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1.
JMIR Public Health Surveill ; 7(6): e28269, 2021 06 16.
Article in English | MEDLINE | ID: covidwho-2197912

ABSTRACT

BACKGROUND: COVID-19 is impacting people worldwide and is currently a leading cause of death in many countries. Underlying factors, including Social Determinants of Health (SDoH), could contribute to these statistics. Our prior work has explored associations between SDoH and several adverse health outcomes (eg, asthma and obesity). Our findings reinforce the emerging consensus that SDoH factors should be considered when implementing intelligent public health surveillance solutions to inform public health policies and interventions. OBJECTIVE: This study sought to redefine the Healthy People 2030's SDoH taxonomy to accommodate the COVID-19 pandemic. Furthermore, we aim to provide a blueprint and implement a prototype for the Urban Population Health Observatory (UPHO), a web-based platform that integrates classified group-level SDoH indicators to individual- and aggregate-level population health data. METHODS: The process of building the UPHO involves collecting and integrating data from several sources, classifying the collected data into drivers and outcomes, incorporating data science techniques for calculating measurable indicators from the raw variables, and studying the extent to which interventions are identified or developed to mitigate drivers that lead to the undesired outcomes. RESULTS: We generated and classified the indicators of social determinants of health, which are linked to COVID-19. To display the functionalities of the UPHO platform, we presented a prototype design to demonstrate its features. We provided a use case scenario for 4 different users. CONCLUSIONS: UPHO serves as an apparatus for implementing effective interventions and can be adopted as a global platform for chronic and infectious diseases. The UPHO surveillance platform provides a novel approach and novel insights into immediate and long-term health policy responses to the COVID-19 pandemic and other future public health crises. The UPHO assists public health organizations and policymakers in their efforts in reducing health disparities, achieving health equity, and improving urban population health.


Subject(s)
COVID-19 , Health Policy , Healthy People Programs/methods , Population Health , Public Health Surveillance/methods , Humans , SARS-CoV-2 , Urban Population
2.
Healthc Q ; 25(3): 1-3, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2145329

ABSTRACT

It would be a vast understatement to say that our healthcare systems are facing extraordinary pressure. The COVID-19 pandemic has pushed our people and our systems to their limits. We observe with trepidation that the current state of healthcare has not looked more precarious at any time in recent memory. Patients and families are feeling it. Providers, clinicians and leaders in the system are feeling it. And all of us recognize that it will take incredible political will and system-wide commitment to make the changes that are needed to renew and strengthen our front-line teams, structures and capacity. As editors for Healthcare Quarterly (HQ), we see the opportunity to contribute to the daunting task ahead by shining a light on leading practices and lessons learned from implementing change across Canada and beyond. Our commitment is to continue to showcase healthcare leadership in all forms and share opportunities for post-pandemic recovery and the future of healthcare.


Subject(s)
COVID-19 , Population Health , Humans , Pandemics , COVID-19/epidemiology , Leadership , Delivery of Health Care
4.
Public Health Nurs ; 39(6): 1255-1270, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2137203

ABSTRACT

BACKGROUND: The innovative Population Health Internship (PHI) addresses the evolving need for baccalaureate-prepared nurses to achieve population health competency. A comprehensive evaluation of the inaugural year of the PHI was conducted using the Centers for Disease Control and Prevention (CDC) Framework for Program Evaluation in Public Health and the Context, Input, Process, Product (CIPP) curricular evaluation model. Students and community agency partners-both key stakeholders-contributed to the evaluation. METHODS AND RESULTS: Quantitative data were used to address functional and outcome areas of the PHI for purposes of PHI logistics, student learning gains, and program impact and sustainability. Qualitative data were used to provide insights into challenges in instituting curricular change, complexity in student-agency communications, importance of student preparedness/attitude, issues of role confusion, misperceptions about the population health nursing role, student learning, and impacts on partner agencies and their populations. IMPLICATIONS: Educational implications include the importance of assessing both learning gains and student buy-in, the need for a long-term evaluation approach to accommodate for challenges related to radical curriculum change, and the importance of strong stakeholder support to facilitate mutually beneficial relationships and a positive learning experience.


