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1.
Front Public Health ; 9: 764559, 2021.
Article in English | MEDLINE | ID: mdl-34888286

ABSTRACT

Over the last 12 years the United Kingdom (UK) has seen the introduction of an austerity programme-a fiscal policy-with the primary goal to reduce the government's budget deficit and the role of the welfare system. Between 2010 and 2015 there was an estimated reduction of £14.5 billion in spending, attributable to decreasing the value of benefits and restricting entitlement to benefit claimants. By 2020, there had been an estimated unprecedented £27 billion less spent on welfare compared with spending in 2010. Whilst fiscally-successful at reducing spending, some implemented welfare policies have had direct consequences for people's health, increasing inequalities which have been heavily criticized. Moreover, there is growing concern that this has an intergenerational effect. In this paper, we describe the ethical principles in human research, how these have been considered in public health policy, and the existing evidence of the direct and intergenerational health and welfare consequences of some recent, nationally-implemented welfare policies. We argue that ethical principles, specifically the ethical principle of safety that is applied in all research, should be applied to all public welfare policies to stop the rising inequalities in health we are seeing across generations. We highlight that initial changes implemented to welfare policies as a response to COVID-19 demonstrate that there can be a political and societal perceived value in going further to support individuals and their families during times of adversity, and consider the ethical implications of this.

2.
Environ Manage ; 2021 Dec 02.
Article in English | MEDLINE | ID: mdl-34859265

ABSTRACT

Global environmental governance (GEG) forums, such as those convened through the United Nations, result in the development of monumental guiding frameworks such as the Sustainable Development Goals (SDGs) and the Convention on Biological Diversity (CBD) Conference of Parties (COPs) Aichi and post-2020 targets. The ratification of policy frameworks by member and/or signatory states can result in major shifts in environmental policy and decision-making and has major implications for Indigenous communities. In this article, we present systematic review of the peer-reviewed literature on Indigenous participation in GEG forums, and focus on the specific questions: (1) what GEG forums include Indigenous participation and (2) how do Indigenous peoples participate in GEG forums, including how their perspectives and knowledges are framed and/or included/excluded within governance discussions, decisions, and negotiations. We provide a bibliometric analysis of the articles and derive seven inductively determined themes from our review: (1) Critical governance forums and decisions; (2) inclusion and exclusion of Indigenous voices and knowledge in GEG forums; (3) capacity barriers; (4) knowledge hierarchies: inclusion, integration, and bridging; (5) representation and grouping of Indigenous peoples in GEG; (6) need for networks among and between Indigenous peoples and other governance actors; and (7) Indigenous peoples influence on GEG decisions and processes. Our findings can be used to improve GEG forums by contributing to the development strategies that address the barriers and inequities to meaningful and beneficial Indigenous participation and can contribute to future research that is focused on understanding the experiences of Indigenous peoples within GEG forums.

3.
J Chin Polit Sci ; : 1-24, 2021 Nov 23.
Article in English | MEDLINE | ID: mdl-34840491

ABSTRACT

Both income inequality and political polarization have increased dramatically in much of the world over the past few decades. One might wonder how these two phenomena correlate with each other. Are there any striking similarities in the correlated patterns of income inequality and polarization across the globe? More importantly, how can improved equality in income distribution contribute to mitigate political polarization? Although the potential polarizing effects of income inequality is a growing concern, the evidence provided by the existing literature, however, has been mixed and incomplete. This research seeks to address the shortcomings of the current scholarship by using the repeated cross-sectional data from six waves of the World Values Survey from 1990 to 2020, to investigate whether and how widened income inequality and growing political polarization are linked globally. The findings indicate that there is a positive and statistically significant cross-country association between levels of income inequality and political polarization. The results remain robust to different specifications. This research has the potential for advancing the study of linkages between income inequality and its political consequences.

