula attributes; formula development; and assessments of political and policy considerations. Results show that the use of funding formulas is positively correlated with the number of local health departments and with the percentage of public health funding provided by the federal government. States use a variety of allocative strategies but most commonly employ a "base-plus" distribution. Resulting distributions are more disproportionate than per capita or per-person-in-poverty allotments, an effect that increases as the proportion of total funding dedicated to equal minimum allotments increases.

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments.

PubMed

Allen, Peg; Jacob, Rebekah R; Lakshman, Meenakshi; Best, Leslie A; Bass, Kathryn; Brownson, Ross C

2018-03-02

Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

Defining and Developing a Global Public Health Course for Public Health Graduates.

PubMed

Karkee, Rajendra; Comfort, Jude; Alfonso, Helman

2015-01-01

Global public health is increasingly being seen as a speciality field within the university education of public health. However, the exact meaning of global public health is still unclear, resulting in varied curricula and teaching units among universities. The contextual differences between high- and low- and middle-income countries, and the process of globalization need to be taken into account while developing any global public health course. Global public health and public health are not separable and global public health often appears as an extension of public health in the era of globalization and interdependence. Though global public health is readily understood as health of global population, it is mainly practiced as health problems and their solutions set within low- and middle-income countries. Additional specialist competencies relevant to the context of low- and middle-income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalization and its impact on health; disease burden; culture, society, and politics; and management are important.

From public health genomics to precision public health: a 20-year journey.

PubMed

Khoury, Muin J; Bowen, M Scott; Clyne, Mindy; Dotson, W David; Gwinn, Marta L; Green, Ridgely Fisk; Kolor, Katherine; Rodriguez, Juan L; Wulf, Anja; Yu, Wei

2018-06-01

In this paper, we review the evolution of the field of public health genomics in the United States in the past two decades. Public health genomics focuses on effective and responsible translation of genomic science into population health benefits. We discuss the relationship of the field to the core public health functions and essential services, review its evidentiary foundation, and provide examples of current US public health priorities and applications. We cite examples of publications to illustrate how Genetics in Medicine reflected the evolution of the field. We also reflect on how public-health genomics is contributing to the emergence of "precision public health" with near-term opportunities offered by the US Precision Medicine (AllofUs) Initiative.

A Review of Global Health Competencies for Postgraduate Public Health Education

PubMed Central

Sawleshwarkar, Shailendra; Negin, Joel

2017-01-01

During the last decade, the literature about global health has grown exponentially. Academic institutions are also exploring the scope of their public health educational programs to meet the demand for a global health professional. This has become more relevant in the context of the sustainable development goals. There have been attempts to describe global health competencies for specific professional groups. The focus of these competencies has been variable with a variety of different themes being described ranging from globalization and health care, analysis and program management, as well as equity and capacity strengthening. This review aims to describe global health competencies and attempts to distill common competency domains to assist in curriculum development and integration in postgraduate public health education programs. A literature search was conducted using relevant keywords with a focus on public health education. This resulted in identification of 13 articles that described global health competencies. All these articles were published between 2005 and 2015 with six from the USA, two each from Canada and Australia, and one each from UK, Europe, and Americas. A range of methods used to describe competency domains included literature review, interviews with experts and employers, surveys of staff and students, and description or review of an academic program. Eleven competency domains were distilled from the selected articles. These competency domains primarily referred to three main aspects, one that focuses on burden of disease and the determinants of health. A second set focuses on core public health skills including policy development, analysis, and program management. Another set of competency domains could be classified as “soft skills” and includes collaboration, partnering, communication, professionalism, capacity building, and political awareness. This review presents the landscape of defined global health competencies for postgraduate

Right Relation and Right Recognition in Public Health Ethics: Thinking Through the Republic of Health

PubMed Central

Jennings, Bruce

2016-01-01

The further development of public health ethics will be assisted by a more direct engagement with political theory. In this way, the moral vocabulary of the liberal tradition should be supplemented—but not supplanted—by different conceptual and normative resources available from other traditions of political and social thought. This article discusses four lines of further development that the normative conceptual discourse of public health ethics might take. (i) The relational turn. The implications for public health ethics of the new ‘ecological’ or ‘relational’ interpretation that is emerging for concepts such as agency, self-identity, autonomy, liberty and justice. (ii) Governing the health commons. The framework of collective action problems is giving way to notions of democratic governance and management of common resources. (iii) The concept of membership. Membership is specified by the notions of equal respect and parity of voice and agency. (iv) The concept of mutuality. Mutuality is specified by the notions of interdependent concern and care. PMID:27551301

Right Relation and Right Recognition in Public Health Ethics: Thinking Through the Republic of Health.

PubMed

Jennings, Bruce

2016-07-01

The further development of public health ethics will be assisted by a more direct engagement with political theory. In this way, the moral vocabulary of the liberal tradition should be supplemented-but not supplanted-by different conceptual and normative resources available from other traditions of political and social thought. This article discusses four lines of further development that the normative conceptual discourse of public health ethics might take. (i) The relational turn. The implications for public health ethics of the new 'ecological' or 'relational' interpretation that is emerging for concepts such as agency, self-identity, autonomy, liberty and justice. (ii) Governing the health commons. The framework of collective action problems is giving way to notions of democratic governance and management of common resources. (iii) The concept of membership. Membership is specified by the notions of equal respect and parity of voice and agency. (iv) The concept of mutuality. Mutuality is specified by the notions of interdependent concern and care.

Public health issues.

PubMed

Ward, R D

1992-04-01

In a recent MSMS survey, MSMS members ranked public health as one the top five issues of major concern to Michigan physicians. Tobacco use, chronic illness, and HIV-infected health care workers comprise some of the major public health issues facing physicians and patients in Michigan. Following is a brief examination of each of these issues. Also included is a brief discussion of medical doctors as public health directors. Should all public health directors be medical doctors? This question is addressed in this cover story.

Health economics in public health.

PubMed

Ammerman, Alice S; Farrelly, Matthew A; Cavallo, David N; Ickes, Scott B; Hoerger, Thomas J

2009-03-01

Economic analysis is an important tool in deciding how to allocate scarce public health resources; however, there is currently a dearth of such analysis by public health researchers. Public health researchers and practitioners were surveyed to determine their current use of health economics and to identify barriers to use as well as potential strategies to decrease those barriers in order to allow them to more effectively incorporate economic analyses into their work. Data collected from five focus groups informed survey development. The survey included a demographic section and 14 multi-part questions. Participants were recruited in 2006 from three national public health organizations through e-mail; 294 academicians, practitioners, and community representatives answered the survey. Survey data were analyzed in 2007. Despite an expressed belief in the importance of health economics, more than half of the respondents reported very little or no current use of health economics in their work. Of those using health economics, cost-benefit and cost-effectiveness analysis and determination of public health costs were cited as the measures used most frequently. The most important barriers were lack of expertise, funding, time, tools, and data, as well as discomfort with economic theory. The resource deemed most important to using health economics was collaboration with economists or those with economic training. Respondents indicated a desire to learn more about health economics and tools for performing economic analysis. Given the importance of incorporating economic analysis into public health interventions, and the desire of survey respondents for more collaboration with health economists, opportunities for such collaborations should be increased.

Ethics in public health research: a research protocol to evaluate the effectiveness of public-private partnerships as a means to improve health and welfare systems worldwide.

PubMed

Barr, Donald A

2007-01-01

Public-private partnerships have become a common approach to health care problems worldwide. Many public-private partnerships were created during the late 1990s, but most were focused on specific diseases such as HIV/AIDS, tuberculosis, and malaria. Recently there has been enthusiasm for using public-private partnerships to improve the delivery of health and welfare services for a wider range of health problems, especially in developing countries. The success of public-private partnerships in this context appears to be mixed, and few data are available to evaluate their effectiveness. This analysis provides an overview of the history of health-related public-private partnerships during the past 20 years and describes a research protocol commissioned by the World Health Organization to evaluate the effectiveness of public-private partnerships in a research context.

Access to nutritious food, socioeconomic individualism and public health ethics in the USA: a common good approach

PubMed Central

2013-01-01

Good nutrition plays an important role in the optimal growth, development, health and well-being of individuals in all stages of life. Healthy eating can reduce the risk of chronic diseases, such as heart disease, stroke, diabetes and some types of cancer. However, the capitalist mindset that shapes the food environment has led to the commoditization of food. Food is not just a marketable commodity like any other commodity. Food is different from other commodities on the market in that it is explicitly and intrinsically linked to our human existence. While possessing another commodity allows for social benefits, food ensures survival. Millions of people in United States of America are either malnourished or food insecure. The purpose of this paper is to present a critique of the current food system using four meanings of the common good--as a framework, rhetorical device, ethical concept and practical tool for social justice. The first section of this paper provides a general overview of the notion of the common good. The second section outlines how each of the four meanings of the common good helps us understand public practices, social policies and market values that shape the distal causal factors of nutritious food inaccessibility. We then outline policy and empowerment initiatives for nutritious food access. PMID:24165577

Access to nutritious food, socioeconomic individualism and public health ethics in the USA: a common good approach.

PubMed

Azétsop, Jacquineau; Joy, Tisha R

2013-10-29

Good nutrition plays an important role in the optimal growth, development, health and well-being of individuals in all stages of life. Healthy eating can reduce the risk of chronic diseases, such as heart disease, stroke, diabetes and some types of cancer. However, the capitalist mindset that shapes the food environment has led to the commoditization of food. Food is not just a marketable commodity like any other commodity. Food is different from other commodities on the market in that it is explicitly and intrinsically linked to our human existence. While possessing another commodity allows for social benefits, food ensures survival. Millions of people in United States of America are either malnourished or food insecure. The purpose of this paper is to present a critique of the current food system using four meanings of the common good--as a framework, rhetorical device, ethical concept and practical tool for social justice. The first section of this paper provides a general overview of the notion of the common good. The second section outlines how each of the four meanings of the common good helps us understand public practices, social policies and market values that shape the distal causal factors of nutritious food inaccessibility. We then outline policy and empowerment initiatives for nutritious food access.

Public Health System Response to Extreme Weather Events.

PubMed

Hunter, Mark D; Hunter, Jennifer C; Yang, Jane E; Crawley, Adam W; Aragón, Tomás J

2016-01-01

Extreme weather events, unpredictable and often far-reaching, constitute a persistent challenge for public health preparedness. The goal of this research is to inform public health systems improvement through examination of extreme weather events, comparing across cases to identify recurring patterns in event and response characteristics. Structured telephone-based interviews were conducted with representatives from health departments to assess characteristics of recent extreme weather events and agencies' responses. Response activities were assessed using the Centers for Disease Control and Prevention Public Health Emergency Preparedness Capabilities framework. Challenges that are typical of this response environment are reported. Forty-five local health departments in 20 US states. Respondents described public health system responses to 45 events involving tornadoes, flooding, wildfires, winter weather, hurricanes, and other storms. Events of similar scale were infrequent for a majority (62%) of the communities involved; disruption to critical infrastructure was universal. Public Health Emergency Preparedness Capabilities considered most essential involved environmental health investigations, mass care and sheltering, surveillance and epidemiology, information sharing, and public information and warning. Unanticipated response activities or operational constraints were common. We characterize extreme weather events as a "quadruple threat" because (1) direct threats to population health are accompanied by damage to public health protective and community infrastructure, (2) event characteristics often impose novel and pervasive burdens on communities, (3) responses rely on critical infrastructures whose failure both creates new burdens and diminishes response capacity, and (4) their infrequency and scale further compromise response capacity. Given the challenges associated with extreme weather events, we suggest opportunities for organizational learning and

Elements of Pacific public health laws: an analysis of the public health acts of Papua New Guinea, Vanuatu, the Solomon Islands, and Fiji.

PubMed

Howse, Genevieve

2012-09-01

Pacific countries are sovereign nations with distinctive histories, ethnicity, customs, primary resources, economies, and health systems. Despite these and other acknowledged differences, similarities exist in many areas such as geography, legal history, and culture. Many share the experience of colonization, with imported British laws and the subsequent experience of independence. Most Pacific countries are also developing countries. This article broadly describes approaches to legislating in public health in Papua New Guinea, Fiji, Vanuatu, and the Solomon Islands and notes common elements in their public health laws, in particular, in relation to administration, allocation of powers and responsibilities, interaction with local government, communicable disease control, and nuisance. The article concludes that many Pacific public health laws could deliver better support for current health policy, more sensitivity to the culture and customs of the region, and better management of public health risk through laws that are better suited to their Pacific environment, easier to understand, more flexible, and more relevant to current health policy.

Alumni survey of Masters of Public Health (MPH) training at the Hanoi School of Public Health

PubMed Central

Le, Linh Cu; Bui, Quyen Tu; Nguyen, Ha Thanh; Rotem, Arie

2007-01-01

Background 1) To elicit the opinions of the Public Health alumni of the MPH program; 2) To assess the applicability of the knowledge and skills acquired; 3) To identify the frequency of the public health competencies that the alumni performed. Methods We requested 187 graduates to complete a self-administered questionnaire and conducted in-depth interviews with 8 alumni as well as a focus group discussion with 14 alumni. Results In total 79.1% (148) of the MPH graduates completed and returned the questionnaire. Most alumni (91%) agreed that the MPH curriculum corresponded with the working requirements of public health professionals; and nearly all were satisfied with what they have learnt (96%). Most respondents said that the MPH program enabled them to develop relevant professional skills (95%) and that they were satisfied with the curriculum (90%). Notably fewer respondents (73%) felt that the MPH program structure was balanced and well designed. Most alumni (64.3%) were satisfied with Hanoi School of Public Health (HSPH) full-time lecturers; but even more (83%) were satisfied with visiting lecturers. The most commonly selected of the 34 pre-identified public health competencies were: applying computer skills (66.4%), planning and managing health programs (47.9%), communicating with the community and/or mobilizing the community to participate in health care (43.2%). Overall, the MPH alumni felt that HSPH emphasized research methods at the expense of some management and operational competencies. The most important challenges at work identified by the alumni were insufficient skills in: data analysis, decision making, inter-sectoral cooperation development, English language and training. Conclusion The training program should be reviewed and revised to meet the needs of its graduates who enter diverse situations and positions. English language skills were identified as top priority for further emphasis. The training program should comply with a more advanced

State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services

PubMed Central

Hoss, Aila; Menon, Akshara; Corso, Liza

2016-01-01

Context Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention’s Public Health Law Program conducted a fundamental activities legal assessment on state public health laws. Objective The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems. Design In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016. Results Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions. Conclusions Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework. PMID

State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services.

PubMed

Hoss, Aila; Menon, Akshara; Corso, Liza

2016-01-01

Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention's Public Health Law Program conducted a fundamental activities legal assessment on state public health laws. The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems. In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016. Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions. Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework.

Across the Atlantic cooperation to address international challenges in eHealth and health IT: managing toward a common goal.

PubMed

Friedman, Charles P; Iakovidis, Ilias; Debenedetti, Laurent; Lorenzi, Nancy M

2009-11-01

Countries on both sides of the Atlantic Ocean have invested in health information and communication technologies. Since eHealth challenges cross borders a European Union-United States of America conference on public policies relating to health IT and eHealth was held October 20-21, 2008 in Paris, France. The conference was organized around the four themes: (1) privacy and security, (2) health IT interoperability, (3) deployment and adoption of health IT, and (4) Public Private Collaborative Governance. The four key themes framed the discussion over the two days of plenary sessions and workshops. Key findings of the conference were organized along the four themes. (1) Privacy and security: Patients' access to their own data and key elements of a patient identification management framework were discussed. (2) Health IT interoperability: Three significant and common interoperability challenges emerged: (a) the need to establish common or compatible standards and clear guidelines for their implementation, (b) the desirability for shared certification criteria and (c) the need for greater awareness of the importance of interoperability. (3) Deployment and adoption of health IT: Three major areas of need emerged: (a) a shared knowledge base and assessment framework, (b) public-private collaboration and (c) and effective organizational change strategies. (4) Public Private Collaborative Governance: Sharing and communication are central to success in this area. Nations can learn from one another about ways to develop harmonious, effective partnerships. Three areas that were identified as highest priority for collaboration included: (1) health data security, (2) developing effective strategies to ensure healthcare professionals' acceptance of health IT tools, and (3) interoperability.

Public health ethics: from foundations and frameworks to justice and global public health.

PubMed

Kass, Nancy E

2004-01-01

Ethics dilemmas have been present throughout the history of public health, and bioethics has devoted considerable attention to issues relevant to public health. Only recently, however, has public health ethics emerged as a recognized subfield of bioethics. Public health ethics requires that public health improvement come through just and respectful means. Bioethics in the future not only will take on more issues of public ethics, but will apply it extensive scholarship in distributive justice to questions of global public health.

Local public health agency funding: money begets money.

PubMed

Bernet, Patrick Michael

2007-01-01

Local public health agencies are funded federal, state, and local revenue sources. There is a common belief that increases from one source will be offset by decreases in others, as when a local agency might decide it must increase taxes in response to lowered federal or state funding. This study tests this belief through a cross-sectional study using data from Missouri local public health agencies, and finds, instead, that money begets money. Local agencies that receive more from federal and state sources also raise more at the local level. Given the particular effectiveness of local funding in improving agency performance, these findings that nonlocal revenues are amplified at the local level, help make the case for higher public health funding from federal and state levels.

Ambivalent helpers and unhealthy choices: public health practitioners' narratives of Indigenous ill-health.

