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1.
PLoS One ; 19(5): e0303392, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38722887

RESUMEN

This study explores the impact of farm households' social capital characteristics and local government policies on the selection of farmland transfer contracts in China's rural industrial revitalization context. Utilizing field research data from 1,979 households in ethnic areas of Hunan Province, this paper constructs an econometric model to assess how farm households' social capital and local governments' involvement in rural industrial revitalization influence farmland transfer contract selections. The findings indicate that, lacking government program support, farmers' social capital significantly affects contract type and duration, but not the rent. Specifically, farmers possessing extensive social capital prefer verbal and short-term contracts (coefficients of 0.525 and 0.643, significant at the 5% level), whereas their influence on rent (coefficient of 2.418, significant at the 5% level) manifests under government program support. These results challenge the conventional theory of farmland transfer contracts and offer substantial empirical support for the development of local government policies in rural industrial revitalization, underlining the critical role of government guidance and social capital in enhancing farmland transfer.


Asunto(s)
Agricultura , Capital Social , Humanos , China , Contratos , Población Rural , Agricultores , Granjas , Gobierno , Composición Familiar , Gobierno Local
2.
Pan Afr Med J ; 47: 35, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38586066

RESUMEN

Introduction: childhood deaths from preventable causes remain high in Nigeria. Although vaccines are available to combat many of these diseases, vaccine coverage remains low in many at-risk communities. With this study, we aimed to determine factors that might have impacted the use of immunization services in Ibadan, the capital of Oyo State in southwest Nigeria. Methods: we conducted a community-based cross-sectional study in a peri-urban local government area in Ibadan using a multi-stage cluster sampling technique to identify respondents for this study. The interviewer-administered questionnaire was used to obtain information on respondents and child socio-demographic details. We reviewed the child´s vaccine card to determine vaccine status. Data were analyzed using STATA version 14 at a 5% level of significance. Results: of the 265 children aged 12 to 59 months who had their vaccine cards appropriately filled, only 65.3% (n=173) received all basic vaccines, while 90.2% (n=239) and 86.8% (n=230) received 3 doses of pentavalent vaccine (PENTA) and pneumococcal conjugate vaccines (PCV-10) respectively. We found a significant difference in the completion of basic vaccination according to the caregiver´s place of residence and the mother´s educational level. Access-related barriers were frequently reported (n=24, 54.5%) as reasons for missing a due vaccine. Conclusion: improvement in vaccine coverage in this setting is necessary. Targeted health information for mothers may be a cost-efficient and sustainable approach to improve vaccine coverage for under-five children.


Asunto(s)
Programas de Inmunización , Gobierno Local , Niño , Femenino , Humanos , Lactante , Estudios Transversales , Inmunización , Nigeria , Vacunación , Vacunas Conjugadas , Masculino
3.
Front Public Health ; 12: 1250192, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38584930

RESUMEN

Background: Since 2020, Thailand has experienced four waves of COVID-19. By 31 January 2022, there were 2.4 million cumulative cases and 22,176 deaths nationwide. This study assessed the governance and policy responses adapted to different sizes of the pandemic outbreaks and other challenges. Methods: A qualitative study was applied, including literature reviews and in-depth interviews with 17 multi-sectoral actors purposively identified from those who were responsible for pandemic control and vaccine rollout. We applied deductive approaches using health systems building blocks, and inductive approaches using analysis of in-depth interview content, where key content formed sub-themes, and different sub-themes formed the themes of the study. Findings: Three themes emerged from this study. First, the large scale of COVID-19 infections, especially the Delta strain in 2021, challenged the functioning of the health system's capacity to respond to cases and maintain essential health services. The Bangkok local government insufficiently performed due to its limited capacity, ineffective multi-sectoral collaboration, and high levels of vulnerability in the population. However, adequate financing, universal health coverage, and health workforce professionalism and commitment were key enabling factors that supported the health system. Second, the population's vulnerability exacerbated infection spread, and protracted political conflicts and political interference resulted in the politicization of pandemic control measures and vaccine roll-out; all were key barriers to effective pandemic control. Third, various innovations and adaptive capacities minimized the supply-side gaps, while social capital and civil society engagement boosted community resilience. Conclusion: This study identifies key governance gaps including in public communication, managing infodemics, and inadequate coordination with Bangkok local government, and between public and private sectors on pandemic control and health service provisions. The Bangkok government had limited capacity in light of high levels of population vulnerability. These gaps were widened by political conflicts and interference. Key strengths are universal health coverage with full funding support, and health workforce commitment, innovations, and capacity to adapt interventions to the unfolding emergency. Existing social capital and civil society action increases community resilience and minimizes negative impacts on the population.