4.
Glob Health J ; 2021 Nov 19.
Article in English | MEDLINE | ID: mdl-34840854

ABSTRACT

Background: Both population-level epidemiological data and individual-level biological data are needed to control the coronavirus disease 2019 (COVID-19) pandemic. Population-level data are widely available and efforts to combat COVID-19 have generated proliferate data on the biology and immunoresponse to the causative pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, there remains a paucity of systemized data on this subject. Objective: In this review, we attempt to extract systemized data on the biology and immuno-response to SARS-CoV-2 from the most up-to-date peer-reviewed studies. We will focus on the biology of the virus and immunological variations that are key for determining long-term immunity, transmission potential, and prognosis. Data Sources and Methods: Peer-reviewed articles were sourced from the PubMed database and by snowballing search of selected publications. Search terms included: "Novel Coronavirus" OR "COVID-19" OR "SARS-CoV-2" OR "2019-nCoV" AND "Immunity" OR "Immune Response" OR "Antibody Response" OR "Immunologic Response". Studies published from December 31, 2019 to December 31, 2020 were included. To ensure validity, papers in pre-print were excluded. Results: Of 2,889 identified papers, 36 were included. Evidence from these studies suggests early seroconversion in patients infected with SARS-CoV-2. Antibody titers appear to markedly increase two weeks after infection, followed by a plateau. A more robust immune response is seen in patients with severe COVID-19 as opposed to mild or asymptomatic presentations. This trend persists with regard to the length of antibody maintenance. However, overall immunity appears to wane within two to three months post-infection. Conclusion: Findings of this study indicate that immune responses to SARS-CoV-2 follow the general pattern of viral infection. Immunity generated through natural infection appears to be short, suggesting a need for long-term efforts to control the pandemic. Antibody testing will be essential to gauge the epidemic and inform decision-making on effective strategies for treatment and prevention. Further research is needed to illustrate immunoglobulin-specific roles and neutralizing antibody activity.

5.
Arch Osteoporos ; 16(1): 177, 2021 11 24.
Article in English | MEDLINE | ID: mdl-34817704

ABSTRACT

Chronic stress from social/environmental pressures has been proposed to affect bone health through increased inflammation. We demonstrate that inflammation from prolonged stress does not cause changes to bone health through inflammation but instead impacts access to health care, social inequalities, and overall health, which in turn impact bone health. PURPOSE: The study provides a comprehensive assessment of how determinants of health across demographic, psychological, mobility-related, health, environmental, and economic domains are associated with the diagnosis of osteoporosis and tests three hypotheses: (1) a diverse set of variables across domains will predict osteoporosis, (2) chronic inflammation as a result of stress (represented by high-sensitivity C-reactive protein) will not be associated with osteoporosis, and (3) the model developed will have high accuracy in predicting osteoporosis. METHODS: Logistic regression and Cox proportional hazards models of osteoporosis diagnosis were estimated using data from 14,792 and 13,169 participants (depending on model) in the 2012-2016 waves of the Health and Retirement Study, including the Biomarker Study, the Contextual Data Resource, and validated measures of childhood socioeconomic status. Predictive accuracy was assessed using k-Nearest Neighbors Discriminant Analysis. RESULTS: Demographic, environmental, and health-related factors were associated with osteoporosis diagnosis, and predictive accuracy of the models was good. High-sensitivity C-reactive protein was not associated with osteoporosis diagnosis. CONCLUSION: Social determinants identified indicate access to health care, inequalities in the greater social environment (e.g., access to resources), and overall health (i.e., underlying medical conditions) are key components for developing osteoporosis and indicate underlying health inequities in this sample. There is a need to further address the interplay between primary health care and social determinants of health.

