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2.
J Public Health Policy ; 40(2): 147-165, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30824824

RESUMO

Campaigns against risk factors for non-communicable diseases (NCDs) caused by smoking and obesity have become increasingly common on multiple levels of government, from the local to the international. Non-governmental actors have cooperated with government bodies to make policies. By analysing the policies of the World Trade Organization, the World Health Organization, the European Union, and the United Kingdom and United States governments, we identify how the struggles between public health advocates and commercial interests reached the global level, and how the relatively successful fight to 'denormalize' tobacco consumption has become a model for anti-obesity advocates. It highlights three factors important in policy change: framing the policy problem, the policymaking environment and 'windows of opportunity'-to analyse the struggle between 'harm regulation' and 'neoprohibition' approaches to an international obesity prevention regime.


Assuntos
Política de Saúde/legislação & jurisprudência , Política Nutricional/legislação & jurisprudência , Obesidade/prevenção & controle , Prática de Saúde Pública/legislação & jurisprudência , Prevenção do Hábito de Fumar/legislação & jurisprudência , União Europeia , Humanos , Legislação sobre Alimentos , Fatores Socioeconômicos , Reino Unido , Estados Unidos , Organização Mundial da Saúde
3.
Bull World Health Organ ; 97(2): 108-117, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30728617

RESUMO

Law lies at the centre of successful national strategies for prevention and control of noncommunicable diseases. By law we mean international agreements, national and subnational legislation, regulations and other executive instruments, and decisions of courts and tribunals. However, the vital role of law in global health development is often poorly understood, and eclipsed by other disciplines such as medicine, public health and economics. This paper identifies key areas of intersection between law and noncommunicable diseases, beginning with the role of law as a tool for implementing policies for prevention and control of leading risk factors. We identify actions that the World Health Organization and its partners could take to mobilize the legal workforce, strengthen legal capacity and support effective use of law at the national level. Legal and regulatory actions must move to the centre of national noncommunicable disease action plans. This requires high-level leadership from global and national leaders, enacting evidence-based legislation and building legal capacities.


Assuntos
Política de Saúde/legislação & jurisprudência , Promoção da Saúde , Internacionalidade , Doenças não Transmissíveis/prevenção & controle , Organização Mundial da Saúde , Saúde Global , Promoção da Saúde/legislação & jurisprudência , Direitos Humanos , Humanos , Agências Internacionais , Internacionalidade/legislação & jurisprudência , Relações Interprofissionais , Prática de Saúde Pública/legislação & jurisprudência , Fatores de Risco
4.
Am J Public Health ; 108(11): 1465-1468, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30252520

RESUMO

This commentary argues that 100 years after the deadly Spanish flu, the public health emergency community's responses to much more limited pandemics and outbreaks demonstrate a critical shortage of personnel and resources. Rather than relying on nonpharmaceutical interventions, such as quarantine, the United States must reorder its health priorities to ensure adequate preparation for a large-scale pandemic.


Assuntos
Controle de Doenças Transmissíveis/história , Surtos de Doenças/história , Saúde Global/história , Influenza Pandêmica, 1918-1919/história , Prática de Saúde Pública/história , Controle de Doenças Transmissíveis/legislação & jurisprudência , Surtos de Doenças/prevenção & controle , Medo , Doença pelo Vírus Ebola/história , Doença pelo Vírus Ebola/prevenção & controle , História do Século XX , História do Século XXI , Humanos , Prática de Saúde Pública/legislação & jurisprudência , Quarentena/história , Quarentena/legislação & jurisprudência , Estados Unidos/epidemiologia
5.
Drug Alcohol Depend ; 185: 360-366, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29524873

