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The Milbank Quarterly Dec 2023Policy Points Inclusive state immigrant policies that expand rights and resources for immigrants may improve population health, but little is known about their...
UNLABELLED
Policy Points Inclusive state immigrant policies that expand rights and resources for immigrants may improve population health, but little is known about their local-level implementation. Local actors that have anti-immigrant attitudes can hinder the implementation of state policies, whereas the persistent influence of anti-immigrant federal policies reinforces barriers to accessing health and other resources granted by state policies. Local actors that serve immigrants and support state policy implementation lack the resources to counter anti-immigrant climates and federal policy threats.
CONTEXT
In the United States, inclusive state-level policies can advance immigrant health and health care access by extending noncitizens' access to public benefits, workplace rights, and protections from immigration enforcement. Although state policies carry promise as structural population health interventions, there has been little examination of their implementation at the local level. Local jurisdictions play multiple roles in state policy implementation and possess distinct immigration climates. Examining the local implementation of state immigrant policy can address challenges and opportunities to ensure the health benefits of inclusive policies are realized equitably across states' regions.
METHODS
To examine the local implementation of state immigrant policies, we selected a purposive sample of California counties with large immigrant populations and distinct social and political dynamics and conducted and analyzed in-depth interviews with 20 community-based organizations that provided health, safety net, and other services.
FINDINGS
We found that there were tensions between the inclusionary goals of state immigrant policies and local anti-immigrant climates and federal policy changes. First, there were tensions between state policy goals and resistance from local law enforcement agencies and policymakers (e.g., Board of Supervisors). Second, because of the ongoing threats from federal immigration policies, there was a mismatch between the services and resources provided by state policies and local community needs. Finally, organizations that served immigrants were responsible for contributing to policy implementation but lacked resources to meet community needs while countering local resistance and federal policy threats.
CONCLUSIONS
This study contributes knowledge regarding the challenges that emerge after state immigrant policies are enacted. The tensions among state immigrant policies, local immigration climates, and federal policy changes indicate that state immigrant policies are not implemented equally across state communities, resulting in challenges and limited benefits from policies for many immigrant communities.
Topics: United States; Humans; Emigrants and Immigrants; Health Services Accessibility; Emigration and Immigration; Policy
PubMed: 37707458
DOI: 10.1111/1468-0009.12671 -
Public Health Nutrition Dec 2023To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs).
OBJECTIVE
To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs).
DESIGN
Food taxation polices, regarding excise taxes and tariffs applied from 2000 to 2020 in twenty-two PICTs, and their key characteristics were reviewed. The search was conducted using databases, government legal repositories and broad-based search engines. Identified documents for screening included legislation, reports, academic literature, news articles and grey literature. Key informants were contacted from each PICT to retrieve further data and confirm results. Results were analysed by narrative synthesis.
SETTING
Noncommunicable diseases (NCD) are the leading cause of premature death in PICTs and in many jurisdictions globally. An NCD crisis has been declared in the Pacific, and food taxation policy has been recommended to address the dietary risk factors associated with. Progress is unclear.
RESULTS
Of the twenty-two PICTs included in the study, fourteen had food taxation policies and five introduced excise taxes. Processed foods, sugar and salt were the main target of excise taxes. A total of eighty-four food taxation policy changes were identified across all food groups. There was a total of 279 taxes identified by food group, of which 85 % were tariffs and 15 % were excise taxes. Individual tax rates varied substantially. The predominant tax design was ad valorem, and this was followed by volumetric.
CONCLUSIONS
A quarter of PICTs have introduced food excise taxes from 2000 to 2020. Further excise taxes, specifically tiered or nutrient-specific designs, could be introduced and more systematically applied to a broader range of unhealthy foods.
Topics: Humans; Food; Noncommunicable Diseases; Nutrition Policy; Pacific Islands; Taxes
PubMed: 38126269
DOI: 10.1017/S1368980023002914 -
The Veterinary Record Aug 2023Veterinary professionals operate at the human-animal-environment interface and are concerned about sustainability issues. This study examined the extent to which...
BACKGROUND
Veterinary professionals operate at the human-animal-environment interface and are concerned about sustainability issues. This study examined the extent to which sustainability is represented in policy and enacted in veterinary practice settings, as reported by practice representatives.