PubMed

Kowal, Emma; Paradies, Yin

2005-03-01

Public health practitioners in Australian indigenous health work in a complex political environment. Public health training is limited in providing them with conceptual tools needed to unpack the postcolonial nexus of 'fourth-world' health. A workshop was designed by the authors to facilitate critical reflection on how the concepts of race and culture are used in constructions of indigenous ill-health. It was attended by researchers, students, clinicians and bureaucrats working in public health in northern Australia. A thematic analysis of the workshop minutes provided insight into public health practitioners' narratives of Indigenous ill-health. The major themes that emerged included tension between structure and agency and between sameness and difference, and ambivalence surrounding the 'helper' identity of public health practitioners. We suggest that these narratives can be understood as attempts to maintain the moral integrity of both Indigenous people and practitioners. This task is necessitated by the specter of cultural relativism intrinsic to contemporary liberal discourses of multiculturalism that attempt to reconcile the universal rights of the citizen with the special rights of minority groups. We argue that the concepts of self-determination and neocolonialism mark the spaces where universal and particular discourses overlap and clash. Practitioners who seek to escape neocolonialism must inhabit only the discursive space of public health congruent with self-determination, leaving them in a bind common to many postcolonial situations. They must relieve the ill-health of indigenous people without acting upon them; change them without declaring that change is required.

Public health literacy defined.

PubMed

Freedman, Darcy A; Bess, Kimberly D; Tucker, Holly A; Boyd, David L; Tuchman, Arleen M; Wallston, Kenneth A

2009-05-01

Public health literacy is an emerging concept necessary to understand and address the broad array of factors, such as climate change, globalization, and poverty, that influence the public's health. Whereas health literacy has traditionally been operationalized as an individual-level construct, public health literacy takes into account the complex social, ecologic, and systemic forces affecting health and well-being. However, public health literacy has not yet been fully articulated. This paper addresses this gap by outlining a broad, new definition of public health literacy. This definition was developed through an inductive analytic process conducted in 2007 by a multidisciplinary research team, and two expert-panel sessions were convened to assess the consensual validity of the emergent definition. Based on this process, public health literacy is defined as the degree to which individuals and groups can obtain, process, understand, evaluate, and act on information needed to make public health decisions that benefit the community. Three dimensions of public health literacy--conceptual foundations, critical skills, and civic orientation--and related competencies are also proposed. Public health literacy is distinct from individual-level health literacy, and together, the two types of literacy form a more comprehensive model of health literacy. A five-part agenda is offered for future research and action aimed at increasing levels of public health literacy.

Publication rates of public health theses in international and national peer-review journals in Turkey.

PubMed

Sipahi, H; Durusoy, R; Ergin, I; Hassoy, H; Davas, A; Karababa, Ao

2012-01-01

Thesis is an important part of specialisation and doctorate education and requires intense work. The aim of this study was to investigate the publication rates of Turkish Public Health Doctorate Theses (PHDT) and Public Health Specialization (PHST) theses in international and Turkish national peer-review journals and to analyze the distribution of research areas. List of all theses upto 30 September 2009 were retrieved from theses database of the Council of Higher Education of the Republic of Turkey. The publication rates of these theses were found by searching PubMed, Science Citation Index-Expanded, Turkish Academic Network and Information Center (ULAKBIM) Turkish Medical Database, and Turkish Medline databases for the names of thesis author and mentor. The theses which were published in journals indexed either in PubMed or SCI-E were considered as international publications. Our search yielded a total of 538 theses (243 PHDT, 295 PHST). It was found that the overall publication rate in Turkish national journals was 18%. The overall publication rate in international journals was 11.9%. Overall the most common research area was occupational health. Publication rates of Turkish PHDT and PHST are low. A better understanding of factors affecting this publication rate is important for public health issues where national data is vital for better intervention programs and develop better public health policies.

Publication Rates of Public Health Theses in International and National Peer-Review Journals in Turkey

PubMed Central

Sipahi, H; Durusoy, R; Ergin, I; Hassoy, H; Davas, A; Karababa, AO

2012-01-01

Background: Thesis is an important part of specialisation and doctorate education and requires intense work. The aim of this study was to investigate the publication rates of Turkish Public Health Doctorate Theses (PHDT) and Public Health Specialization (PHST) theses in international and Turkish national peer-review journals and to analyze the distribution of research areas. Methods: List of all theses upto 30 September 2009 were retrieved from theses database of the Council of Higher Education of the Republic of Turkey. The publication rates of these theses were found by searching PubMed, Science Citation Index-Expanded, Turkish Academic Network and Information Center (ULAKBIM) Turkish Medical Database, and Turkish Medline databases for the names of thesis author and mentor. The theses which were published in journals indexed either in PubMed or SCI-E were considered as international publications. Results: Our search yielded a total of 538 theses (243 PHDT, 295 PHST). It was found that the overall publication rate in Turkish national journals was 18%. The overall publication rate in international journals was 11.9%. Overall the most common research area was occupational health. Conclusion: Publication rates of Turkish PHDT and PHST are low. A better understanding of factors affecting this publication rate is important for public health issues where national data is vital for better intervention programs and develop better public health policies. PMID:23193503

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice.

PubMed

Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-08-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall.

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

PubMed Central

Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-01-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

The University-Public Health Partnership for Public Health Research Training in Quebec, Canada.

PubMed

Paradis, Gilles; Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie

2017-01-01

Enhancing effective preventive interventions to address contemporary public health problems requires improved capacity for applied public health research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating public health practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on public health interventions that embedded doctoral and postdoctoral trainees in public health organizations in Quebec, Canada. This university-public health partnership for research training is an example of how to link science and practice to meet emerging needs in public health.

[Brazilian bibliographical output on public oral health in public health and dentistry journals].

PubMed

Celeste, Roger Keller; Warmling, Cristine Maria

2014-06-01

The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on public health and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in public health, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in public health and key words about public health in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in public health journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral health publications in dentistry journals, though not in public health journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of public health, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

Do health policy advisors know what the public wants? An empirical comparison of how health policy advisors assess public preferences regarding smoke-free air, and what the public actually prefers

PubMed Central

2013-01-01

Background Health policy-making, a complex, multi-factorial process, requires balancing conflicting values. A salient issue is public support for policies; however, one reason for limited impact of public opinion may be misperceptions of policy makers regarding public opinion. For example, empirical research is scarce on perceptions of policy makers regarding public opinion on smoke-free public spaces. Methods Public desire for smoke-free air was compared with health policy advisor (HPA) perception of these desires. Two representative studies were conducted: one with the public (N = 505), and the other with a representative sample of members of Israel’s health-targeting initiative, Healthy Israel 2020 (N = 34), in December 2010. Corresponding questions regarding desire for smoke-free areas were asked. Possible smoke-free areas included: 100% smoke-free bars and pubs; entrances to health facilities; railway platforms; cars with children; college campuses; outdoor areas (e.g., pools and beaches); and common areas of multi-dweller apartment buildings. A 1–7 Likert scale was used for each measure, and responses were averaged into a single primary outcome, DESIRE. Our primary endpoint was the comparison between public preferences and HPA assessment of those preferences. In a secondary analysis, we compared personal preferences of the public with personal preferences of the HPAs for smoke-free air. Results HPAs underestimated public desire for smoke-free air (Public: Mean: 5.06, 95% CI:[4.94, 5.17]; HPA: Mean: 4.06, 95% CI:[3.61, 4.52]: p < .0001). Differences at the p = .05 level were found between HPA assessment and public preference for the following areas: 100% smoke-free bars and pubs; entrances to healthcare facilities; train platforms; cars carrying children; and common areas of multi-dweller apartment buildings. In our secondary comparison, HPAs more strongly preferred smoke-free areas than did the public (p < .0001). Conclusions Health policy advisors

Benefits and Perceptions of Public Health Accreditation Among Health Departments Not Yet Applying.

PubMed

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

To identify the benefits and perceptions among health departments not yet participating in the public health accreditation program implemented by the Public Health Accreditation Board (PHAB). Quantitative and qualitative data were gathered via Web-based surveys of health departments that had not yet applied for PHAB accreditation (nonapplicants) and health departments that had been accredited for 1 year. Respondents from 150 nonapplicant health departments and 57 health departments that had been accredited for 1 year. The majority of nonapplicant health departments are reportedly conducting a community health assessment (CHA), community health improvement plan (CHIP), and health department strategic plan-3 documents that are required to be in place before applying for PHAB accreditation. To develop these documents, most nonapplicants are reportedly referencing PHAB requirements. The most commonly reported perceived benefits of accreditation among health departments that planned to or were undecided about applying for accreditation were as follows: increased awareness of strengths and weaknesses, stimulated quality improvement (QI) and performance improvement activities, and increased awareness of/focus on QI. Nonapplicants that planned to apply reported a higher level of these perceived benefits. Compared with health departments that had been accredited for 1 year, nonapplicants were more likely to report that their staff had no or limited QI knowledge or familiarity. The PHAB accreditation program has influenced the broader public health field-not solely health departments that have undergone accreditation. Regardless of their intent to apply for accreditation, nonapplicant health departments are reportedly referencing PHAB guidelines for developing the CHA, CHIP, and health department strategic plan. Health departments may experience benefits associated with accreditation prior to their formal involvement in the PHAB accreditation process. The most common

Childhood constipation as an emerging public health problem

PubMed Central

Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

2016-01-01

Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities. PMID:27570423

Childhood constipation as an emerging public health problem.

PubMed

Rajindrajith, Shaman; Devanarayana, Niranga Manjuri; Crispus Perera, Bonaventure Jayasiri; Benninga, Marc Alexander

2016-08-14

Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities.

Public health nutrition practice in Canada: a situational assessment.

PubMed

Fox, Ann; Chenhall, Cathy; Traynor, Marie; Scythes, Cindy; Bellman, Jane

2008-08-01

Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

Beacon Communities’ Public Health Initiatives: A Case Study Analysis

PubMed Central

Massoudi, Barbara L.; Marcial, Laura H.; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

Introduction: The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. Background: The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Methods: Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Findings: Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7–14) present for each Beacon compared to barriers (range = 4–6). Discussion: Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. Conclusions: A common weakness was the lack of a framework or model for

Beacon communities' public health initiatives: a case study analysis.

PubMed

Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach

Opportunities for Public Relations Research in Public Health.

ERIC Educational Resources Information Center

Wise, Kurt

2001-01-01

Considers how communication researchers have developed a solid body of knowledge in the health field but know little about the activities of public relations practitioners in public health bodies. Suggests that public relations scholarship and practice have much to offer the field of public health in helping public health bodies meet their…

Planetree health information services: public access to the health information people want.

PubMed Central

Cosgrove, T L

1994-01-01

In July 1981, the Planetree Health Resource Center opened on the San Francisco campus of California Pacific Medical Center (Pacific Presbyterian Medical Center). Planetree was founded on the belief that access to information can empower people and help them face health and medical challenges. The Health Resource Center was created to provide medical library and health information resources to the general public. Over the last twelve years, Planetree has tried to develop a consumer health library collection and information service that is responsive to the needs and interests of a diverse public. In an effort to increase accessibility to the medical literature, a consumer health library classification scheme was created for the organization of library materials. The scheme combines the specificity and sophistication of the National Library of Medicine classification scheme with the simplicity of common lay terminology. PMID:8136762

Training Public Health Advisors.

PubMed

Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L

2015-01-01

Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

A survey of suppression of public health information by Australian governments.

PubMed

Yazahmeidi, Boshra; Holman, C D'Arcy J

2007-12-01

It is cause for concern when a democratically elected government suppresses embarrassing information by hindering public health research or the publication of research findings. We conducted a survey of Australian public health academics to estimate the level of acts of suppression of research by Australian governments, to characterise these events, and to gather views on what interventions might be effective in curbing them. A total of 302 academics in 17 institutions completed a postal questionnaire in August 2006 (46% of 652 invited). The instrument sought details of suppression events they had witnessed since 2001. There were 142 suppression events, including 85 personally experienced by 21.2% (n=64) of respondents. The rates were higher in 2005/06 than in earlier years. No State or Territory was immune from suppression. Although governments most commonly hindered research by sanitising, delaying or prohibiting publications (66% of events), no part of the research process was unaffected. Researchers commonly believed their work was targeted because it drew attention to failings in health services (48%), the health status of a vulnerable group (26%), or pointed to a harm in the environment (11%). The government agency seeking to suppress the health information mostly succeeded (87%) and, consequently, the public was left uninformed or given a false impression. Respondents identified a full range of participative, cognitive, structural and legislative control strategies. The suppression of public health information is widely practised by Australian governments. Systemic interventions are necessary to preserve the integrity of public health research conducted with government involvement.

Climate change and public health policy: translating the science.

PubMed

Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

2013-12-19

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character.

Climate Change and Public Health Policy: Translating the Science

PubMed Central

Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

2013-01-01

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character. PMID:24452252

Vitamin D and public health: an overview of recent research on common diseases and mortality in adulthood.

PubMed

Scragg, Robert

2011-09-01

There is increasing interest in vitamin D and its possible health effects. The aims of the present overview are to summarise the research on common diseases for which there is substantial evidence on vitamin D, identify diseases where vitamin D may be beneficial and discuss the public health implications of these findings. Literature search of PubMed for the years 2000 to 2010 to identify cohort studies with baseline measures of 25-hydroxyvitamin D (25(OH)D) and randomised controlled trials (RCT) of vitamin D supplementation in relation to fractures, colorectal cancer, CVD and all-cause mortality. Risk ratios of disease from comparisons between 25(OH)D quantiles in these studies were summarised using RevMan software version 5·1 (The Nordic Cochrane Centre, Copenhagen). Community-based samples recruited into cohort studies from many countries. Older men and women, mostly above 50 years of age. When comparing the lowest 25(OH)D category with the highest (or reference), the pooled risk ratio (95 % CI) was: 1·34 (1·13, 1·59) for fractures from nine studies; 1·59 (1·30, 1·95) for colorectal cancer from nine studies; 1·35 (1·17, 1·56) for CVD from twelve studies; and 1·42 (1·23, 1·63) for all-cause mortality from twelve studies. Cohort studies show that baseline 25(OH)D levels predict increased risk of fractures, colorectal cancer, CVD and all-cause mortality. These associations are weak and could be explained by confounding variables such as obesity and physical activity. Because of their potential public health significance, RCT using vitamin D doses ≥50 μg/d are required to determine whether vitamin D protects against these diseases.

[Terrorism, public health and health services].

PubMed

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Evaluating the Health Impact of Large-Scale Public Policy Changes: Classical and Novel Approaches

PubMed Central

Basu, Sanjay; Meghani, Ankita; Siddiqi, Arjumand

2018-01-01

Large-scale public policy changes are often recommended to improve public health. Despite varying widely—from tobacco taxes to poverty-relief programs—such policies present a common dilemma to public health researchers: how to evaluate their health effects when randomized controlled trials are not possible. Here, we review the state of knowledge and experience of public health researchers who rigorously evaluate the health consequences of large-scale public policy changes. We organize our discussion by detailing approaches to address three common challenges of conducting policy evaluations: distinguishing a policy effect from time trends in health outcomes or preexisting differences between policy-affected and -unaffected communities (using difference-in-differences approaches); constructing a comparison population when a policy affects a population for whom a well-matched comparator is not immediately available (using propensity score or synthetic control approaches); and addressing unobserved confounders by utilizing quasi-random variations in policy exposure (using regression discontinuity, instrumental variables, or near-far matching approaches). PMID:28384086

[Stewardship of public health surveillance in the health system in Colombia: a case study].

PubMed

López, Yolanda Lucía; González, Claudia; Gallego, Berta Natalia; Moreno, Ana Lida

2009-12-01

With the reform of the Colombian health system in 1993, public health surveillance continued to be a governmental responsibility under the stewardship of the Ministry of Social Protection along with state and local health authorities. The effectiveness of the development and organization of state and municipality public health surveillance programs will be studied as they have evolved under the general social security system in Colombia. Qualitative study and case-study method are applied to several institutions as they function in 5 states and 11 counties, ten years after the health system reforms. Public health authorities have reduced resources for providing advice, technical assistance, supervision and control of the process of the public health surveillance. Weaknesses in administrative control are common. Quantity and quality of human resources, as well as, staffing and financial resources are inadequate to meet the responsibilities that have been assigned to each state and county. The public health surveillance has prioritized the notification and registration of cases, and the strength of development of particular areas occasionally has been subject to the particular interests of officials in charge, particularly in the public hospitals. Little commitment or interest is shown by mayors, insurance companies, and institutions providing health services that are supposed to be involved with monitoring. A lack of cross-institutional collaboration is apparent in the development of health services surveillance. The implementation of public health surveillance at state and local levels is weak due to problems with the governmental stewardship. These weaknesses are manifested in the lack of regulation, financing and control of the health system.

Manifold Restraints: Liberty, Public Health, and the Legacy of Jacobson v Massachusetts

PubMed Central

Colgrove, James; Bayer, Ronald

2005-01-01

February 2005 marks the centenary of one of the most important pieces of public health jurisprudence, the US Supreme Court case of Jacobson v Massachusetts, which upheld the authority of states to pass compulsory vaccination laws. The Court’s decision articulated the view that the freedom of the individual must sometimes be subordinated to the common welfare. We examined the relationship between the individual and society in 20th-century public health practice and law and the ways that compulsory measures have been used to constrain personal liberty for the sake of protecting the public health. (Am J Public Health. PMID:15798111

Dental public health capacity worldwide: Results of a global survey.

PubMed

Lomazzi, Marta; Wordley, Valerie; Bedi, Raman

2016-12-01

The World Federation of Public Health Associations' Oral Health Working Group (WFPHA OHWG) carried out a survey to establish the extent of global dental public health (DPH) capacity. Senior stakeholders in DPH completed 124 surveys, covering 73 countries and all WHO regions. The survey evaluated DPH workforce within the country, funding, education, current services, and integration between public health and DPH in countries across the world. In 62 per cent of countries, DPH is only partially integrated in the public health system, while in 25 per cent of countries it has not yet been formally integrated. DPH programs at Masters level are available in 44 per cent of countries. Over half of countries have 0 to 10 trained DPH professionals. Because both poor oral and general health share several common risk factors, DPH must be integrated into national health systems and budgets, with an emphasis on having trained DPH specialists available in every country to collaborate in healthcare policy and provision.