6.
Article in English | MEDLINE | ID: mdl-34769868

ABSTRACT

Assisted living (AL) is an emerging model of care in countries where long-term care needs are escalating, with emphasis given to promoting independence and autonomy among the residents to achieve active and healthy ageing. Unlike established nursing homes, the governance of AL is nebulous due to its novelty and diverse nature of operations in many jurisdictions. A comprehensive understanding of how AL is governed globally is important to inform regulatory policies as the adoption of AL increases. A systematic literature review was undertaken to understand the different levels of regulations that need to be instituted to govern AL effectively. A total of 65 studies, conducted between 1990 to 2020, identified from three major databases (PubMed, Medline, and Scopus), were included. Using a thematic synthesis analytical approach, we identified macro-level regulations (operational authorisation, care quality assessment and infrastructural requirements), meso-level regulations (operational management, staff management and distribution, service provision and care monitoring, and crisis management), and micro-level regulations (clear criteria for resident admission and staff hiring) that are important in the governance of AL. Large-scale adoption of AL without compromising the quality, equity and affordability would require clear provisions of micro-, meso- and macro-level regulations.


Subject(s)
Long-Term Care , Nursing Homes , Delivery of Health Care , Humans , Quality of Health Care
7.
Article in English | MEDLINE | ID: mdl-34814667

ABSTRACT

Suzuki et al have identified commonalities in the policy positions adopted at a global forum by commercial sector actors and high-income countries (HICs), on the one hand, and non-governmental organizations (NGOs) and low-and middle-income countries (LMICs), on the other, in ways that may allow commercial sector actors to block or delay evidence-based policies through the creation of political controversy. The ability of industry actors to draw on the support of the most politically and economically powerful countries for their favoured policy agenda is an important contribution to understanding the dynamics of global health governance in the area of non-communicable diseases (NCDs) and beyond. Here we assess the relevance of this paper for the field of corporate actors' research and the potential avenues this opens up for further study. More specifically we emphasize the need for comparative, cross disciplinary research to examine the power of heath-harming industries and the relevance of these findings for decolonizing global health.

8.
PLoS One ; 16(10): e0257631, 2021.
Article in English | MEDLINE | ID: mdl-34610016

ABSTRACT

The humans of modern society are enjoying the luxuries and comforts today but future generations will be facing a more polluted environment and scarcity of natural resources. So the effects of global warming and climatic changes are a major policy concern nowadays around the world. The majority of the literature treats the Carbon Dioxide emissions as an indicator of environmental deterioration but this paper considers the environmental performance index as an indicator of environment. This paper addresses the role of institutional reforms for environmental performance that is hardly discussed in the earlier literature. It is argued that a novel approach of institutional reforms can provide some useful insights for environmental performance in developing countries. There is wide agreement that institutional quality is crucial for economic sustainability but rarely focused to explore the impacts of institutional reforms on environmental performance. The institutional reforms are generally divided into two categories; economic and political reforms. This paper investigated the impact of each category of institutional reforms for environmental performance by using panel data of 122 developing economies for a period of 1996-2020. Difference in differences technique is applied to determine the impact of each category of reforms on the environment. It is found that economic and political reforms significantly contribute to protecting the environment in developing countries, and it will be a good policy option to reform the economic and political institutions to preserve the environment in these countries along with sustainable development.


Subject(s)
Conservation of Natural Resources , Developing Countries , Economic Development , Carbon Dioxide/analysis , Conservation of Natural Resources/economics , Developing Countries/economics , Environmental Pollution/economics , Humans , Politics
9.
Article in English | MEDLINE | ID: mdl-34627995

