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Annual Review of Public Health Apr 2021Extreme weather and climate events, such as heat waves, cyclones, and floods, are an expression of climate variability. These events and events influenced by climate... (Review)
Review
Extreme weather and climate events, such as heat waves, cyclones, and floods, are an expression of climate variability. These events and events influenced by climate change, such as wildfires, continue to cause significant human morbidity and mortality and adversely affect mental health and well-being. Although adverse health impacts from extreme events declined over the past few decades, climate change and more people moving into harm's way could alter this trend. Long-term changes to Earth's energy balance are increasing the frequency and intensity of many extreme events and the probability of compound events, with trends projected to accelerate under certain greenhouse gas emissions scenarios. While most of these events cannot be completely avoided, many of the health risks could be prevented through building climate-resilient health systems with improved risk reduction, preparation, response, and recovery. Conducting vulnerability and adaptation assessments and developing health system adaptation plans can identify priority actions to effectively reduce risks, such as disaster risk management and more resilient infrastructure. The risks are urgent, so action is needed now.
Topics: Climate Change; Delivery of Health Care; Extreme Weather; Global Health; Humans; Population Health
PubMed: 33406378
DOI: 10.1146/annurev-publhealth-012420-105026 -
Journal of Medical Systems Sep 2018Electronic health records (EHRs) have emerged among health information technology as "meaningful use" to improve the quality and efficiency of healthcare, and health... (Review)
Review
Electronic health records (EHRs) have emerged among health information technology as "meaningful use" to improve the quality and efficiency of healthcare, and health disparities in population health. In other instances, they have also shown lack of interoperability, functionality and many medical errors. With proper implementation and training, are electronic health records a viable source in managing population health? The primary objective of this systematic review is to assess the relationship of electronic health records' use on population health through the identification and analysis of facilitators and barriers to its adoption for this purpose. Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE (PubMed), 10/02/2012-10/02/2017, core clinical/academic journals, MEDLINE full text, English only, human species and evaluated the articles that were germane to our research objective. Each article was analyzed by multiple reviewers. Group members recognized common facilitators and barriers associated with EHRs effect on population health. A final list of articles was selected by the group after three consensus meetings (n = 55). Among a total of 26 factors identified, 63% (147/232) of those were facilitators and 37% (85/232) barriers. About 70% of the facilitators consisted of productivity/efficiency in EHRs occurring 33 times, increased quality and data management each occurring 19 times, surveillance occurring 17 times, and preventative care occurring 15 times. About 70% of the barriers consisted of missing data occurring 24 times, no standards (interoperability) occurring 13 times, productivity loss occurring 12 times, and technology too complex occurring 10 times. The analysis identified more facilitators than barriers to the use of the EHR to support public health. Wider adoption of the EHR and more comprehensive standards for interoperability will only enhance the ability for the EHR to support this important area of surveillance and disease prevention. This review identifies more facilitators than barriers to using the EHR to support public health, which implies a certain level of usability and acceptance to use the EHR in this manner. The public-health industry should combine their efforts with the interoperability projects to make the EHR both fully adopted and fully interoperable. This will greatly increase the availability, accuracy, and comprehensiveness of data across the country, which will enhance benchmarking and disease surveillance/prevention capabilities.
Topics: Electronic Health Records; Humans; Meaningful Use; Population Health
PubMed: 30269237
DOI: 10.1007/s10916-018-1075-6 -
Yearbook of Medical Informatics Aug 2018To summarize the recent public and population health informatics literature with a focus on the synergistic "bridging" of electronic data to benefit communities and... (Review)
Review
OBJECTIVE
To summarize the recent public and population health informatics literature with a focus on the synergistic "bridging" of electronic data to benefit communities and other populations.
METHODS
The review was primarily driven by a search of the literature from July 1, 2016 to September 30, 2017. The search included articles indexed in PubMed using subject headings with (MeSH) keywords "public health informatics" and "social determinants of health". The "social determinants of health" search was refined to include articles that contained the keywords "public health", "population health" or "surveillance".
RESULTS
Several categories were observed in the review focusing on public health's socio-technical infrastructure: evaluation of surveillance practices, surveillance methods, interoperable health information infrastructure, mobile health, social media, and population health. Common trends discussing socio-technical infrastructure included big data platforms, social determinants of health, geographical information systems, novel data sources, and new visualization techniques. A common thread connected these categories of workforce, governance, and sustainability: using clinical resources and data to bridge public and population health.