Asunto(s)
COVID-19 , Vacunas , Humanos , COVID-19/epidemiología , Tailandia/epidemiología , Pandemias , Gobierno Local , Políticas
4.
Soc Sci Med ; 348: 116801, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38564957

RESUMEN

Devolution and decentralisation policies involving health and other government sectors have been promoted with a view to improve efficiency and equity in local service provision. Evaluations of these reforms have focused on specific health or care measures, but little is known about their full impact on local health systems. We evaluated the impact of devolution in Greater Manchester (England) on multiple outcomes using a whole system approach. We estimated the impact of devolution until February 2020 on 98 measures of health system performance, using the generalised synthetic control method and adjusting for multiple hypothesis testing. We selected measures from existing monitoring frameworks to populate the WHO Health System Performance Assessment framework. The included measures captured information on health system functions, intermediatory objectives, final goals, and social determinants of health. We identified which indicators were targeted in response to devolution from an analysis of 170 health policy intervention documents. Life expectancy (0.233 years, S.E. 0.012) and healthy life expectancy (0.603 years, S.E. 0.391) increased more in GM than in the estimated synthetic control group following devolution. These increases were driven by improvements in public health, primary care, hospital, and adult social care services as well as factors associated with social determinants of health, including a reduction in alcohol-related admissions (-110.1 admission per 100,000, S.E. 9.07). In contrast, the impact on outpatient, mental health, maternity, and dental services was mixed. Devolution was associated with improved population health, driven by improvements in health services and wider social determinants of health. These changes occurred despite limited devolved powers over health service resources suggesting that other mechanisms played an important role, including the allocation of sustainability and transformation funding and the alignment of decision-making across health, social care, and wider public services in the region.


Asunto(s)
Política de Salud , Humanos , Inglaterra , Determinantes Sociales de la Salud , Política , Atención a la Salud/organización & administración , Reforma de la Atención de Salud , Gobierno Local , Esperanza de Vida/tendencias
5.
Soc Sci Med ; 348: 116844, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38615613

RESUMEN

This study investigated the impact of local government spending on mental health in England between 2013 and 2019. Guided by the "Health in All Policies" vision, which encourages the integration of health in all decision-making areas, we explored how healthcare and multiple nonmedical budgeting decisions related to population mental health. We used random curve general cross-lagged modelling to dynamically partition effects into the short-run (from t to t + 1) and long-run (from t to t + 2) impacts, account for unobserved area-level heterogeneity and reverse causality from health outcomes to financial investments, and comprehensive modelling of budget items as an interconnected system. Our findings revealed that spending in adult social care, healthcare, and law & order predicted long-term mental health gains (0.004-0.081 SDs increase for each additional 10% in expenditure). However, these sectors exhibited negative short-term impulses (0.012-0.077 SDs decrease for each additional 10% in expenditure), markedly offsetting the long-term gains. In turn, infrastructural and environmental spending related to short-run mental health gains (0.005-0.031 SDs increase for each additional 10% in expenditure), while the long-run effects were predominantly negative (0.005-0.028 SDs decrease for each additional 10% in expenditure). The frequent occurrence of short-run and long-run negative links suggested that government resources may not be effectively reaching the areas that are most in need. In the short-term, negative effects could also imply temporary disruptions to service delivery largely uncompensated by later mental health improvements. Nonetheless, some non-health spending policies, such as law & order and infrastructure, can be related to long-lasting positive mental health impacts.


