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1.
Int J Health Serv ; : 207314221125151, 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-2240787

ABSTRACT

Existing frameworks seek to elucidate the social, political, and commercial determinants of health in order to inform practice, policy, and research that can improve health and reduce health inequities. Each approach has widened the scope of public health practice and research and identified new partners and targets for intervention. But as the public health crises of the past decade have shown, these frameworks have not yet yielded insights that have enabled the public health profession and movement to prevent or overcome dominant threats to global health and health equity. This report explores the value of an integrated framework that combines insights from previous scholarship and practice using the social, political, and commercial determinants of health. It proposes the questions such an integration would need to answer and suggests processes and tasks that could lead to the creation of a blended framework.

2.
J Am Coll Health ; : 1-4, 2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-1931618

ABSTRACT

Objective: To test the association between food insecurity and educational disruptions from the COVID-19 pandemic and the role of anxiety or depression in mediating this association. Participants: Representative sample of 2,282 City University of New York students. Methods: Using an April 2020 online survey, we estimated adjusted prevalence ratios (aPR) for educational outcomes based on food insecurity status, adjusting for age, sex, race/ethnicity, and degree level with weighted Poisson regressions with robust standard errors. Results: Prevalence of decreased ability to do schoolwork was greater in those with moderate (aPR = 1.12, 95% CIs 1.02, 1.23) and high (aPR = 1.18, 95% CIs 1.08, 1.2) levels of food insecurity compared to food-secure students. Results were similar for dropping/withdrawing from classes and expecting delays or uncertainty around graduation. Anxiety and depression mediated the relationship between food insecurity and educational outcomes. Conclusion: Findings emphasize the urgency of expanded food assistance and mental health services for college students.

3.
American Journal of Public Health ; 112(7):953-955, 2022.
Article in English | ProQuest Central | ID: covidwho-1904694

ABSTRACT

[...]from her vantage points as a medical student, a resident, an emergency room doctor, a public health professional, and a political commentator, Wen provides a capsule history of several major public health events of the last few decades, including the continuing burden of HIV, the opioid epidemic, food insecurity, the Affordable Care Act, the rising toll of gun violence, the COVID-19 pandemic, the climate emergency, and more. [...]Wen describes her interactions with a glittering cast of mentors and role models as well as her efforts to pay this support forward by advising, assisting, and advancing the careers of her colleagues and students and the life success of her patients. Wen devotes limited space to a very public phase of her career, her brief stint as president of the Planned Parenthood Federation of America (PPFA).7 Hoping to provide a new direction for PPFA, she reports she had taken the job with the goal of repositioning the organization from being a leading advocate for abortion and reproductive rights into becoming a women's health organization that speaks for the health care needs of all women.

4.
SSM Popul Health ; 17: 100952, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1616773

ABSTRACT

The U.S government has historically responded to human, natural and economic disruptions that threaten food insecurity by modifying federally-funded public food programs. The authors conducted a scoping review to identify and summarize available evidence on the efforts of a 20-year period to modify food benefit programs in response to emergencies; describe how food benefit programs interact to support vulnerable populations; identify key facilitators and barriers to effective implementation and impact; and assess relevance of evidence to COVID-19 pandemic. Scoping reviews address broad research questions aimed at mapping key concepts and available evidence in a defined area, and include academic and gray literature and reports from governments and NGOs. This review followed the PRISMA Extension for Scoping Reviews and included a three-stage search strategy. Studies were independently screened for eligibility by two researchers with multiple rounds of review. A content based charting method was used to summarize evidence. More than 2289 documents were identified and screened. After review, 44 documents were analyzed. Only 18% of documents reported program or policy impact data. Additionally, review of 149 policy records from State by State FNS Disaster Assistance Data from Oct 2016-Dec 2020 assessed 96 state specific food policy responses to 72 distinct events. Analysis revealed 53 distinct packages of food policy modifications used in response to crises. This scoping review demonstrates that few studies document the impact on food insecurity of food benefit modifications in response to crises. Most documents present output level details about costs and total number of individuals served. Many documents describe food policy response to crises without providing evaluation of response. Analysis points to SNAP and Child Nutrition Programs as most commonly modified food benefit programs in the wake of U.S. crises. The review concludes with a number of considerations for continued response to the ongoing COVID-19 crisis.

5.
Am J Public Health ; 111(12): 2202-2211, 2021 12.
Article in English | MEDLINE | ID: covidwho-1604898

ABSTRACT

In recent years, the concept of commercial determinants of health (CDoH) has attracted scholarly, public policy, and activist interest. To date, however, this new attention has failed to yield a clear and consistent definition, well-defined metrics for quantifying its impact, or coherent directions for research and intervention. By tracing the origins of this concept over 2 centuries of interactions between market forces and public health action and research, we propose an expanded framework and definition of CDoH. This conceptualization enables public health professionals and researchers to more fully realize the potential of the CDoH concept to yield insights that can be used to improve global and national health and reduce the stark health inequities within and between nations. It also widens the utility of CDoH from its main current use to study noncommunicable diseases to other health conditions such as infectious diseases, mental health conditions, injuries, and exposure to environmental threats. We suggest specific actions that public health professionals can take to transform the burgeoning interest in CDoH into meaningful improvements in health. (Am J Public Health. 2021;111(12):2202-2211. https://doi.org/10.2105/AJPH.2021.306491).


