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Journal of Public Health Management and...Laws and policies are critical determinants of health and well-being. They can encourage positive behaviors and discourage harmful behaviors, and they can enhance or...
Laws and policies are critical determinants of health and well-being. They can encourage positive behaviors and discourage harmful behaviors, and they can enhance or worsen health, health equity, health disparities, and health literacy. Recognizing their contribution to conditions in the environments in which people are born, live, learn, work, play, worship, and age, and people's experiences of these conditions, the US Department of Health and Human Services considered the roles of law and policy throughout its development of Healthy People 2030. Laws and policies often interrelate, but they have different purposes. A law is an established procedure, standard, or system of rules that members of a society must follow. A policy is a decision or set of decisions meant to address a long-term purpose or problem. Healthy People 2030 offers an opportunity for users in diverse sectors and at all levels to use laws and policies to support or inform the initiative's implementation, address health disparities and health inequities, and improve health and well-being in this decade. Introducing new laws and policies or rescinding existing ones to achieve Healthy People 2030 goals offers a chance to rigorously assess outcomes and weigh the balance of good outcomes against unintended consequences.
Topics: Health Equity; Health Literacy; Health Policy; Health Status; Humans; Policy; Social Determinants of Health
PubMed: 34016909
DOI: 10.1097/PHH.0000000000001358 -
Cadernos de Saude Publica 2022This study aims to conduct a search of public-policy instruments seeking explicit references to subsequent adolescent pregnancy, as well as to discern what kinds of... (Review)
Review
This study aims to conduct a search of public-policy instruments seeking explicit references to subsequent adolescent pregnancy, as well as to discern what kinds of actions have been proposed as part of the international and national agendas to facilitate subsequent adolescent pregnancy prevention and care. During June 2021, we used an integrative review to search and to analyze national and international public policy instruments along with other documents related to subsequent adolescent pregnancy. We observed, for each, the presence of statements on subsequent adolescent pregnancy. The research team was then divided into triads to discuss and to classify each reference under one of the following categories: (a) a symbolic statement, that is, an intention not implying a specific action but rather presenting a vision for the future; (b) a substantive-material statement concerning an action intended to solve a problem; and (c) a procedural-material statement indicating specific actions, processes, budgets, and actors. We analyzed a total of 135 public-policy documents: 102 in Mexico and 33 internationally. Only four national and six international documents contained either symbolic or substantive-material references to the subject of interest and only one specified a procedural-material statement. The prevention and care of subsequent adolescent pregnancy are addressed only secondarily on the public agendas. Only a minimal number of actions comprise specific and standardized measures to prevent subsequent adolescent pregnancy according to the different actors involved. Designing a greater number of procedural-material policies will help to reduce morbidity and mortality in the mother-child binomial and promote a comprehensive development of this population.
Topics: Adolescent; Brazil; Female; Health Policy; Humans; Mexico; Pregnancy; Pregnancy in Adolescence; Public Policy
PubMed: 36169509
DOI: 10.1590/0102-311XEN025922 -
International Journal of Environmental... Jul 2020The role of smart cities in order to improve older people's quality of life, sustainability and opportunities, accessibility, mobility, and connectivity is increasing... (Review)
Review
The role of smart cities in order to improve older people's quality of life, sustainability and opportunities, accessibility, mobility, and connectivity is increasing and acknowledged in public policy and private sector strategies in countries all over the world. Smart cities are one of the technological-driven initiatives that may help create an age-friendly city. Few research studies have analysed emerging countries in terms of their national strategies on smart or age-friendly cities. In this study, Romania which is predicted to become one of the most ageing countries in the European Union is used as a case study. Through document analysis, current initiatives at the local, regional, and national level addressing the issue of smart and age-friendly cities in Romania are investigated. In addition, a case study is presented to indicate possible ways of the smart cities initiatives to target and involve older adults. The role of different stakeholders is analysed in terms of whether initiatives are fragmentary or sustainable over time, and the importance of some key factors, such as private-public partnerships and transnational bodies. The results are discussed revealing the particularities of the smart cities initiatives in Romania in the time frame 2012-2020, which to date, have limited connection to the age-friendly cities agenda. Based on the findings, a set of recommendations are formulated to move the agenda forward.
Topics: Cities; City Planning; Environment Design; Humans; Public Policy; Quality of Life; Romania; Sustainable Development; Urban Health
PubMed: 32708488
DOI: 10.3390/ijerph17145202 -
International Journal For Equity in... Dec 2023Cancer causes a major disease burden worldwide. This is increasingly being realised in low and middle-income countries, which account disproportionately for preventable... (Review)
Review
BACKGROUND
Cancer causes a major disease burden worldwide. This is increasingly being realised in low and middle-income countries, which account disproportionately for preventable cancer deaths. Despite the World Health Organization calling for governments to develop policies to address this and alleviate cancer inequality, numerous challenges in executing effective cancer policies remain, which require consideration of the country-specific context. As this has not yet been considered in Ghana, the aim of this review was to bring together and critique the social-environmental, health policy and system factors to identifying opportunities for future health policies to reduce cancer burden in the Ghanian context. A critical policy-focused review was conducted to bring together and critique the current health systems context relating to cancer in Ghana, considering the unmet policy need, health system and social factors contributing to the burden and policy advances related to cancer.
