Taxing sugar-sweetened beverages: Knowledge, beliefs and where should the money go?

Background: The Sugar-Sweetened Beverage (SSB) industry consciously and subconsciously influences consumers to buy its products. Countering unhealthy messaging and behaviour could be tackled through the SSB levy and allocation of revenue toward healthy lifestyle programs. Given the limited information in the UAE on demographic and consumer knowledge and beliefs and allocation of SSB levy, we conducted a study to explore this further. The study objectives were to a) explore the association between demographic factors (nationality, income and education) with knowledge and beliefs for SSB and b) explore participants' views on allocating SSB levy toward healthy lifestyle programs. Methods: A cross-sectional study of adults in the United Arab Emirates. Results: The findings suggest knowledge was high for Sugar-Sweetened Beverages (SSB), obesity, and diabetes (1,231, 96.1%), and there was a high awareness of SSB tax (1,066, 83.2%). Knowledge and beliefs about Sugar-Sweetened Beverages were statistically significant for two demographic factors. There was support for the tax revenue to be spent on government programs and greater support for spending to be directed toward specific healthy lifestyle programs such as school health programmes (514, 39.8%), children's diet and nutrition programmes (497, 38.5%), physical activity programmes (480, 37.2%), among others. Conclusions: The findings shed light on the influence demographic factors have on knowledge and beliefs, public health gaps and potential areas for SSB levy expenditure. Further research is needed to understand how best to implement healthy lifestyle programs within the community to optimise coverage, cost-effectiveness, and health outcomes.

Monkeypox: Is the world ready for another pandemic?

As the world continues to endure the impact of the COVID-19 pandemic, an outbreak of Monkeypox occurs and continues to spread unabatedly. The double-stranded DNA monkeypox virus is a sylvatic zoonosis, which occasionally infects humans and is a member of the genus Orthopoxviruses. Although scientists believed the virus to have low transmissibility, the speed and degree with which it spreads is alarming and could land one in a hospital or even kill one. Additionally, the fact that unusual transmissions are occurring among people without travel history to endemic regions suggests undetected transmissions, raising concerns about our preparedness for another pandemic. Contrary to the COVID-19 pandemic, there is a vaccine that could offer some protection against the monkeypox virus. Therefore, there is a need for coordinated efforts among authorities concerned and community-based organizations to raise awareness of the potential pandemic of monkeypox, activate surveillance systems and laboratory capacity, and heighten contact tracing and vaccination of at-risk individuals to stem the outbreak while there is still the opportunity to prevent it from becoming a pandemic.

An epidemiological investigation of a cholera outbreak in peri-urban slum settlements of Gujarat, India.

Background: Cholera is an acute diarrhoeal disease caused by consuming contaminated food and water. The burden may remain underreported due to several issues like the low capacity of epidemiological surveillance systems, laboratory testing facilities, and socioeconomic disparities in urban slums. The disease has very short incubation period resulted in quick clustering of cases. Aim: A thorough outbreak investigation was carried out with the objective of strengthening the surveillance activity, finding out the sources of infection, and recommending necessary actions to control the outbreak immediately. Methods: An unusual increase in cases of diarrhoea was reported in slum area of Kalol town during the first week of July 2021. The stool samples were taken and investigated for confirmation and declaration of the outbreak by the Rapid Response Team. Time, place, and person distribution were carried out to generate a hypothesis and provide an immediate public health response to contain the outbreak. This study was conducted during the emergency public health response, no ethical approval was sought before the survey. Results: The cholera outbreak was confirmed when three out of five stool samples were positive for the bacterium V. cholerae O1 biotype El Tor serotype Ogawa. The overall attack rate and case fatality rate were 3.6% and 1.1%, respectively. The leakages caused the mixing of drainage water with the drinking water supply, which could be the possible cause of outbreak. Conclusion: The early identification and management of the cases, source reduction, health education on water chlorination, and hand hygiene were initiated based on our recommendations, which controlled the present outbreak.

The Austrian Health Information System "ÖGIS" - supporting implementation of the Public Health Action Cycle in Austria.

The Austrian National Public Health Institute (GÖG) started to develop the Austrian Health Information System (ÖGIS) by combining technology of Geographic Information Systems (GIS) and common approaches of epidemiology in the early 1990ies. Today, ÖGIS is designed as a specific GIS-application, continuously maintained and developed further by in-house development within GÖG and accessible to all employees of GÖG as well as to interested external institutions and persons. ÖGIS covers all major data sources relevant to health, health determinants and the health care system in Austria. It is used for epidemiological research, health reporting, health services monitoring and research as well as for integrated planning of the health care system. After ÖGIS has proven itself as a useful support for implementation of the Public Health Action Cycle in Austria over many years, the maintenance of the ÖGIS databases will be continued and the employment of ÖGIS for purposes of regional health services research will be intensified in the upcoming years.

Prioritisation for future surveillance, prevention and control of 98 communicable diseases in Belgium: a 2018 multi-criteria decision analysis study.