RESUMO

OBJECTIVE: This paper aims to quantify the population-level associations between child injury deaths and adult (aged 15+ years) per capita alcohol consumption (PCC) and between child injury deaths and the impact of major alcohol and safety policy changes in Australia. METHODS: All child deaths due to external causes during 1910-2013, and child deaths due specifically to road crashes, assaults, suicide and other external causes, were obtained from the Australian Institute of Health and Welfare. Child (0-14 year) mortality rates were analysed in relation to PCC using an Autoregressive Integrated Moving Average model. RESULTS: A positive association between PCC and overall child external mortality was identified. The estimated coefficient was 0.326 (p = .002), indicating that a 10% decrease in PCC was associated with a 3.3% reduction in child injury mortality. A positive association was identified for road traffic and other child injury mortality, but not assault injuries. The introduction of compulsory seatbelt legislation in combination with random breath testing was associated with a reduction in overall injury and road traffic child mortality. Decreasing the legal drinking age was associated with an increase in the rate of other external-cause child mortality. CONCLUSION: Reducing PCC in Australia is likely to result in a small but significant reduction in the injury mortality rate of children aged 0-14 years.


Assuntos
Consumo de Bebidas Alcoólicas/mortalidade , Consumo de Bebidas Alcoólicas/tendências , Mortalidade da Criança/tendências , Prática de Saúde Pública , Ferimentos e Lesões/mortalidade , Acidentes de Trânsito/legislação & jurisprudência , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/tendências , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Austrália/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prática de Saúde Pública/legislação & jurisprudência , Suicídio/legislação & jurisprudência , Suicídio/prevenção & controle , Suicídio/tendências , Ferimentos e Lesões/prevenção & controle
6.
Community Ment Health J ; 54(6): 766-772, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29127561

RESUMO

When confronted with complex situations of hoarding and severe domestic squalor, small municipal communities and their partners frequently feel overwhelmed due to limited resources at their disposal. Stakeholders often report these situations to Public Health Service and seek their support. In order to facilitate more effective and coordinated actions, the main stakeholders involved (municipal, fire, police, public health and the regional health center) must agree on the most appropriate intervention strategies. An agreement providing services for the management of severe cases of domestic squalor in rural and semi-urban areas located in Quebec, Canada was produced by the Laurentians regional public health, and signed with fourteen local municipalities.


Assuntos
Promoção da Saúde/métodos , Transtorno de Acumulação , Relações Interinstitucionais , Prática de Saúde Pública , Autonegligência , Participação dos Interessados , Algoritmos , Colecionismo , Transtorno de Acumulação/terapia , Humanos , Desenvolvimento de Programas , Saúde Pública , Prática de Saúde Pública/legislação & jurisprudência , Quebeque , População Rural , Autonegligência/legislação & jurisprudência , Comportamento Social , População Urbana
9.
BMC Public Health ; 16(1): 1132, 2016 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-27806712

RESUMO

BACKGROUND: Hepatitis C affects over 185 million people around the world. This silent disease is responsible for up to 700,000 deaths per year. Despite the scientific revolution in diagnosis and treatment, hepatitis C control remains a huge challenge due to the cost of effective medications. In response to the global outcry of hepatitis epidemic and the need to improve the nation's public health response, the Ministry of Health of Brazil revolutionized hepatitis C treatment by incorporating highly effective drugs that can be accessed through sustainable and universal means. DISCUSSION: This paper describes the unique process of implementing evidence-informed policy to respond to hepatitis C epidemic through the update of hepatitis C treatment in Brazil based on the estimate of disease prevalence, current international guidelines, and the cost-effectiveness impact in the Brazilian Unified Health System. Through a debate of an experience report, the authors underlie the strategic plan implemented according to the situation analysis that emphasized the need to improve its current response over a relatively short-term period. The comprehensive response is detailed comprising three main objectives: improve treatment outcomes by evaluating and incorporating new and effective medications at a sustainable price; elaborate on clinical guidelines to treat hepatitis C patients; and develop awareness and diagnosis campaigns targeted at the population of interest. In this scenario, Brazil was able to obtain an unprecedented discount for a high-medium income country; provided treatment to more than 7000 individuals in the last 2 months of 2015; and expects to treat 38,000 new patients in 2016. The remarkable process applied in Brazil was developed according to epidemiological data and scientific evidence, and it was motivated by the engagement of the country in the Sustainable Development Goals, which may inspire other developing countries to identify ways to achieve these goals by 2030.