CONCLUSION
The findings highlight the changing burden of cancer in Ghana and the contextual factors within the socio-ecosystem that contribute to this. Policies around expanding access to and coverage of services, as well as the harmonization with medical pluralism have potential to improve outcomes and increase equity but their implementation and robust data to monitor their impact pose significant barriers.
Topics: Humans; Ghana; Health Policy; Neoplasms; Public Policy
PubMed: 38066530
DOI: 10.1186/s12939-023-02067-2 -
BMC Pediatrics Dec 2022The prevalence of childhood obesity (CO) and related complications is high and alarmingly increasing in Iran. This study applied a mixed Delphi & Policy Dialogue... (Review)
Review
BACKGROUND
The prevalence of childhood obesity (CO) and related complications is high and alarmingly increasing in Iran. This study applied a mixed Delphi & Policy Dialogue approach to exploring and prioritizing policy options to control childhood obesity in Iran.
METHODS
This study is organized in three Delphi phases followed by a policy dialogue session. This study applied the advocacy collation framework and evidence-informed policy-making approach to enhance the chance of a feasible and acceptable policy package. The first step consisted of interviews with 30 experts and primary stakeholders. Based on their answers and a comprehensive literature review, a list of presumed effective policy options to combat CO in Iran was made. Then, panelists were asked to score each policy option using a five-point Likert scale in seven constructs. To maximize the spread of opinions, panelists were chosen to represent three perspectives: policy-makers at different levels, presidents of various organizations who would implement potential policy options, and academics. Twenty-one stakeholders were invited to discuss the policy options in a policy dialogue section.
RESULTS
We introduced 27 policy options and asked stakeholders to rank them using seven criteria on a five-level Likert scale. Totally, 41 experts participated in round 2 (66.2% response rate), and 33 experts took part in round 3 (72% response rate). Participants believed that healthy schools, creating healthy environments in kindergartens and other child care centers, subsidizing healthy foods, educating healthy lifestyles in mass media, and increasing access to physical activity facilities are the most effective and feasible policies in controlling CO. After the policy dialogue, the healthy school remained the most prioritized policy. a policy package to combat CO in Iran was designed with the participation of all stakeholders.
CONCLUSION
The advocacy collation framework and the evidence-informed policy-making approach were used to draft a policy package to combat CO, increasing the acceptability and feasibility of the developed policy package.
Topics: Child; Humans; Pediatric Obesity; Iran; Policy Making; Schools; Policy; Health Policy
PubMed: 36536338
DOI: 10.1186/s12887-022-03796-z -
International Journal of Health Policy... 2023Globally, data on stillbirth is limited. A call to action has been issued to governments to address the data gap by strengthening national policies and strategies to... (Review)
Review
BACKGROUND
Globally, data on stillbirth is limited. A call to action has been issued to governments to address the data gap by strengthening national policies and strategies to drive urgent action on stillbirth reduction. This study aims to understand the policy environment for stillbirths to advance stillbirth recording and reporting in data systems.
METHODS
A systematic three-step process (survey tool examination, identifying relevant study questions, and reviewing country responses to the survey and national documents) was taken to review country responses to the global 2018-2019 World Health Organization (WHO) Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) Policy Survey. Policy Survey responses were reviewed to identify if and how stillbirths were included in national documents. This paper uses descriptive analyses to identify and describe the relationship between multiple variables.
RESULTS
Responses from 155 countries to the survey were analysed, and over 800 national policy documents submitted by countries in English reviewed. Fewer than one-fifth of countries have an established stillbirth rate (SBR) target, with higher percentages reported for under-5 (71.0%) and neonatal mortality (68.5%). Two-thirds (65.8%) of countries reported a national maternal death review panel. Less than half (43.9%) of countries have a national policy that requires stillbirths to be reviewed. Two-thirds of countries have a national policy requiring review of neonatal deaths. WHO websites and national health statistics reports are the common data sources for stillbirth estimates. Countries that are signatories to global initiatives on stillbirth reduction have established national targets. Globally, nearly all countries (94.8%) have a national policy that requires every death to be registered. However, 45.5% of reviewed national policy documents made mention of registering stillbirths. Only 5 countries had national policy documents recommending training of health workers in filling out death certificates using the International Classification of Diseases (ICD)-10 for stillbirths.
CONCLUSION
The current policy environment in countries is not supportive for identifying stillbirths and recording causes of death. This is likely to contribute to slow progress in stillbirth reduction. The paper proposes policy recommendations to make every baby count.
Topics: Humans; Infant, Newborn; Infant Mortality; Policy; Stillbirth; Sustainable Development
PubMed: 38618824
DOI: 10.34172/ijhpm.2023.7391 -
Trends and Insights from Transportation Congestion Pricing Policy Research: A Bibliometric Analysis.International Journal of Environmental... Jun 2022Toll-based congestion pricing (CP) policies are increasingly implemented globally for alleviating road traffic congestion. Several interconnected factors affecting or...