BACKGROUND: National public health agencies are required to prioritise infectious diseases for prevention and control. We applied the prioritisation method recommended by the European Centre for Disease Prevention and Control to rank infectious diseases, according to their relative importance for surveillance and public health, to inform future public health action in Belgium. METHODS: We applied the multi-criteria-decision-analysis approach. A working group of epidemiologists and statisticians from Belgium (n = 6) designed a balanced set of prioritisation criteria. A panel of Belgian experts (n = 80) allocated in an online survey each criteria a weight, according to perceived relative importance. Next, experts (n = 37) scored each disease against each criteria in an online survey, guided by disease-specific factsheets referring the period 2010-2016 in Belgium. The weighted sum of the criteria's scores composed the final weighted score per disease, on which the ranking was based. Sensitivity analyses quantified the impact of eight alternative analysis scenarios on the top-20 ranked diseases. We identified criteria and diseases associated with data-gaps as those with the highest number of blank answers in the scoring survey. Principle components of the final weighted score were identified. RESULTS: Working groups selected 98 diseases and 18 criteria, structured in five criteria groups. The diseases ranked highest were (in order) pertussis, human immunodeficiency virus infection, hepatitis C and hepatitis B. Among the five criteria groups, overall the highest weights were assigned to 'impact on the patient', followed by 'impact on public health', while different perceptions were identified between clinicians, microbiologists and epidemiologists. Among the 18 individual criteria, 'spreading potential' and 'events requiring public health action' were assigned the highest weights. Principle components clustered with thematic disease groups. Notable data gaps were found among hospital-related diseases. CONCLUSIONS: We ranked infectious diseases using a standardised reproducible approach. The diseases ranked highest are included in current public health programs, but additional reflection for example about needs among risk groups is recommended. Cross-reference of the obtained ranking with current programs is needed to verify whether resources and activities map priority areas. We recommend to implement this method in a recurrent evaluation cycle of national public health priorities.

Two communities, one highway and the fight for clean air: the role of political history in shaping community engagement and environmental health research translation.

BACKGROUND: This paper explores strategies to engage community stakeholders in efforts to address the effects of traffic-related air pollution (TRAP). Communities of color and low-income communities are disproportionately impacted by environmental threats including emissions generated by major roadways. METHODS: Qualitative instrumental case study design was employed to examine how community-level factors in two Massachusetts communities, the City of Somerville and Boston's Chinatown neighborhood, influence the translation of research into practice to address TRAP exposure. Guided by the Interactive Systems Framework (ISF), we drew on three data sources: key informant interviews, observations and document reviews. Thematic analysis was used. RESULTS: Findings indicate political history plays a significant role in shaping community action. In Somerville, community organizers worked with city and state officials, and embraced community development strategies to engage residents. In contrast, Chinatown community activists focused on immediate resident concerns including housing and resident displacement resulting in more opposition to local municipal leadership. CONCLUSIONS: The ISF was helpful in informing the team's thinking related to systems and structures needed to translate research to practice. However, although municipal stakeholders are increasingly sympathetic to and aware of the health impacts of TRAP, there was not a local legislative or regulatory precedent on how to move some of the proposed TRAP-related policies into practice. As such, we found that pairing the ISF with a community organizing framework may serve as a useful approach for examining the dynamic relationship between science, community engagement and environmental research translation. Social workers and public health professionals can advance TRAP exposure mitigation by exploring the political and social context of communities and working to bridge research and community action.

Metal air pollution partnership solutions: building an academic-government-community-industry collaboration to improve air quality and health in environmental justice communities in Houston.

BACKGROUND: From 2006 to 2011, the City of Houston received nearly 200 community complaints about air pollution coming from some metal recycling facilities. The investigation by the Houston Health Department (HHD) found that while operating within legal limits, emissions from facilities that use torch cutting, a technique generating metal aerosols, may increase health risks for neighboring residents. Choosing to use collaborative problem solving over legislative rulemaking, HHD reached out to The University of Texas Health Science Center at Houston (UTHealth) to further evaluate and develop plans to mitigate, if necessary, health risks associated with metal emissions from these facilities. METHODS: Utilizing a community-based participatory research approach, we constituted a research team from academia, HHD and an air quality advocacy group and a Community Advisory Board (CAB) to draw diverse stakeholders (i.e., frustrated and concerned residents and wary facility managers acting within their legal rights) into an equitable, trusting and respectful space to work together. Next, we investigated metal air pollution and inhalation health risks of adults living near metal recyclers and ascertained community views about environmental health using key informant interviews, focus groups and surveys. Finally, working collaboratively with the CAB, we developed neighborhood-specific public health action plans to address research findings. RESULTS: After overcoming challenges, the CAB evolved into an effective partnership with greater trust, goodwill, representation and power among members. Working together to translate and share health risk assessment results increased accessibility of the information. These results, coupled to community survey findings, set the groundwork for developing and implementing a stakeholder-informed action plan, which included a voluntary framework to reduce metal emissions in the scrap yard, improved lines of communication and environmental health leadership training. Tangible outcomes of enhanced capacity of our community and governmental partners included trained residents to conduct door-to-door surveys, adaptation of our field training protocol and survey by our community partner and development of a successful HHD program to engage residents to improve environmental health in their neighborhood. CONCLUSIONS: Academic-government-community-industry partnerships can reduce environmental health disparities in underserved neighborhoods near industrial facilities.