METHODS
An online survey was completed by 392 veterinary centre representatives in the UK and Republic of Ireland to identify existing policies and practices around the environmental impacts of veterinary services and animal husbandry, responsible medicine use, animal welfare and social wellbeing.
RESULTS
A minority of respondents were aware of an environmental policy at their practice (17%, 68/392). Many others were undertaking waste reduction initiatives, but wider environmental interventions were infrequently reported. The majority were aware of medicine stewardship and animal welfare policies or guidelines, but a minority reported social wellbeing policies (40%, 117/289) and the provision of advice to clients on the environmental impacts of animal husbandry (31%, 92/300).
LIMITATIONS
The bias arising from the small convenience sample of practice representatives and potential discrepancies between the claims of survey respondents and their practices' policies and activities are acknowledged.
CONCLUSION
Results depict a value-action gap between the concern of veterinary professionals towards sustainability and the policies and practices at their workplaces. Building on progress in the sector, wider adoption of comprehensive policies and practices, with guidance, could enhance veterinary contributions to the sustainability agenda, in particular to mitigate the environmental externalities of veterinary services and animal care and ensure safe, fair and inclusive workplaces.
Topics: Humans; Animals; Ireland; Animal Husbandry; Surveys and Questionnaires; Policy; United Kingdom
PubMed: 37227247
DOI: 10.1002/vetr.2998 -
BMC Public Health Dec 2023Lebanon is a middle-income country facing substantial fragility features. Its health profile shows a high burden of NCD morbidity and mortality. This paper intends to...
Political Economy of Non-Communicable Disease (NCD) prevention and control in Lebanon: identifying challenges and opportunities for policy change and care provision reforms.
INTRODUCTION
Lebanon is a middle-income country facing substantial fragility features. Its health profile shows a high burden of NCD morbidity and mortality. This paper intends to analyse the political economy of NCD prevention and control in Lebanon.
METHODS
This study adopted a literature-based case study research design using a problem-driven political economy analysis framework. A total of 94 peer-reviewed articles and documents from the grey literature published before June 2019 were retrieved and analysed.
RESULTS
Lebanon's political instability and fragile governance negatively affect its capacity to adapt a Health-in-All-Policies approach to NCD prevention and enable the blocking of NCD prevention policies by opposed stakeholders. Recent economic crises limit the fiscal capacity to address health financing issues and resulting health inequities. NCD care provision is twisted by powerful stakeholders towards a hospital-centred model with a powerful private sector. Stakeholders like the MOPH, UN agencies, and NGOs have been pushing towards changing the existing care model towards a primary care model. An incremental reform has been adopted to strengthen a network of primary care centres, support them with health technologies and improve the quality of primary care services. Nevertheless, outpatient services that are covered by other public funds remain specialist-led without much institutional regulation.
CONCLUSION
Our study revealed a locked equilibrium in NCD prevention policymaking in Lebanon, but with an incremental progress in service delivery reforms towards a primary care model. Advocacy and close monitoring by policy entrepreneurs (such as civil society) could initiate and sustain the implementation of policy change and care model reforms.
Topics: Humans; Noncommunicable Diseases; Lebanon; Policy Making; Policy; Case-Control Studies; Health Policy
PubMed: 38110967
DOI: 10.1186/s12889-023-17357-1 -
Environmental Science and Pollution... Sep 2023China's fast industrialization and economic expansion has led to environmental degradation, prompting the government to implement a slew of environmental regulations and...
China's fast industrialization and economic expansion has led to environmental degradation, prompting the government to implement a slew of environmental regulations and laws. This article examines how China's stringent environmental policies and legislation have impacted the development of environmental technology. The study's panel of Chinese companies confirmed that more stringent regulations really spurred innovation in green technology. This research lends credence to the premise that stricter environmental regulations are helpful in inspiring the development of cleaner technology that may help mitigate environmental issues. Research also shows that tighter environmental legislation increases environmental policy's effect on technological development. According to these results, environmental law may improve the efficiency of environmental policy by providing a hospitable framework for the application of technological innovation. The findings of this research have significant implications for Chinese policymakers committed to fostering sustainable development. The need of rigorous environmental rules to support comprehensive environmental policies that promote the development of greener technology is emphasized. The results shed even more light on how crucial it is to enforce environmental laws in order to ensure that environmental policies are effectively implemented. In essence, this study contributes to the expanding body of knowledge on the link between environmental policy and technical advancement by illuminating the potential for China's environmental policy and law to work together to encourage sustainable development. China's investment in green tech research and development may mitigate the environmental damage caused by its rapid economic growth.