Subject(s)
Education, Nursing, Baccalaureate , Internship and Residency , Population Health , Students, Nursing , Humans , Curriculum , Students , Learning , Education, Nursing, Baccalaureate/methods
5.
Int J Environ Res Public Health ; 19(20)2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2093856

ABSTRACT

BACKGROUND: The World Health Organization identified climate change as the 21st century's biggest health threat. This study aimed to identify the current knowledge base, evidence gaps, and implications for climate action and health policymaking to address the health impact of climate change, including in the most underserved groups. METHODS: The Horizon-funded project ENBEL ('Enhancing Belmont Research Action to support EU policy making on climate change and health') organised a workshop at the 2021-European Public Health conference. Following presentations of mitigation and adaptation strategies, seven international researchers and public health experts participated in a panel discussion linking climate change and health. Two researchers transcribed and thematically analysed the panel discussion recording. RESULTS: Four themes were identified: (1) 'Evidence is key' in leading the climate debate, (2) the need for 'messaging about health for policymaking and behaviour change' including health co-benefits of climate action, (3) existing 'inequalities between and within countries', and (4) 'insufficient resources and funding' to implement national health adaptation plans and facilitate evidence generation and climate action, particularly in vulnerable populations. CONCLUSION: More capacity is needed to monitor health effects and inequities, evaluate adaptation and mitigation interventions, address current under-representations of low- or middle-income countries, and translate research into effective policymaking.


Subject(s)
Climate Change , Population Health , Public Health , Policy Making , World Health Organization
6.
Med Trop Sante Int ; 2(3)2022 09 30.
Article in French | MEDLINE | ID: covidwho-2091751

ABSTRACT

The concept of "health literacy" has been widely used in English-speaking countries for about 20 years. However, its meaning has evolved since its first definition as "cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health", to be most often centered on the narrower meaning of "functional health literacy", which is the ability to read and understand written medical documents. This narrow definition excludes illiterate populations and don't take into consideration the social skills. Moreover, it doesn't take into consideration the barriers erected by the culture. Working in the field of health communication, we propose the broadest concept of "health culture", which encompasses health literacy as well as all the representations that influence people decisions about their health. The health culture approach makes it possible to base strategies, messages and communication tools on the representations of the target populations, in order to sensitize them to the behavioral changes promoted by this communication. We show some examples of its application in public health programs in sub-Saharan Africa: breastfeeding, pregnancy support, Ebola virus disease, HIV testing, tuberculosis, and COVID-19.


Subject(s)
COVID-19 , Health Communication , Health Literacy , Population Health , Humans , COVID-19/epidemiology , Africa South of the Sahara
7.
Int J Environ Res Public Health ; 19(21)2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2090152

ABSTRACT

BACKGROUND: COVID-19 pandemic has struck all of us suddenly and unexpectedly; it deprived the society of a sense of control over their lives on different levels. In a short period of time, it led to a number of changes in everyday life of people all over the world. In particular, these changes affected medical staff, who, all of a sudden, were burdened with new work-related responsibilities and duties. This situation may have had a detrimental effect on their mental health. Due to the unpredictability of the COVID-19 pandemic, we attempted to assess its consequences in terms of mental health and physical fitness of university students from countries in which different approaches to these issues were adopted. METHODS: A total of 779 medical students (374 students from John Paul II University of Applied Sciences (ABNS) in Biala Podlaska, Poland, and 405 students from Yanka Kupala State University of Grodno (YKSUG), Belarus) took part in the survey. Three standardised psychometric tools were used in the study: The Satisfaction With Life Scale (SWLS), The General Health Questionnaire (GHQ-28) and Stress Coping Inventory (Mini-COPE). In addition, the International Physical Activity Questionnaire (IPAQ) was applied. RESULTS: The vast majority of students both from Poland and Belarus demonstrated high levels of physical activity. However, students from ABNS manifested significantly higher levels of physical activity compared to their counterparts from YKSUG. Students from Biala Podlaska had greater satisfaction with life during the COVID-19 pandemic, whereas their peers from Grodno exhibited higher levels of mental distress. CONCLUSION: The COVID-19 pandemic resulted in a significant exacerbation of mental health issues among medical students. In order to alleviate negative effects of the pandemic, it seems necessary for universities to monitor the physical and mental health state of students and to implement prevention programmes.


