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1.
BMC Public Health ; 23(1): 167, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694154

RESUMO

BACKGROUND: Quality of life (QoL) is one of the most important indicators for evaluating an individual's overall health status. However, evidence exploring the trend in QoL of the Chinese population is still lacking. This study aimed to investigate the trend in QoL of the Chinese population measured by the EQ-5D from 2008 to 2020, as well as compare the changing trends in QoL categorized by populations with different socio-demographic characteristics. METHODS: Data were obtained from the 2008, 2013, and 2020 waves of the Health Services Surveys conducted in Tianjin, China. Respondents completed the EQ-5D (EQ-5D-3L in 2008 and 2013 and EQ-5D-5L in 2020) through face-to-face interviews or self-administration. Responses of the EQ-5D-3L in 2008 and 2013 were mapped onto the EQ-5D-5L responses, and then converted to utility values using the Chinese value set. The trend in QoL was explored by comparing the percentage of any reported problems on each EQ-5D dimension and the corresponding utility values across the three waves. Subgroup analyses were performed to compare trends in utility values stratified by socio-demographic indicators. The effect of the time variable (year) on utility values was assessed by multiple linear regression analyses using the pooled data. RESULTS: By analyzing and comparing the three waves of the data (N = 25,939 in the 2008 wave, N = 22,138 in 2013, and N = 19,177 in 2020), an upward trend was observed in the percentages of reporting problems on all five dimensions (p < 0.001), resulting in a decreasing trend in utility values (2008: 0.948, 2013: 0.942, 2020: 0.939, p < 0.001). Utility values declined more over time among the female, the elder, the recipients of medical assistance, the widowed, the unemployed, and respondents with primary or lower education. The effect of the year (Coef. for 2013 = - 0.009, p < 0.001; Coef. for 2020 = - 0.010, p < 0.001) confirmed the downward trend in the utility values. CONCLUSIONS: The overall QoL of the Chinese population decreased over the period from 2008 to 2020. The QoL of the disadvantaged or vulnerable populations in terms of socioeconomic characteristics declined more over time.


Assuntos
Saúde da População , Qualidade de Vida , Humanos , Feminino , Nível de Saúde , Inquéritos e Questionários , Inquéritos Epidemiológicos
2.
Clin Exp Dermatol ; 48(1): 24-26, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36669173

RESUMO

Atopic dermatitis (AD) has been previously associated with migraine headaches in paediatric and adolescent populations, though there is less evidence for this relationship among adults. In this cross-sectional study, we investigated the association between AD and migraine among a cohort of US adults in the All of Us research programme. After controlling for common comorbidities, we found that adults with AD were 89% more likely to have a diagnosis of migraine (OR = 1·89, P < 0·001).


Assuntos
Dermatite Atópica , Transtornos de Enxaqueca , Saúde da População , Adolescente , Adulto , Humanos , Criança , Dermatite Atópica/complicações , Dermatite Atópica/epidemiologia , Dermatite Atópica/diagnóstico , Estudos Transversais , Comorbidade , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/epidemiologia , Índice de Gravidade de Doença
3.
Pac Symp Biocomput ; 28: 31-42, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36540962

RESUMO

The objective of this research was to build and assess the performance of a prediction model for post-operative recovery status measured by quality of life among individuals experiencing a variety of surgery types. In addition, we assessed the performance of the model for two subgroups (high and moderately consistent wearable device users). Study variables were derived from the electronic health records, questionnaires, and wearable devices of a cohort of individuals with one of 8 surgery types and that were part of the NIH All of Us research program. Through multivariable analysis, high frailty index (OR 1.69, 95% 1.05-7.22, p<0.006), and older age (OR 1.76, 95% 1.55-4.08, p<0.024) were found to be the driving risk factors of poor recovery post-surgery. Our logistic regression model included 15 variables, 5 of which included wearable device data. In wearable use subgroups, the model had better accuracy for high wearable users (81%). Findings demonstrate the potential for models that use wearable measures to assess frailty to inform clinicians of patients at risk for poor surgical outcomes. Our model performed with high accuracy across multiple surgery types and were robust to variable consistency in wearable use.