Asunto(s)
Gastos en Salud , Gobierno Local , Humanos , Inglaterra , Gastos en Salud/estadística & datos numéricos , Salud Mental , Servicios de Salud Mental/economía , Financiación Gubernamental/estadística & datos numéricos
6.
Int J Health Policy Manag ; 13: 7841, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38618835

RESUMEN

BACKGROUND: Local governments are the closest level of government to the communities they serve. Traditionally providing roads, rates and garbage services, they are also responsible for policy and regulation, particularly land use planning and community facilities and services that have direct and indirect impacts on (equitable) health and well-being. Partnerships between health agencies and local government are therefore an attractive proposition to progress actions that positively impact community health and well-being. Yet, the factors underpinning these partnerships across different contexts are underdeveloped, as mechanisms to improve population health and well-being. METHODS: A scoping review was conducted to gain insight into the concepts, theories, sources, and knowledge gaps that shape partnerships between health and local governments. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was informed by a critical realist approach that identifies necessary, contingent and contextual factors in the literature. MEDLINE, Scopus, Web of Science, and ProQuest Central databases were searched for studies published between January 2005 and July 2021. RESULTS: The search yielded 3472 studies, after deleting duplicates and initial title and abstract screening, 188 papers underwent full text review. Twenty-nine papers were included in the review. Key themes shaping partnerships included funding and resources; partnership qualities; governance and policy; and evaluation and measures of success. The functional, organisational and individual aspects of these themes are explored and presented in a framework. CONCLUSION: Given that local government are the closest level of government to community, this paper provides a sophisticated roadmap that can underpin partnerships between local government and health agencies aiming to influence population health outcomes. By identifying key themes across contexts, we provide a framework that may assist in designing and evaluating evidence-informed health and local government partnerships.


Asunto(s)
Exactitud de los Datos , Gobierno Local , Humanos , Bases de Datos Factuales , Renta , Conocimiento
7.
PLoS One ; 19(4): e0297446, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38625884

RESUMEN

Despite significant growth in fiscal expenditure, the overall level of public services in China remains inadequate. One approach to improving government public service efficiency from the perspective of management psychology is to strengthen government competition. However, only a few studies have explored the improvement of public service efficiency through government competition, with even fewer addressing the phenomena of market segmentation and spatial effects that accompany the process of government competition. This paper aims to fill this research gap by examining the effects of government competition and market segmentation on public service efficiency, as well as their spatial disparities. We initially employs the DEA method to assess the efficiency of public services based on inputs and outputs, and examines its spatial variations. Subsequently, a semi-parametric spatial lag panel model is utilized to validate the effects of market segmentation and government competition on public service efficiency. Our findings indicate that inter-provincial market segmentation leads to a decline in public service efficiency. Moreover, the influence of horizontal competition between local governments on public service efficiency varies depending on the degree of positive and negative effects in their competition dynamics. The impact of vertical competition between central and local governments on public service efficiency is influenced by the degree of fiscal decentralization. When the level of fiscal decentralization is below 0.808, vertical competition between central and local governments has a promoting effect on public service efficiency. However, when the degree of fiscal decentralization exceeds 0.08, this promoting effect weakens and gradually transforms into a negative influence. The insights and evidence provided by this study offer valuable guidance for for effectively reshaping the fiscal relations between the central and local governments in China and improving public service efficiency in the context of a new round of fiscal and tax system reforms.


Asunto(s)
Eficiencia , Política , Gastos en Salud , Gobierno Local , China , Desarrollo Económico
8.
JAMA Netw Open ; 7(4): e241429, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38598241