Subject(s)
COVID-19 , Population Health , Students, Medical , Humans , COVID-19/epidemiology , Pandemics , Mental Health , Poland/epidemiology , Republic of Belarus , Exercise
8.
Can J Public Health ; 113(5): 649-652, 2022 10.
Article in English | MEDLINE | ID: covidwho-2067410
9.
Perspect Public Health ; 142(5): 244-245, 2022 09.
Article in English | MEDLINE | ID: covidwho-2064682
10.
BMJ ; 379: o2466, 2022 10 12.
Article in English | MEDLINE | ID: covidwho-2064132
11.
mSphere ; 7(5): e0025722, 2022 10 26.
Article in English | MEDLINE | ID: covidwho-2053133

ABSTRACT

Accurate, highly specific immunoassays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are needed to evaluate seroprevalence. This study investigated the concordance of results across four immunoassays targeting different antigens for sera collected at the beginning of the SARS-CoV-2 pandemic in the United States. Specimens from All of Us participants contributed between January and March 2020 were tested using the Abbott Architect SARS-CoV-2 IgG (immunoglobulin G) assay (Abbott) and the EuroImmun SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) (EI). Participants with discordant results, participants with concordant positive results, and a subset of concordant negative results by Abbott and EI were also tested using the Roche Elecsys anti-SARS-CoV-2 (IgG) test (Roche) and the Ortho-Clinical Diagnostics Vitros anti-SARS-CoV-2 IgG test (Ortho). The agreement and 95% confidence intervals were estimated for paired assay combinations. SARS-CoV-2 antibody concentrations were quantified for specimens with at least two positive results across four immunoassays. Among the 24,079 participants, the percent agreement for the Abbott and EI assays was 98.8% (95% confidence interval, 98.7%, 99%). Of the 490 participants who were also tested by Ortho and Roche, the probability-weighted percentage of agreement (95% confidence interval) between Ortho and Roche was 98.4% (97.9%, 98.9%), that between EI and Ortho was 98.5% (92.9%, 99.9%), that between Abbott and Roche was 98.9% (90.3%, 100.0%), that between EI and Roche was 98.9% (98.6%, 100.0%), and that between Abbott and Ortho was 98.4% (91.2%, 100.0%). Among the 32 participants who were positive by at least 2 immunoassays, 21 had quantifiable anti-SARS-CoV-2 antibody concentrations by research assays. The results across immunoassays revealed concordance during a period of low prevalence. However, the frequency of false positivity during a period of low prevalence supports the use of two sequentially performed tests for unvaccinated individuals who are seropositive by the first test. IMPORTANCE What is the agreement of commercial SARS-CoV-2 immunoglobulin G (IgG) assays during a time of low coronavirus disease 2019 (COVID-19) prevalence and no vaccine availability? Serological tests produced concordant results in a time of low SARS-CoV-2 prevalence and no vaccine availability, driven largely by the proportion of samples that were negative by two immunoassays. The CDC recommends two sequential tests for positivity for future pandemic preparedness. In a subset analysis, quantified antinucleocapsid and antispike SARS-CoV-2 IgG antibodies do not suggest the need to specify the antigen targets of the sequential assays in the CDC's recommendation because false positivity varied as much between assays targeting the same antigen as it did between assays targeting different antigens.


Subject(s)
COVID-19 , Population Health , Humans , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology , Prevalence , Seroepidemiologic Studies , Sensitivity and Specificity , Antibodies, Viral , Immunoglobulin G
13.
Int J Environ Res Public Health ; 19(17)2022 Aug 25.
Article in English | MEDLINE | ID: covidwho-2006001

ABSTRACT

Virtual care spread rapidly at the outbreak of the COVID-19 pandemic. Restricting in-person contact contributed to reducing the spread of infection and saved lives. However, the benefits of virtual care were not evenly distributed within and across social groups, and existing inequalities became exacerbated for those unable to fully access to, or benefit from virtual services. This "perspective" paper discusses the extent to which challenges in virtual care access and use in the context of COVID-19 follow the Inverse Care Law. The latter stipulates that the availability and quality of health care is inversely proportionate to the level of population health needs. We highlight the inequalities affecting some disadvantaged populations' access to, and use of public and private virtual care, and contrast this with a utopian vision of technology as the "solution to everything". In public and universal health systems, the Inverse Care Law may manifests itself in access issues, capacity, and/or lack of perceived benefit to use digital technologies, as well as in data poverty. For commercial "Direct-To-Consumer" services, all of the above may be encouraged via a consumerist (i.e., profit-oriented) approach, limited and episodic services, or the use of low direct cost platforms. With virtual care rapidly growing, we set out ways forward for policy, practice, and research to ensure virtual care benefits for everyone, which include: (1) pay more attention to "capabilities" supporting access and use of virtual care; (2) consider digital technologies as a basic human right that should be automatically taken into account, not only in health policies, but also in social policies; (3) take more seriously the impact of the digital economy on equity, notably through a greater state involvement in co-constructing "public health value" through innovation; and (4) reconsider the dominant digital innovation research paradigm to better recognize the contexts, factors, and conditions that influence access to and use of virtual care by different groups.