Assuntos
Fragilidade , Saúde da População , Dispositivos Eletrônicos Vestíveis , Humanos , Qualidade de Vida , Biologia Computacional
4.
Pac Symp Biocomput ; 28: 1-6, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36540959

RESUMO

Data from digital health technologies (DHT), including wearable sensors like Apple Watch, Whoop, Oura Ring, and Fitbit, are increasingly being used in biomedical research. Research and development of DHT-related devices, platforms, and applications is happening rapidly and with significant private-sector involvement with new biotech companies and large tech companies (e.g. Google, Apple, Amazon, Uber) investing heavily in technologies to improve human health. Many academic institutions are building capabilities related to DHT research, often in cross-sector collaboration with technology companies and other organizations with the goal of generating clinically meaningful evidence to improve patient care, to identify users at an earlier stage of disease presentation, and to support health preservation and disease prevention. Large research consortia, cross-sector partnerships, and individual research labs are all represented in the current corpus of published studies. Some of the large research studies, like NIH's All of Us Research Program, make data sets from wearable sensors available to the research community, while the vast majority of data from wearable sensors and other DHTs are held by private sector organizations and are not readily available to the research community. As data are unlocked from the private sector and made available to the academic research community, there is an opportunity to develop innovative analytics and methods through expanded access. This Session solicited research results leveraging digital health technologies, including wearable sensor data, describing novel analytical methods, and issues related to diversity, equity, inclusion (DEI) of both the underlying research data sets and the community of researchers working in this area. We particularly encouraged submissions describing opportunities for expanding and democratizing academic research using data from wearable sensors and related digital health technologies.


Assuntos
Saúde da População , Humanos , Biologia Computacional , Tecnologia Biomédica
5.
Pediatr Clin North Am ; 70(1): 53-65, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36402471

RESUMO

This case study illustrates state legislative advocacy in action in Maryland. Success in strengthening maternal and child health is described using the Academic Pediatric Association's 4-step approach to advocacy: (1) Identify the Issue and Target Audience; (2) Craft the Message; (3) Develop Relationships and Coalitions, and (4) Communicate the Message. Starting with state legislation and formation of a Maryland Maternal Child Health Task Force led to maternal child health named as 1 of 3 state population health priorities. This guided subsequent programmatic investment and attention. Further dissemination of task force recommendations has led to additional supportive legislation.


Assuntos
Prioridades em Saúde , Saúde da População , Criança , Humanos , Maryland , Saúde da Criança
6.
Pac Symp Biocomput ; 28: 19-30, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36540961

RESUMO

The National Institutes of Health's (NIH) All of Us Research Program aims to enroll at least one million US participants from diverse backgrounds; collect electronic health record (EHR) data, survey data, physical measurements, biospecimens for genomics and other assays, and digital health data; and create a researcher database and tools to enable precision medicine research [1]. Since inception, digital health technologies (DHT) have been envisioned as essential to achieving the goals of the program [2]. A "bring your own device" (BYOD) study for collecting Fitbit data from participants' devices was developed with integration of additional DHTs planned in the future [3]. Here we describe how participants can consent to share their digital health technology data, how the data are collected, how the data set is parsed, and how researchers can access the data.


Assuntos
Saúde da População , Humanos , Biologia Computacional , Inquéritos e Questionários , Medicina de Precisão
7.
Am J Public Health ; 113(1): 35-36, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36516382
8.
Front Public Health ; 10: 958168, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36457330

RESUMO

The capacity of self-assessment, to learn from experience, to make information-based decisions, and to adapt over time are essential drivers of success for any project aiming at healthcare system change. Yet, many of those projects are managed by healthcare providers' teams with little evaluation capacity. In this article, we describe the support mission delivered by an interdisciplinary scientific team to 12 integrated care pilot projects in Belgium, mobilizing a set of tools and methods: a dashboard gathering population health indicators, a significant event reporting method, an annual report, and the development of a sustainable "learning community." The article provides a reflexive return on the design and implementation of such interventions aimed at building organizational evaluation capacity. Some lessons were drawn from our experience, in comparison with the broader evaluation literature: The provided support should be adapted to the various needs and contexts of the beneficiary organizations, and it has to foster experience-based learning and requires all stakeholders to adopt a learning posture. A long-time, secure perspective should be provided for organizations, and the availability of data and other resources is an essential precondition for successful work.