Toll-based congestion pricing (CP) policies are increasingly implemented globally for alleviating road traffic congestion. Several interconnected factors affecting or induced by CP implementation include air quality/emissions, travel time, and road user safety. We sought to examine and characterize research output and patterns across several domains (e.g., health, policy acceptability) surrounding toll-based CP policies, in order to identify where research has focused and where gaps exist. We conducted a structured review and identified 2333 relevant publications, using semi-supervised and machine learning strategies combined with manual review. Annual publication counts peaked in 2015 (n = 122). Themes identified from title and abstract terms included policy implementation characteristics, advanced transportation modeling methods and approaches, and public perception and acceptability. Authorship networks indicated a lack of interdisciplinary research. Country analyses identified the US, China, and the UK as the most frequently represented countries, and underrepresentation from low-income countries. Findings indicate that research focused on specific road user types (e.g., pedestrians) and safety impacts, and equity considerations were relatively sparse compared to other topics (e.g., policy economics, public perception). Additional research on these critical topics is necessary to ensure that such policies are designed to promote positive and equitable effects on road user health and safety.
Topics: Air Pollution; Bibliometrics; Costs and Cost Analysis; Policy; Transportation
PubMed: 35742442
DOI: 10.3390/ijerph19127189 -
International Journal of Environmental... Nov 2020Alcohol is a major risk factor for burden of disease. However, there are known effective and cost-effective alcohol control policies that could reduce this burden. Based... (Review)
Review
Alcohol is a major risk factor for burden of disease. However, there are known effective and cost-effective alcohol control policies that could reduce this burden. Based on reviews, international documents, and contributions to this special issue of International Journal of Environmental Research and Public Health (IJERPH), this article gives an overview of the implementation of such policies in the World Health Organization (WHO) European Region, and of best practices. Overall, there is a great deal of variability in the policies implemented between countries, but two countries, the Russian Federation and Lithuania, have both recently implemented significant increases in alcohol taxation, imposed restrictions on alcohol availability, and imposed bans on the marketing and advertising of alcohol within short time spans. Both countries subsequently saw significant decreases in consumption and all-cause mortality. Adopting the alcohol control policies of these best-practice countries should be considered by other countries. Current challenges for all countries include cross-border shopping, the impact from recent internet-based marketing practices, and international treaties.
Topics: Advertising; Alcohol Drinking; Europe; Health Policy; Lithuania; Public Policy; Russia
PubMed: 33158307
DOI: 10.3390/ijerph17218162 -
Tobacco Control May 2023The US Food and Drug Administration (FDA) applies the Population Health Standard in tobacco product review processes by weighing anticipated health benefits against...
The US Food and Drug Administration (FDA) applies the Population Health Standard in tobacco product review processes by weighing anticipated health benefits against risks associated with a given commercial tobacco product at the population level. However, systemic racism (ie, discriminatory policies and practices) contributes to an inequitable distribution of tobacco-related health benefits and risks between white and Black/African Americans at the population level. Therefore, Black-centered, antiracist data standards for tobacco product review processes are needed to achieve racial equity and social justice in US tobacco control policy. Regardless of whether FDA implements such data standards, non-industry tobacco scientists should prioritise producing and disseminating Black-centred data relevant to FDA's regulatory authority. We describe how systemic racism contributes to disparities in tobacco-related outcomes and why these disparities are relevant for population-level risk assessments, then discuss four possible options for Black-centred data standards relevant to tobacco product review processes.
Topics: Humans; United States; Tobacco Control; Racial Groups; Tobacco Products; Social Justice; Policy; Nicotiana; Racism
PubMed: 34526408
DOI: 10.1136/tobaccocontrol-2021-056704 -
Social Science & Medicine (1982) Aug 2021Existing research has identified numerous barriers to the adoption of public health policies for alcohol, including the cross-cutting nature of the policy problem and...
Existing research has identified numerous barriers to the adoption of public health policies for alcohol, including the cross-cutting nature of the policy problem and industry influence. Recent developments in Ireland suggest that while formidable, such barriers can be overcome. Ireland's 2018 alcohol legislation adopts key evidence-based measures, introducing pricing, availability and marketing regulations that are world-leading in public health terms. Drawing primarily on the Multiple Streams Approach (MSA), this study investigates the adoption of the Public Health (Alcohol) Act 2018. We draw data from 20 semi-structured interviews with politicians, government advisors, public health experts, and advocates, as well as from relevant primary documents, newspaper articles, and other material in the public domain. We find that increased public attention to alcohol-related harms in Ireland (problem stream), developments within the institutional location of policymaking (the policy stream), and the political pressure exerted by politicians and advocates (the political stream) all combined to open a policy window. Unlike previous alcohol policy reform efforts in Ireland, several personally committed and well-positioned leaders championed policy change. This study suggests that political leadership might be important in understanding why public health approaches to alcohol have been embraced in some contexts but not in others.
Topics: Health Policy; Humans; Ireland; Leadership; Policy Making; Public Health; Public Policy
PubMed: 34192619
DOI: 10.1016/j.socscimed.2021.114116