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Proceedings of the National Academy of... Sep 2023Homelessness is an economic and social crisis. In a cluster-randomized controlled trial, we address a core cause of homelessness-lack of money-by providing a one-time... (Randomized Controlled Trial)
Randomized Controlled Trial
Homelessness is an economic and social crisis. In a cluster-randomized controlled trial, we address a core cause of homelessness-lack of money-by providing a one-time unconditional cash transfer of CAD$7,500 to each of 50 individuals experiencing homelessness, with another 65 as controls in Vancouver, BC. Exploratory analyses showed that over 1 y, cash recipients spent fewer days homeless, increased savings and spending with no increase in temptation goods spending, and generated societal net savings of $777 per recipient via reduced time in shelters. Additional experiments revealed public mistrust toward the ability of homeless individuals to manage money and demonstrated interventions to increase public support for a cash transfer policy using counter-stereotypical or utilitarian messaging. Together, this research offers a new approach to address homelessness and provides insights into homelessness reduction policies.
Topics: Humans; Ill-Housed Persons; Social Problems; Income; Motivation; Policy
PubMed: 37643214
DOI: 10.1073/pnas.2222103120 -
Nature Communications Dec 2023Endometriosis is an incurable, under-diagnosed, systemic inflammatory disease affecting millions world-wide. Common symptoms include life-impacting pain,...
Endometriosis is an incurable, under-diagnosed, systemic inflammatory disease affecting millions world-wide. Common symptoms include life-impacting pain, gastrointestinal/urinary symptoms, excessive fatigue, and infertility. Global public health policies are urgently needed to promote awareness, implement multidisciplinary care, and fund research for aetiology, biomarker discovery, and effective therapies for symptoms associated with endometriosis.
Topics: Female; Humans; Endometriosis; Global Health; Health Policy
PubMed: 38049392
DOI: 10.1038/s41467-023-43913-9 -
BMC Public Health Sep 2023Immunization information systems (IIS) are confidential, population-based computerized databases that record vaccination doses administered to persons residing within a... (Review)
Review
BACKGROUND
Immunization information systems (IIS) are confidential, population-based computerized databases that record vaccination doses administered to persons residing within a given geopolitical area. We sought to highlight the evolution of IIS policy over the last two decades, as IIS play a pivotal role in achieving equitable and high vaccine uptake.
METHODS
Legal epidemiological research methods were used to assess relevant IIS statutes and administrative codes across all 50 states, the District of Columbia, Philadelphia, and New York City. Where relevant, laws were cross-checked or supplemented with state and local health department resources. Comparisons to previous legal studies enabled evaluation of trends in IIS laws over time.
RESULTS
The compilation of current laws provides an updated overview of the diverse interstate and intrastate policies within the US that govern the capabilities and implementation of IIS. The findings of this study show the progress that has been made in the past decade in improving policies that enable IIS to be utilized across the life-course. Conversely, gaps in IIS data collection, limited interoperability with local and national health information systems, and inconsistent access to view or utilize IIS records due to existing policies, continue to limit the full potential of IIS.
CONCLUSIONS
In the United States (US), IIS are implemented and managed at the state and local level, creating variability in IIS policies and implementation. Findings from this study serve as a comprehensive benchmark of current IIS laws that may aid policy stakeholders who are exploring amendments to jurisdictional IIS laws.
Topics: Humans; Vaccination; Immunization; Health Information Systems; Benchmarking; Policy
PubMed: 37730618
DOI: 10.1186/s12889-023-16457-2 -
Frontiers in Public Health 2023While there are several approaches to collect basic information on physical activity (PA) promotion policies, some governments require more in-depth overviews on the... (Review)
Review
INTRODUCTION
While there are several approaches to collect basic information on physical activity (PA) promotion policies, some governments require more in-depth overviews on the situation in their country. In Germany, the Federal Ministry of Health expressed its interest in collecting detailed data on target group specific PA promotion, as relevant competences are distributed across a wide range of political levels and sectors. This study describes the development of a policy brief on physical activity promotion for children and adolescents in Germany. In particular, it addresses two major gaps in the current literature by systematically assessing good practice examples and "routine practices," i.e., PA promotion activities already taking place on large scale and regular basis.
MATERIALS AND METHODS
Based on relevant national and international guidelines, the TARGET:PA tool was co-produced by researchers and ministry officials. It includes (1) PA recommendations, (2) national prevalence rates, (3) recommendations for PA promotion, and data on national (4) routine practices, (5) good practice projects and (6) policies. Data were collected for children and adolescents in Germany using desk research, semi-structured interviews and secondary data analysis.