Subject(s)
COVID-19 , Population Health , COVID-19/epidemiology , Delivery of Health Care , Health Policy , Humans , Pandemics
15.
JAMA Psychiatry ; 79(9): 898-906, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-1958659

ABSTRACT

Importance: The COVID-19 pandemic has coincided with an increase in depressive symptoms as well as a growing awareness of health inequities and structural racism in the United States. Objective: To examine the association of mental health with everyday discrimination during the pandemic in a large and diverse cohort of the All of Us Research Program. Design, Setting, and Participants: Using repeated assessments in the early months of the pandemic, mixed-effects models were fitted to assess the associations of discrimination with depressive symptoms and suicidal ideation, and inverse probability weights were applied to account for nonrandom probabilities of completing the voluntary survey. Main Outcomes and Measures: The exposure and outcome measures were ascertained using the Everyday Discrimination Scale and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Scores for PHQ-9 that were greater than or equal to 10 were classified as moderate to severe depressive symptoms, and any positive response to the ninth item of the PHQ-9 scale was considered as presenting suicidal ideation. Results: A total of 62 651 individuals (mean [SD] age, 59.3 [15.9] years; female sex at birth, 41 084 [65.6%]) completed at least 1 assessment between May and July 2020. An association with significantly increased likelihood of moderate to severe depressive symptoms and suicidal ideation was observed as the levels of discrimination increased. There was a dose-response association, with 17.68-fold (95% CI, 13.49-23.17; P < .001) and 10.76-fold (95% CI, 7.82-14.80; P < .001) increases in the odds of moderate to severe depressive symptoms and suicidal ideation, respectively, on experiencing discrimination more than once a week. In addition, the association with depressive symptoms was greater when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino participants at all 3 time points and among non-Hispanic Asian participants in May and June 2020. Furthermore, high levels of discrimination were as strongly associated with moderate to severe depressive symptoms as was history of prepandemic mood disorder diagnosis. Conclusions and Relevance: In this large and diverse sample, increased levels of discrimination were associated with higher odds of experiencing moderate to severe depressive symptoms. This association was particularly evident when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino participants and, early in the pandemic, among non-Hispanic Asian participants.


Subject(s)
COVID-19 , Population Health , Adolescent , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Female , Humans , Infant, Newborn , Pandemics , Suicidal Ideation , United States/epidemiology
17.
BMC Med Educ ; 22(1): 532, 2022 Jul 08.
Article in English | MEDLINE | ID: covidwho-1928178

ABSTRACT

BACKGROUND: In 2019 a new Lifestyle Medicine (LM) module was introduced to the undergraduate medical curriculum at Imperial College London. Lifestyle Medicine is an emergent discipline which aims to tackle the increasing burden of non-communicable disease. Previous work has suggested that students value clinical teaching over traditional Public Health topics. Taking a constructivist view of learning, this paper assesses changes in medical students' attitudes towards Public Health and LM in response to living through a pandemic. We then make suggestions as to how this lived experience might be useful in teaching LM, and discuss the interaction between teaching, behaviour, and experience with consideration of self-determination theories in learning. METHODS: First-year medical students were surveyed at the end of their first year of teaching and asked if living during the COVID-19 pandemic had changed the value they place on LM and if so, how. Thematic analysis was conducted on responses representing 71% (n = 216) of the year group. RESULTS: Four themes were defined in the data: acknowledging importance; impact on behaviour; health inequalities and the wider determinants; and promoting Public Health and prevention. These themes highlight the distinct levels through which the pandemic has had an impact: from personal behaviour to population health. CONCLUSIONS: This is the first study to look at the impact of living through a pandemic on attitudes to LM. Our results suggest that the pandemic has led to increased reflection on health behaviours. The lived-experience of COVID-19 may facilitate a better understanding of health inequalities and their impact, alongside the opportunities presented by effective LM interventions.