Training Programs to Strengthen Pennsylvania's Public Health Response

PubMed Central

Churchill, R. Elliott; Lautenbach, Ebbing; Mactavish, Lindsay E.; Pollock, Timothy R.; Weand, Crystal L.; Polachek, Catherine; Reynolds, Stanley M.; Ostroff, Stephen M.

2009-01-01

This report describes Pennsylvania's 9-year experience in implementing training programs to strengthen public health response to emerging infectious diseases. During the biannual 3-5-day-long Pennsylvania Public Health Institute (PHI) events, which have been held since 2000, courses have covered topics such as emerging infectious disease outbreaks, monitoring of antimicrobial-resistant pathogens in retail food, and zoonotic diseases commonly associated with companion animals. Core competency courses include the legal basis for public health and epidemiology for nonepidemiologists. Emerging infectious disease seminars offered to clinicians since 2005 have focused on the emergence of community-associated methicillin-resistant Staphylococcus aureus and Clostridium difficile antibiotic-associated diarrhea. Complementing the PHI, the Pennsylvania Department of Health's monthly Epidemiology Journal Club offers additional interactions with presenters from academic institutions and federal agencies. Lunch-time forums also provide a venue for health department staff to share their work with colleagues. Innovative use of modern communication technology increases participation of frontline health workers in Journal Club events, and video conference capability offers flexibility in the selection of presenters. Pennsylvania's experience over the past 9 years demonstrates that with political will, commitment from content experts, and adequate administrative support, modest state and federal resources can be used to sustain public health training programs tailored to local needs. PMID:19635002

Public Health Workforce Self-Identified Training Needs by Jurisdiction and Job Type.

PubMed

Yeager, Valerie A; Wisniewski, Janna M; Chapple-McGruder, Theresa; Castrucci, Brian; Gould, Elizabeth

2018-06-21

Ensuring adequate and appropriate training of the workforce is a crucial priority for governmental public health. This is particularly important, given the diverse backgrounds of the public health workforce; the vast majority (approximately 83%) do not have formal training in public health, and those that do have formal training in public health have limited training in management and other essential organizational skills. The purpose of this article is to identify training needs among public health workers in specific job types and settings. This cross section study used 2014 data from the Public Health Workforce Interests and Needs Survey. Qualitative analyses were used to code open-ended responses to questions about training needs. Needs are stratified across job types and jurisdiction. Eight main themes or skill areas were identified with the largest proportion indicating a need for management/leadership skills (28.2%). The second most frequent need was communication skills (21.3%). Across the 9 job types examined, general management skills were either the first or second training need for 7 job types. Among individuals who already have leadership/management positions, budgeting was the most common training need. Findings from this study can inform targeted strategies to address training needs for specific types of employees. Such strategies can influence the efficiency and effectiveness of public health efforts and employee satisfaction. As new public health frameworks-like Public Health 3.0 and the Chief Health Strategist-are advanced nationally, it is necessary to ensure that the workforce has the skills and abilities to implement these frameworks.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission

Public health policy research: making the case for a political science approach.

PubMed

Bernier, Nicole F; Clavier, Carole

2011-03-01

The past few years have seen the emergence of claims that the political determinants of health do not get due consideration and a growing demand for better insights into public policy analysis in the health research field. Several public health and health promotion researchers are calling for better training and a stronger research culture in health policy. The development of these studies tends to be more advanced in health promotion than in other areas of public health research, but researchers are still commonly caught in a naïve, idealistic and narrow view of public policy. This article argues that the political science discipline has developed a specific approach to public policy analysis that can help to open up unexplored levers of influence for public health research and practice and that can contribute to a better understanding of public policy as a determinant of health. It describes and critiques the public health model of policy analysis, analyzes political science's specific approach to public policy analysis, and discusses how the politics of research provides opportunities and barriers to the integration of political science's distinctive contributions to policy analysis in health promotion.

What makes public health studies ethical? Dissolving the boundary between research and practice

PubMed Central

2014-01-01

Background The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants – have been unsatisfactory. Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle – from initial planning through to knowledge exchange. Discussion The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives. The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services

What makes public health studies ethical? Dissolving the boundary between research and practice.

PubMed

Willison, Donald J; Ondrusek, Nancy; Dawson, Angus; Emerson, Claudia; Ferris, Lorraine E; Saginur, Raphael; Sampson, Heather; Upshur, Ross

2014-08-08

The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary - whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants - have been unsatisfactory.Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle - from initial planning through to knowledge exchange. The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives.The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Public

Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries.

PubMed

Nsubuga, Peter; Nwanyanwu, Okey; Nkengasong, John N; Mukanga, David; Trostle, Murray

2010-12-03

There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO) has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening.With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention.We describe two ways that health ministries in developing countries could leverage President Obama's Global Health Initiative (GHI) to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM]) can also adapt their current health systems strengthening programs to build sustainable public health systems.

Contribution of the Nordic School of Public Health to the public mental health research field: a selection of research initiatives, 2007-2014.

PubMed

Forsman, Anna K; Fredén, Lars; Lindqvist, Rafael; Wahlbeck, Kristian

2015-08-01

The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of

Complementary competencies: public health and health sciences librarianship

PubMed Central

Banks, Marcus A.; Cogdill, Keith W.; Selden, Catherine R.; Cahn, Marjorie A.

2005-01-01

Objectives: The authors sought to identify opportunities for partnership between the communities of public health workers and health sciences librarians. Methods: The authors review competencies in public health and health sciences librarianship. They highlight previously identified public health informatics competencies and the Medical Library Association's essential areas of knowledge. Based on points of correspondence between the two domains, the authors identify specific opportunities for partnership. Results: The points of correspondence between public health and health sciences librarianship are reflected in several past projects involving both communities. These previous collaborations and the services provided by health sciences librarians at many public health organizations suggest that some health sciences librarians may be considered full members of the public health workforce. Opportunities remain for productive collaboration between public health workers and health sciences librarians. Conclusions: Drawing on historical and contemporary experience, this paper presents an initial framework for forming collaborations between health sciences librarians and members of the public health workforce. This framework may stimulate thinking about how to form additional partnerships between members of these two communities. PMID:16059423

Health for all: a public health vision.

PubMed

McBeath, W H

1991-12-01

The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.

Health for all: a public health vision.

PubMed Central

McBeath, W H

1991-01-01

The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals. PMID:1746649

Public Health, Embodied History, and Social Justice: Looking Forward.

PubMed

Krieger, Nancy

2015-01-01

This essay was delivered as a commencement address at the University of California-Berkeley School of Public Health on May 17, 2015. Reflecting on events spanning from 1990 to 1999 to 2015, when I gave my first, second, and third commencement talks at the school, I discuss four notable features of our present era and offer five insights for ensuring that health equity be the guiding star to orient us all. The four notable features are: (1) growing recognition of the planetary emergency of global climate change; (2) almost daily headlines about armed conflicts and atrocities; (3) growing public awareness of and debate about epic levels of income and wealth inequalities; and (4) growing activism about police killings and, more broadly, "Black Lives Matter." The five insights are: (1) public health is a public good, not a commodity; (2) the "tragedy of the commons" is a canard; the lack of a common good is what ails us; (3) good science is not enough, and bad science is harmful; (4) good evidence--however vital--is not enough to change the world; and (5) history is vital, because we live our history, embodied. Our goal: a just and sustainable world in which we and every being on this planet may truly thrive. © The Author(s) 2015.

Informatics Metrics and Measures for a Smart Public Health Systems Approach: Information Science Perspective

PubMed Central

Shea, Christopher Michael

2017-01-01

Public health informatics is an evolving domain in which practices constantly change to meet the demands of a highly complex public health and healthcare delivery system. Given the emergence of various concepts, such as learning health systems, smart health systems, and adaptive complex health systems, health informatics professionals would benefit from a common set of measures and capabilities to inform our modeling, measuring, and managing of health system “smartness.” Here, we introduce the concepts of organizational complexity, problem/issue complexity, and situational awareness as three codependent drivers of smart public health systems characteristics. We also propose seven smart public health systems measures and capabilities that are important in a public health informatics professional's toolkit. PMID:28167999

Informatics Metrics and Measures for a Smart Public Health Systems Approach: Information Science Perspective.

PubMed

Carney, Timothy Jay; Shea, Christopher Michael

2017-01-01

Public health informatics is an evolving domain in which practices constantly change to meet the demands of a highly complex public health and healthcare delivery system. Given the emergence of various concepts, such as learning health systems, smart health systems, and adaptive complex health systems, health informatics professionals would benefit from a common set of measures and capabilities to inform our modeling, measuring, and managing of health system "smartness." Here, we introduce the concepts of organizational complexity, problem/issue complexity, and situational awareness as three codependent drivers of smart public health systems characteristics. We also propose seven smart public health systems measures and capabilities that are important in a public health informatics professional's toolkit.

Profile of Public Health Leadership.

PubMed

Little, Ruth Gaskins; Greer, Annette; Clay, Maria; McFadden, Cheryl

2016-01-01

Public health leaders play pivotal roles in ensuring the population health for our nation. Since 2000, the number of schools of public health has almost doubled. The scholarly credentials for leaders of public health in academic and practice are important, as they make decisions that shape the future public health workforce and important public health policies. This research brief describes the educational degrees of deans of schools of public health and state health directors, as well as their demographic profiles, providing important information for future public health leadership planning. Data were extracted from a database containing information obtained from multiple Web sites including academic institution Web sites and state government Web sites. Variables describe 2 sets of public health leaders: academic deans of schools of public health and state health directors. Deans of schools of public health were 73% males and 27% females; the PhD degree was held by 40% deans, and the MD degree by 33% deans. Seventy percent of deans obtained their terminal degree more than 35 years ago. State health directors were 60% males and 40% females. Sixty percent of state health directors had an MD degree, 4% a PhD degree, and 26% no terminal degree at all. Sixty-four percent of state health directors received their terminal degree more than 25 years ago. In addition to terminal degrees, 56% of deans and 40% of state health directors held MPH degrees. The findings call into question competencies needed by future public health professionals and leadership and the need to clarify further the level of public health training and degree type that should be required for leadership qualifications in public health.

Climate change and local public health in the United States: preparedness, programs and perceptions of local public health department directors.

PubMed

Maibach, Edward W; Chadwick, Amy; McBride, Dennis; Chuk, Michelle; Ebi, Kristie L; Balbus, John

2008-07-30

While climate change is inherently a global problem, its public health impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The public health infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local public health departments view and are responding to climate change as a public health issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department--and other key stakeholders in their community--had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their words and actions

Climate Change and Local Public Health in the United States: Preparedness, Programs and Perceptions of Local Public Health Department Directors

PubMed Central

Maibach, Edward W.; Chadwick, Amy; McBride, Dennis; Chuk, Michelle; Ebi, Kristie L.; Balbus, John

2008-01-01

While climate change is inherently a global problem, its public health impacts will be experienced most acutely at the local and regional level, with some jurisdictions likely to be more burdened than others. The public health infrastructure in the U.S. is organized largely as an interlocking set of public agencies at the federal, state and local level, with lead responsibility for each city or county often residing at the local level. To understand how directors of local public health departments view and are responding to climate change as a public health issue, we conducted a telephone survey with 133 randomly selected local health department directors, representing a 61% response rate. A majority of respondents perceived climate change to be a problem in their jurisdiction, a problem they viewed as likely to become more common or severe over the next 20 years. Only a small minority of respondents, however, had yet made climate change adaptation or prevention a top priority for their health department. This discrepancy between problem recognition and programmatic responses may be due, in part, to several factors: most respondents felt personnel in their health department–and other key stakeholders in their community–had a lack of knowledge about climate change; relatively few respondents felt their own health department, their state health department, or the Centers for Disease Control and Prevention had the necessary expertise to help them create an effective mitigation or adaptation plan for their jurisdiction; and most respondents felt that their health department needed additional funding, staff and staff training to respond effectively to climate change. These data make clear that climate change adaptation and prevention are not currently major activities at most health departments, and that most, if not all, local health departments will require assistance in making this transition. We conclude by making the case that, through their words and actions

Does More Public Health Spending Buy Better Health?

PubMed Central

Sung, Jaesang; Honore, Peggy

2015-01-01

Background: In this article, we attempt to address a persistent question in the health policy literature: Does more public health spending buy better health? This is a difficult question to answer due to unobserved differences in public health across regions as well as the potential for an endogenous relationship between public health spending and public health outcomes. Methods: We take advantage of the unique way in which public health is funded in Georgia to avoid this endogeneity problem, using a twelve year panel dataset of Georgia county public health expenditures and outcomes in order to address the “unobservables” problem. Results: We find that increases in public health spending lead to increases in mortality by several different causes, including early deaths and heart disease deaths. We also find that increases in such spending leads to increases in morbidity from heart disease. Conclusions: Our results suggest that more public health funding may not always lead to improvements in health outcomes at the county level. PMID:28462255

Calibrating well-being, quality of life and common mental disorder items: psychometric epidemiology in public mental health research.

PubMed

Böhnke, Jan R; Croudace, Tim J

2016-08-01

The assessment of 'general health and well-being' in public mental health research stimulates debates around relative merits of questionnaire instruments and their items. Little evidence regarding alignment or differential advantages of instruments or items has appeared to date. Population-based psychometric study of items employed in public mental health narratives. Multidimensional item response theory was applied to General Health Questionnaire (GHQ-12), Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and EQ-5D items (Health Survey for England, 2010-2012; n = 19 290). A bifactor model provided the best account of the data and showed that the GHQ-12 and WEMWBS items assess mainly the same construct. Only one item of the EQ-5D showed relevant overlap with this dimension (anxiety/depression). Findings were corroborated by comparisons with alternative models and cross-validation analyses. The consequences of this lack of differentiation (GHQ-12 v. WEMWBS) for mental health and well-being narratives deserves discussion to enrich debates on priorities in public mental health and its assessment. © The Royal College of Psychiatrists 2015.

Legal Protections in Public Accommodations Settings: A Critical Public Health Issue for Transgender and Gender-Nonconforming People

PubMed Central

Reisner, Sari L; Hughto, Jaclyn M White; Dunham, Emilia E; Heflin, Katherine J; Begenyi, Jesse Blue Glass; Coffey-Esquivel, Julia; Cahill, Sean

2015-01-01

). Conclusions Discrimination in public accommodations is common and is associated with adverse health outcomes among transgender and gender-nonconforming adults in Massachusetts. Discrimination in health care settings creates a unique health risk for gender minority people. The passage and enforcement of transgender rights laws that include protections against discrimination in public accommodations—inclusive of health care—are a public health policy approach critically needed to address transgender health inequities. PMID:26219197

Impact of public health emergencies on modern disaster taxonomy, planning, and response.

PubMed

Burkle, Frederick M; Greenough, P Gregg

2008-10-01

Current disaster taxonomy describes diversity, distinguishing characteristics, and common relations in disaster event classifications. The impact of compromised public health infrastructure and systems on health consequences defines and greatly influences the manner in which disasters are observed, planned for, and managed, especially those that are geographically widespread, population dense, and prolonged. What may first result in direct injuries and death may rapidly change to excess indirect illness and subsequent death as essential public health resources are destroyed, deteriorate, or are systematically denied to vulnerable populations. Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict. We posit here that disaster frameworks be reformed to emphasize and clarify the relation of public health emergencies and modern disasters.

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN).

PubMed

Gaynor, Mark; Lenert, Leslie; Wilson, Kristin D; Bradner, Scott

2014-01-01

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions--for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of 'common carriage' or 'public calling,' the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN)

PubMed Central

Gaynor, Mark; Lenert, Leslie; Wilson, Kristin D; Bradner, Scott

2014-01-01

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions—for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of ‘common carriage’ or ‘public calling,’ the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare. PMID:23837992

Discover: What Is Public Health?

MedlinePlus

... Resources Contact About Membership Contact Discover What is Public Health? Public health protects and improves the health of individuals, families, communities, and populations, locally and globally. Public health is personal. Public health professionals focus on preventing ...

Designing Health Information Technology Tools to Prevent Gaps in Public Health Insurance.

PubMed

Hall, Jennifer D; Harding, Rose L; DeVoe, Jennifer E; Gold, Rachel; Angier, Heather; Sumic, Aleksandra; Nelson, Christine A; Likumahuwa-Ackman, Sonja; Cohen, Deborah J

2017-06-23

Changes in health insurance policies have increased coverage opportunities, but enrollees are required to annually reapply for benefits which, if not managed appropriately, can lead to insurance gaps. Electronic health records (EHRs) can automate processes for assisting patients with health insurance enrollment and re-enrollment. We describe community health centers' (CHC) workflow, documentation, and tracking needs for assisting families with insurance application processes, and the health information technology (IT) tool components that were developed to meet those needs. We conducted a qualitative study using semi-structured interviews and observation of clinic operations and insurance application assistance processes. Data were analyzed using a grounded theory approach. We diagramed workflows and shared information with a team of developers who built the EHR-based tools. Four steps to the insurance assistance workflow were common among CHCs: 1) Identifying patients for public health insurance application assistance; 2) Completing and submitting the public health insurance application when clinic staff met with patients to collect requisite information and helped them apply for benefits; 3) Tracking public health insurance approval to monitor for decisions; and 4) assisting with annual health insurance reapplication. We developed EHR-based tools to support clinical staff with each of these steps. CHCs are uniquely positioned to help patients and families with public health insurance applications. CHCs have invested in staff to assist patients with insurance applications and help prevent coverage gaps. To best assist patients and to foster efficiency, EHR based insurance tools need comprehensive, timely, and accurate health insurance information.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

PubMed

Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

PubMed Central

Lister, Cameron; Payne, Hannah; Hanson, Carl L.; Barnes, Michael D.; Davis, Siena F.; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes. PMID:28824899

Feminism and public health nursing: partners for health.