CONCLUSIONS
Both medical care providers and public health agencies are increasingly using informatics and big data tools to create and share digital information. The intent of this "bridging" is to proactively identify, monitor, and improve a range of medical, environmental, and social factors relevant to the health of communities. These efforts show a significant growth in a range of population health-centric information exchange and analytics activities.
Topics: Datasets as Topic; Humans; Medical Informatics; Population Health; Public Health Informatics; Social Determinants of Health; Telemedicine; United States; Workforce
PubMed: 30157524
DOI: 10.1055/s-0038-1667081 -
The Milbank Quarterly Sep 2019Policy Points Racism is a fundamental cause of health inequities and disease, which requires policy solutions that address this cause directly rather than only targeting...
UNLABELLED
Policy Points Racism is a fundamental cause of health inequities and disease, which requires policy solutions that address this cause directly rather than only targeting mechanisms. Cultural systems, such as cultural racism, undergird the social conditions that shape racial inequities in health, including social and health policy decision making, governance, practice, and public reception. Policies targeting racial health equity benefit from integrating social theory and meaningful assessments of the social context concerning race, racism, and health.
CONTEXT
Improving the health of the total population may be insufficient in eliminating racial disparities in population health. An expanding commitment to understanding social determinants of health aims to address the social conditions that produce racialized patterns in health inequity. There is also a resurging and evolving interest in the influence of cultural barriers and assets in shaping racial inequities in health. The meaning and function of culture, however, remains underspecified.
METHODS
This paper synthesizes analogous but fragmented concepts of cultural threat related to social and racial inequity as examined in public and population health, psychology, sociology, communications, media studies, and law. It draws on an existing typology of culture and social inequity to organize concepts related to cultural racism. Employing a transdisciplinary approach, the paper integrates multiple scholarly perspectives on cultural threat to frame cultural racism as cultural systems that promote false presumptions of white superiority relative to non-whites.
FINDINGS
The lack of shared conceptual grounding and language regarding cultural threats to health hinders a more precise identification and measurement of cultural processes as well as comparisons of relative prevalence and influence of pathways linking cultural processes and social inequity. Evaluating intersections among culture, structures, and racism is a valuable analytical tool for understanding the production of social and racial inequities in health. To adequately address health inequities rooted in systemic racism, it is imperative to discuss the function of cultural racism in shaping population health in the United States.
CONCLUSIONS
Building a culture of health and achieving health equity requires that we assess cultural racism in a more meaningful way. Cultural processes are commonly referenced in health inequity scholarship, but the empirical literature generally lags behind the conceptual emphasis. A rich literature across disciplines has substantively engaged conceptualizations of culture and cultural processes, the importance of these processes as part of a system of racism, and mechanisms that may link cultural threats to health. When integrated, this literature offers essential insights for ways population health may address the complex issue of eradicating racial disparities in health.
Topics: Culture; Health Status Disparities; Humans; Population Health; Racism; Social Determinants of Health; United States
PubMed: 31512293
DOI: 10.1111/1468-0009.12411 -
The Lancet. Public Health Jul 2020One possible policy response to the burden of diet-related disease is food taxes and subsidies, but the net health gains of these approaches are uncertain because of...
BACKGROUND
One possible policy response to the burden of diet-related disease is food taxes and subsidies, but the net health gains of these approaches are uncertain because of substitution effects between foods. We estimated the health and cost impacts of various food taxes and subsidies in one high-income country, New Zealand.
METHODS
In this modelling study, we compared the effects in New Zealand of a 20% fruit and vegetable subsidy, of saturated fat, sugar and salt taxes (each set at a level that increased the total food price by the same magnitude of decrease from the fruit and vegetable subsidy), and of an 8% so-called junk food tax (on non-essential, energy-dense food). We modelled the effect of price changes on food purchases, the consequent changes in fruit and vegetable and sugar-sweetened beverage purchasing, nutrient risk factors, and body-mass index, and how these changes affect health status and health expenditure. The pre-intervention intake for 340 food groups was taken from the New Zealand National Nutrition Survey and the post-intervention intake was estimated using price and expenditure elasticities. The resultant changes in dietary risk factors were then propagated through a proportional multistate lifetable (with 17 diet-related diseases) to estimate the changes in health-adjusted life years (HALYs) and health system expenditure over the 2011 New Zealand population's remaining lifespan.