ABSTRACT

OBJECTIVE: To examine trends in mental health care use for Black and Latinx children and adolescents. METHOD: Data from the Medical Expenditure Panel Survey for 2010-2017 were analyzed to assess trends among youth ages 5-17 in use and expenditures for any mental health care, outpatient mental health care, and psychotropic medication prescription fills. Unadjusted trends for all youth and the subpopulation of youth reporting need for mental health care and disparities adjusting for need were examined. RESULTS: Between 2010 and 2017, Black youth rates of any past year mental health care use decreased (from 9% to 8%), while White (from 13% to 15%) and Latinx (from 6% to 8%) youth rates increased. Among the subpopulation with need and in regression analysis adjusting for need, we identified significant Black-White and Latinx-White disparities in any mental health care use and any outpatient mental health care use in 2010-2011 and 2016-2017, with significant worsening of Black-White disparities over time. White youth were more than twice as likely as Latinx youth to use psychotropic medications, and Latinx-White and Black-White disparities in psychotropic medication prescription fills persisted over time. Black-White disparities existed in overall mental health expenditures (2016-2017) and outpatient mental health expenditures (2010-2011 and 2016-2017). CONCLUSION: Affordable, ubiquitous access to mental health care for Black and Latinx youth remains an elusive target. Significant disparities exist in receiving mental health care despite reforms and policies designed to increase mental health care access in the general population. Additional outreach and treatment strategies tailored to the cultural, linguistic, and structural needs of youth of color are required.

10.
Article in English | MEDLINE | ID: mdl-34639617

ABSTRACT

There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.


Subject(s)
Health Services, Indigenous , Humans
11.
BMJ Open ; 11(10): e048922, 2021 10 22.
Article in English | MEDLINE | ID: mdl-34686550

ABSTRACT

INTRODUCTION: Strengthening first-line mental healthcare services for youth remains a priority for the Swedish government. The government is currently investigating how different sectors involved can be strengthened, but evidence is scarce. Youth clinics play a key role in these discussions, being one of the most trusted services for youth. However, analysis of organisational functions and coordination with other services is important to strengthen youth clinics' role in first-line mental healthcare. This study investigates these challenges and aims to analyse the integration of mental healthcare within youth clinics to identify strategies to strengthen first-line mental healthcare for youth in Sweden. METHODS AND ANALYSIS: This study adopts a health policy and systems approach. In the first phase, a formative realist evaluation is conducted to ascertain what works in terms of integrating mental healthcare services within youth clinics, for what type of youth subpopulations and under what circumstances. National-level stakeholders will be interviewed to elicit the programme theory that explains how the intervention is supposed to work. The programme theory will then be tested in three-five cases. The cases will be comprised of youth clinics and their stakeholders. Quantitative and qualitative information will be gathered, including via visual methodologies and questionnaires. The second phase includes a concept mapping study, engaging stakeholders and young people to build consensus on strategies to strengthen the integration of mental healthcare into youth clinics. ETHICS AND DISSEMINATION: The Swedish Ethical Review Authority has approved the study (2019-02910 and 2020-04720). The results will be published in open-access peer-reviewed journals and presented at scientific conferences.


Subject(s)
Adolescent Health Services , Mental Health Services , Adolescent , Delivery of Health Care , Health Policy , Humans , Sweden
12.
Article in Spanish | PAHO-IRIS | ID: phr-54975

ABSTRACT

[RESUMEN]. Objetivo. En el 2010 se propuso el principio del universalismo proporcional como solución para reducir las desigualdades en materia de salud. Aunque tuvo una gran resonancia, no parece haber sido aplicado ampliamente y no existen directrices sobre cómo aplicarlo. Los dos objetivos específicos de esta revisión sistemática exploratoria fueron: 1) describir el contexto teórico en el que se estableció el universalismo proporcional, y 2) describir cómo los investigadores aplican el universalismo proporcional y las cuestiones metodológicas relacionadas. Métodos. Se buscó en todas las bases de datos de la Web of Science los artículos publicados hasta el 6 de febrero del 2020 que tuvieran como tema “universalismo proporcional” o sus sinónimos “universalismo dirigido” o “universalismo progresivo”. Resultados. Esta revisión de 55 artículos permitió obtener una visión global del universalismo proporcional en cuanto a sus fundamentos teóricos y su aplicación práctica. El principio del universalismo proporcional se basa en las teorías sociales del universalismo y el direccionamiento, y propone vincular estos dos aspectos para lograr una reducción efectiva de las desigualdades en materia de salud. Respecto de su aplicación práctica, las intervenciones basadas en este principio son poco frecuentes y dan lugar a diferentes interpretaciones. Todavía existen muchos desafíos metodológicos y éticos en relación con la concepción y evaluación de las intervenciones relacionadas con el universalismo proporcional, incluida la forma de aplicar la proporcionalidad y la identificación de las necesidades. Conclusión. En esta revisión se llevó a cabo un mapeo de la literatura científica disponible sobre el universalismo proporcional y sus conceptos relacionados. Este principio se basa en teorías sociales. Tal como lo destacaron autores que implementaron intervenciones de universalismo proporcional, su aplicación plantea muchos desafíos, desde el diseño hasta la evaluación. El análisis de las aplicaciones del universalismo proporcional presentado en esta revisión respondió a algunos de ellos, pero los desafíos metodológicos restantes requieren ser abordados en futuras investigaciones.