Assuntos
Epidemias , Política de Saúde , Hepatite C/epidemiologia , Prática de Saúde Pública/legislação & jurisprudência , Antivirais/uso terapêutico , Brasil/epidemiologia , Hepatite C/tratamento farmacológico , Hepatite C/prevenção & controle , Humanos
10.
Bull World Health Organ ; 94(7): 534-9, 2016 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-27429492

RESUMO

A robust health infrastructure in every country is the most effective long-term preparedness strategy for global health emergencies. This includes not only health systems and their human resources, but also countries' legal infrastructure for health: the laws and policies that empower, obligate and sometimes limit government and private action. The law is also an important tool in health promotion and protection. Public health professionals play important roles in health law - from the development of policies, through their enforcement, to the scientific evaluation of the health impact of laws. Member States are already mandated to communicate their national health laws and regulations to the World Health Organization (WHO). In this paper we propose that WHO has the authority and credibility to support capacity-building in the area of health law within Member States, and to make national laws easier to access, understand, monitor and evaluate. We believe a strong case can be made to donors for the funding of a public health law centre or unit, that has adequate staffing, is robustly networked with its regional counterparts and is integrated into the main work of WHO. The mission of the unit or centre would be to define and integrate scientific and legal expertise in public health law, both technical and programmatic, across the work of WHO, and to conduct and facilitate global health policy surveillance.


Assuntos
Fortalecimento Institucional/organização & administração , Assistência à Saúde/legislação & jurisprudência , Saúde Global/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Organização Mundial da Saúde/organização & administração , Fortalecimento Institucional/legislação & jurisprudência , Planejamento em Desastres , Política de Saúde , Humanos , Prática de Saúde Pública/legislação & jurisprudência
14.
Am J Public Health ; 105 Suppl 2: S252-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25689203

RESUMO

OBJECTIVES: We examined the effect of a state law in Colorado that required local public health agencies to deliver a minimum package of public health services. METHODS: We used a longitudinal, pre-post study design, with baseline data collected in 2011 and follow-up data collected in 2013. We conducted means testing to analyze the change in service delivery and activities. We conducted linear regression to test for system structure effects on the implementation of core services. RESULTS: We observed statistically significant increases in several service areas within communicable disease, prevention and population health promotion, and environmental health. In addition to service and program areas, specific activities had significant increases. The significant activity increases were all in population- and systems-based services. CONCLUSIONS: This project provided insight into the likely effect of national adoption of a minimum package as recommended by the Institute of Medicine. The implementation of a minimum package showed significant changes in service delivery, with specific service delivery measurement over a short period of time. Our research sets up a research framework to further explore core service delivery measure development.


Assuntos
Governo Local , Prática de Saúde Pública/legislação & jurisprudência , Doença Crônica/prevenção & controle , Colorado , Controle de Doenças Transmissíveis , Meio Ambiente , Promoção da Saúde , Humanos , Estudos Longitudinais
15.
Disaster Med Public Health Prep ; 9(1): 47-50, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25300952

RESUMO

The global rise of Ebola viral diseases in 2014 necessitates legal responses that promote effective public health responses and respect for the health and human rights of populations. Compulsory public health interventions, approval and administration of experimental drugs or vaccines, and allocation of finite resources require difficult choices in law and policy. Crafting legal decisions in real-time emergencies is neither easy nor predictable, but it is essential to controlling epidemics and saving lives.


Assuntos
Planejamento em Desastres/organização & administração , Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Prática de Saúde Pública/legislação & jurisprudência , Planejamento em Desastres/legislação & jurisprudência , Liberdade , Política de Saúde , Direitos Humanos , Humanos
16.
Health (London) ; 19(1): 51-66, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24948593