PubMed

Leipert, B D

2001-01-01

It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

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 nutrition: results and research.

PubMed

Binns, C W; Leong, J F

2000-01-01

Public health nutrition is focused on the prevention of diet-related diseases and the attainment of good health, through policy, education and health promotion. It involves many sectors of the community, cooperating to improve the health and wellbeing of the population with emphasis on prevention, equity, wellbeing and improved quality of life. In the majority of western countries, an epidemic of coronary heart disease (CHD) began after World War One, reaching its peak in the 1970's. In Asia, the epidemic began after WW2 with the rapid economic development of the region. In western countries, of which Australia is a typical example, health promotion activities and improved hospital treatment have been effective in reducing the impact of the CHD epidemic. The life expectancy of the population has steadily grown to 75.6 years for males and 81.3 years for females. Despite major advances in the prevention and treatment of cardiovascular disease, it is still the leading cause of premature mortality and morbidity in Australia. Furthermore, cardiovascular disease shares common risk factors with other leading causes of death, including lifestyle behaviours (diet, physical inactivity, alcohol consumption, smoking), physiological states (obesity, hypertension, high blood cholesterol) and socioeconomic factors. For Asia, the challenge is to implement public health policies that will tackle the epidemic of chronic disease before it reaches its peak. Health Promotion policies will be important for all countries. The use of the disability adjusted life years (DALY) methodology to measure the association between the cause of disease and relate its occurrence to health outcomes will be an important public health planning tool.

[Professional stressors and common mental health disorders: Causal links?

PubMed

Nicolas, C; Chawky, N; Jourdan-Ionescu, C; Drouin, M-S; Page, C; Houlfort, N; Beauchamp, G; Séguin, M

2018-06-01

According to the World Health Organization, depression has become the leading cause of disability in the world, contributing significantly to the burden of health issues especially in the industrialized countries. This is a major public health problem, with potential impact on work climates, productivity at work and the continued existence of the organizations. Some recent studies have examined potential links between professional factors and common mental health disorders, but none have demonstrated a direct causal link. In the present study, we explored possible links between work-related stressors and common mental health disorders, with the objective of determining priority mental health prevention axes. The study used a life trajectory method. We compared professional stressors and difficulties present in other spheres of life in the last five years between two groups: a group of 29 participants with common mental health disorders during the last five years (depression, anxiety disorders, eating disorders, substance use disorders, pathological gambling), and a group of 29 participants who have not experienced a mental health disorder in the last five years. Data were collected from semi-structured interviews with the participants using a life course analysis method. Each participant was interviewed during two or three meetings of two to three hour duration. Questions regarding difficulties in different spheres of life and mental health were asked. More precisely, data were collected with regards to the presence or absence of mental health disorders in the last five years and the nature of mental health disorders and difficulties. Moreover, we collected data pertaining to the most important positive and negative events in different spheres of life that were present in the last five years, including family life, romantic relationships, social life, academic difficulties, losses and separations, episodes of personal difficulties, financial difficulties as well as

Common Mental Health Issues

ERIC Educational Resources Information Center

Stock, Susan R.; Levine, Heidi

2016-01-01

This chapter provides an overview of common student mental health issues and approaches for student affairs practitioners who are working with students with mental illness, and ways to support the overall mental health of students on campus.

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

Measuring the Value of Public Health Systems: The Disconnect Between Health Economists and Public Health Practitioners

PubMed Central

Jacobson, Peter D.; Palmer, Jennifer A.

2008-01-01

We investigated ways of defining and measuring the value of services provided by governmental public health systems. Our data sources included literature syntheses and qualitative interviews of public health professionals. Our examination of the health economic literature revealed growing attempts to measure value of public health services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture “intangibles” (e.g., social justice and reassurance value). Academic researchers evaluating the economics of public health investments should increase focus on the working needs of public health professionals. PMID:18923123

Public health ethics related training for public health workforce: an emerging need in the United States.

PubMed

Kanekar, A; Bitto, A

2012-01-01

Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making. Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.

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

Feminism and public health ethics

PubMed Central

Rogers, W A

2006-01-01

This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health. PMID:16731735

Feminism and public health ethics.

PubMed

Rogers, W A

2006-06-01

This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

Insights in Public Health

PubMed Central

Oshiro, Peter

2015-01-01

Reducing the occurrence of and influencing the rapid correction of food illness risk factors is a common goal for all governmental food regulatory programs nationwide. Foodborne illness in the United States is a major cause of personal distress, preventable illness, and death. To improve public health outcomes, additional workforce was required due to long standing staffing shortages and was obtained partially through consolidation of the Hawai‘i Department of Health's (HDOH) two food safety programs, the Sanitation Branch, and the Food & Drug Branch in July 2012, and through legislation that amended existing statutes governing the use of food establishment permit fees. Additionally, a more transparent food establishment grading system was developed after extensive work with industry partners based on three possible placards issued after routine inspections: green, yellow, and red. From late July 2014 to May 2015, there were 6,559 food establishments inspected statewide using the placard system with 79% receiving a green, 21% receiving a yellow, and no red placards issued. Sufficient workforce to allow timely inspections, continued governmental transparency, and use of new technologies are important to improve food safety for the public. PMID:26279966

The science commons in health research: structure, function, and value.

PubMed

Cook-Deegan, Robert

The "science commons," knowledge that is widely accessible at low or no cost, is a uniquely important input to scientific advance and cumulative technological innovation. It is primarily, although not exclusively, funded by government and nonprofit sources. Much of it is produced at academic research centers, although some academic science is proprietary and some privately funded R&D enters the science commons. Science in general aspires to Mertonian norms of openness, universality, objectivity, and critical inquiry. The science commons diverges from proprietary science primarily in being open and being very broadly available. These features make the science commons particularly valuable for advancing knowledge, for training innovators who will ultimately work in both public and private sectors, and in providing a common stock of knowledge upon which all players-both public and private-can draw readily. Open science plays two important roles that proprietary R&D cannot: it enables practical benefits even in the absence of profitable markets for goods and services, and its lays a shared foundation for subsequent private R&D. The history of genomics in the period 1992-2004, covering two periods when genomic startup firms attracted significant private R&D investment, illustrates these features of how a science commons contributes value. Commercial interest in genomics was intense during this period. Fierce competition between private sector and public sector genomics programs was highly visible. Seemingly anomalous behavior, such as private firms funding "open science," can be explained by unusual business dynamics between established firms wanting to preserve a robust science commons to prevent startup firms from limiting established firms' freedom to operate. Deliberate policies to create and protect a large science commons were pursued by nonprofit and government funders of genomics research, such as the Wellcome Trust and National Institutes of Health. These

Bibliometric analysis on Australian rural health publications from 2006 to 2012.

PubMed

Mendis, Kumara; Edwards, Tegan; Stevens, Wendy; McCrossin, Tim

2014-08-01

To review Australian rural health (ARH) publications in PubMed from 2006 to 2012 and address ARH issues raised by the 2013 Health and Medical Research report. Retrospective observational study. Internet-based bibliometric analysis using PubMed. MEDLINE-indexed ARH publications from 2006 to 2012 were retrieved using PubMed queries. ARH publications were defined as Australian publications that explore issues relevant to the health of the regional, rural or remote Australian population. Two authors independently reviewed a random sample of 5% of publications for validity. Analysis determined country of origin (Australia); publications relevant to the National Health Priority Areas, the 2013 National Rural Health Alliance priority areas and Rural Clinical Schools/University Departments of Rural Health; and journal frequencies and publication types. ARH publications increased from 286 in 2006 to 393 in 2012 and made up 1.4% of all Australian PubMed publications. Combined, the health priority areas were addressed in 52% of ARH publications. Rural Clinical Schools/University Departments of Rural Health articles made up 7% of ARH publications. An increase in cohort studies, systematic reviews and reviews indicated improved quality of articles. ARH articles were most commonly published in the Australian Journal of Rural Health (15.9%), Rural and Remote Health (13.4%) and the Medical Journal of Australia (6.3%). Striking a balance between broadening the queries (increasing sensitivity) and limiting the false positives by restricting the breadth of the queries (increasing specificity) was the main limitation. This reproducible analysis, repeated at given timelines, can track the progress of ARH publications and provide directions regarding future rural health research. © 2014 National Rural Health Alliance Inc.

The public health aspects of complex emergencies and refugee situations.

PubMed

Toole, M J; Waldman, R J

1997-01-01

Populations affected by armed conflict have experienced severe public health consequences mediated by population displacement, food scarcity, and the collapse of basic health services, giving rise to the term complex humanitarian emergencies. These public health effects have been most severe in underdeveloped countries in Africa, Asia, and Latin America. Refugees and internally displaced persons have experienced high mortality rates during the period immediately following their migration. In Africa, crude mortality rates have been as high as 80 times baseline rates. The most common causes of death have been diarrheal diseases, measles, acute respiratory infections, and malaria. High prevalences of acute malnutrition have contributed to high case fatality rates. In conflict-affected European countries, such as the former Yugoslavia, Georgia, Azerbaijan, and Chechnya, war-related injuries have been the most common cause of death among civilian populations; however, increased incidence of communicable diseases, neonatal health problems, and nutritional deficiencies (especially among the elderly) have been documented. The most effective measures to prevent mortality and morbidity in complex emergencies include protection from violence; the provision of adequate food rations, clean water and sanitation; diarrheal disease control; measles immunization; maternal and child health care, including the case management of common endemic communicable diseases; and selective feeding programs, when indicated.

Gambling and the Health of the Public: Adopting a Public Health Perspective.

PubMed

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

A school-based public health model to reduce oral health disparities.

PubMed

Dudovitz, Rebecca N; Valiente, Jonathan E; Espinosa, Gloria; Yepes, Claudia; Padilla, Cesar; Puffer, Maryjane; Slavkin, Harold C; Chung, Paul J

2018-12-01

Although dental decay is preventable, it remains the most common pediatric chronic disease. We describe a public health approach to implementing a scalable and sustainable school-based oral health program for low-income urban children. The Los Angeles Trust for Children's Health, a nonprofit affiliated with the Los Angeles Unified School District, applied a public health model and developed a broad-based community-coalition to a) establish a District Oral Health Nurse position to coordinate oral health services, and b) implement a universal school-based oral health screening and fluoride varnishing program, with referral to a dental home. Key informant interviews and focus groups informed program development. Parent surveys assessed preventative oral health behaviors and access to oral health services. Results from screening exams, program costs and rates of reimbursement were recorded. From 2012 to 2015, six elementary schools and three dental provider groups participated. Four hundred ninety-one parents received oral health education and 89 served as community oral health volunteers; 3,399 screenings and fluoride applications were performed on 2,776 children. Sixty-six percent of children had active dental disease, 27 percent had visible tooth decay, and 6 percent required emergent care. Of the 623 students who participated for two consecutive years, 56 percent had fewer or no visible caries at follow-up, while only 17 percent had additional disease. Annual program cost was $69.57 per child. Using a broad based, oral health coalition, a school-based universal screening and fluoride varnishing program can improve the oral health of children with a high burden of untreated dental diseases. © 2017 American Association of Public Health Dentistry.

Social Determinants of Health, Violent Radicalization, and Terrorism: A Public Health Perspective.

PubMed

Alcalá, Héctor E; Sharif, Mienah Zulfacar; Samari, Goleen

2017-01-01

Background: Terrorism-related deaths are at an all-time high as there were 32,685 and 29,376 terrorism-related deaths in 2014 and 2015, respectively. Terrorism is defined as the use of violence and intimidation in the pursuit of political aims. Terrorism is detrimental for mental health, premature mortality, and economic losses and undermines the central tenets of public health to improve the health and well-being of populations. Despite the impact terrorism has on avoidable morbidity and mortality, population health research largely overlooks social determinants of terrorism and risk factors that contribute to terrorist activities. Methods: Drawing from what is known about commonly studied social determinants of health topics, including the relationships between structural and interpersonal discrimination, social cohesion, and gang violence and health, we present a public health framework, rooted in the social determinants of health, for identifying potential factors influencing terrorism and violent radicalization. Results: Social determinants of health provide unique insight into how interpersonal and structural factors can influence risk for violent radicalization and terrorist activity. Each of the topics we review provides an entry point for existing public health and behavioral science knowledge to be used in preventing and understanding violent radicalization and terrorism. For example, anti-Muslim sentiment has promoted discrimination against Muslims, while also serving to marginalize and stigmatize Muslim communities. These conditions limit the social resources, like social cohesion, that Muslims have access to and make political violence more appealing to some. Conclusions: Public health can contribute much to the ongoing debate around terrorism. The field must take a more prevention-focused approach to the problem of terrorism. Failure to do so only perpetuates approaches that have not been successful.

Development of an online tool for public health: the European Public Health Law Network.

PubMed

Basak, P

2011-09-01

The European Public Health Law Network was established in 2007 as part of the European Union (EU) co-funded Public Health Law Flu project. The aims of the website consisted of designing an interactive network of specialist information and encouraging an exchange of expertise amongst members. The website sought to appeal to academics, public health professionals and lawyers. The Public Health Law Flu project team designed and managed the website. Registered network members were recruited through publicity, advertising and word of mouth. Details of the network were sent to health organizations and universities throughout Europe. Corresponding website links attracted many new visitors. Publications, news, events and a pandemic glossary became popular features on the site. Although the website initially focused only on pandemic diseases it has grown into a multidisciplinary website covering a range of public health law topics. The network contains over 700 publications divided into 28 public health law categories. News, events, front page content, legislation and the francophone section are updated on a regular basis. Since 2007 the website has received over 15,000 views from 156 countries. Newsletter subscribers have risen to 304. There are now 723 followers on the associated Twitter site. The European Public Health Law Network has been a successful and innovative site in the area of public health law. Interest in the site continues to grow. Future funding can contribute to a bigger site with interactive features and pages in a wider variety of languages to attract a wider global audience. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Public health and peace.

PubMed

Laaser, Ulrich; Donev, Donco; Bjegović, Vesna; Sarolli, Ylli

2002-04-01

The modern concept of public health, the New Public Health, carries a great potential for healthy and therefore less aggressive societies. Its core disciplines are health promotion, environmental health, and health care management based on advanced epidemiological methodologies. The main principles of living together in healthy societies can be summarized as four ethical concepts of the New Public Health essential to violence reduction equity, participation, subsidiarity, and sustainability. The following issues are discussed as violence determinants: the process of urbanization; type of neighborhood and accommodation, and consequent stigmatization; level of education; employment status; socialization of the family; women's status; alcohol and drug consumption; availability of the firearms; religious, ethnic, and racial prejudices; and poverty. Development of the health systems has to contribute to peace, since aggression, violence, and warfare are among the greatest risks for health and the economic welfare. This contribution can be described as follows: 1) full and indiscriminate access to all necessary services, 2) monitoring of their quality, 3) providing special support to vulnerable groups, and 4) constant scientific and public accountability of the evaluation of the epidemiological outcome. Violence can also destroy solidarity and social cohesion of groups, such as family, team, neighborhood, or any other social organization. Durkheim coined the term anomie for a state in which social disruption of the community results in health risks for individuals. Health professionals can make a threefold contribution to peace by 1) analyzing the causal interrelationships of violence phenomena, 2) curbing the determinants of violence according to the professional standards, and 3) training professionals for this increasingly important task. Because tolerance is an essential part of an amended definition of health, monitoring of the early signs of public intolerance is

The place of human rights and the common good in global health policy.

PubMed

Tasioulas, John; Vayena, Effy

2016-08-01

This article offers an integrated account of two strands of global health justice: health-related human rights and health-related common goods. After sketching a general understanding of the nature of human rights, it proceeds to explain both how individual human rights are to be individuated and the content of their associated obligations specified. With respect to both issues, the human right to health is taken as the primary illustration. It is argued that (1) the individuation of the right to health is fixed by reference to the subject matter of its corresponding obligations, and not by the interests it serves, and (2) the specification of the content of that right must be properly responsive to thresholds of possibility and burden. The article concludes by insisting that human rights cannot constitute the whole of global health justice and that, in addition, other considerations-including the promotion of health-related global public goods-should also shape such policy. Moreover, the relationship between human rights and common goods should not be conceived as mutually exclusive. On the contrary, there sometimes exists an individual right to some aspect of a common good, including a right to benefit from health-related common goods such as programmes for securing herd immunity from diphtheria.

Making Common Sense of Vaccines: An Example of Discussing the Recombinant Attenuated Salmonella Vaccine with the Public.

PubMed

Dankel, Dorothy J; Roland, Kenneth L; Fisher, Michael; Brenneman, Karen; Delgado, Ana; Santander, Javier; Baek, Chang-Ho; Clark-Curtiss, Josephine; Strand, Roger; Curtiss, Roy

2014-01-01

Researchers have iterated that the future of synthetic biology and biotechnology lies in novel consumer applications of crossing biology with engineering. However, if the new biology's future is to be sustainable, early and serious efforts must be made towards social sustainability. Therefore, the crux of new applications of synthetic biology and biotechnology is public understanding and acceptance. The RASVaccine is a novel recombinant design not found in nature that re-engineers a common bacteria ( Salmonella ) to produce a strong immune response in humans. Synthesis of the RASVaccine has the potential to improve public health as an inexpensive, non-injectable product. But how can scientists move forward to create a dialogue of creating a 'common sense' of this new technology in order to promote social sustainability? This paper delves into public issues raised around these novel technologies and uses the RASVaccine as an example of meeting the public with a common sense of its possibilities and limitations.

Transportation and public health.