Assuntos
Prestação Integrada de Cuidados de Saúde , Saúde da População , Humanos , Bélgica , Pessoal de Saúde , Equipe de Assistência ao Paciente
9.
Global Health ; 18(1): 99, 2022 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-36464737

RESUMO

Population health needs to pivot toward the primordial prevention of global chronic diseases, most specifically the disease cascade that runs from marketing to obesity to diabetes to its known complications. Medical sciences can now manage these diseases and prolong meaningful life, but can only do so at an enormous cost, a cost that will threaten societal stability everywhere. The fall in global fertility and the explosion in elderly populations will facilitate this fiscal pandemic attributable to good health. Risk factor mitigation, not effective for obesity, enhanced longevity but did not prevent chronic illness, only forestalled it. For public health, but not health practitioners, the risk factor era needs to be supplanted by a focus on public policy to alter public behavior via primordial prevention of the emergence of risk factors. And public health needs to lead that effort. The historical pathway to this present dilemma that linked science to economic development can be illuminated by the efforts of four scientists, Francis Bacon at the dawn of the seventeenth century, James Lind in the 18th and Vannevar Bush and Abdel Omran in the 20th. This perspective introduces a near inevitability to the emergence of the current critical pivot point but also teaches that there is a powerful rationale to assume that dramatic and expensive changes will be coming and need be anticipated and planned for.


Assuntos
Saúde da População , Saúde Pública , Idoso , Humanos , Desenvolvimento Econômico , Política Pública , Obesidade/prevenção & controle
10.
J Public Health (Oxf) ; 44(Supplement_1): i17-i22, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36465051

RESUMO

BACKGROUND: This article explores a set of changes and continuities in relation to public health and its publics in the UK since the establishment of the Faculty of Public Health in 1972. METHODS: The article draws on historical research to produce a synthetic analysis of key changes and continuities in British public health since 1972. RESULTS: Three key areas are identified. The first centres on the issue of who has responsibility for public health. The second examines the persistence of social and racial inequalities in population health. The third considers the 'return' of infectious disease as a threat to public health. CONCLUSIONS: Despite the trend to place more responsibility for individual and collective health on the public itself, there was a proliferation in the actors and authorities involved in securing and protecting the health of the public. The strong linkages between health and structural inequality, and the challenges of addressing these, demonstrate that public health never was (and never can be) solely an individual matter. The appearance of new diseases, such as HIV/AIDS and the return of ones thought to have been conquered, like tuberculosis, raised profound questions for public health authorities and the people they cared for.


Assuntos
Síndrome de Imunodeficiência Adquirida , Saúde da População , Humanos , Docentes , Saúde Pública
12.
Health Aff (Millwood) ; 41(12): 1763-1771, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36469831

RESUMO

Population health strategies tend to focus on individuals' behaviors, genes, or health care access, yet it is well established that socioecological conditions are fundamental to health and strongly influenced by policy. In the US, health and other policies continue to be shaped by the country's unique legacy of racial and economic segregation. Policy reform must be at the center of population health. This requires communities to have power. We present theoretical and empirical research linking community power and health, and we share an example of our work in which communities organized to hold policy makers accountable for advancing health equity in the distribution of parks. We call this a democratic approach to health improvement and discuss how population health, whether part of public health, philanthropy, or health care, needs to focus on community power and include funding for power-building organizations. We conclude that achieving health equity requires enhancing the quality of democracy.