RESUMO

This article is interested in how notions of the 'public' are conceived, marshalled and enacted in drug-treatment responses to methamphetamine use in Melbourne, Australia. After reviewing qualitative data collected among health-care providers and methamphetamine consumers, we draw on the work of Michael Warner to argue that services for methamphetamine consumers in Melbourne betray ongoing tensions between 'public' and 'counterpublic' constituencies. Our analysis indicates that these tensions manifest in two ways: in the management of 'street business' in the delivery of services and in negotiating the meaning of health and the terms of its restoration or promotion. Reflecting these tensions, while the design of services for methamphetamine consumers is largely modelled on public health principles, the everyday experience of these services may be more accurately characterised in terms of what Kane Race has called 'counterpublic health'. Extending Race's analysis, we conclude that more explicit focus on the idea of counterpublic health may help local services engage with methamphetamine consumers in new ways, providing grounds for novel outreach, harm-reduction and treatment strategies.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/terapia , Usuários de Drogas/psicologia , Redução do Dano , Política de Saúde/legislação & jurisprudência , Aplicação da Lei , Prática de Saúde Pública/normas , Transtornos Relacionados ao Uso de Anfetaminas/prevenção & controle , Transtornos Relacionados ao Uso de Anfetaminas/psicologia , Humanos , Entrevistas como Assunto , Metanfetamina/efeitos adversos , Prática de Saúde Pública/legislação & jurisprudência , Pesquisa Qualitativa , Fatores Socioeconômicos , Vitória
18.
J Sch Health ; 84(9): 581-5, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25117892

RESUMO

BACKGROUND: Despite broad public support and legislative activity, policies intended to promote physical activity in schools have not produced positive outcomes in levels of physical activity or student health. What explains the broad failure of Physical Activity Policies (PAPs)? Thus far, PAP research has used limited quantitative methods to assess PAP outcomes. New paradigms of qualitative policy implementation research can make important contributions to explaining the causes of policy failure and to the future design of more efficacious PAP legislation. METHODS: This analysis is a case study of South Carolina's 2005 Student Health and Fitness Act (SHFA). Written documents, investigators' observation and experience, and an interview with a key stakeholder were analyzed to for themes based on theoretical frameworks from education implementation research including (1) bottom-up and top-down perspectives, (2) conceptualizing policy as practice, and (3) the implementer as learner. RESULTS: "Weak policy signals" in SHFA undermined the implementation of PAP in 3 problematic areas: inadequate capacity development for implementers, inappropriate measures of implementation, and insufficient funding. CONCLUSIONS: These findings illustrate the contributions of qualitative research and establish the need for further qualitative research into PAP implementation processes. To ensure successful future physical activity policies, policymakers, and stakeholders need to consider implementation, evaluation, and funding from the beginning phases of policy development.


Assuntos
Política de Saúde , Atividade Motora , Prática de Saúde Pública , Serviços de Saúde Escolar , Criança , Exercício , Política de Saúde/economia , Política de Saúde/legislação & jurisprudência , Humanos , Entrevistas como Assunto , Prática de Saúde Pública/economia , Prática de Saúde Pública/legislação & jurisprudência , Prática de Saúde Pública/normas , Pesquisa Qualitativa , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/legislação & jurisprudência , Serviços de Saúde Escolar/normas , South Carolina
19.
J Public Health Manag Pract ; 20(3): 330-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24667195

RESUMO

The mark of an "academic health department" includes shared activity by academic and practice partners sustained over time. Despite a long history of productive interactivity, the Pennsylvania Department of Health and the University of Pittsburgh's Graduate School of Public Health often faced administrative hurdles in contracting for projects of mutual interest. Seeking to overcome these hurdles, the Commonwealth of Pennsylvania and the University of Pittsburgh's Graduate School of Public Health negotiated a Master Agreement on the basis of statutes designating both as "public procurement units." This provided a template for project specifications, standard financial terms, and a contracting process. Since taking effect, the Master Agreement has supported projects in policy development, capacity building, workforce development, program evaluation, data analysis, and program planning. This experience suggests an approach potentially useful for other states and localities seeking to solidify academic health department partnerships either envisioned for the future or already in place.


Assuntos
Prática de Saúde Pública/legislação & jurisprudência , Faculdades de Saúde Pública/organização & administração , Orçamentos , Educação Profissional em Saúde Pública/legislação & jurisprudência , Educação Profissional em Saúde Pública/organização & administração , Financiamento Governamental , Humanos , Relações Interinstitucionais , Pennsylvania , Faculdades de Saúde Pública/legislação & jurisprudência , Governo Estadual
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