RESUMEN

Importance: Equity-driven citywide park redesign and renovation, such as the Community Parks Initiative (CPI), has the potential to increase park use and opportunities for physical activity in underserved communities. Objective: To evaluate changes in patterns of park use following park redesign and renovation in low-income New York City (NYC) neighborhoods. Design, Setting, and Participants: The Physical Activity and Redesigned Community Spaces study was a prospective quality improvement preintervention-postintervention study design with matched control parks. Thirty-three intervention and 21 control neighborhood parks were selected based on specific criteria related to poverty rates, population growth, and population density in park neighborhoods and not having received more than $250 000 in investment in the past 2 decades. Data were collected at baseline (prerenovation) and 2 follow-up points (3 months and 1 year post renovation) between June 5 and December 4 from 2016 to 2022. Participants were individuals observed as users of study parks. Intervention: The CPI, which involved the redesign and renovation of neighborhood parks by the municipal government of New York City. Main Outcomes and Measures: Main outcomes encompassed park use and physical activity levels assessed using the well-validated System for Observing Play and Recreation in Communities. Park use was quantified by total number of park users, categorized by age group (≤20 years vs ≥21 years), sex, and physical activity level (sitting or standing vs walking or vigorous activity). Changes in outcomes between groups were compared via the generalized estimation equation. Results: A total of 28 322 park users were observed across 1458 scans. At baseline, 6343 of 10 633 users (59.7%) were 20 years or younger, 4927 of 10 632 (46.3%) were female and 5705 (53.7%) were male, and 4641 of 10 605 (43.8%) were sitting or standing. Intervention parks showed more net park users compared with control parks from baseline to the final follow-up (difference-in-difference relative rate ratio, 1.69 [95% CI, 1.22-2.35] users/scan; P = .002). The association was driven by a significant increase in adult users at intervention parks and overall decrease in all users at control parks. Park users engaging in sitting or standing at intervention parks increased (difference, 4.68 [95% CI, 1.71-7.62] users/scan; P = .002) and park users engaging in walking or vigorous physical activity at control parks decreased (difference, -7.30 [95% CI, -10.80 to -4.26] users/scan; P < .001) over time. Conclusions and Relevance: In this quality improvement study, park redesign and renovation were positively associated with park use in low-income neighborhoods. However, park renovations may need to be accompanied by other programmatic strategies to increase physical activity.


Asunto(s)
Ejercicio Físico , Inversiones en Salud , Adulto , Humanos , Femenino , Masculino , Adulto Joven , Ciudad de Nueva York , Estudios Prospectivos , Gobierno Local
9.
J Public Health Manag Pract ; 30(3): 416-419, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38603748

RESUMEN

This study assessed the staffing allocations and associated costs incurred by Ohio local health departments (LHDs) in response to the challenges posed by the COVID-19 pandemic. Data were extracted from the annual financial reports of Ohio LHDs for 2020 and 2021, encompassing a sample of 38 LHDs in 2020 and 60 LHDs in 2021. Descriptive analysis showed that Ohio LHDs committed substantial resources to responding to the COVID-19 pandemic. Although there was considerable variability across LHDs, median staffing and compensation collectively constituted 22% of total staffing and compensation. Multivariate regression analysis found minimal associations between the examined agency and community-level variables and the differences in staffing allocations and associated costs incurred by LHDs in response to the COVID-19 pandemic. After decades of underfunding and understaffing, securing sustainable funding will be crucial to equip LHDs across the country with the necessary resources to deliver comprehensive public health services in their communities.


Asunto(s)
COVID-19 , Pandemias , Humanos , Ohio/epidemiología , Gobierno Local , COVID-19/epidemiología , Recursos Humanos , Salud Pública
11.
J Emerg Manag ; 22(7): 11-23, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38573726

RESUMEN

The goal of this study is to examine how disaster experience influences local government views on citizen participation in addressing issues of sustainability, such as climate change. This study considers concepts such as wicked problems, the social order, the environment, economic development, and citizen participation where sustainability can be considered a solution to help manage and solve the challenges of disaster, like climate change. The data are taken from a 2015 International City/County Management Association national survey that examines the link between disaster and sustainability. The results show that more than half of the respondents do not view public participation as having much of an impact on sustainability; however, we can expect public participation to increasingly impact sustainability efforts as communities experience more disaster. This suggests that emergency management needs to understand public pressures regarding wicked problems, such as climate change, to collectively address the global influence of environmental, economic, and social issues that have local effects on their communities.