Topics: Environmental Policy; Conservation of Natural Resources; China; Sustainable Development; Technology; Economic Development
PubMed: 37648917
DOI: 10.1007/s11356-023-29023-5 -
Journal of Racial and Ethnic Health... Oct 2023States have broad discretion over the implementation of policies like Medicaid expansion and other policies that impact the well-being and integration of immigrants....
States have broad discretion over the implementation of policies like Medicaid expansion and other policies that impact the well-being and integration of immigrants. While numerous studies document Medicaid expansion on immigrants' health insurance coverage and the role of state immigrant policy climates on immigrants' well-being, no research to date has studied whether the association between a state's Medicaid expansion on immigrants' health insurance coverage varies based on the inclusiveness or exclusiveness of a state's immigrant policy climate. We combine nationally representative data from the 2014-2018 American Community Survey (ACS) with state policy data and estimate multivariate regression models. The results reveal a state immigrant policy climate gradient whereby ACA Medicaid expansion on noncitizens is negative and most severe in exclusionary climates. This study highlights how state policies intersect as important structural forces that influence immigrant health and well-being.
Topics: United States; Humans; Medicaid; Insurance Coverage; Emigrants and Immigrants; Health Care Reform; Policy; Insurance, Health; Patient Protection and Affordable Care Act
PubMed: 36036841
DOI: 10.1007/s40615-022-01399-z -
Health Research Policy and Systems Nov 2023Even though the importance of physical activity policy monitoring has increased in the last decade, there is a lack of understanding what different approaches exist and...
BACKGROUND
Even though the importance of physical activity policy monitoring has increased in the last decade, there is a lack of understanding what different approaches exist and which methodology they employ. In order to address this research gap, this review attempts to map existing approaches of physical activity policy monitoring and to analyse methodological aspects, especially with regards to the roles of governments and researchers.
METHODS
A systematic search was conducted in five scientific databases (PubMed, Scopus, SportDiscus, Psycinfo, Web of Knowledge) in July 2021, and the identified records were screened independently by two reviewers. Records were included if they (a) focused on the monitoring of public policies to promote PA, (b) allowed to compare policies across time, across nations/regions or across policy sectors, and (c) were written in English, German or Russian. During full text analysis, information on methodological aspects was extracted and studies were categorized based on the level of government involvement.
RESULTS
The search yielded in a total of 112 studies. 86 of these studies (76.8%) followed a research-driven approach (little or no government involvement) while only two studies (1.8%) were based on a government-driven approach (led by governments). The remaining 24 studies (21.4%) were based on a co-production approach (strong collaboration between researchers and governments). All in all, 18 different tools for physical activity policy monitoring were identified; key examples are the Report Cards on Physical Activity for Children and Youth (research-driven approach), the HEPA Monitoring Framework (government-driven approach) and the HEPA Policy Audit Tool (co-production approach).
CONCLUSIONS
The level of government involvement in policy monitoring differs significantly, and research-driven, government-driven and co-production approaches can be distinguished. These approaches have different strengths and weaknesses, and can be linked to distinct theories of change and models on research-policy relations. Increasing awareness on the implications of these approaches is key to improve the understanding and further development of physical activity policy monitoring.
Topics: Child; Humans; Adolescent; Exercise; Public Policy; Government
PubMed: 38012659
DOI: 10.1186/s12961-023-01068-5 -
Health Research Policy and Systems Nov 2023Health impact assessment (HIA) is a procedure, method and tool for evaluating the potential health impacts of policies, plans and construction projects, as well as the...
BACKGROUND
Health impact assessment (HIA) is a procedure, method and tool for evaluating the potential health impacts of policies, plans and construction projects, as well as the distribution of these impacts on population. Majority of international studies on health impact assessment have focussed on conceptual papers or case evaluations, neglecting participants' views on policies.