Subject(s)
Commerce , Population Health , Social Determinants of Health , Global Health , Humans , Public Health
6.
Journal of Agriculture, Food Systems, and Community Development ; 10(4):55, 2021.
Article in English | ProQuest Central | ID: covidwho-1478341

ABSTRACT

New York City was hit hard by the COVID-19 pandemic. Although the immediate health burden was devastating, we posit that its long-term impact will be even greater, because the rapid spread of COVID-19 both depended on and exacerbated other deep-seated inequities related to food and broader living conditions. Using the Bronx as a case study, we explore the intersection of the pandemic with two other persistent problems: food insecurity and diet-related diseases, a constellation we label the COVID-Food Syndemic. Syndemic theory focuses on the common causes and biological and social interactions between two or more health problems. We hypothesize that with its focus on the common social causes of ill health, this approach can inform and strengthen the synergies between community-based, activist-driven solutions and municipal government responses, thus reducing the burden of ill health in the Bronx. We suggest that combining these two approaches can more fully mobilize the social changes that are needed in the food system and beyond to interrupt the fundamental drivers of this syndemic and capitalize on the respective strengths of government, civil society, and activists.

7.
American Journal of Public Health ; 111(10):1757-1760, 2021.
Article in English | ProQuest Central | ID: covidwho-1464360

ABSTRACT

[...]a successful public health movement in the United States must make eliminating systemic racism a top priority. Had the federal government more closely monitored the deceptive advertising campaigns of Purdue Pharma, it could have countered the company's false messages to doctors, preventing tens of thousands of opioid deaths.11 In addition, continuingto allow industry sectors to use developments in science and technology-from digital data collection and precision agriculture to autonomous vehicles-without public accountability enables them to use this knowledge to benefit their bottom lines at the expense of public well-being, a likely cause for health crises of the next decade. [...]our nation needs to strengthen its democracy. According to the American Public Health Association, public health champions the health of all people and communities.

8.
American Journal of Public Health ; 111(7):1177-1179, 2021.
Article in English | ProQuest Central | ID: covidwho-1359608

ABSTRACT

Oxford University Press;2021 Hardcover: 361 pp;$38.50 ISBN-10: 0190885300 ISBN-13: 978-0190885304 rban Public Health: A Research Toolkit for Practice and Impact seeks to prepare public health and other professionals to understand, measure, and change urban settings to improve the well-being of people living in cities and shrink the wide gaps in health that now characterize most cities. Edited by Gina S. Lovasi, Ana V. Diez-Roux, and Jennifer Kolker, three leaders at the Dornsife School of Public Health at Drexel University, and including 51 authors, of whom 11 are based outside the United States, the book provides essential lessons for health professionals who work in cities. Three main sections discuss core competencies for urban health professionals: identifying and collecting data for urban health research, choosing appropriate tools for working with urban health data, and selecting strategies to convert evidence into action to improve health. Both implementation science and, as Green has suggested, system science can be used to generate practice-based evidence,9 an approach that could enable researchers and policymakers to better learn from the public health policy and programmatic successes and failures that occur in cities every day.10 Urban health researchers have long grappled with the questions of scale.11 How can we bring interventions to the level where they have a meaningful impact on population health?

9.
Glob Public Health ; 16(10): 1523-1536, 2021 10.
Article in English | MEDLINE | ID: covidwho-1221435

ABSTRACT

The COVID-19 pandemic has brought renewed attention to the topic of challenging drug patents in the interest of public health. Pharmaceutical companies have already begun to patent existing medicines for the treatment and prevention of SARS-CoV-2, affording them exclusive manufacturing rights over vital medicines. Advocates have raised concerns regarding the pricing of COVID-19 drugs, as well as patent monopolies on the manufacture of COVID-19 treatments. The HIV/AIDS pandemic provides a useful lens through which we can analyse existing pathways for challenging pharmaceutical patents in the context of global pandemic. In this article, we review three legal pathways for overriding and seizing patents on medicines by describing cases in which they were employed to make antiretroviral drugs more accessible to people living with HIV. Last, we highlight the weaknesses inherent in these pathways and offer advocacy and policy suggestions for how to strengthen these pathways to improve access to COVID-19 treatments as they become available in the United States and globally.


Subject(s)
Acquired Immunodeficiency Syndrome , Drug Industry , Humans , Pandemics/prevention & control , SARS-CoV-2 , United States
10.
J Urban Health ; 98(2): 187-196, 2021 04.
Article in English | MEDLINE | ID: covidwho-1077643

ABSTRACT

Understanding the effect of the coronavirus disease 2019 (COVID-19) pandemic on students' health and financial stability is important to establish effective interventions to mitigate these effects, which may have long-term consequences on their health and well-being. Public universities in urban centers represent a substantial proportion of college students in the USA. We implemented a cross-sectional population-based online survey of 2282 students in a large, public university in New York City in April 2020. We created weights to account for non-response and used Poisson regression with robust standard errors to estimate adjusted prevalence ratios (aPR) for factors associated with mental health outcomes. Students experienced high rates of anxiety/depression and financial instability due to the pandemic. Half of the students reported anxiety/depression (54.5%) and an increased need for mental health services (49.0%) as a result of the COVID-19 pandemic. The majority (81.1%) reported loss of household income, and half (49.8%) reported worries about losing housing. High levels of food (aPR  = 1.4, 95% CI 1.2, 1.6) and housing (aPR = 1.3, 95% CI 1.2, 1.4) insecurity were the strongest predictors of anxiety/depression. Household and personal experiences with possible COVID-19 symptoms were also associated with anxiety/depression or the need for increased mental health services. Addressing student needs at public urban universities requires an integrated holistic approach that targets urgent mental health and economic needs related to the impact of COVID-19. Students who become infected need mental health services as well as health monitoring.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Depression/epidemiology , Humans , New York City/epidemiology , SARS-CoV-2 , Students , Universities
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