Asunto(s)
Cambio Climático , Desastres , Humanos , Gobierno Local
12.
Artículo en Inglés | MEDLINE | ID: mdl-38673366

RESUMEN

Methamphetamine contamination of residential properties remains a serious public health concern for members of the public. External stakeholders including Environmental Health Officers (EHOs) and testing and remediation technicians are engaged on investigating whether contamination has occurred from manufacturing or smoking processes. More specifically, local council EHOs are responsible for managing clandestine drug laboratories when notified by police and also for responding to public enquiries. However, the full scope of these contaminated properties is not seen by any single stakeholder, making it very challenging to quantify these situations. To evaluate the prevalence of methamphetamine related enquiries from the general public to EHOs, this study surveyed and interviewed officers from around Australia. It was found that public enquiries were infrequent with only 6% of respondents having received enquiries in the last month, which indicates that people are seeking information from other sources. Interestingly, there were case study scenarios that also mentioned issues with awareness and the flow of information. Concerns regarding difficult cases, police notifications, and site visits were also highlighted. The results of this study provide a benchmark of how methamphetamine related cases are managed and highlight the need for trustworthy information that is available to EHOs, governments, industry members, and the public in a unified location.


Asunto(s)
Gobierno Local , Metanfetamina , Humanos , Australia , Salud Ambiental , Encuestas y Cuestionarios , Prevalencia , Policia
13.
BMC Health Serv Res ; 24(1): 428, 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38575933

RESUMEN

INTRODUCTION: The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and highlighted the need to understand the concept, pathways, and elements of resilience in different country contexts. In this study, we assessed the health system response to COVID-19 in Nepal and examined the processes of policy formulation, communication, and implementation at the three tiers of government, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country, and clarity in roles and capacity to implement functions were the prevailing challenges, especially among the subnational governments. METHODS: We adopted a cross-sectional exploratory design, using mixed methods. We conducted a desk-based review of all policy documents introduced in response to COVID-19 from January to December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation. RESULTS: In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized system. The federal government effectively led the policy formulation process, but with minimal engagement of sub-national governments. Local governments could not demonstrate resilience capacities due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level, which was further aggravated by the limited availability of human, technical and financial resources. CONCLUSIONS: The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to the resilience capacities of health systems from the experience of Nepal. We draw out lessons that can be applied to other fragile and shock-prone settings.


Asunto(s)
COVID-19 , Resiliencia Psicológica , Humanos , COVID-19/epidemiología , Pandemias , Nepal/epidemiología , Estudios Transversales , Gobierno Local
14.
Soc Sci Med ; 348: 116797, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38547805

RESUMEN

Medical service fragmentation is a common problem worldwide, and many countries have adopted integration to solve the difficulty. Contrary to developed countries, developing countries such as China must consider how to implement integration under a relatively weak medical foundation. This study aims to evaluate the effect of the "Compact Union of County and Township Health Sectors" policy on the medical service capacity of a typical integration model represented by Shanxi Province in China and determine the path the policy followed. By using Shanxi's county-level medical integration as a quasi-natural experiment, this study establishes a difference-in-differences model to investigate the effect of the policy using official data. A series of tests are conducted to verify the robustness of the result. Finally, the policy pathway is tested. The results show that the third-level surgeries and outpatient service utilization of leading hospitals and township institutions increased. Still, inpatient service utilization and fourth-level surgeries did not show a significant change in either type of institution. Moreover, the enhancement of leading hospitals' service capacity comes mainly through improving asset efficiency and personal income, while the improvement of township institutions' capacity comes primarily through increased personal income. Compact integration of county-level medical institutions can stimulate and improve service capacity by improving asset efficiency and personal income, even with a weak medical foundation. However, to achieve continuous service capacity improvement, the professional level of county-level institutions must be strengthened with a superior hospital's assistance, and personnel's enthusiasm for active innovation must be cultivated.


Asunto(s)
Política de Salud , China , Humanos , Prestación Integrada de Atención de Salud , Formulación de Políticas , Gobierno Local
15.
BMC Public Health ; 24(1): 847, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38504205