RESULTS
A policy brief and scientific background document were developed. Results showed that 46% of the 4-5-year-olds fulfil WHO recommendations but only 15% of the 11-17-year-olds, and that girls are less active than boys. Currently, in Germany no valid data are available on the PA behaviour of children under the age of three. An overview of routine practices for PA promotion for children and adolescents was compiled, and experts were asked to critically assess their effectiveness, reach and durability. Overall, 339 target group specific projects for PA promotion were found, with 22 classified as examples of good practice. National PA policies for children and adolescents were identified across different sectors and settings.
CONCLUSION
The study provides a comprehensive overview of the current status of PA promotion for children and adolescents in Germany. The co-production of the policy brief was a strength of the study, as it allowed researchers to take the needs of ministry officials into account, and as it supported the immediate uptake of results in the policymaking process. Future studies should test the applicability of the TARGET:PA tool to different target groups and countries.
Topics: Male; Female; Humans; Child; Adolescent; Child, Preschool; Health Promotion; Exercise; Motor Activity; Policy Making; Policy
PubMed: 37841728
DOI: 10.3389/fpubh.2023.1215746 -
Preventing Chronic Disease Aug 2023Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet.
Changes in Policy Supports for Healthy Food Retailers, Farmers Markets, and Breastfeeding Among US Municipalities, 2014-2021: National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL).
INTRODUCTION
Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet.
METHODS
We used data from the 2014 and 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living to examine prevalence among US municipalities of policies to support access to healthier food in supermarkets, convenience stores, and farmers markets, as well as policies to support breastfeeding among government employees. Chi-square tests were conducted to compare prevalence estimates from 2021 to 2014 overall and according to municipal characteristics.
RESULTS
In 2021, 29% of municipalities had at least 1 policy to encourage full-service grocery stores to open stores, which was not significantly different from 31% in 2014. Prevalence of having at least 1 policy to help corner stores sell healthier foods declined significantly from 13% in 2014 to 9% in 2021. Prevalence of policies providing all local government employees who were breastfeeding breaktime and space to pump breast milk increased significantly from 25% in 2014 to 52% in 2021. The percentage of municipalities that provided 8 or more weeks of paid maternity leave for employees increased significantly from 16% in 2014 to 19% in 2021.
CONCLUSION
Prevalence of supports for supermarkets, convenience stores, and farmers markets generally did not increase among US municipalities from 2014 to 2021, while some supports for breastfeeding among municipal employees increased during this time. Opportunities exist to improve municipal-level policies that support healthy eating and breastfeeding among community residents and employees.
Topics: Female; Pregnancy; Humans; Diet, Healthy; Breast Feeding; Cities; Farmers; Policy
PubMed: 37590900
DOI: 10.5888/pcd20.230018 -
Frontiers in Public Health 2023
Topics: Public Policy; Health Policy
PubMed: 37593723
DOI: 10.3389/fpubh.2023.1227503 -
BMJ Open Jul 2023This study explored multistakeholder perspectives on existing adolescent-specific tobacco control policies and programmes, to advance India's transition towards a...
OBJECTIVE
This study explored multistakeholder perspectives on existing adolescent-specific tobacco control policies and programmes, to advance India's transition towards a tobacco-free generation.
DESIGN
Qualitative semi-structured interviews.
SETTING
Interviews were conducted with officials involved in tobacco control at the national (India), state (Karnataka), district (Udupi) and village level. Interviews were audio recorded, transcribed verbatim and analysed thematically.
PARTICIPANTS
Thirty-eight individuals representing national (n=9), state (n=9), district (n=14) and village (n=6) levels, participated.
RESULTS
The study findings highlighted the need to strengthen and amend the existing Tobacco Control Law (2003) provisions, particularly in the vicinity of schools (Sections 6a and 6b). Increasing the minimum legal age to buy tobacco from 18 to 21 years, developing an 'application' for 'compliance and monitoring indicators' in Tobacco-Free Educational Institution guidelines were proposed. Policies to address smokeless tobacco use, stricter enforcement including regular monitoring of existing programmes, and robust evaluation of policies was underscored. Engaging adolescents to co-create interventions was advocated, along with integrating national tobacco control programmes into existing school and adolescent health programmes, using both an intersectoral and whole-societal approach to prevent tobacco use, were recommended. Finally, stakeholders mentioned that when drafting and implementing a comprehensive national tobacco control policy, there is a need to adopt a vision striving toward a tobacco-free generation.