PubMed

Litman, Todd

2013-01-01

This article investigates various ways that transportation policy and planning decisions affect public health and better ways to incorporate public health objectives into transport planning. Conventional planning tends to consider some public health impacts, such as crash risk and pollution emissions measured per vehicle-kilometer, but generally ignores health problems resulting from less active transport (reduced walking and cycling activity) and the additional crashes and pollution caused by increased vehicle mileage. As a result, transport agencies tend to undervalue strategies that increase transport system diversity and reduce vehicle travel. This article identifies various win-win strategies that can help improve public health and other planning objectives.

Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

PubMed

Guyon, Ak'ingabe; Perreault, Robert

2016-10-20

Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

[Public health conceptual models and paradigms].

PubMed

Hernández-Girón, Carlos; Orozco-Núñez, Emanuel; Arredondo-López, Armando

2012-01-01

The epidemiological transition model proposed by Omhran at the beginning of the 1970s (decreased fecundity rate and increased life expectancy), together with modifications in lifestyles and diet, showed increased mortality due to chronically degenerative causes. This essay thus discusses and makes a comparative analysis of some currents of thought, taking as its common thread an analysis of epidemiological change identified in different eras or stages and relationships with some public health models or conceptual frameworks. Discussing public health paradigms leads to a historical recapitulation of conceptual models ranging from magical-religious conceptions to ecological and socio-medical models. M. Susser proposed 3 eras in this discipline's evolution in his speech on the future of the epidemiology. The epidemiological changes analysed through different approaches constitute elements of analysis that all models discussed in this essay include to delimit the contributions and variables so determining them.

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.

Transitions in state public health law: comparative analysis of state public health law reform following the Turning Point Model State Public Health Act.

PubMed

Meier, Benjamin Mason; Hodge, James G; Gebbie, Kristine M

2009-03-01

Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health.

Moving from Intersection to Integration: Public Health Law Research and Public Health Systems and Services Research

PubMed Central

Burris, Scott; Mays, Glen P; Douglas Scutchfield, F; Ibrahim, Jennifer K

2012-01-01

Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the

Public health workforce taxonomy.

PubMed

Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J

2014-11-01

Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Social determinants and lifestyles: integrating environmental and public health perspectives.

PubMed

Graham, H; White, P C L

2016-12-01

Industrialization and urbanization have been associated with an epidemiological transition, from communicable to non-communicable disease, and a geological transition that is moving the planet beyond the stable Holocene epoch in which human societies have prospered. The lifestyles of high-income countries are major drivers of these twin processes. Our objective is to highlight the common causes of chronic disease and environmental change and, thereby, contribute to shared perspectives across public health and the environment. Integrative reviews focused on social determinants and lifestyles as two 'bridging' concepts between the fields of public health and environmental sustainability. We drew on established frameworks to consider the position of the natural environment within social determinants of health (SDH) frameworks and the position of social determinants within environmental frameworks. We drew on evidence on lifestyle factors central to both public health and environmental change (mobility- and diet-related factors). We investigated how public health's focus on individual behaviour can be enriched by environmental perspectives that give attention to household consumption practices. While SDH frameworks can incorporate the biophysical environment, their causal structure positions it as a determinant and one largely separate from the social factors that shape it. Environmental frameworks are more likely to represent the environment and its ecosystems as socially determined. A few frameworks also include human health as an outcome, providing the basis for a combined public health/environmental sustainability framework. Environmental analyses of household impacts broaden public health's concern with individual risk behaviours, pointing to the more damaging lifestyles of high-income households. The conditions for health are being undermined by rapid environmental change. There is scope for frameworks reaching across public health and environmental

DEVELOPMENT AND IMPLEMENTATION OF A PRACTICAL PUBLIC HEALTH TRAINING SYSTEM IN CHINA.

PubMed

Liu, Changjiang; Zhang, Junyue; Chen, Guoyuan; Yang, Kedi

2015-03-01

Public health education is becoming an increasing priority among educators of medicine. In China, little attention has been paid to public health education reform. A new public health training system was introduced in China in 2007. We conducted this study during 2006-2012 to evaluate the graduate core competencies under the new system. Data were collected from 231 graduates and 49 public health agencies. The 144 graduates who enrolled in 2006 and were trained under the old system constituted the control group; the 87 graduates who enrolled in 2007 and were trained under the new system constituted the experimental group. Surveys of graduate core competencies found analyzing and solving problems in the laboratory, conducting on-site practice and learning new technologies were the top three abilities most expected by public health agencies. After 5-year practical ability training, the graduates in the experimental group had better performance; on-site practical ability and laboratory practical ability increased significantly by 24.5% and 20.0%, respectively. Three other important competencies also improved: designing epidemiologic surveys, collecting information from the literature and doing statistical analyses. However, preventing and controlling common diseases and dealing with emergencies remained weak. These results show the new training system should be continued, but revisions are needed to improve this training system, especially in the areas of preventing and controlling common diseases and dealing with emergencies.

Public Schools and the Common Good.

ERIC Educational Resources Information Center

Reese, William J.

1988-01-01

Improving public school education, especially for the poor, requires defining and articulating some vision of the common good. This article reviews key positions taken by liberals and conservatives regarding educational reform during the 19th and 20th centuries and critiques these positions with regard to their disservice to the poor. (IAH)

Current FDA directives for promoting public health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayes, A.H. Jr.

1982-03-01

The current directions of the FDA are outlined. The underlying philosophy of the FDA under the Reagan Administration is that both the private sector and the government must address the responsibilities to which they are best suited for the health-care system to work more efficiently. To facilitate this, FDA is conducting comprehensive reviews of FDA regulations and the drug-evaluation process. There are many dimensions to promoting public health, and the FDA alone cannot assure an adequate supply of safe and effective drugs. Innovative science and technology are needed to develop new drugs, followed by maximum potentiation (maximum good and leastmore » harm) after FDA approval. Hospital pharmacists have a role in maximizing the potential benefits of drugs through pharmacy and therapeutics committees. The current status of the pilot program for patient package inserts is described. The response at a recent hearing on the program indicates that the responsibility to protect the public health is shared by the government, health professions, industry, and the public. The FDA's campaign on sodium is based on that shared responsibility. By improving communication and building upon their common objections, both pharmacy and the FDA can do their jobs successfully.« less

Public health relevance of drug-nutrition interactions.

PubMed

Péter, Szabolcs; Navis, Gerjan; de Borst, Martin H; von Schacky, Clemens; van Orten-Luiten, Anne Claire B; Zhernakova, Alexandra; Witkamp, Renger F; Janse, André; Weber, Peter; Bakker, Stephan J L; Eggersdorfer, Manfred

2017-08-01

The public health relevance of drug-nutrition interactions is currently highly undervalued and overlooked. This is particularly the case for elderly persons where multi-morbidity and consequently polypharmacy is very common. Vitamins and other micronutrients have central functions in metabolism, and their interactions with drugs may result in clinically relevant physiological impairments but possibly also in positive effects. On 12 April 2016, the University Medical Center Groningen (The Netherlands), as part of its Healthy Ageing program, organized a workshop on the public health relevance of drug-nutrient interactions. In this meeting, experts in the field presented results from recent studies on interactions between pharmaceuticals and nutrients, and discussed the role of nutrition for elderly, focusing on those persons receiving pharmaceutical treatment. This paper summarizes the proceedings of the symposium and provides an outlook for future research needs and public health measures. Since food, pharma and health are closely interconnected domains, awareness is needed in the medical community about the potential relevance of drug-nutrition interactions. Experts and stakeholders should advocate for the integration of drug-nutrition evaluations in the drug development process. Strategies for the individual patients should be developed, by installing drug review protocols, screening for malnutrition and integrating this topic into the general medical advice.

A decade review of publications in Families, Systems, & Health: 2005-2015.

PubMed

Mendenhall, Tai J; Li, Yiting; Schulz, Catherine L

2016-09-01

The purpose of this investigation was to review recent publication content and trends in Families, Systems, & Health ( FSH ). How do the journal’s articles reflect current and emerging challenges in health care? We hope that our findings can guide special issues and content foci. All work published in FSH between 2005 and 2015 was included (n = 452); each piece was coded for article type, general foci, and specific foci. The most common type of article published over the 10-year time frame was research reports (43%; n = 195), followed by other types (e.g., tribute pieces, poems), commentaries, conceptual/theory papers, literature reviews, and case studies. The most common general focus included family health and/or functioning (28%; n = 128). The most common specific foci centered on children (15%; n = 55). Common themes found in FSH ’s most frequently cited publications included family relationships in care, chronic physical illnesses, and mental health. Marked trends in journal content included increases in articles targeting family health and/or functioning and primary care and decreased attention to theory. FSH’s emphasis on research reports to inform current and evolving interventions that target contemporary health challenges suggests that the journal is keeping stride with the most pressing issues in health care today. Future special issues can continue to serve and meet these needs. FSH’s robust inclusion of other article types sustains the journal’s mission to advance multiple ways of understanding health-care phenomena. PsycINFO Database Record (c) 2016 APA, all rights reserved

A public health training center experience: professional continuing education at schools of public health.

PubMed

Potter, Margaret A; Fertman, Carl I; Eggleston, Molly M; Holtzhauer, Frank; Pearsol, Joanne

2008-01-01

The Public Health Training Center (PHTC) national program was first established at accredited schools of public health in 2000. The PHTC program used the US Health Resources and Services Administration's grants to build workforce development programs, attracting schools as training providers and the workforce as training clients. This article is a reflection on the experience of two schools, whose partnership supported one of the PHTCs, for the purpose of opening a conversation about the future of continuing education throughout schools and degree programs of public health. This partnership, the Pennsylvania & Ohio Public Health Training Center (POPHTC), concentrated its funding on more intensive training of public healthcare workers through a relatively narrow inventory of courses that were delivered typically in-person rather than by distance-learning technologies. This approach responded to the assessed needs and preferences of the POPHTC's workforce population. POPHTC's experience may not be typical among the PHTCs nationally, but the collective experience of all PHTCs is instructive to schools of public health as they work to meet an increasing demand for continuing education from the public health workforce.

Social Determinants of Health, Violent Radicalization, and Terrorism: A Public Health Perspective

PubMed Central

Alcalá, Héctor E.; Sharif, Mienah Zulfacar; Samari, Goleen

2017-01-01

Abstract Background: Terrorism-related deaths are at an all-time high as there were 32,685 and 29,376 terrorism-related deaths in 2014 and 2015, respectively. Terrorism is defined as the use of violence and intimidation in the pursuit of political aims. Terrorism is detrimental for mental health, premature mortality, and economic losses and undermines the central tenets of public health to improve the health and well-being of populations. Despite the impact terrorism has on avoidable morbidity and mortality, population health research largely overlooks social determinants of terrorism and risk factors that contribute to terrorist activities. Methods: Drawing from what is known about commonly studied social determinants of health topics, including the relationships between structural and interpersonal discrimination, social cohesion, and gang violence and health, we present a public health framework, rooted in the social determinants of health, for identifying potential factors influencing terrorism and violent radicalization. Results: Social determinants of health provide unique insight into how interpersonal and structural factors can influence risk for violent radicalization and terrorist activity. Each of the topics we review provides an entry point for existing public health and behavioral science knowledge to be used in preventing and understanding violent radicalization and terrorism. For example, anti-Muslim sentiment has promoted discrimination against Muslims, while also serving to marginalize and stigmatize Muslim communities. These conditions limit the social resources, like social cohesion, that Muslims have access to and make political violence more appealing to some. Conclusions: Public health can contribute much to the ongoing debate around terrorism. The field must take a more prevention-focused approach to the problem of terrorism. Failure to do so only perpetuates approaches that have not been successful. PMID:28905048

[Evaluative designs in public health: methodological considerations].

PubMed

López, Ma José; Marí-Dell'Olmo, Marc; Pérez-Giménez, Anna; Nebot, Manel

2011-06-01

Evaluation of public health interventions poses numerous methodological challenges. Randomization of individuals is not always feasible and interventions are usually composed of multiple factors. To face these challenges, certain elements, such as the selection of the most appropriate design and the use of a statistical analysis that includes potential confounders, are essential. The objective of this article was to describe the most frequently used designs in the evaluation of public health interventions (policies, programs or campaigns). The characteristics, strengths and weaknesses of each of these evaluative designs are described. Additionally, a brief explanation of the most commonly used statistical analysis in each of these designs is provided. Copyright © 2011 Sociedad Española de Salud Pública y Administración Sanitaria. Published by Elsevier Espana. All rights reserved.

The Public Health Implications of Resource Wars

PubMed Central

Klare, Michael T.; Sidel, Victor W.

2011-01-01

Competition for resources between or within nations is likely to become an increasingly common cause of armed conflict. Competition for petroleum is especially likely to trigger armed conflict because petroleum is a highly valuable resource whose supply is destined to contract. Wars fought over petroleum and other resources can create public health concerns by causing morbidity and mortality, damaging societal infrastructure, diverting resources, uprooting people, and violating human rights. Public health workers and the organizations with which they are affiliated can help prevent resource wars and minimize their consequences by (1) promoting renewable energy and conservation, (2) documenting the impact of past and potential future resource wars, (3) protecting the human rights of affected noncombatant civilian populations during armed conflict, and (4) developing and advocating for policies that promote peaceful dispute resolution. PMID:21778501

Transforming Public Health?

PubMed Central

ALDOUS, Chris

2008-01-01

Historical assessments of the Occupation’s efforts to tackle enteric diseases (cholera, typhoid, paratyphoid and dysentery) have generally reflected a celebratory narrative of US-inspired public health reforms, strongly associated with the head of the Public Health and Welfare Section, Crawford F. Sams. Close inspection of the documentary record, however, reveals much greater continuity with pre-war Japanese public health practices than has hitherto been acknowledged. Indeed, there are strong grounds for disputing American claims of novelty and innovation in such areas as immunisation, particularly in relation to typhoid vaccine, and environmental sanitation, where disparaging comments about the careless use of night soil and a reluctance to control flies and other disease vectors reveal more about the politics of public health reform than the reality of pre-war practices. Likewise, the representation of American-inspired sanitary teams as clearly distinct from and far superior to traditional sanitary associations (eisei kumiai) was closer to propaganda than an accurate rendering of past and present developments. PMID:19048809

Transitions in State Public Health Law: Comparative Analysis of State Public Health Law Reform Following the Turning Point Model State Public Health Act

PubMed Central

Meier, Benjamin Mason; Gebbie, Kristine M.

2009-01-01

Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health. PMID:19150900

Educating the future public health workforce: do schools of public health teach students about the private sector?

PubMed

Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

2013-01-01

Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers.

PubMed

Yeager, Valerie A; Wisniewski, Janna M; Amos, Kathleen; Bialek, Ron

2016-01-01

The public health workforce is critical to the functioning of the public health system and protection of the population's health. Ensuring a sufficient workforce depends on effectively recruiting and retaining workers. This study examines factors influencing decisions to take and remain in jobs within public health, particularly for workers employed in governmental public health. This cross-sectional study employed a secondary data set from a 2010 national survey of US public health workers. Survey respondents were included in this study if they responded to at least 1 survey item related to recruitment and retention. A total of 10 859 survey responses fit this criterion. Data examined demographics of public health workers and factors that influenced decisions to take jobs in and remain in public health. Job security (β = 0.42; 95% confidence interval [CI], 0.28-0.56) and competitive benefits (β = 0.49; 95% CI, 0.28-0.70) were significantly and positively associated with governmental employees' decisions to take positions with their current employers compared with public health workers employed by other types of organizations. The same finding held with regard to retention: job security (β = 0.40; 95% CI, 0.23-0.57) and competitive benefits (β = 0.53; 95% CI, 0.24-0.83). Two personal factors, personal commitment to public service (β = 0.30; 95% CI, 0.17-0.42) and wanted a job in the public health field (β = 0.44; 95% CI, 0.18-0.69), were significantly and positively related to governmental employees deciding to remain with their current employers. It is important to recognize the value of competitive benefits for both current and potential employees. Public health agencies should maintain these if possible and make the value of these benefits known to policy makers or other agencies setting these benefit policies. Job security associated with governmental public health jobs also appears to offer public health an advantage in recruiting and retaining employees.

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.

Social marketing in public health.

PubMed

Grier, Sonya; Bryant, Carol A

2005-01-01

Social marketing, the use of marketing to design and implement programs to promote socially beneficial behavior change, has grown in popularity and usage within the public health community. Despite this growth, many public health professionals have an incomplete understanding of the field. To advance current knowledge, we provide a practical definition and discuss the conceptual underpinnings of social marketing. We then describe several case studies to illustrate social marketing's application in public health and discuss challenges that inhibit the effective and efficient use of social marketing in public health. Finally, we reflect on future developments in the field. Our aim is practical: to enhance public health professionals' knowledge of the key elements of social marketing and how social marketing may be used to plan public health interventions.

Increasing the Delivery of Preventive Health Services in Public Education.

PubMed

Cruden, Gracelyn; Kelleher, Kelly; Kellam, Sheppard; Brown, C Hendricks

2016-10-01

The delivery of prevention services to children and adolescents through traditional healthcare settings is challenging for a variety of reasons. Parent- and community-focused services are typically not reimbursable in traditional medical settings, and personal healthcare services are often designed for acute and chronic medical treatment rather than prevention. To provide preventive services in a setting that reaches the widest population, those interested in public health and prevention often turn to school settings. This paper proposes that an equitable, efficient manner in which to promote health across the life course is to integrate efforts from public health, primary care, and public education through the delivery of preventive healthcare services, in particular, in the education system. Such an integration of systems will require a concerted effort on the part of various stakeholders, as well as a shared vision to promote child health via community and institutional stakeholder partnerships. This paper includes (1) examination of some key system features necessary for delivery of preventive services that improve child outcomes; (2) a review of the features of some common models of school health services for their relevance to prevention services; and (3) policy and implementation strategy recommendations to further the delivery of preventive services in schools. These recommendations include the development of common metrics for health outcomes reporting, facilitated data sharing of these metrics, shared organization incentives for integration, and improved reimbursement and funding opportunities. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Antibiotic innovation for future public health needs.