RESUMEN

BACKGROUND: System dynamics approaches, including group model building (GMB) and causal loop diagrams (CLDs), can be used to document complex public health problems from a community perspective. This paper aims to apply Social Network Analysis (SNA) methods to combine multiple CLDs created by local communities into a summary CLD, to identify common drivers of the health and wellbeing of children and young people. METHODS: Thirteen community CLDs regarding children and young people health and wellbeing were merged into one diagram involving three steps: (1) combining variable names; (2) CLD merging, where multiple CLDs were combined into one CLD with a set of unique variables and connections; (3) paring, where the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was used to generate a cut-point to reduce the number of variables and connections and to rank the overall importance of each variable in the merged CLD. RESULTS: Combining variable names resulted in 290 variables across the 13 CLDS. A total of 1,042 causal links were identified in the merged CLD. The DEMATEL analysis of the merged CLD identified 23 common variables with a net importance between 1.0 and 4.5 R + C values and 57 causal links. The variables with the highest net importance were 'mental health' and 'social connection & support' classified as high net receivers of influence within the system. CONCLUSIONS: Combining large CLDs into a simple diagram represents a generalisable model of the drivers of complex health problems.


Asunto(s)
Gobierno Local , Salud Pública , Niño , Humanos , Adolescente
16.
PLoS One ; 19(3): e0298115, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38507355

RESUMEN

In the current polarized political climate, citizens frequently face conflicting directives from their local and federal government officials. For instance, on April 16th, 2020, The White House launched the "Opening up America Again" (OuAA) campaign while many U.S. counties had stay-at-home orders. We created a panel data set of U.S. counties to study the impact of U.S. counties' stay-at-home orders on community mobility before and after The White House's campaign to reopen the country. Our results suggest that before the OuAA campaign, stay-at-home orders substantially decreased the time spent in retail and recreation businesses. However, after the launch of the OuAA campaign, the time spent at retail and recreational businesses in a typical conservative county increased significantly more than in liberal counties (23% increase in a typical conservative county vs. 9% increase in a typical liberal county). We also found that in conservative counties with stay-at-home orders, time spent at retail and recreational businesses increased less than in those without stay-at-home orders. These findings illuminate that when federal and local government policies are at odds, residents decide which policies to adhere to based on the alignment between their political ideology and the government body. Our findings highlight the substantial importance of each government body in forming citizens' behaviors, offering practical implications for policy makers during natural disasters.


Asunto(s)
COVID-19 , Humanos , Estados Unidos , SARS-CoV-2 , Gobierno Local , Políticas , Mercadotecnía
17.
J Health Commun ; 29(4): 256-264, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38461495

RESUMEN

Community structure analysis compared city characteristics and newspaper coverage of state/local government responses to COVID-19 in 25 major U.S. cities, sampling all 250+ word articles from 4/4/20 to 7/6/20. The resulting 588 articles were coded for "prominence" and "direction" (favorable/unfavorable/balanced-neutral coverage), then combined into each newspaper's composite "Media Vector" (range=0.3552 to -0.5197, or 0.8749). Twenty-one of 25 newspapers (84%) displayed unfavorable coverage of local COVID-19 responses. Pearson correlations and regression analysis confirmed a muscular "violated way of life" pattern, when a community perceives itself as threatened by a "biological threat or a threat to a cherished way of life." Political and belief system polarization (in particular percent Evangelical and percent voting Republican) were strongly associated with unfavorable coverage of local pandemic responses, compared to more favorable responses linked to percent voting Democratic or percent Catholic. Vulnerability (percent uninsured) was also linked to negative coverage. Conversely, two different measures of access to healthcare (percent municipal spending on health and welfare, and physicians/100,000) were significantly linked to favorable coverage of the same local government efforts. Community structure theory's grass roots "bottom up" expectations linking community demographics to variations in reporting on critical issues were robustly confirmed.


Asunto(s)
COVID-19 , Ciudades , Periódicos como Asunto , Humanos , COVID-19/epidemiología , Estados Unidos , Periódicos como Asunto/estadística & datos numéricos , Medios de Comunicación de Masas/estadística & datos numéricos , Política , Gobierno Local , Comunicación en Salud/métodos
18.
Prev Chronic Dis ; 21: E15, 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38452193