Locating People Diagnosed With HIV for Public Health Action: Utility of HIV Case Surveillance and Other Data Sources.

INTRODUCTION: Human immunodeficiency virus (HIV) case surveillance and other health care databases are increasingly being used for public health action, which has the potential to optimize the health outcomes of people living with HIV (PLWH). However, often PLWH cannot be located based on the contact information available in these data sources. We assessed the accuracy of contact information for PLWH in HIV case surveillance and additional data sources and whether time since diagnosis was associated with accurate contact information in HIV case surveillance and successful contact. MATERIALS AND METHODS: The Case Surveillance-Based Sampling (CSBS) project was a pilot HIV surveillance system that selected a random population-based sample of people diagnosed with HIV from HIV case surveillance registries in 5 state and metropolitan areas. From November 2012 through June 2014, CSBS staff members attempted to locate and interview 1800 sampled people and used 22 data sources to search for contact information. RESULTS: Among 1063 contacted PLWH, HIV case surveillance data provided accurate telephone number, address, or HIV care facility information for 239 (22%), 412 (39%), and 827 (78%) sampled people, respectively. CSBS staff members used additional data sources, such as support services and commercial people-search databases, to locate and contact PLWH with insufficient contact information in HIV case surveillance. PLWH diagnosed <1 year ago were more likely to have accurate contact information in HIV case surveillance than were PLWH diagnosed ≥1 year ago ( P = .002), and the benefit from using additional data sources was greater for PLWH with more longstanding HIV infection ( P < .001). PRACTICE IMPLICATIONS: When HIV case surveillance cannot provide accurate contact information, health departments can prioritize searching additional data sources, especially for people with more longstanding HIV infection.

Comprehensive public health action for our aging world: the quintessence of public health policy.

The number of elderly people is increasing rapidly because of decreasing mortality rates and increasing lifespans throughout the world. Policies and programs for elderly people are limited, and existing programs/policies are not implemented effectively towards the goal of healthier aging. Unlike other public health issues and actions, there is an urgent need to build an evidence-based comprehensive public health action policy for healthy aging.

Epidemiology and whole genome sequencing of an ongoing point-source Salmonella Agona outbreak associated with sushi consumption in western Sydney, Australia 2015.

During May 2015, an increase in Salmonella Agona cases was reported from western Sydney, Australia. We examine the public health actions used to investigate and control this increase. A descriptive case-series investigation was conducted. Six outbreak cases were identified; all had consumed cooked tuna sushi rolls purchased within a western Sydney shopping complex. Onset of illness for outbreak cases occurred between 7 April and 24 May 2015. Salmonella was isolated from food samples collected from the implicated premise and a prohibition order issued. No further cases were identified following this action. Whole genome sequence (WGS) analysis was performed on isolates recovered during this investigation, with additional S. Agona isolates from sporadic-clinical cases and routine food sampling in New South Wales, January to July 2015. Clinical isolates of outbreak cases were indistinguishable from food isolates collected from the implicated sushi outlet. Five additional clinical isolates not originally considered to be linked to the outbreak were genomically similar to outbreak isolates, indicating the point-source contamination may have started before routine surveillance identified an increase. This investigation demonstrated the value of genomics-guided public health action, where near real-time WGS enhanced the resolution of the epidemiological investigation.

Ideological and organizational components of differing public health strategies for addressing the social determinants of health.

Despite a history of conceptual contributions to reducing health inequalities by addressing the social determinants of health (SDH), Canadian governmental authorities have struggled to put these concepts into action. Ontario's-Canada's most populous province-public health scene shows a similar pattern. In statements and reports, governmental ministries, professional associations and local public health units (PHUs) recognize the importance of these issues, yet there has been varying implementation of these concepts into public health activity. The purpose of this study was to gain insight into the key features responsible for differences in SDH-related activities among local PHUs. We interviewed Medical Officers of Health (MOH) and key staff members from nine local PHUs in Ontario varying in SDH activity as to their understandings of the SDH, public health's role in addressing the SDH, and their units' SDH-related activities. We also reviewed their unit's documents and their organizational structures in relation to acting on the SDH. Three clusters of PHUs are identified based on their SDH-related activities: service-delivery-oriented; intersectoral and community-based; and public policy/public education-focused. The two key factors that differentiate PHUs are specific ideological commitments held by MOHs and staff and the organizational structures established to carry out SDH-related activities. The ideological commitments and the organizational structures of the most active PHUs showed congruence with frameworks adopted by national jurisdictions known for addressing health inequalities. These include a structural analysis of the SDH and a centralized organizational structure that coordinates SDH-related activities.