PubMed

Theuretzbacher, U

2017-10-01

The public health threat of antibiotic resistance has gained attention at the highest political levels globally, and recommendations on how to respond are being considered for implementation. Among the recommended responses being explored for their feasibility is the introduction of economic incentives to promote research and development of new antibiotics. There is broad agreement that public investment should stimulate innovation and be linked to policies promoting sustainable and equitable access to antibiotics. Though commonly used, the term 'innovation' is not based on a common understanding. This article aims to initiate discussion on the meaning of 'innovation' in this context. Literature and expert opinion. As the definition of a novel class (novel scaffold, novel pharmacophore), a novel target (novel binding site) and a novel mode of action-the three traditional criteria for 'innovation' in this context-may be confounded by the complexities of antibacterial drug discovery, a biological and outcome-oriented definition of innovation is presented to initiate discussion. Such an expanded definition of innovation in this specific context is based on the overarching requirement that a drug not be affected by cross-resistance to existing drugs in the organisms and indications for which it is intended to be used, and that it have low potential for high-frequency, high-level single-step resistance if intended as a single drug therapy. Policy makers, public health authorities and funders could use such a comprehensive definition of innovation to prioritize where publicly funded incentives should be applied. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Public Health Nursing Staff Health Education Attitudes.

ERIC Educational Resources Information Center

Collins, Terence R.; And Others

Health education attitudes toward prevention, detection, and treatment of selected chronic diseases and conditions confronting public health nursing staffs were investigated at a Florida Department of Health and Rehabilitative Services District, which is composed of 16 county public health units (CPHU). Findings were used to determine type of…

Public Health Dental Hygienists in Massachusetts: A Qualitative Study.

PubMed

Rainchuso, Lori; Salisbury, Helen

2017-06-01

Purpose: The aim of this qualitative, phenomenological study was to explore the attitudes and perceptions of public health dental hygienists on providing preventive care to underserved populations in Massachusetts. Methods: Non-probability purposive sampling was used for initial participant recruitment, and snowball sampling occurred thereafter. Data collection occurred through semi-structured interviews. Qualitative analysis was conducted using Pitney and Parker's eight-step CREATIVE process. Results: Data saturation occurred with 10 participants (n=10), one-third of the public health dental hygienists who are practicing in Massachusetts. The majority of practice settings included school-based programs (70%), while programs for children with special needs (10%) were the least common. Two major themes emerged from the data; (a) the opportunity to be an oral health change agent and (b) barriers to practice. Six subcategories emerged from the data and are reviewed within the context of their associated themes. Additionally, career satisfaction emerged as an unintended theme, and was reported as the driving force for the majority of participants. Conclusion: This study revealed a better understanding of the public health dental hygiene workforce model in Massachusetts. Public health dental hygienists in Massachusetts perceive themselves as change agents within the health care profession, and although barriers to practice are plentiful, these oral health care professionals are committed to improving access to dental care. Copyright © 2017 The American Dental Hygienists’ Association.

Public mental health.

PubMed

Lindert, Jutta; Bilsen, Johan; Jakubauskiene, Marija

2017-10-01

Public mental health (PMH) is a major challenge for public health research and practice. This article is organized in six parts. First, we will highlight the significance of PMH; second, we will define mental health and mental disorders; third, we identify and describe determinants of mental health and mental disorders on which we worked in the past 10 years since the establishment of the PMH section such as social determinants and violence. Fourth, we will describe the development of the EUPHA PMH section and provide details on vulnerable groups in the field of PMH, on violence as a main determinant and on suicide as an outcome which affects all countries in the European region. Fifth, we describe policy and practice implications of the development of PMH and highlight the European dimension of PMH. We will conclude this article by providing an outlook on potential further development of PMH as regards research and policy and practice. Finally, we hope that the EUPHA PMH section will contribute to public health in the next 25 years and we can contribute to improvement of PMH in Europe. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

National support to public health research: a survey of European ministries.

PubMed

Conceição, Cláudia; Leandro, Alexandra; McCarthy, Mark

2009-06-25

Within SPHERE (Strengthening Public Health Research in Europe), a collaborative study funded by the European Commission, we have assessed the support for public health research at ministry level in European countries. We surveyed the health and science ministries in 25 EU countries and 3 EEA countries, using a broad definition of public-health research at population level. We made over 600 phone calls and emails to identify respondents and to gain answers. We gained formal replies from 42 out of 56 ministries (73% response) in 25 countries. There were 22 completed questionnaires (from 25 ministries), 6 short answers and 11 contacts declaring that their ministries were not responsible for public health research, while in 14 ministries (both ministries in three countries) no suitable ministry contact could be found. In most European countries, ministries of health, or their devolved agencies, were regarded as the leading organizations. Most ministries were able to specify thematic areas for public-health research (from three to thirty), and others ministries referred to policy documents, health plans or public-health plans to define research priorities. Ministries and their agencies led on decisions for financial support of public-health research, with less involvement of other external organisations compared with the process of identifying priorities. However, the actual funds available for public health were not easily identifiable. Most ministries relied on general academic means for dissemination of results of public-health research, while ministries get information on the use of public-health research usually through informal means. Ministries made suggestions for strengthening public-health research through initiatives of their own countries and of the European Union: as well as more resources, improving coordination was most frequently suggested. There is no common approach to support for public-health research across Europe, and significant gaps in

Insights in Public Health

PubMed Central

Hayes, Donald

2014-01-01

There are significant shortages in the public health workforce and it's expected to worsen. Efforts to reduce this shortage are varied and include building the workforce by increasing exposure of students and young professionals in applied public health experiences. Providing these experiences increases productivity, and may help alleviate some of the workforce shortages in public health. This article seeks to highlight the work done at the Family Health Services Division (FHSD) in the Hawai‘i Department of Health over the past 6 and half years in working with students in epidemiology practicum and fellowship experiences. PMID:24660128

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

Legal Protections in Public Accommodations Settings: A Critical Public Health Issue for Transgender and Gender-Nonconforming People.

PubMed

Reisner, Sari L; Hughto, Jaclyn M White; Dunham, Emilia E; Heflin, Katherine J; Begenyi, Jesse Blue Glass; Coffey-Esquivel, Julia; Cahill, Sean

2015-09-01

health care was independently associated with adverse self-reported health, adjusting for discrimination in other public accommodations settings. Overall, 65% of respondents reported public accommodations discrimination in the past 12 months. The 5 most prevalent discrimination settings were transportation (36%), retail (28%), restaurants (26%), public gatherings (25%), and health care (24%). Public accommodations discrimination in the past 12 months in health care settings was independently associated with a 31% to 81% increased risk of adverse emotional and physical symptoms and a 2-fold to 3-fold increased risk of postponement of needed care when sick or injured and of preventive or routine health care, adjusting for discrimination in other public accommodations settings (which also conferred an additional 20% to 77% risk per discrimination setting endorsed). Discrimination in public accommodations is common and is associated with adverse health outcomes among transgender and gender-nonconforming adults in Massachusetts. Discrimination in health care settings creates a unique health risk for gender minority people. The passage and enforcement of transgender rights laws that include protections against discrimination in public accommodations-inclusive of health care-are a public health policy approach critically needed to address transgender health inequities. © 2015 Milbank Memorial Fund.

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

PubMed

Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

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.

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.

Developing and sustaining leadership in public health nursing: findings from one British Columbia health authority.

PubMed

Mills, Leslie; Wong, Sabrina T; Bhagat, Radhika; Quail, Donna; Triolet, Kathy; Weber, Tannis

2012-12-01

To develop clinical leadership among front-line public health nurses (PHNs). This paper describes a quality improvement process to develop clinical leadership among front-line PHNs. Three activities were undertaken by a working group consisting mainly of front-line staff: engaging PHNs in an online change-readiness questionnaire, administering a survey to clients who had ever used public health services delivered by one Vancouver Community Infant, Child and Youth (ICY) program team and conducting three group interviews with public health providers. The group interviews asked about PHN practice. They were analyzed using thematic content analysis. This quality improvement project suggests that PHNs (n=70) strongly believed in opportunities for system improvement. Client surveys (n=429) and community partner surveys (n=79) revealed the importance of the PHN role. Group interview data yielded three themes: PHNs were the "hub" of community care; PHNs lacked a common language to describe their work; PHNs envisioned their future practice encompassing their full scope of competencies. PHNs developed the "ICY Public Health Nursing Model," which articulates 14 public health interventions and identifies the scope of their work. Developing and sustaining clinical leadership in front-line PHNs was accomplished through these various quality assurance activities. Copyright © 2013 Longwoods Publishing.

Health needs and public health functions addressed in scientific publications in Francophone sub-Saharan Africa.

PubMed

Benie-Bi, J; Cambon, L; Grimaud, O; Kivits, J; Alla, F

2013-09-01

To describe the reporting of public health research in Francophone sub-Saharan Africa (FSA). A bibliometric research study of scientific public health publications in FSA, which includes 24 countries and approximately 260 million people. Two researchers analysed original articles published in 2007 in the medical or social sciences fields and indexed in Scopus. At least one co-author of articles had to be based in FSA. The analysis focused on research field, public health function (WHO classification), FSA country author's affiliation, language, journal type and global burden of disease (WHO classification). Of 1047 articles retrieved by the search, 212 were from the public health field. The number of articles per country varied from 0 to 36. Public health functions examined were health service research (24.5%), health monitoring (27.4%), prevention (15%) and legislation (0.5%). The distribution of health needs described in the articles was close to that of the WHO data for Africa for 2004: infectious and parasitic diseases (70% vs 54%), maternal and perinatal conditions (15% vs 17%), non-communicable diseases (15.6% vs 21%), and injuries (0.5% vs 8%). The areas reported in published articles from sub-Saharan Africa reflect the health needs distribution in Africa; however, the number of publications is low, particularly for prevention. In light of the current focus on evidence-based public health, this study questions whether the international scientific community adequately considers the expertise and perspectives of African researchers and professionals. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Rethinking public health: promoting public engagement through a new discursive environment.

PubMed

Sun, Ye

2014-01-01

I reexamine the notion of public health after reviewing critiques of the prevalent individualistic conception of health. I argue that public health should mean not only the health of the public but also health in the public and by the public, and I expound on the social contingency of health and highlight the importance of the interpersonal dimensions of health conditions and health promotion efforts. Promoting public health requires activating health-enhancing communicative behaviors (such as interpersonal advocacy and mutual responsibility taking) in addition to individual behavioral change. To facilitate such communicative behaviors, it is imperative to first construct a new discursive environment in which to think and talk about health in a language of interdependence and collective efforts.

Experts, Public to Weigh in on Common Tests

ERIC Educational Resources Information Center

McNeil, Michele

2009-01-01

As 48 states charge ahead with plans to adopt common academic standards, the U.S. Department of Education will enlist experts and the public to help design a $350 million competition for the next step: the development of common tests. In coming weeks, top Education Department officials will travel to Atlanta, Boston, and Denver for a series of…

Public health and media advocacy.

PubMed

Dorfman, Lori; Krasnow, Ingrid Daffner

2014-01-01

Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.

Assessing Entrepreneurship in Governmental Public Health

PubMed Central

Wasserman, Jeffrey; Wu, Helen W.; Lauer, Johanna R.

2015-01-01

Objectives. We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Methods. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Results. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Conclusions. Ongoing PHE activity has the potential to reduce LHDs’ reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs’ current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative. PMID:25689182

Assessing entrepreneurship in governmental public health.

PubMed

Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

2015-04-01

We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

Division of Public Health

Science.gov Websites

State Employees Public Health DHSS State of Alaska Home Divisions and Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public

[The key role of public health medical resident education for future public health challenges].

PubMed

Costantino, Claudio; Cinquetti, Sandro; Garavelli, Elena; Marcantoni, Claudio; Murru, Claudia; Pieroni, Giovanni; Privitera, Gaetano; Ricciardi, Walter; Soncini, Francesco; Tedesco, Dario; Triassi, Maria; Vitale, Francesco; Campanella, Francesca

2014-01-01

The Italian Committee of medical residents in Hygiene, Preventive Medicine and Public Health is a member of the Italian Society of Hygiene, Preventive Medicine and Public Health with the aim of developing a network among Italian resident in public health and promoting the educational path improvement through comparisons and debates between postgraduate medical schools. In this perspective, during last years account has been taken of some essential topics concerning education of public health medical residents, which represent future health-care and public health experts. Cross-sectional researches were conducted among Italian public health medical residents (PHMRs) through self-administered and web-based questionnaires. Each questionnaire was previously validated by pilot studies conducted during the 46th National Conference of the Italian Society of Hygiene, Preventive Medicine and Public Health. Seventy percent of Italian PHMRs considered the actual length of Public Health postgraduate medical school excessively long, with regard to predetermined educational goals. Confirming this statement, 90% of respondents were inclined to a reduction from 5 to 4 years of postgraduate medical school length, established by Law Decree 104/2013. Seventy seven percent of surveyed PHMRs stand up for a rearrangement on a national setting of the access contest to postgraduate medical schools. Moreover 1/3 of Italian schools performed less than 75%of learning and qualifying activities specified in Ministerial Decree of August 2005. In particular, data analysis showed considerable differences among Italian postgraduate schools. Finally, in 2015 only four Italian Universities (Napoli Federico II, Palermo, Pavia, Roma Tor Vergata) provide for the Second Level Master qualify for the functions of occupational doctor. This offer makes available 60 positions against a request of over 200 future Public Health medical doctors who have shown interest in the Master. In Italy, after the

Public health educational comprehensiveness: The strategic rationale in establishing networks among schools of public health.

PubMed

Otok, Robert; Czabanowska, Katarzyna; Foldspang, Anders

2017-11-01

The establishment and continuing development of a sufficient and competent public health workforce is fundamental for the planning, implementation, evaluation, effect and ethical validity of public health strategies and policies and, thus, for the development of the population's health and the cost-effectiveness of health and public health systems and interventions. Professional public health strategy-making demands a background of a comprehensive multi-disciplinary curriculum including mutually, dynamically coherent competences - not least, competences in sociology and other behavioural sciences and their interaction with, for example, epidemiology, biostatistics, qualitative methods and health promotion and disease prevention. The size of schools and university departments of public health varies, and smaller entities may run into problems if seeking to meet the comprehensive curriculum challenge entirely by use of in-house resources. This commentary discusses the relevance and strength of establishing comprehensive curriculum development networks between schools and university departments of public health, as one means to meet the comprehensiveness challenge. This commentary attempts to consider a two-stage strategy to develop complete curricula at the bachelor and master's as well as PhD levels.

EMB history to increase health technology literacy in the general public for improved health worldwide.

PubMed

Leder, Ron S

2009-01-01

History provides common access to technology for both technical and non technical persons and for youngsters. Placed in an historical context complex health technology and health care can be more understandable and therefore more accessible to the general public; technical persons can understand past health technology advances to help propel the field. History is a reference for experts disguised as a story that anyone can understand and enjoy. This can be useful and effective at improving self advocate based health care.

Expert searching in public health

PubMed Central

Alpi, Kristine M.

2005-01-01

Objective: The article explores the characteristics of public health information needs and the resources available to address those needs that distinguish it as an area of searching requiring particular expertise. Methods: Public health searching activities from reference questions and literature search requests at a large, urban health department library were reviewed to identify the challenges in finding relevant public health information. Results: The terminology of the information request frequently differed from the vocabularies available in the databases. Searches required the use of multiple databases and/or Web resources with diverse interfaces. Issues of the scope and features of the databases relevant to the search questions were considered. Conclusion: Expert searching in public health differs from other types of expert searching in the subject breadth and technical demands of the databases to be searched, the fluidity and lack of standardization of the vocabulary, and the relative scarcity of high-quality investigations at the appropriate level of geographic specificity. Health sciences librarians require a broad exposure to databases, gray literature, and public health terminology to perform as expert searchers in public health. PMID:15685281

Rethinking Public Health: Promoting Public Engagement Through a New Discursive Environment

PubMed Central

2014-01-01

I reexamine the notion of public health after reviewing critiques of the prevalent individualistic conception of health. I argue that public health should mean not only the health of the public but also health in the public and by the public, and I expound on the social contingency of health and highlight the importance of the interpersonal dimensions of health conditions and health promotion efforts. Promoting public health requires activating health-enhancing communicative behaviors (such as interpersonal advocacy and mutual responsibility taking) in addition to individual behavioral change. To facilitate such communicative behaviors, it is imperative to first construct a new discursive environment in which to think and talk about health in a language of interdependence and collective efforts. PMID:24228674

42 CFR 90.9 - Public health advisory.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

42 CFR 90.9 - Public health advisory.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

42 CFR 90.9 - Public health advisory.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

42 CFR 90.9 - Public health advisory.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

42 CFR 90.9 - Public health advisory.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on the findings of a...

Is housing a public health issue? A survey of directors of public health.

PubMed

Roderick, P; Victor, C; Connelly, J

1991-01-19

To determine the views of directors of public health on the importance of housing for public health and their departments' and health authorities' participation in housing issues. Postal self administered questionnaire survey. All district health authorities in England and health boards in Wales, Scotland, and Northern Ireland. All 221 district directors of public health in England and chief administrative medical officers in Wales, Scotland, and Northern Ireland. Response to questionnaire consisting of fixed and open ended questions on housing issues. The response rate was 89% (196/221). Housing was perceived as a major health problem by 33% (65/196) of directors. Positive responses were most likely from inner city districts. In 47% (93/196) of departments there was a formal time commitment to housing issues with a median time of one session/week (range one per month to 10 per week). The main function was allocation of medical priority for public sector rehousing. Overall, 73% (144/196) reported some participation in this process. Reported participation in joint care planning and links with non-statutory housing organisations were uncommon. 53% (104/196) of directors had included housing issues in their annual health report. In 16% (32/196) of districts specific services for the homeless had been set up. Although concern about the impact of current housing policy on public health was shown by a substantial number of directors, the main activity was still allocation of medical priority despite a background of increasing housing need and homelessness. The underlying need is for greater advocacy to produce a healthy housing policy for all, and the annual public health report could be used to promote this objective.