FINDINGS
Health gains (expressed in HALYs per 1000 people) ranged from 127 (95% uncertainty interval 96-167; undiscounted) for the 8% junk food tax and 212 (102-297) for the fruit and vegetable subsidy, up to 361 (275-474) for the saturated fat tax, 375 (272-508) for the salt tax, and 581 (429-792) for the sugar tax. Health expenditure savings across the remaining lifespan per capita (at a 3% discount rate) ranged from US$492 (334-694) for the junk food tax to $2164 (1472-3122) for the sugar tax.
INTERPRETATION
The large magnitude of the health gains and cost savings of these modelled taxes and subsidies suggests that their use warrants serious policy consideration.
FUNDING
Health Research Council of New Zealand.
Topics: Adult; Female; Food; Food Assistance; Fruit; Health Care Costs; Humans; Male; Models, Statistical; New Zealand; Population Health; Taxes; Vegetables
PubMed: 32619542
DOI: 10.1016/S2468-2667(20)30116-X -
The Milbank Quarterly Jun 2018
Topics: Firearms; Florida; Humans; Needs Assessment; Population Health; Violence
PubMed: 29652089
DOI: 10.1111/1468-0009.12321 -
JAMA Pediatrics Feb 2022
Topics: Humans; Population Health; Sugar-Sweetened Beverages; Taxes
PubMed: 34902011
DOI: 10.1001/jamapediatrics.2021.5051 -
Journal of Athletic Training Feb 2022To define and discuss the role of population health as a framework to improve care and clinical decision making in athletic training practice.
OBJECTIVE
To define and discuss the role of population health as a framework to improve care and clinical decision making in athletic training practice.
BACKGROUND
Athletic trainers (ATs) are allied health professionals who are uniquely suited to provide preventive and educational health and wellness programs to improve health outcomes across a physically active population. Athletic trainers are often the first contacts for high school athletes seeking health and wellness education, which may allow ATs to be the first intervention or prevention point for reducing or eliminating negative health behaviors and outcomes among their patients.
CONCLUSIONS
Integrating a population-health framework into the athletic training setting prepares ATs to address complex health concerns in communities that result from factors that influence determinants of health. The field of athletic training could benefit from a population-health approach to care by broadening consideration of the factors that affect the health of homogeneous populations that are served by ATs.
Topics: Athletes; Humans; Population Health; Schools; Sports
PubMed: 33626134
DOI: 10.4085/314-19 -
MEDICC Review Oct 2018Medicine is a social science, and politics nothing else but medicine on a large scale. His point is well taken. Articles in this issue of MEDICC Review explore the often...
Medicine is a social science, and politics nothing else but medicine on a large scale. His point is well taken. Articles in this issue of MEDICC Review explore the often turbulent relationship between science and those with the power to use it. Eventually, it is they who can wield science for their benefit alone or to improve population and planetary health. They can pay attention to science, they can ignore science, or, in the worst cases, they can bend it to serve their own narrow interests.
Topics: Humans; Intersectoral Collaboration; Politics; Population Health; Power, Psychological
PubMed: 31242163
DOI: 10.37757/MR2018.V20.N4.1 -
International Journal of Environmental... Feb 2021(1) Background: Health services that were already under pressure before the COVID-19 pandemic to maximize its impact on population health, have not only the imperative...
(1) Background: Health services that were already under pressure before the COVID-19 pandemic to maximize its impact on population health, have not only the imperative to remain resilient and sustainable and be prepared for future waves of the virus, but to take advantage of the learnings from the pandemic to re-configure and support the greatest possible improvements. (2) Methods: A review of articles published by the Special Issue on Population Health and Health Services to identify main drivers for improving the contribution of health services on population health is conducted. (3) Health services have to focus not just on providing the best care to health problems but to improve its focus on health promotion and disease prevention. (4) Conclusions: Implementing innovative but complex solutions to address the problems can hardly be achieved without a multilevel and multisectoral deliberative debate. The CHRODIS PLUS policy dialog method can help standardize policy-making procedures and improve network governance, offering a proven method to strengthen the impact of health services on population health, which in the post-COVID era is more necessary than ever.
Topics: COVID-19; Delivery of Health Care; Humans; Pandemics; Population Health
PubMed: 33572355
DOI: 10.3390/ijerph18041658