[ABSTRACT]. Objective. In 2010, the principle of proportionate universalism (PU) has been proposed as a solution to reduce health inequalities. It had a great resonance but does not seem to have been widely applied and no guidelines exist on how to implement it. The two specific objectives of this scoping review were: (1) to describe the theoretical context in which PU was established, (2) to describe how researchers apply PU and related methodological issues. Methods. We searched for all articles published until 6th of February 2020, mentioning “Proportionate Universalism” or its synonyms “Targeted universalism” OR “Progressive Universalism” as a topic in all Web of Science databases. Results. This review of 55 articles allowed us a global vision around the question of PU regarding its theoretical foundations and practical implementation. PU principle is rooted in the social theories of universalism and targeting. It proposes to link these two aspects in order to achieve an effective reduction of health inequalities. Regarding practical implementation, PU interventions were rare and led to different interpretations. There are still many methodological and ethical challenges regarding conception and evaluation of PU interventions, including how to apply proportionality, and identification of needs. Conclusion. This review mapped available scientific literature on PU and its related concepts. PU principle originates from social theories. As highlighted by authors who implemented PU interventions, application raises many challenges from design to evaluation. Analysis of PU applications provided in this review answered to some of them but remaining methodological challenges could be addressed in further research.


[RESUMO]. Objetivo. Em 2010, o princípio do Universalismo Proporcional (UP) foi proposto como uma solução para reduzir as desigualdades na saúde. Houve uma grande receptividade, mas o princípio parece não ter sido amplamente aplicado e não há diretrizes sobre como implementá-lo. Os dois objetivos específicos desta análise de escopo foram: (1) descrever o contexto teórico no qual o UP foi estabelecido e (2) descrever como os pesquisadores aplicam o UP e questões metodológicas correlatas. Métodos. Buscamos em todas as bases de dados científicas da Web todos os artigos publicados até 6 de fevereiro de 2020 que mencionavam, como tema, o “Universalismo Proporcional” ou seus sinônimos “Universalismo Visado” ou “Universalismo Progressivo”. Resultados. Essa análise de 55 artigos nos permitiu ter uma visão global relacionada com o UP, suas bases teóricas e sua implementação na prática. Os princípios do UP têm suas raízes nas teorias sociais do universalismo e na definição de metas. A proposta é vincular esses dois aspectos para atingir uma redução efetiva das desigualdades em saúde. Com relação ao aspecto prático da implementação, as intervenções de UP foram raras e levaram a diferentes interpretações. Ainda há muitos obstáculos metodológicos e éticos relativos ao conceito e à avaliação das intervenções de UP, inclusive sobre como aplicar o aspecto da proporcionalidade e a identificação das necessidades. Conclusões. Esta análise fez um mapeamento da literatura científica disponível sobre UP e seus conceitos correlatos. O princípio por trás do UP tem suas origens nas teorias sociais. Como destacam os autores que implementaram as intervenções de UP, sua aplicação produz muitas dificuldades, da elaboração à avaliação. A análise das aplicações de UP fornecidas nesta pesquisa permitiu a obtenção de algumas respostas. No entanto, pesquisas futuras poderiam abordar as dificuldades metodológicas remanescentes.