Training Physicians for Public Health Careers

ERIC Educational Resources Information Center

Hernandez, Lyla M., Ed.; Munthali, A. Wezi, Ed.

2007-01-01

Public health efforts have resulted in tremendous improvements in the health of individuals and communities. The foundation for effective public health interventions rests, in large part, on a well-trained workforce. Unfortunately there is a major shortage of public health physicians who are prepared to face today's public health challenges.…

Assessment of Public Health Infrastructure to Determine Public Health Preparedness

DTIC Science & Technology

2006-03-01

and Theodore M. Brown, "The Unfulfilled Promise of Public Health: Deja Vu all Over again," Health Affairs 21, no. 6 (November/December, 2002): 31...Health: Deja Vu all Over Again." Health Affairs 21, no. 6 (November/December 2002). http://proquest.umi.com/ (accessed February 3, 2006). Flynn

77 FR 28883 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

...-2012-0004] Draft Public Health Action Plan--A National Public Health Action Plan for the Detection...), Department of Health and Human Services (HHS). ACTION: Notice of availability and request for public comment..., Division of Reproductive Health, Attn: National Public Health Action Plan for the Detection, Prevention...

Mental health in prisons: A public health agenda.

PubMed

Fraser, A

2009-01-01

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law-abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons' role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Twitter and Public Health (Part 2): Qualitative Analysis of How Individual Health Professionals Outside Organizations Use Microblogging to Promote and Disseminate Health-Related Information.

PubMed

Hart, Mark; Stetten, Nichole; Islam, Sabrina; Pizarro, Katherine

2017-10-04

Twitter is the most popular form of microblogging that is being utilized in public health to engage audiences and to communicate health-related information. Although there is some research showing the various forms of Twitter use in public health, little is known about how individual public health professionals are using their personal Twitter accounts to disseminate health information. The purpose of this research was to categorize public health professionals' tweets to evaluate how individual public health professionals are furthering the mission of public health. Twitter accounts held by public health professionals were identified, and researchers proceeded to record 6 months' worth of each individual's Twitter feed. During the 6-month period, a total of 15,236 tweets were collected and analyzed using the constant comparison method. A total of 23 tweet categories among the 15,236 tweets were initially identified. Some of the most common topics among the 23 categories included the following: health nutrition (n=2008), conferences (n=815), Ebola (n=789), Affordable Care Act (ACA)/health care (n=627), and social justice (n=626). Each of these categories were then stratified into one of four themes: (1) informing and educating, (2) monitoring health statuses and trends, (3) social justice, and (4) professional development. Using Twitter, public health professionals are helping dispel misinformation through education and by translating technical research into lay terms, advocating for health inequalities, and using it as a means to promote professional development. ©Mark Hart, Nichole Stetten, Sabrina Islam, Katherine Pizarro. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 04.10.2017.

Knowledge of Rabies Prevention in Vietnamese Public Health and Animal Health Workers.

PubMed

Nguyen, K A T; Nguyen, H T T; Pham, T N; Van, K D; Hoang, T V; Olowokure, B

2016-11-01

Rabies is an invariably fatal, but preventable zoonotic disease. Despite a national programme for its prevention and control, the number of rabies associated deaths in Vietnam has increased in recent years. A cross-sectional survey was undertaken in 2012 to assess and compare the knowledge, awareness and practices of 189 public health workers (PHW) and animal health workers (AHW) attending a joint training course for professionals from provinces in northern Vietnam with the highest number of deaths from rabies. Questionnaires facilitating self-evaluation were provided, and total knowledge scores were calculated (maximum 38 points) and categorized into: 'high' (>30 points), 'moderate' (21-30) and 'low' (<21). The response rate was 100%, and among the 189 participants, 56% were PHW compared to 44% who were AHW. Although most respondents knew rabies could be transmitted through the bite of an animal, most commonly a dog, and that rabies is a preventable disease, significant differences between groups were identified. Major areas included poor knowledge of common rabies reservoirs, wound management and guidance on post-exposure prophylaxis. Overall, the total mean knowledge scores for PHW was significantly higher (P = 0.011) compared to those for AHW, but both scores fell within the 'moderate' knowledge range. However, proportionately more PHW than AHW achieved 'high' knowledge scores (P = 0.0098). To our knowledge this is the first published study to simultaneously assess the knowledge and awareness of animal health and public health professionals attending joint training activities aimed at strengthening rabies prevention and control. To ensure effective prevention and control of rabies requires that AHW and PHW not only coordinate and collaborate, but have a common knowledge and understanding of rabies prevention and control measures. This study provides important baseline data in a relatively unexplored area of research that can focus future interventions and

Health visitor or public health nurse? A Scottish study.

PubMed

Wilson, Susan

2006-09-01

The Scottish Executive and the National Health Service (NHS) have been consistently promoting 'public health nursing' as a new way forward in the community. In addition, since 2001 traditional health visitor and school nurse education programmes have been replaced by a single public health nurse training curriculum. However, many of the roles, responsibilities and job descriptions of clinical health visiting staff have remained unchanged within health board areas. This has led to apparent confusion among staff, both newly qualified and those already in post. This lack of clarity in policy and role prompted this research study, which set out to investigate the perceptions of the public health role of the health visitor within a health board area in Scotland. Initially, a review of the relevant literature was undertaken to provide in-depth background information on the topic, to enable a critical analysis of the current public health role of the health visitor. This analysis was further informed by obtaining qualitative and quantitative data via a questionnaire sent to 89 health visitors, to determine the attitudes and opinions of health visitors currently working within a Scottish health board area. Results from the study indicate that, despite the plethora of public health-related Scottish Executive publications and the changes in educational programmes, many health visitors still carry out what is perceived as a traditional role with mainly the under-five age group. The study also identified the need for clear direction in the public health role for health visitors, with many health visitors expressing a willingness to make changes to their current role.

A Public Health Grid (PHGrid): Architecture and value proposition for 21st century public health.

PubMed

Savel, T; Hall, K; Lee, B; McMullin, V; Miles, M; Stinn, J; White, P; Washington, D; Boyd, T; Lenert, L

2010-07-01

This manuscript describes the value of and proposal for a high-level architectural framework for a Public Health Grid (PHGrid), which the authors feel has the capability to afford the public health community a robust technology infrastructure for secure and timely data, information, and knowledge exchange, not only within the public health domain, but between public health and the overall health care system. The CDC facilitated multiple Proof-of-Concept (PoC) projects, leveraging an open-source-based software development methodology, to test four hypotheses with regard to this high-level framework. The outcomes of the four PoCs in combination with the use of the Federal Enterprise Architecture Framework (FEAF) and the newly emerging Federal Segment Architecture Methodology (FSAM) was used to develop and refine a high-level architectural framework for a Public Health Grid infrastructure. The authors were successful in documenting a robust high-level architectural framework for a PHGrid. The documentation generated provided a level of granularity needed to validate the proposal, and included examples of both information standards and services to be implemented. Both the results of the PoCs as well as feedback from selected public health partners were used to develop the granular documentation. A robust high-level cohesive architectural framework for a Public Health Grid (PHGrid) has been successfully articulated, with its feasibility demonstrated via multiple PoCs. In order to successfully implement this framework for a Public Health Grid, the authors recommend moving forward with a three-pronged approach focusing on interoperability and standards, streamlining the PHGrid infrastructure, and developing robust and high-impact public health services. Published by Elsevier Ireland Ltd.

How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives.

PubMed

Saramunee, Kritsanee; Krska, Janet; Mackridge, Adam; Richards, Jacqueline; Suttajit, Siritree; Phillips-Howard, Penelope

2014-01-01

Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Ranking of Cities According to Public Health Criteria: Pitfalls and Opportunities

PubMed Central

Ham, Sandra A.; Levin, Sarah; Zlot, Amy I.; Andrews, Richard R.; Miles, Rebecca

2004-01-01

Popular magazines often rank cities in terms of various aspects of quality of life. Such ranking studies can motivate people to visit or relocate to a particular city or increase the frequency with which they engage in healthy behaviors. With careful consideration of study design and data limitations, these efforts also can assist policymakers in identifying local public health issues. We discuss considerations in interpreting ranking studies that use environmental measures of a city population’s public health related to physical activity, nutrition, and obesity. Ranking studies such as those commonly publicized are constrained by statistical methodology issues and a lack of a scientific basis in regard to design. PMID:15053999

Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education

PubMed Central

PHELPS, CHARLES; RAPPUOLI, RINO; LEVIN, SCOTT; SHORTLIFFE, EDWARD; COLWELL, RITA

2016-01-01

Policy Points: Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning.Public health agencies’ current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost‐effectiveness.As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost‐effectiveness analyses widely recommended and used for public health planning.Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Context Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost‐effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Methods Our work employed a multicriteria systems analysis approach—specifically, multiattribute utility theory—to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost‐effectiveness analysis approach. Findings (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost‐effectiveness analysis. (2) More sophisticated systems‐level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become

Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education.

PubMed

Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Levin, Scott; Shortliffe, Edward; Colwell, Rita

2016-03-01

Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning. Public health agencies' current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost-effectiveness. As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost-effectiveness analyses widely recommended and used for public health planning. Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Our work employed a multicriteria systems analysis approach--specifically, multiattribute utility theory--to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach. (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. The teaching of strategic planning in public

Training the public health workforce at the National School of Public Health: meeting Africa's needs.

PubMed

Mokwena, Kebogile; Mokgatle-Nthabu, Mathilda; Madiba, Sphiwe; Lewis, Helen; Ntuli-Ngcobo, Busi

2008-01-01

The inadequate number of trained public health personnel in Africa remains a challenge. In sub-Saharan Africa, the estimated workforce of public health practitioners is 1.3% of the world's health workforce addressing 25% of the world's burden of disease. To address this gap, the National School of Public Health at the then Medical University of Southern Africa created an innovative approach using distance learning components to deliver its public health programmes. Compulsory classroom teaching is limited to four two-week blocks. Combining mainly online components with traditional classroom curricula reduced limitations caused by geographical distances. At the same time, the curriculum was structured to contextualize continental health issues in both course work and research specific to students' needs. The approach used by the National School of Public Health allows for a steady increase in the number of public health personnel in Africa. Because of the flexible e-learning components and African-specific research projects, graduates from 16 African countries could benefit from this programme. An evaluation showed that such programmes need to constantly motivate participants to reduce student dropout rates and computer literacy needs to be a pre-requisite for entry into the programme. Short certificate courses in relevant public health areas would be beneficial in the African context. This programme could be replicated in other regions of the continent.

Training of public health workforce at the National School of Public Health: meeting Africa's needs.

PubMed

Mokwena, Kebogile; Mokgatle-Nthabu, Mathilda; Madiba, Sphiwe; Lewis, Helen; Ntuli-Ngcobo, Busi

2007-12-01

The inadequate number of trained public health personnel in Africa remains a challenge. In sub-Saharan Africa, the estimated workforce of public health practitioners is 1.3% of the world's health workforce addressing 25% of the world's burden of disease. To address this gap, the National School of Public Health at the then Medical University of Southern Africa created an innovative approach using distance learning components to deliver its public health programmes. Compulsory classroom teaching is limited to four two-week blocks. RELEVABT CHANGES: Combining mainly online components with traditional classroom curricula reduced limitations caused by geographical distances. At the same time, the curriculum was structured to contextualize continental health issues in both course work and research specific to students' needs. The approach used by the National School of Public Health allows for a steady increase in the number of public health personnel in Africa. Because of the flexible e-learning components and African-specific research projects, graduates from 16 African countries could avail of this programme. An evaluation showed that such programmes need to constantly motivate participants to reduce student dropout rates and computer literacy needs to be a pre-requisite for entry into the programme. Short certificate courses in relevant public health areas would be beneficial in the African context. This programme could be replicated in other regions of the continent.

Development of Systematic Knowledge Management for Public Health: A Public Health Law Ontology

ERIC Educational Resources Information Center

Keeling, Jonathan

2012-01-01

The Institute of Medicine has stated that legal structures and the authority vested in health agencies and other partners within the public health system are essential to improving the public's health. Variation between the laws of different jurisdictions within the United States allows for natural experimentation and research into their…

Public Health Nursing: Public Health Centers

Science.gov Websites

Locations Anchorage-based Itinerants Bethel Craig Delta Junction Dillingham Fairbanks Homer Juneau Kenai agencies with state grant assistance Frontier Region Delta Junction Dillingham Fairbanks Kodiak Nome Tok [back to top] Delta Junction Public Health Center 2857 Alaska Hwy, Room 210 Delta Junction, Alaska 99737

[A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

PubMed

Petrini, Carlo

2015-01-01

The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

An analysis of the health status of the United Arab Emirates: the 'Big 4' public health issues.

PubMed

Loney, Tom; Aw, Tar-Ching; Handysides, Daniel G; Ali, Raghib; Blair, Iain; Grivna, Michal; Shah, Syed M; Sheek-Hussein, Mohamud; El-Sadig, Mohamed; Sharif, Amer A; El-Obaid, Yusra

2013-02-05

The United Arab Emirates (UAE) is a rapidly developing country composed of a multinational population with varying educational backgrounds, religious beliefs, and cultural practices, which pose a challenge for population-based public health strategies. A number of public health issues significantly contribute to morbidity and mortality in the UAE. This article summarises the findings of a panel of medical and public health specialists from UAE University and various government health agencies commissioned to report on the health status of the UAE population. A systematic literature search was conducted to retrieve peer-reviewed articles on health in the UAE, and unpublished data were provided by government health authorities and local hospitals. The panel reviewed and evaluated all available evidence to list and rank (1=highest priority) the top four main public health issues: 1) Cardiovascular disease accounted for more than 25% of deaths in 2010; 2) Injury caused 17% of mortality for all age groups in 2010; 3) Cancer accounted for 10% of all deaths in 2010, and the incidence of all cancers is projected to double by 2020; and 4) Respiratory disorders were the second most common non-fatal condition in 2010. The major public health challenges posed by certain personal (e.g. ethnicity, family history), lifestyle, occupational, and environmental factors associated with the development of chronic disease are not isolated to the UAE; rather, they form part of a global health problem, which requires international collaboration and action. Future research should focus on population-based public health interventions that target the factors associated with the development of various chronic diseases.

Public health tools for holding self-regulators accountable: lessons from the alcohol experience.

PubMed

Jernigan, David H

2011-05-01

Self-regulation is a common strategy used by industries to avoid or supplement statutory health and safety regulation of their products and practices. The public health experience with self-regulation in the alcohol industry provides methods and lessons relevant to health educators and advocates working in other public health fields. Methods for and examples and limitations of monitoring content and placement of marketing messages are described. The alcohol experience shows that, although self-regulation has many drawbacks in terms of protecting the health of the public, there are tools available for valid monitoring of self-regulated activities that, when combined with aggressive dissemination of results to media and policy makers, can make self-regulation more accountable and build an evidence base for effective measures to be taken.

An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference

PubMed Central

Goodman, Kenneth W; Gotham, Ivan J; Holmes, John H; Lang, Lisa; Miner, Kathleen; Potenziani, David D; Richards, Janise; Turner, Anne M; Fu, Paul C

2012-01-01

The AMIA Public Health Informatics 2011 Conference brought together members of the public health and health informatics communities to revisit the national agenda developed at the AMIA Spring Congress in 2001, assess the progress that has been made in the past decade, and develop recommendations to further guide the field. Participants met in five discussion tracks: technical framework; research and evaluation; ethics; education, professional training, and workforce development; and sustainability. Participants identified 62 recommendations, which clustered into three key themes related to the need to (1) enhance communication and information sharing within the public health informatics community, (2) improve the consistency of public health informatics through common public health terminologies, rigorous evaluation methodologies, and competency-based training, and (3) promote effective coordination and leadership that will champion and drive the field forward. The agenda and recommendations from the meeting will be disseminated and discussed throughout the public health and informatics communities. Both communities stand to gain much by working together to use these recommendations to further advance the application of information technology to improve health. PMID:22395299

Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents

PubMed Central

Hunter, Jennifer C.; Yang, Jane E.; Crawley, Adam W.; Biesiadecki, Laura; Aragón, Tomás J.

2013-01-01

As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. PMID:24236137

Urban planning and public health at CDC.

PubMed

Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T

2006-12-22

Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept

77 FR 38296 - Draft Public Health Action Plan-A National Public Health Action Plan for the Detection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

...-2012-0004] Draft Public Health Action Plan--A National Public Health Action Plan for the Detection...), Department of Health and Human Services (HHS). ACTION: Extension of public comment period. SUMMARY: On May 16... National Public Health Action Plan for the Detection, Prevention, and Management of Infertility (77 FR...

Trauma is a public health issue.

PubMed

Magruder, Kathryn M; McLaughlin, Katie A; Elmore Borbon, Diane L

2017-01-01

Exposure to trauma is pervasive in societies worldwide and is associated with substantial costs to the individual and society, making it a significant global public health concern. We present evidence for trauma as a public health issue by highlighting the role of characteristics operating at multiple levels of influence - individual, relationship, community, and society - as explanatory factors in both the occurrence of trauma and its sequelae. Within the context of this multi-level framework, we highlight targets for prevention of trauma and its downstream consequences and provide examples of where public health approaches to prevention have met with success. Finally, we describe the essential role of public health policies in addressing trauma as a global public health issue, including key challenges for global mental health and next steps for developing and implementing a trauma-informed public health policy agenda. A public health framework is critical for understanding risk and protective factors for trauma and its aftermath operating at multiple levels of influence and generating opportunities for prevention.