RESUMEN

Purpose and Objectives: Although considered a promising model of practice, integrating healthy nutrition standards and practices into a large county government's contracting process with food vendors has not been widely described in empirical literature. We conducted an implementation evaluation project to address this gap. Intervention Approach: County of Los Angeles food vendors provide food or meals annually to more than 100,000 employees and millions of clients and visitors. In 2011, the County of Los Angeles Board of Supervisors adopted a policy to integrate healthy nutrition standards and practices into its requests for proposals (RFPs) and contracting process with food vendors. The policy required all contracts awarded to adhere to these new standards. Evaluation Methods: In 2011, the Los Angeles County Department of Public Health (DPH) began reviewing RFPs for food services for county departments that procured, served, or sold food. From 2011 through 2021, DPH applied a 4-pronged formative-evaluative approach to help county departments implement the Board of Supervisors policy and ensure that nutritional requirements were appropriately integrated into all RFPs for new and renewing contracts with food vendors. We focused our evaluation on understanding the process and tracking the progress of this policy intervention. Our evaluation included 13 key informant interviews, a 2-part survey, reviews of contract data, and synthesis of lessons learned. Results: Based on reviews and subsequent actions taken on more than 20 RFPs, DPH successfully assisted 7 county departments to incorporate healthy nutrition standards and practices into their food vendor contracts. Implementation of the food policy encountered several challenges, including staffing and training constraints and a limited infrastructure. An iterative approach to program improvement facilitated the process. Implications for Public Health: Although the model for integrating healthy nutrition standards and practices into a government contracting process is promising, more work is needed to make it less resource-intensive and to increase user buy-in.


Asunto(s)
Dieta Saludable , Servicios de Alimentación , Humanos , Gobierno Local , Política Nutricional , Encuestas y Cuestionarios
19.
PLoS One ; 19(3): e0298594, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38446790

RESUMEN

China's agricultural economy has been hindered by insufficient accumulation of agricultural capital and credit constraints. It is worth investigating whether China's county financial marketization reform policy can alleviate these constraints and promote high-quality development of the agricultural economy (HQDAE). This paper presents an empirical analysis of the impact of county financial marketization reform on the HQDAE, based on county panel data. The focus is on the mechanism of county urbanization in the above relationship. The results show that county financial marketization has a significant non-linear impact on the HQDAE. Specifically, it has a 'U-shaped' impact on the overall growth of the agricultural economy and an inverted 'N-shaped' impact on the quality improvement of the agricultural economy. Secondly, the relationship between county financial marketization and the HQDAE is influenced by a threshold effect based on the level of county urbanization. As the level of county urbanization increases, the promoting effect of county financial marketization on HQDAE also increases significantly. Additionally, county financial marketization helps to promote county urbanization and accelerate urban-rural integration, which in turn leads to HQDAE. The research in this paper suggests that county-level local governments should promote a differentiated county financial system. In the early stages of financial market-oriented reform, the government should enhance the capacity of financial services in rural areas through tax breaks, policy incentives, and other measures to prevent financial leakage from agriculture. In the later stages of financial marketization reform, the government should strengthen financial supervision to prevent financial resources from being diverted from industry to capital. Moreover, to achieve the HQDAE, it is necessary to promote county financial market-oriented reform and accelerate the construction of county urbanization. This will help break the dual economic structure of urban and rural areas and promote the flow of financial capital, technology, and human capital from county cities to rural areas.


Asunto(s)
Agricultura , Urbanización , Humanos , Tecnología , Ciudades , Gobierno Local
20.
Environ Sci Pollut Res Int ; 31(16): 23839-23857, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38429595

RESUMEN

The paper examines how digital finance affects energy efficiency in China using a dynamic panel model and data from 282 cities between 2011 and 2019. The study is based on the hypothesis which is related with digital finance, environmental regulation, and energy efficiency. The results indicate that: (1) Digital finance significantly improves energy efficiency, and this finding is consistent after several tests; (2) Digital finance has a positive effect on energy efficiency in non-resource-based cities, recession and regeneration resource-based cities, and old industrial base cities, but no significant effect on energy efficiency in growth and maturity resource-based cities and non-old industrial base cities; (3) Environmental regulation positively influences how digital finance affects energy efficiency; (4) The impact of digital finance on energy efficiency depends on the degree and tools of environmental regulation. This research offers valuable insights to local governments in China for promoting financial digitization and enhancing energy efficiency.


Asunto(s)
Conservación de los Recursos Energéticos , Industrias , China , Ciudades , Gobierno Local , Desarrollo Económico , Eficiencia
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