Subject(s)
COVID-19 , Population Health , Students, Medical , Humans , Life Style , Pandemics , Self Care
18.
Public Health Nurs ; 39(6): 1355-1360, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1909512

ABSTRACT

Public health nurses (PHNs) use principles of epidemiology in their work with communities; however, teaching these concepts at the baccalaureate level can be challenging. To reinforce the epidemiologic concepts taught in the classroom, two nursing faculty in our baccalaureate nursing program developed a population health project that allows students to explore concepts of epidemiology within the context of a population health concern. This article describes how the project provides students with a realistic opportunity to research the health issue. As a part of the project, students collect and analyze data about the health concern at the county, state, and national level. The project also requires students to identify local agencies who provide services for people who are impacted by the health issue and describe their role and function within the community. Furthermore, students discuss the roles and responsibilities of nurses in managing the population health concern under investigation. In doing so, students recognize how epidemiology informs population level nursing care. If nursing students understand epidemiological concepts, they will be better prepared to educate the communities they serve after graduation when a population health crisis, such as the recent COVID-19 pandemic, occurs.


Subject(s)
COVID-19 , Education, Nursing, Baccalaureate , Population Health , Students, Nursing , Humans , Pandemics , Teaching , Curriculum
19.
N Z Med J ; 135(1550): 133-139, 2022 02 25.
Article in English | MEDLINE | ID: covidwho-1897752

ABSTRACT

People with mental health and substance use issues (tangata whai ora katoa), regardless of ethnicity, are much more likely to be hospitalised or die from COVID-19 and were identified as a priority population (Priority Group 3) in Aotearoa New Zealand's vaccination roll-out plan. Data released by the Ministry of Health show that, despite tangata whai ora katoa being a priority group, their vaccination rates are well below those of the general population. These inequities are pronounced for Maori with mental health and addiction issues (tangata whai ora Maori). This is not acceptable. To support tangata whai ora physical health and wellbeing, the onus is on all of us in the health system to actively reach out, have conversations, be supportive and provide accessible vaccination for people with mental health and addiction issues. Urgent action is needed. Now is the time to ensure tangata whai ora katoa can be equally well.


Subject(s)
COVID-19 , Population Health , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Mental Health , New Zealand/epidemiology , Vaccination
20.
Soc Sci Med ; 306: 115156, 2022 08.
Article in English | MEDLINE | ID: covidwho-1895443

ABSTRACT

RATIONALE: The coronavirus disease 2019 (COVID-19) pandemic and consequent lockdown measures have had a large impact on people's lives. Recent evidence suggests that self-rated health (SRH) scores remained relatively stable or increased during the pandemic. OBJECTIVE: For the current project, we examine potential changes in the variance decomposition of SRH before and during the COVID-19 pandemic in the Netherlands. METHODS: We analyse data from the Netherlands Twin Register to examine pre-pandemic SRH scores (N = 16,127), pandemic SRH scores (N = 17,451), and SRH difference scores (N = 7464). Additionally, we perform bivariate genetic analyses to estimate genetic and environmental variance components in pre-pandemic and pandemic SRH, and estimate the genetic correlation to assess potential gene-environment interaction. RESULTS: The majority of the sample (66.7%) reported the same SRH before and during the pandemic, while 10.8% reported a decrease, and 22.5% an increase. Individuals who reported good/excellent SRH before the pandemic were most likely to report unchanged SRH during the pandemic, and individuals with bad/mediocre/reasonable SRH more often reported increased SRH. The bivariate longitudinal genetic model reveals no significant change in variance decomposition of SRH from before to during the pandemic, with a heritability estimate of 45% (CI 36%-52%). We found that the genetic correlation could be constrained to 1, and a moderate unique environmental correlation (rE = 0.49, CI = 0.37 to 0.60). CONCLUSIONS: We theorize that the increases in SRH are explained by uninfected individuals evaluating their health more positively than under normal circumstances (partly through social comparison with infected individuals), rather than actual improvements. As the same genes are expressed under different environmental exposures, these results imply no evidence for gene-environment interaction. While different environmental factors might influence SRH at the two time-points, the influence of environmental factors does not become relatively more important during the pandemic.


Subject(s)
COVID-19 , Population Health , COVID-19/epidemiology , Communicable Disease Control , Health Status , Humans , Longitudinal Studies , Pandemics
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