PPACA and public health: creating a framework to focus on prevention and wellness and improve the public's health.

PubMed

Majette, Gwendolyn Roberts

2011-01-01

PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health. © 2011 American Society of Law, Medicine & Ethics, Inc.

One Health Perspectives on Emerging Public Health Threats

PubMed Central

2017-01-01

Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm. PMID:29207450

A Bridge Back to the Future: Public Health Ethics, Bioethics, and Environmental Ethics.

PubMed

Lee, Lisa M

2017-09-01

Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three "fields" of ethics to promote a healthier planet.

Climate Change and Public Health.

PubMed

Ciesielski, Timothy

2017-05-01

It is clear that the public health community is concerned about the human health impacts of climate change, but are we inadvertently underestimating the scope of the problem and obfuscating potentially useful interventions by using a narrow intellectual frame in our discussions with policy makers? If we take a more holistic approach, we see that the public health impacts of climate change are only one subset of the enormous public health impacts of fossil fuel burning. This broader perspective can provide a more accurate and comprehensive assessment that is more useful for decision making in public policy settings.

Fielding a current idea: exploring the public health impact of electromagnetic radiation.

PubMed

Genuis, Stephen J

2008-02-01

Several publications in the scientific literature have raised concern about the individual and public health impact of adverse non-ionizing radiation (a-NIR) from electromagnetic field (EMF) exposure emanating from certain power, electrical and wireless devices commonly found in the home, workplace, school and community. Despite the many challenges in establishing irrefutable scientific proof of harm and the various gaps in elucidating the precise mechanisms of harm, epidemiological analyses continue to suggest considerable potential for injury and affliction as a result of a-NIR exposure. As environmental health has not been emphasized in medical education, some clinicians are not fully aware of possible EMF-related health problems and, as a result, manifestations of a-NIR may remain misdiagnosed and ineffectually managed. It is important for physicians and public health officials to be aware of the fundamental science and clinical implications of EMF exposure. A review of the scientific literature relating to the link between electromagnetic radiation and human health, several public health recommendations, and four case histories are presented for consideration.

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.

Evidence-based information needs of public health workers: a systematized review.

PubMed

Barr-Walker, Jill

2017-01-01

This study assessed public health workers' evidence-based information needs, based on a review of the literature using a systematic search strategy. This study is based on a thesis project conducted as part of the author's master's in public health coursework and is considered a systematized review. Four databases were searched for English-language articles published between 2005 and 2015: PubMed, Web of Science, Library Literature & Information Science Index, and Library, Information Science & Technology Abstracts (LISTA). Studies were excluded if there was no primary data collection, the population in the study was not identified as public health workers, "information" was not defined according to specific criteria, or evidence-based information and public health workers were not the major focus. Studies included in the final analysis underwent data extraction, critical appraisal using CASP and STROBE checklists, and thematic analysis. Thirty-three research studies were identified in the search, including twenty-one using quantitative methods and twelve using qualitative methods. Critical appraisal revealed many potential biases, particularly in the validity of research. Thematic analysis revealed five common themes: (1) definition of information needs, (2) current information-seeking behavior and use, (3) definition of evidence-based information, (4) barriers to information needs, and (5) public health-specific issues. Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers' information needs.

The health care home model: primary health care meeting public health goals.

PubMed

Grant, Roy; Greene, Danielle

2012-06-01

In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.

Enhancing crisis leadership in public health emergencies.

PubMed

Deitchman, Scott

2013-10-01

Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

Sustainable waste management in the UK: the public health role.

PubMed

Mohan, R; Spiby, J; Leonardi, G S; Robins, A; Jefferis, S

2006-10-01

This paper discusses waste management in the UK and its relationship with health. It aims to outline the role of health professionals in the promotion of waste management, and argues for a change in their role in waste management regulation to help make the process more sustainable. The most common definition of sustainable development is that by the Brundtland commission, i.e. "development that meets the needs of the present without compromising the ability of future generations to meet their own needs". Managing waste sites in a manner that minimises toxic impacts on the current and future generations is obviously a crucial part of this. Although the management of waste facilities is extremely complex, the Integrated Pollution Prevention and Control regime, which requires the input of public health professionals on the regulation of such sites, means that all waste management installations should now be operating in a fashion that minimises any toxicological risks to human health. However, the impacts upon climate change, resource use and health inequalities, as well as the effects of waste transportation, are currently not considered to be part of public health professionals' responsibilities when dealing with these sites. There is also no requirement for public health professionals to become involved in waste management planning issues. The fact that public health professionals are not involved in any of these issues makes it unlikely that the potential impacts upon health are being considered fully, and even more unlikely that waste management will become more sustainable. This paper aims to show that by only considering direct toxicological impacts, public health professionals are not fully addressing all the health issues and are not contributing towards sustainability. There is a need for a change in the way that health professionals deal with waste management issues.

[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.

Building Public Health Ontario: experience in developing a new public health agency.

PubMed

Goel, Vivek

2012-06-05

The history and development of Ontario's new public health agency, Public Health Ontario, is explored. The governance model and organizational structure are identified along with an overview of the relationship with the Ontario Ministry of Health and Long-Term Care. The strategic mission and vision are described as are the key functions. The building of the organization through new investments and divestments is explained. The paper concludes with an overview of the challenges encountered and the opportunities ahead.

Understanding the public's health problems: applications of symbolic interaction to public health.

PubMed

Maycock, Bruce

2015-01-01

Public health has typically investigated health issues using methods from the positivistic paradigm. Yet these approaches, although they are able to quantify the problem, may not be able to explain the social reasons of why the problem exists or the impact on those affected. This article will provide a brief overview of a sociological theory that provides methods and a theoretical framework that has proven useful in understanding public health problems and developing interventions. © 2014 APJPH.

Surfing the net for public health resources.

PubMed

Angell, C; Hemingway, A; Hartwell, H

2011-08-01

To identify public health open educational resources (OER) available online, map the identified OER to The Public Health Skills and Career Framework (PHSCF), and triangulate these findings with public health practitioners. Systematic online search for public health OER. An online search was undertaken using a pre-defined set of search terms and inclusion/exclusion criteria. Public health OER were then mapped against the UK PHSCF. The findings of the search were discussed with public health specialists to determine whether or not they used these resources. A number of public health OER were identified, located on 42 websites from around the world. Mapping against the UK PHSCF demonstrated a lack of coverage in some areas of public health education. It was noted that many of the OER websites identified were not those generally used in practice, and those sites preferred by public health specialists were not identified by the online search. Public health OER are available from a number of providers, frequently universities and government organizations. However, these reflect a relatively small pool of original OER providers. Tagging of websites does not always identify their public health content. In addition, users of public health OER may not use search engines to identify resources but locate them using other means. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The State Public Health Laboratory System.

PubMed

Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

2010-01-01

This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

Factors influencing women's utilization of public health care services during childbirth in Malawi Public health facility utilization.

PubMed

Machira, Kennedy; Palamuleni, Martin

2017-06-01

Maternal mortality remains a public health challenge claiming many lives at the time of giving birth lives. However, there have been scanty studies investigating factors influencing women's use of public health facilities during childbirth. The aim of the study was to explore the factors associated with women choice of public health facility during childbirth. The study used 2010 Malawi Demographic Health Survey dataset and a binary logistics regression analysis to estimate the determinants influencing women's use of public health facilities at the time they give birth. Of 23020 women respondents, 8454(36.7%) chose to give birth in public health facilities. Multivariate analysis reported that frequency of antenatal care (ANC), birth order, women's education, wealth status and quality of care were the major predictors increasing women's choice to use public health facilities at childbirth. There is need to use multimedia approach to engage women on significance of utilizing public health facilities during childbirth and promote quality of care in facilities if their health outcome is to improve in Malawi.

Ethics in public health: call for shared moral public health literacy.

PubMed

Maeckelberghe, Els L M; Schröder-Bäck, Peter

2017-10-01

Public Health (PH) in Europe has become much more vocal about its moral understandings since 1992. The rising awareness that PH issues were inseparable from issues of human rights and social justice almost self-evidently directed the agenda of EUPHA and the European Public Health (EPH)-conferences. Problems of cultural and behavioural change, and environmental issues on a global scale were also added. The Section Ethics in PH invited the EPH community to join in 'arm chair thinking': coming together at conferences not only to share the 'how' and 'what' of PH research, practices and policies but also the 'why'. Time has been reserved to genuinely discuss what moral values are at stake in the work of PH and to actively develop a moral language and framework for PH Ethics. The challenge for the next decades is to find ways to involve the general public in the cultivation of a shared moral PH literacy. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Ethics in Public Health Research

PubMed Central

Myers, Julie; Frieden, Thomas R.; Bherwani, Kamal M.; Henning, Kelly J.

2008-01-01

Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies. PMID:18382010

Public health, GIS, and the internet.

PubMed

Croner, Charles M

2003-01-01

Internet access and use of georeferenced public health information for GIS application will be an important and exciting development for the nation's Department of Health and Human Services and other health agencies in this new millennium. Technological progress toward public health geospatial data integration, analysis, and visualization of space-time events using the Web portends eventual robust use of GIS by public health and other sectors of the economy. Increasing Web resources from distributed spatial data portals and global geospatial libraries, and a growing suite of Web integration tools, will provide new opportunities to advance disease surveillance, control, and prevention, and insure public access and community empowerment in public health decision making. Emerging supercomputing, data mining, compression, and transmission technologies will play increasingly critical roles in national emergency, catastrophic planning and response, and risk management. Web-enabled public health GIS will be guided by Federal Geographic Data Committee spatial metadata, OpenGIS Web interoperability, and GML/XML geospatial Web content standards. Public health will become a responsive and integral part of the National Spatial Data Infrastructure.

Housing and Health: Time Again for Public Health Action

PubMed Central

Krieger, James; Higgins, Donna L.

2002-01-01

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing. PMID:11988443

Big Data in Public Health: Terminology, Machine Learning, and Privacy.

PubMed

Mooney, Stephen J; Pejaver, Vikas

2018-04-01

The digital world is generating data at a staggering and still increasing rate. While these "big data" have unlocked novel opportunities to understand public health, they hold still greater potential for research and practice. This review explores several key issues that have arisen around big data. First, we propose a taxonomy of sources of big data to clarify terminology and identify threads common across some subtypes of big data. Next, we consider common public health research and practice uses for big data, including surveillance, hypothesis-generating research, and causal inference, while exploring the role that machine learning may play in each use. We then consider the ethical implications of the big data revolution with particular emphasis on maintaining appropriate care for privacy in a world in which technology is rapidly changing social norms regarding the need for (and even the meaning of) privacy. Finally, we make suggestions regarding structuring teams and training to succeed in working with big data in research and practice.

Public health workforce: challenges and policy issues

PubMed Central

Beaglehole, Robert; Dal Poz, Mario R

2003-01-01

This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce. PMID:12904251

Why feminism in public health?

PubMed

Hammarström, A

1999-12-01

The issues raised in this editorial and exemplified within a number of the studies reported in this issue indicate new directions for public health, directions which take feminist scholarship, both outside and within the medical framework, into account. The changing potential of feminist public health, as derived from the articles in this issue, can be summarised within the following issues: new research areas, positioning women as actors, development of theoretical frameworks, reflexive theory of science, interplay between sex and gender, gender-sensitive methods, diversities among women/men, pro-feminist research on men's health and using the results for change. Thus, feminist public health represents a shift towards the new public health, with holistic and multidisciplinary activities, based on theoretical pluralism, multiple perspectives and collective actions with the aim of improving the health of gender-subordinated groups.

Education Improves Public Health and Promotes Health Equity

PubMed Central

Hahn, Robert A.; Truman, Benedict I.

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. PMID:25995305

Education Improves Public Health and Promotes Health Equity.

PubMed

Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

40 CFR 158.2204 - Public health and nonpublic health claims.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Public health and nonpublic health claims. (a) Public health claim. An antimicrobial pesticide is considered to make a public health claim if the pesticide product bears a claim to control pest microorganisms that pose a threat to human health, and whose presence cannot readily be observed by the user...

40 CFR 158.2204 - Public health and nonpublic health claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Public health and nonpublic health claims. (a) Public health claim. An antimicrobial pesticide is considered to make a public health claim if the pesticide product bears a claim to control pest microorganisms that pose a threat to human health, and whose presence cannot readily be observed by the user...

Public health preparedness: evolution or revolution?

PubMed

Lurie, Nicole; Wasserman, Jeffrey; Nelson, Christopher D

2006-01-01

The recent emphasis on preparedness has created heightened expectations and has raised questions about the extent to which U.S. public health systems have evolved in recent years. This paper describes how public health preparedness is transforming public health agencies. Key signs of change include new partnerships, changes in the workforce, new technologies, and evolving organizational structures. Each of these elements has had some positive impact on public health; however, integration of preparedness with other public health functions remains challenging. The preparedness mission has also raised challenges in the areas of leadership, governance, quality, and accountability.

Applications of health information exchange information to public health practice.

PubMed

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

Applications of Health Information Exchange Information to Public Health Practice

PubMed Central

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-01-01

Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health. PMID:25954386

The Public Health Challenge.

ERIC Educational Resources Information Center

Ember, Lois R.

1987-01-01

Discussed are public health challenges related to Acquired Immune Deficiency Syndrome (AIDS). A major challenge is changing habits and damping incipient fear. Education is considered by some to be one of the major public health weapons. Described are various programs, legal issues, and policies being considered and implemented. (RH)

Development of a new graduate public health nurse residency program using the core competencies of public health nursing.

PubMed

Larsen, Rachelle; Ashley, Julia; Ellens, Tess; Frauendienst, Renee; Jorgensen-Royce, Karen; Zelenak, Mary

2018-06-27

Due to the continued shortage of public health nurses, some local public health agencies have begun hiring new graduate baccalaureate nurses into the public health nurse role. These new graduates require an increased level of support for transition to practice. The goal of this project was creation of a transition to practice program designed specifically to meet the needs of new graduates hired in public health settings. The core competencies of public health nursing were used as a framework to develop this residency program. A group of public health staff, supervisors, and faculty met monthly for three years to develop this program. Key features include general orientation, preceptors, looping experiences, case studies and peer support. The program is available as a web resource beginning spring 2018. In order to evaluate this program, data on job satisfaction, employee retention and level of competence in the core competencies of public health will occur using instruments administered prior to beginning and immediately following completion of the new graduate residency. The components of the program mirror best practices for new graduate residencies and are based on core competencies for public health nursing. This residency program is an important step for enhancing the professional development of new baccalaureate graduates in public health settings, and preparing the next generation of public health nurses. Through the increased support and intentional education of the residency program, public health agencies will be able to attract and retain new graduates who develop the essential knowledge and skills to provide safe and effective care in the public health setting. © 2018 Wiley Periodicals, Inc.

Designing the framework for competency-based master of public health programs in India.

PubMed

Sharma, Kavya; Zodpey, Sanjay; Morgan, Alison; Gaidhane, Abhay; Syed, Zahiruddin Quazi; Kumar, Rajeev

2013-01-01

Competency in the practice of public health is the implicit goal of education institutions that offer master of public health (MPH) programs. With the expanding number of institutions offering courses in public health in India, it is timely to develop a common framework to ensure that graduates are proficient in critical public health. Steps such as situation assessment, survey of public health care professionals in India, and national consultation were undertaken to develop a proposed competency-based framework for MPH programs in India. The existing curricula of all 23 Indian MPH courses vary significantly in content with regard to core, concentration, and crosscutting discipline areas and course durations. The competency or learning outcome is not well defined. The findings of the survey suggest that MPH graduates in India should have competencies ranging from monitoring of health problems and epidemics in the community, applying biostatistics in public health, conducting action research, understanding social and community influence on public health developing indicators and instruments to monitor and evaluate community health programs, developing proposals, and involving community in planning, delivery, and monitoring of health programs. Competency statements were framed and mapped with domains including epidemiology, biostatistics, social and behavioral sciences, health care system, policy, planning, and financing, and environmental health sciences and a crosscutting domain that include health communication and informatics, health management and leadership, professionalism, systems thinking, and public health biology. The proposed competency-based framework for Indian MPH programs can be adapted to meet the needs of diverse, unique programs. The framework ensures the uniqueness and diversity of individual MPH programs in India while contributing to measures of overall program success.

Public health in the 21st century: working differently means leading and learning differently.

PubMed

Czabanowska, Katarzyna; Rethmeier, Kenneth A; Lueddeke, George; Smith, Tony; Malho, André; Otok, Robert; Stankunas, Mindaugas

2014-12-01

Public health needs to adapt to the complex context of 21st century Europe. Unquestionably, leaders for health require new skills to face a myriad of wicked problems and challenges that are at a critical juncture for potential improvements. Public health curricula are traditionally oriented around core educational disciplines, and there is little room for developing students' leadership capabilities within the context of public health. The aim is to present the meaning of contemporary public health leadership based on qualitative research and propose a curriculum model for contemporary public health leadership. A series of in-depth semi-structured interviews were carried out with six European public health leaders from a variety of countries and professional backgrounds. The interviews recorded and transcribed. A thematic content analysis was undertaken to identify themes within the data. Five common themes that help to inform future leadership capacity arose from the interviews: the inner path of leadership, the essence of leadership, new types of leadership, future leaders' imperatives functioning within a complex and uncertain European public health context. The leadership thematic model makes an important contribution to defining public health leadership in Europe and can help to guide the content development of public health leadership curricula. The authors assert that a new 'integrative inquiry-based learning model', with leadership as a central component, will allow schools and departments of public health across Europe to be able to ensure that tomorrow's public health leaders are adequately trained and prepared for the challenges they will face. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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