CONCLUSION
Strengthening and developing tobacco control programmes and policies are warranted which are monitored and evaluated rigorously, and where adolescents should be involved, accordingly.
Topics: Adolescent; Humans; India; Tobacco Use; Policy; Schools
PubMed: 37419637
DOI: 10.1136/bmjopen-2022-067779 -
BMJ Global Health Nov 2023Negotiations are underway at the WHO for a legally binding instrument for pandemic prevention, preparedness and response. As seen in the International Health... (Review)
Review
Negotiations are underway at the WHO for a legally binding instrument for pandemic prevention, preparedness and response. As seen in the International Health Regulations, however, countries signing up to an agreement is no guarantee of its effective implementation. We, therefore, investigated the potential design features of an accountability framework for the proposed pandemic agreement that could promote countries' compliance with it. We reviewed the governance of a number of international institutions and conducted over 40 interviews with stakeholders and experts to investigate how the pandemic agreement could be governed.We found that enforcement mechanisms are a key feature for promoting the compliance of countries with the obligations they sign up for under international agreements but that they are inconsistently applied. It is difficult to design enforcement mechanisms that successfully avoid inflicting unintended harm and, so, we found that enforcement mechanisms generally rely on soft political levers rather than hard legal ones to promote compliance. Identifying reliable information on states' behaviour with regard to their legal obligations requires using a diverse range of information, including civil society and intergovernmental organisations, and maintaining legal, financial, and political independence.We, therefore, propose that there should be an independent mechanism to monitor states' compliance with and reporting on the pandemic agreement. It would mainly triangulate a diverse range of pre-existing information and have the authority to receive confidential reports and seek further information from states. It would report to a high-level political body to promote compliance with the pandemic agreement.
Topics: Humans; Pandemics; International Health Regulations
PubMed: 37931937
DOI: 10.1136/bmjgh-2023-013348 -
The International Journal on Drug Policy Jul 2023Post-Retirement Enlightenment Syndrome is a term used by some in illicit drug policy to reflect the experience of having politicians "come out" in favour of drug policy...
Post-Retirement Enlightenment Syndrome is a term used by some in illicit drug policy to reflect the experience of having politicians "come out" in favour of drug policy reform only after retirement. To date, the phenomenon has not been examined in any systematic manner. While discussions of the phenomenon on social media tend to be playful, they nevertheless express real frustration with the reluctance of privately supportive sitting politicians and policing officials to speak out in favour of non-punitive and/or harm reduction-oriented policies. In this commentary, we give an overview of the phenomenon of Post-Retirement Enlightenment Syndrome. We argue that these instances of sitting officials speaking out publicly in favour of drug policy reform, as well as instances in which such apparent "enlightenment" is not publicly expressed until after retirement, are potentially highly fruitful areas for investigation. Public positions on drug policy are invariably contoured by conditions of political possibility. We raise the call for both an unpacking and examination of the structural and relational aspects of "political will" and "political courage". Sitting and retired politicians each have a role in the drug policy landscape, whether as lawmakers or as high-profile and often respected commentators. This commentary argues that a more nuanced understanding of the conditions that may support or hinder the expression of public support for drug policy reform by political office bearers, whether sitting or former, has implications for advocates and researchers invested in policy change.
Topics: Humans; Retirement; Politics; Public Policy; Illicit Drugs
PubMed: 37196378
DOI: 10.1016/j.drugpo.2023.104059 -
Bioethics Nov 2023The debate around lockdowns as a response to the recent pandemic is typically framed in terms of a tension between freedom and health. However, on some views, protection...
The debate around lockdowns as a response to the recent pandemic is typically framed in terms of a tension between freedom and health. However, on some views, protection of health or reduction of virus-related risks can also contribute to freedom. Therefore, there might be no tension between freedom and health in public health restrictions. I argue that such views fail to appreciate the different understandings of freedom that are involved in the trade-off between freedom and health. Grasping these distinctions would allow to appreciate why different people give more weight to different aspects of limitations of freedom, including whether certain options are made simply risky or impossible, whether limitations of freedomĀ are posed intentionally or happen accidentally, whether risks are beyond a threshold of acceptability, and who gets to decide that. I provide a conceptual analysis of the relationship between different types of freedom, public health policies, viruses and diseases. As I argue, identifying what freedom-based reasons count for and against different types of public health restrictions requires distinguishing between viruses and diseases, between lockdowns and other types of restrictive policies, and between risks posed by viruses and threats of penalties involved by restrictive policies.
Topics: Humans; Public Health; Pandemics; Public Policy; Freedom
PubMed: 37638849
DOI: 10.1111/bioe.13217