Assuntos
Equidade em Saúde , Saúde da População , Humanos , Política de Saúde , Saúde Pública , Responsabilidade Social
13.
14.
Public Health Res Pract ; 32(4)2022 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-36509684

RESUMO

Biobanks have great potential in advancing population health research by enabling access to biospecimens that can be linked to health data. Governments and research institutes worldwide have made large commitments to biobanking in recent years, often through combining cohort studies and biospecimen collections. We aim to explore the opportunities and challenges of establishing a population-scale biobank in Australia. Using existing longitudinal cohort studies to collect biospecimens can be an efficient way to rapidly advance research infrastructure in Australia. The 45 and Up Study is a large-scale longitudinal cohort with self-reported health, behaviour and lifestyle data, and may be one suitable candidate to include biospecimen collections to contribute to a population biobank. However, there are a number of ethical and practical issues specific to biospecimen collections, such as ensuring the privacy and rights of participants are protected, and ensuring sufficient resourcing to support infrastructure. Overcoming these challenges and bringing together diverse fields of expertise will enable us to maximise the potential of cohort studies and biobanks. In combination, these data sources can efficiently advance population health research beyond what is achievable with either of these resources separately.


Assuntos
Pesquisa Biomédica , Saúde da População , Humanos , Bancos de Espécimes Biológicos , Estudos Longitudinais , Estudos de Coortes , Austrália
15.
Front Public Health ; 10: 1068092, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36568761

RESUMO

Health sciences curricular planners are challenged to add new content to established education programs. There is increasing pressure for content in public health, health systems, global health, and planetary health. These important areas often compete for curricular time. What is needed is a convergence model that builds a common framework within which students can integrate areas and better align this knowledge to the individual client or patient who they have responsibility to support. A population health framework is proposed for health sciences education programs that supports a common conceptual understanding of population health. The framework links five thematic areas that have influence on health and wellbeing and a sixth element that defines the range of methodologies essential to understanding health and wellbeing, from the individual to the population. The five areas providing convergence are: (1) the biopsychosocial development of the individual, (2) the socioeconomic factors that influence health and wellbeing, (3) the physical natural and built environment including climate, (4) the continuum of public health and health care systems, and (5) the nation state and global relationships. Using this framework, students are encouraged to think and understand individual health and wellbeing in context to the population and to utilize the appropriate methodological tools to explore these relationships. Planning for a new undergraduate medicine program illustrates the curricular elements that will be used to support student learning with foundation knowledge applied and tracked throughout the program. The proposed framework has application across health sciences disciplines and serves to build a common understanding that supports cross professional communication and collaboration.


Assuntos
Educação Médica , Saúde da População , Humanos , Estudantes , Atenção à Saúde
16.
J Health Care Poor Underserved ; 33(4S): 152-172, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36533464

RESUMO

Technological innovation can improve health care and population health. However, it is not often designed with public health systems and diverse patients in mind. In 2016, university faculty digital health experts established an innovation incubator in an academic setting based in a public health care system. The incubator conducted projects with a cohort of private technology companies and sparked cross-sector dialogue about digital health equity. The incubator completed rapid-cycle research and evaluation projects with industry and in partnership with publicly insured patients and public health care workers to improve the fit of technology with diverse user needs and preferences. Lessons learned include the importance of an explicit focus on equity, early alignment of expectations, broader investment and communications, and inclusive stakeholder relationships. Partnerships between the digital health industry and public health researchers can bridge the gap between technology offerings and the needs and preferences of publicly insured patients.


