Advocating for improvements to building codes for the population's health.

Construction codes are a major component of building codes. They provide normative standards by which buildings are designed, built, altered, inspected, and assessed. Persistently high, fall-related injury rates on stairs and in bathrooms indicate that public health advocacy is needed to enhance the passive protection of these codes. Targets and strategies for code improvement advocacy by public health professionals, organizations, and associations are discussed. Approaches pertinent to describing the problem, proposing solutions, and framing the message are considered. Attention is given to issues that may be particularly challenging for advocates. These include the need to address minimum standards, tackling gaps in injury-related surveillance data that may be used by the building industry to rebut proposed code changes, describing how construction code changes align with other progressive legal tools that shape our built environments, and considering which sector pays and which sector benefits from code improvements. Ergonomic and epidemiologic evidence indicates that construction code improvements can reduce falls and fall-related injuries. Public health advocates have an important role to play in strengthening these codes.

Digital technologies for population health and health equity gains: the perspective of public health associations.

Digital technology (DT) plays an increasingly important role in the health sector. This study explores how national public health associations (PHAs) use DT to achieve their mandate. The World Federation of Public Health Associations canvassed and conducted a semi-structured interview with its national public health association members about their use of DT, the challenges they encounter in using it, and their experiences and thoughts as to how to assess its impact, both organizationally as well as on population health and health equity. The study found that digital technology plays an important role in some PHAs, principally those in higher income countries. PHAs want to broaden their use within PHAs and to assess how DT enables PHAs to achieve their organizational mandates and goals, including improved public health and health equity.

A survey of the governance capacity of national public health associations to enhance population health.

BACKGROUND: National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public's health. Governance and organizational capacity are among the key determinants of a PHA's effectiveness as an advocate for appropriate public health policies and practice. METHODS: During 2014, the World Federation of Public Health Associations (WFPHA) conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis RESULTS: Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA's leaders (77 %) and the competence of people serving on the PHA's governing body (76 %). The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %). The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health leaders. CONCLUSION: National PHA have a responsibility to put into place the practices and infrastructure that enhance organizational governance. This will enhance their ability to be effective advocates for policies and practices that enhance, protect and promote the public's health. The WFPHA has an important role to play in providing the technical assistance and financial resources to assist PHAs in attaining and sustaining a higher level of governance capacity.

Building codes: An often overlooked determinant of health.

Although the vast majority of the world's population spends most of their time in buildings, building codes are not often thought of as 'determinants of health'. The standards that govern the design, construction, and use of buildings affect our health, security, safety, and well-being. This is true for dwellings, schools, and universities, shopping centers, places of recreation, places of worship, health-care facilities, and workplaces. We urge proactive engagement by the global public health community in developing these codes, and in the design and implementation of health protection and health promotion activities intended to reduce the risk of injury, disability, and death, particularly when due to poor building code adoption/adaption, application, and enforcement.

Global youth tobacco surveillance, 2000-2007.

PROBLEM: Tobacco use is a major contributor to deaths from chronic diseases. The findings from the Global Youth Tobacco Survey (GYTS) suggest that the estimate of a doubling of deaths from smoking (from 5 million per year to approximately 10 million per year by 2020) might be an underestimate because of the increase in smoking among young girls compared with adult females, the high susceptibility of smoking among never smokers, high levels of exposure to secondhand smoke, and protobacco indirect advertising. REPORTING PERIOD COVERED: This report includes GYTS data collected during 2000-2007 from 140 World Health Organization (WHO) member states, six territories (American Samoa, British Virgin Islands, Guam, Montserrat, Puerto Rico, and the U.S. Virgin Islands), two geographic regions (Gaza Strip and West Bank), one United Nations administered province (Kosovo), one special administrative region (Macau), and one Commonwealth (Northern Mariana Islands). For countries that have repeated GYTS, only the most recent data are included. For countries with multiple survey sites, only data from the capital or largest city are presented. DESCRIPTION OF SYSTEM: GYTS is a school-based survey of a defined geographic site that can be a country, a province, a city, or any other geographic entity. GYTS uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, conducting field procedures, and processing data. GYTS standard sampling methodology uses a two-stage cluster sample design that produces samples of students in grades associated with students aged 13-15 years. Each sampling frame includes all schools (usually public and private) in a geographically defined area containing any of the identified grades. In the first stage, the probability of schools being selected is proportional to the number of students enrolled in the specified grades. In the second sampling stage, classes within the selected schools are selected randomly. All students in selected classes attending school the day the survey is administered are eligible to participate. Student participation is voluntary and anonymous using self-administered data collection procedures. The GYTS sample design produces independent, cross-sectional estimates that are representative of each site. RESULTS: The findings in this report indicate that the level of cigarette smoking between boys and girls is similar in many sites; the prevalence of cigarette smoking and use of other tobacco products is similar; and susceptibility to initiate smoking among never smokers is similar among boys and girls and is higher than cigarette smoking in the majority of sites. Approximately half of the students reported that they were exposed to secondhand smoke in public places during the week preceding the survey. Approximately eight in 10 favor a ban on smoking in public places. Approximately two in 10 students own an object with a cigarette brand logo on it, and one in 10 students have been offered free cigarettes by a tobacco company representative. Approximately seven in 10 students who smoke reported that they wanted to stop smoking. Approximately seven in 10 students who smoked were not refused purchase of cigarettes from a store during the month preceding the survey. Finally, approximately six in 10 students reported having been taught in school about the harmful effects of smoking during the year preceding the survey. INTERPRETATION: The findings in this report suggest that interventions that decrease tobacco use among youth (e.g., increasing excise taxes, media campaigns, school programs in conjunction with community interventions, and community interventions that decrease minors' access to tobacco) must be broad-based, focused on boys and girls, and have components directed toward prevention and cessation. If effective programs are not developed and implemented soon, future morbidity and mortality attributed to tobacco probably will increase. PUBLIC HEALTH ACTION: The synergy between countries in passing tobacco-control laws, regulations, or decrees; ratifying the WHO Framework Convention on Tobacco Control; and conducting GYTS offers a unique opportunity to develop, implement, and evaluate comprehensive tobacco-control policy that can be helpful to each country. The challenge for each country is to develop, implement, and evaluate a tobacco-control program and make changes where necessary.

Prevalence of tobacco use among students aged 13-15 years in the South-Eastern Europe health network.

OBJECTIVE: To examine adolescent tobacco use among members of the South-Eastern Europe (SEE) Health Network using data from the Global Youth Tobacco Survey (GYTS). METHODS: Nationally representative samples were drawn from students in grades associated with youth aged 13 to 15 in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, the Former Yugoslavian Republic of Macedonia, Montenegro, Republic of Moldova, Romania, and Serbia. RESULTS: Current cigarette smoking rates among students ranged from 5.6% to 33.1%. Current use of tobacco products other than cigarettes ranged from 3.6% to 10.2%. CONCLUSIONS: If effective programs are not developed, implemented, and enforced, morbidity and mortality attributed to tobacco use will surely increase.