METHODS
A semi-structured interview with 30 health impact assessment experts was employed in this study, and the Nvivo software was utilized to analyse factors that influence policy identification. Subsequently, a multi-stage stratified random sampling method was adopted to survey 655 pilot staff members involved in health impact assessment in Zhejiang Province. Descriptive statistics were used to describe the current status and identify the factors influencing policy identification. In addition, hierarchical linear regression analysis and structural equation modelling were employed to determine the relationship between policy identification and influencing factors.
RESULTS
Statistically significant differences were found among participants in the level of identification of policies across three dimensions. The policy sentiment dimension had the highest score (4.137 ± 0.664), followed by policy cognition (4.075 ± 0.632) and policy evaluation (3.631 ± 0.797) dimensions. Subject trust had a positive impact on policy cognition (β = 0.503, P < 0.001), policy sentiment (β = 0.504, P < 0.001) and policy evaluation (β = 0.465, P < 0.001). Procedural justice had a positive impact on policy sentiment (β = 0.085, P < 0.01) and policy evaluation (β = 0.084, P < 0.05), but not policy cognition (β = 0.056, P > 0.05). Policy identification is influenced by age and average monthly salary among other factors.
CONCLUSION
These results highlight the importance of subjective trust and procedural justice in policy identification of health impact assessment. They provide valuable insights to developing interventions to overcome barriers to the implementation and enhancement of global identification of policies. Going forward, cross-sectoral synergies, enhanced international communication and training to increase participants' trust in the policy should be optimized to improve health impact assessment. Additional measures should be taken, such as ensuring seamless communication channels, embedding health impact assessment in administrative mechanisms, and establishing strong oversight and grievance mechanisms to improve fairness and transparency in the implementation and results of health impact assessment.
Topics: Humans; Policy; Health Impact Assessment; Health Policy
PubMed: 37932791
DOI: 10.1186/s12961-023-01064-9 -
Academic Medicine : Journal of the... Dec 2023Academic medicine institutions have historically employed policies as a means to tackle various types of discrimination and harassment within educational and...
Academic medicine institutions have historically employed policies as a means to tackle various types of discrimination and harassment within educational and professional settings, thereby affirming their dedication to promoting diversity, equity, and inclusion. However, the implementation and effectiveness of policies are constrained by limitations, including a lack of awareness and barriers to reporting. Due to concerns about accountability and transparency, many groups and individuals experiencing discrimination have lost trust in policy-based solutions to address equity in academic medicine. To address such challenges, the authors offer an evidence-informed policy framework with actionable recommendations. First, policy should be cowritten through meaningful and participatory engagement. Second, organizations should publicly report on metrics of policy effectiveness. Third, to ensure accountability, external organizations or adjudicators should be involved in oversight of policy-based processes. Fourth, leadership commitment is essential for success. Overall, policy can be an effective mechanism to address discrimination and harassment; however, a more inclusive approach is needed.
Topics: Humans; Medicine; Health Policy; Organizations; Schools; Benchmarking
PubMed: 37801596
DOI: 10.1097/ACM.0000000000005466 -
Current Opinion in Insect Science Aug 2023To date, insect conservation policy mainly consists of species protection lists, with some requiring habitat or ecosystem preservation to protect insect ecology. While a... (Review)
Review
To date, insect conservation policy mainly consists of species protection lists, with some requiring habitat or ecosystem preservation to protect insect ecology. While a landscape or habitat approach seems the most appropriate for insect conservation, cases are rare of protected areas designated specifically for insects or other arthropods. Moreover, neither of these conservation approaches (species or habitat protection) have halted the worldwide decline in insects: species protection lists and reserves at best serve as band-aids for a massive hemorrhage. The main drivers of insect decline (global changes) are only loosely addressed by national and international policies. So, if we know the causes, what stands in the way of prevention and treatment for the problem? To save insects, our civilization needs psychotherapy rather than first-aid gestures: a paradigm shift that would place value on insects, and give rise to ecocentric policies informed by a wide range of stakeholders.
Topics: Animals; Arthropods; Ecosystem; Conservation of Natural Resources; Insecta; Policy
PubMed: 37327945
DOI: 10.1016/j.cois.2023.101075