Assuntos
Equidade em Saúde , Saúde da População , Humanos , Atenção à Saúde , Universidades , Organizações , Parcerias Público-Privadas
18.
Front Public Health ; 10: 913851, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36505008

RESUMO

Introduction: Rapid urbanization (growth of cities) can upset the local population's health and wellbeing by creating obesogenic environments which increase the burden of non-communicable diseases (NCDs). It is important to understand how stakeholders perceive the impact of urbanizing interventions (such as the construction of a new hypermarket) on the health and wellbeing of local populations. Because low- and middle-income countries (LMICs) lack the reliable infrastructure to mitigate the effects of obesogenic environments, so engaging stakeholders who influence dietary habits is one population-level strategy for reducing the burden of NCDs caused by newly built developments. Methods: We conducted key informant interviews with 36 stakeholders (25 regulatory and 11 local community stakeholders) from Kisumu and Homa Bay Counties of Western Kenya in June 2019. We collected stakeholders' perspectives on the impacts of a new Mall and supermarket in Kisumu, and existing supermarkets in Homa Bay on the health and wellbeing of local populations. Results: Through thematic discourse analysis, we noted that some stakeholders thought supermarkets enabled access to unhealthy food items despite these outlets being also reliable food sources for discerning shoppers. Others linked the changing physical environment to both an increase in pollution and different types of diseases. Stakeholders were unsure if the pricing and convenience of supermarkets would stop local populations from buying from their usual small-scale food vendors. The key finding of this study was that engaging relevant stakeholders as part of population health impact assessments of new developments in cities are important as it directs focus on health equity and prevention in instances of resource constraints. The findings highlight, also, that community members have a strong awareness of the potential for interventions that would improve the health and wellbeing of local populations.


Assuntos
Equidade em Saúde , Doenças não Transmissíveis , Saúde da População , Humanos , Cidades , Meio Ambiente
19.
BMC Public Health ; 22(1): 2372, 2022 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-36528613

RESUMO

BACKGROUND: The association between social distress and child health is important and attracts research interest. This study aims to examine the trend of inequality in the mortality rate for children under five (U5MR) over time and decompose the population mental health (PMH)-gradient in U5MR into different drivers at the national level. METHODS: Data from 1990 to 2019 on the U5MR, PMH, and potential risk factors, such as socioeconomic status, environmental exposures at the national level, health behavior, basic water and sanitation services, urbanization, healthcare level, and HIV prevalence, were collected from online databases. We described the trend of U5MR and broke down U5MR based on the countries' risk factor status and PMH. We constructed regression models and decomposed the drivers of change in U5MR disparity based on PMH-gradient. RESULTS: The difference in U5MR between countries with different levels of air pollution and income status was narrowed since 1990 for the high PMH groups. Countries with a higher level of PMH had less significant differences in U5MR between low- and middle-income groups than those with a lower level of PMH. The development of PMH-related gradient in child health is not consistent thoroughly. Before 2000, boys experienced a sharper decline in PMH-related gradient in health than girls did. The decomposition shows that the changes in PMH-gradient in child health were mainly caused by changes in the return to risk factors. The mental health of female population matters more in child health outcomes. CONCLUSION: Although the U5MR converges across countries, the reason varies. The PMH gradient in child mortality is mainly explained by the change in the return to risk factors. The PMH-gradient health disparity in boys is larger than that in girls in 2019, which indicates that boys' health may be more vulnerable to the development of PMH recently. The findings remind us that we need to pay attention to the hidden reasons for the growth of disparity. It also suggests that improving PMH has a great impact on reducing PMH-related health disparity, especially for boys. Our research contributes to the understanding of the transition of PMH-related health disparity in U5MR and provides policy implications for reducing gender disparity in child health.


Assuntos
Saúde da Criança , Saúde da População , Criança , Masculino , Feminino , Humanos , Saúde Mental , Mortalidade da Criança , Classe Social
20.
BMJ Open ; 12(12): e063714, 2022 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-36535714

RESUMO

OBJECTIVES: To examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-level All of Us Research Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions. DESIGN: A retrospective case-control study. SETTING: Secondary analysis of online surveys conducted in the USA. PARTICIPANTS: 62 664 participant responses to COPE from May to July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version. RESULTS: A multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10-4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10-6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10-10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy. CONCLUSION: Our study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.


Assuntos
COVID-19 , Saúde da População , Humanos , Saúde Mental , SARS-CoV-2 , Estudos de Casos e Controles , Habitação , Estudos Retrospectivos
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