Subject(s)
Health Equity , Health Policy , Socioeconomic Factors , Health Equity , Health Policy , Socioeconomic Factors , Health Equity , Health Policy , Socioeconomic Factors
14.
Nutrients ; 13(9)2021 Sep 08.
Article in English | MEDLINE | ID: mdl-34579007

ABSTRACT

Food-Based Dietary Guidelines (FBDG) include dietary recommendations based on food groups according to the general and accepted nutrition principles and current scientific evidence. Adoption of FBDG contributes to the prevention of malnutrition in all its forms, promotes human health, and reduces environmental impact. The present review aims to perform an international comparative analysis of the FBDG adopted in different countries from three different continents (America, Asia, and Europe), with particular reference to the Spanish Food Safety and Nutrition Agency (AESAN, Agencia Española de Seguridad Alimentaria y Nutrición) Scientific Committee dietary recommendations. A total of twelve countries with the most updated FBDG and/or closest to the traditional and cultural preferences of Spain were finally selected. All the reviewed FBDG provided recommendations for fruits, vegetables, cereals, legumes, nuts, milk and dairy products, meat and derivatives, fish, eggs, water, and oil; however, remarkable differences regarding recommended amounts were found among countries.


Subject(s)
Diet, Healthy/standards , Global Health/standards , Nutrition Policy , Asia , Europe , Food/standards , Humans , North America
15.
Global Health ; 17(1): 110, 2021 09 19.
Article in English | MEDLINE | ID: mdl-34538254

ABSTRACT

BACKGROUND: In the nearly half century since it began lending for population projects, the World Bank has become one of the largest financiers of global health projects and programs, a powerful voice in shaping health agendas in global governance spaces, and a mass producer of evidentiary knowledge for its preferred global health interventions. How can social scientists interrogate the role of the World Bank in shaping 'global health' in the current era? MAIN BODY: As a group of historians, social scientists, and public health officials with experience studying the effects of the institution's investment in health, we identify three challenges to this research. First, a future research agenda requires recognizing that the Bank is not a monolith, but rather has distinct inter-organizational groups that have shaped investment and discourse in complicated, and sometimes contradictory, ways. Second, we must consider how its influence on health policy and investment has changed significantly over time. Third, we must analyze its modes of engagement with other institutions within the global health landscape, and with the private sector. The unique relationships between Bank entities and countries that shape health policy, and the Bank's position as a center of research, permit it to have a formative influence on health economics as applied to international development. Addressing these challenges, we propose a future research agenda for the Bank's influence on global health through three overlapping objects of and domains for study: knowledge-based (shaping health policy knowledge), governance-based (shaping health governance), and finance-based (shaping health financing). We provide a review of case studies in each of these categories to inform this research agenda. CONCLUSIONS: As the COVID-19 pandemic continues to rage, and as state and non-state actors work to build more inclusive and robust health systems around the world, it is more important than ever to consider how to best document and analyze the impacts of Bank's financial and technical investments in the Global South.


Subject(s)
Banking, Personal/organization & administration , Healthcare Financing , /methods , Banking, Personal/trends , Financial Management , Global Health , Health Policy , Humans , /organization & administration
18.
Nutr Metab Cardiovasc Dis ; 31(11): 2989-2992, 2021 10 28.
Article in English | MEDLINE | ID: mdl-34565661

ABSTRACT

Excess intake of energy, sugars, salt and saturated fats is an important causal factor of obesity and related non-communicable diseases. In order to help consumers to make healthy food choices, many European countries have developed proposals for "front-of-pack" food labeling, intended as an integration to the nutritional information provided by the mandatory nutritional declaration. Based on the European strategic program "Farm to Fork", the intention is to achieve a harmonized front-of-pack label proposal by Q4 2022. Among the different proposals, the one which received most attention by experts and greater feedback by the EU member countries is the Nutri-Score, a tool based on an algorithm whereby a "quality" category ranging from A to E is assigned to each single food on a background colored from dark green to dark orange. As an alternative to Nutri-Score, the NutrInform Battery has been developed by Italy in association with a few other EU member states: this proposal is objectively alternative to the Nutri-Score proposal due to a different underlying philosophy, in particular for its informative and educational intent rather than purchase orientation. The present document, prepared by the Scientific Board and reviewed by the Scientific Council of the Italian Society of Human Nutrition, represents the scientific-based position of the Society in relation to the general theme of front-of-pack labeling and in particular to the dualism created between the Nutri-Score and NutrInform Battery proposals.


Subject(s)
Decision Support Techniques , Food Labeling/legislation & jurisprudence , Nutritive Value , Recommended Dietary Allowances/legislation & jurisprudence , Choice Behavior , Color , Consensus , Consumer Behavior , Energy Intake , Food Labeling/standards , Food Preferences , Health Education , Humans
19.
Public Health ; 198: 146-155, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34428607

ABSTRACT

OBJECTIVES: This study aimed to investigate the extent and key characteristics of academic research and scholarship on the public health community's use of social media for policy advocacy purposes. This will enable an evaluation of extant research and provide insight into directions for future research. STUDY DESIGN: This study was a scoping review of academic literature. METHODS: A scoping review of academic literature published between 1 January 2011 and 31 December 2020 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Boolean searches were conducted using a university library platform, which included databases, such as EBSCO host, Informit, Scopus, and ScienceDirect. Data were extracted using an a priori code frame, and publication, content, and disciplinary characteristics were analysed. The results of coding and screening comparison checks were within acceptable limits. RESULTS: In total, 2672 works from around the world were identified and screened for inclusion. Twenty-two English language articles were included in the final analysis. The public health community's use of social media for policy advocacy purposes has largely been approached from a health perspective, despite research and scholarship about social media in communication and policy disciplines (among others). Reported research aims or questions emphasised functional rather than theoretical contributions. Most analysed works used empirical or case study-based methods and were produced by authors in Western geographies. Among the health issues discussed, tobacco and tobacco control were discussed most frequently. While recognising issues with social media, most publications framed social media as more of an opportunity than a problem. CONCLUSIONS: The public health community's use of social media for policy advocacy purposes is an emerging field. There is considerable potential to expand scholarship and research in this field internationally, especially by integrating transdisciplinary knowledge and perspectives and by applying social media to foster policy change around identified global health challenges. Greater representation of authors from institutions in the Global South is also encouraged, as are applied and theoretical contributions.


Subject(s)
Social Media , Delivery of Health Care , Global Health , Humans , Policy , Public Health
20.
Healthcare (Basel) ; 9(7)2021 Jul 18.
Article in English | MEDLINE | ID: mdl-34356286

ABSTRACT

OBJECTIVES: The aim of this study was to determine the impact of the Zero Markup drug (ZMD) policy on hospitalization expenses for inpatients in tertiary Chinese hospitals. METHODS: Using the administrative data from hospital electronic health records (EHRs) between 2015 and 2017, we implemented the quantile difference-in-differences (QDID) estimators to evaluate the impact of the ZMD policy on hospitalization expenses while controlling for patient-level and hospital-level characteristics. RESULTS: According to the QDID models, the introduction of ZMD policy significantly induced lower drug costs for all inpatients especially at the 50th (-USD 507.84 (SE = USD 90.91), 75th (-USD 844.77 (SE = USD 149.70), and 90th (-USD 1400.00 (SE = USD 209.97)) percentiles of the overall distributions. However, the total hospitalization, diagnostic, treatment, material and services expenses for inpatients were significantly higher for the treated group than the control group. This tendency was more pronounced for inpatients in tertiary hospitals with lower expenses (in the 10th, 25th and 50th percentiles). CONCLUSION: The implementation of ZMD policy alone may not be enough to change the medical service providers' profit-driven behavior. The targeted supervision of hospital costs by the Chinese health administration department should be strengthened to avoid unreasonable hospital charges.

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