Common Problems! and Common Solutions? - Teaching at the Intersection Between Public Health and Criminology: A Public Health Perspective.

Public health and criminology share similar current and future challenges, mostly related to crime and health causation, prevention, and sustainable development. Interdisciplinary and transdisciplinary approaches to education at the intersection of public health and criminology can be an integral part of future training in areas of mutual interest. Based on reflections on teaching criminology students, this viewpoint discusses the main interconnections between public health and criminology teaching through the public health lens. The paper discusses potential challenges associated with interdisciplinarity and transdisciplinarity. Among these challenges is communication across the different fields and their perspectives to be able to achieve the desired complementarity at the intersection of the two disciplines.

A qualitative study of factors that managers in small companies consider important for their wellbeing.

PURPOSE: Given the importance of small businesses for society, and the significance of managers' wellbeing for employee health, leadership, and business performance, more knowledge is needed on the sources of managers' wellbeing. This study explored factors within the small business context that were perceived by managers to hinder or enable their wellbeing. METHODS: Data were collected through qualitative semi-structured interviews with 20 managers from 12 small companies, and analysed with content analysis. RESULTS: The factors that these managers in small businesses experienced as enhancing or hindering their personal wellbeing covered five categories: demands and resources in the daily managerial work, achievement of results, social factors, organizational factors, and individual factors. CONCLUSIONS: The specific context of managerial work in small companies encompasses unique factors. For instance, the small company managers' wellbeing was affected by vulnerability due to the smallness of the business and the absence of available resources. Simultaneously, a small company context provided a strong social climate and close relationships with employees and customers that strengthened the managers' wellbeing. The findings suggest that the availability of financial, personnel, and organizational resources varies between small companies of different size, which may have implications for small business managers' work and wellbeing.

Does Structural Violence by Institutions Enable Revictimization and Lead to Poorer Health Outcomes?-A Public Health Viewpoint.

Although structural violence is known to interact with and reinforce direct violence in the form of interpersonal violence (e.g., intimate partner violence), little debate takes place in public health on how it can lead to revictimization, leading to even poorer health outcomes (including psychological ill health). This viewpoint aims to discuss this issue using examples from empirical studies to elucidate how structural violence (perpetrated through institutions) contributes to revictimization among people who are already suffering direct violence. Public health professionals (and researchers) need to make efforts to theorize and measure structural violence to aid efforts toward the study of how it intersects with interpersonal violence to influence health outcomes. This will ultimately contribute to better prevention and intervention efforts to curb interpersonal violence and improve population health and well-being. In addition, there is a need to include structural violence in the academic curriculum when training future generations of public health professionals. Increased education on structural violence will bring about an awareness of the grave consequences of the potential additional harm that institutions could inflict on the lives of people they should be protecting or care for.

Effects of acne severity and acne-related quality of life on depressive symptoms among adolescents and young adults: a cross-sectional study in Bangladesh.

Introduction: Depression is a common mental health disorder and one of the major causes of disability. This study aimed at investigating the relationship of acne severity and acne-related quality of life with depressive symptoms, and the mediating effect of acne-related quality of life in a relationship between acne severity and depressive symptoms. Methods: This is a cross-sectional study. Data were collected from acne patients attending a tertiary-level hospital, using a questionnaire that comprised three validated instruments - Investigator's Global Assessment (a single item) scale, Cardiff Acne Disability Index, and Beck Depression Inventory for measuring acne severity, acne-related quality of life, and depressive symptoms, respectively. Logistic regression and linear regression were used to examine the association between acne severity and depressive symptoms and a correlation between the acne-related quality of life and depressive symptoms, respectively. A mediation analysis was also performed to see the mediation effects of acne-related quality of life in a relationship between acne severity and depressive symptoms. Results: A total of 185 acne patients (155 females, 83.8%) with a mean age was 22.55 ± 8.67 years were included in the study. Adolescents and young adults with severe and moderate acne had 6.14-and 2.28 times higher odds of depression compared to their peers with mild acne, respectively. Patients with low levels of acne-related quality of life had a higher level of depressive symptoms (ß = 0.42, p < 0.001). The total effect (direct + indirect) was also significant (ß = 0.27, 95% CI: 1.29-4.09), implying the effect of acne severity on depression. Conclusion: The present study suggests that acne severity and acne-related quality of life were associated with depressive symptoms among patients with acne vulgaris. The study also indicates that the relationship between acne severity and depressive symptoms might occur through a chain-mediating effect of acne disability in this population.

Food Insecurity and Associated Factors among Households in Maputo City.

Food insecurity (FI) is a global concern and is one of the main causes of malnutrition in low- and middle-income countries. In Mozambique, the burden of FI and how various factors contribute to FI is not well known. This study aimed to investigate the prevalence of FI and its associated factors in southern Mozambique. Data from 1842 household heads in Maputo City were analyzed in a cross-sectional design. Food insecurity was measured using a modified version of the US Department of Agriculture Household Food Security scale, and its association with socio-demographic factors was assessed through multiple regressions. Altogether, 79% of the households were food insecure; of these, 16.6% had mild FI, 28.1% moderate and 34.4% severe FI. The study revealed that low-income households, those with less educated heads, and those engaged in informal work were significantly more prone to FI. Likewise, dietary diversity and the number of meals were also significant predictors of FI. These findings suggest the need for decent work and job creation, which calls for joint efforts from government, the private sector, and international institutions. Furthermore, these key drivers should be considered in the development of public health policies and programs designed to alleviate household FI and malnutrition in Mozambique.

Perceptions of Health and Wellbeing Among Employees in a Work Integration Social Enterprise in Sweden.

Background: Work Integration Social Enterprises (WISEs) constitute an important vehicle for providing employment opportunities for disadvantaged groups. Objective: The goal of this qualitative case study is to explore perceptions of health and wellbeing among employees working in a WISE located in the Gävleborg region, in east central Sweden. Methods: Data were gathered using 16 in-depth, semi-structured interviews with the social enterprise employees. Results: Findings were categorized into three main categories: the importance of financial independence and societal benefits; team spirit and a sense of belonging; and improved quality of life and wellbeing. Conclusion: The participants perceived that working in the WISE gave them a feeling of freedom and increased their self-esteem because of the possibility to earn an income. Also, they were satisfied with their job (e.g., with regard to work quality and flexibility) and believed that their work contributed to society. Moreover, through working in a WISE, the participants felt a sense of belonging and togetherness through interaction with co-workers and managers, and an improved quality of life for themselves and their families.

The Association between Fear of Crime, Educational Attainment, and Health.

Fear of crime is an important public health problem that impacts people's quality of life, health, and wellbeing, and causes mental health ailments (e.g., anxiety). This study aimed to determine whether there was an association between fear of crime, educational attainment, and self-rated health and anxiety among women residing in a county in east-central Sweden. A sample (n = 3002) of women aged 18-84 years surveyed in the Health on Equal Terms survey carried out in 2018 was included in the study. Bivariate and multivariate regression analysis was performed on the relationship between the composite variables fear of crime, educational attainment, and self-rated health and anxiety. Women with primary education or similar who reported fear of crime had increased odds of poor health (odds ratio (OR) 3.17; 95% confidence interval (CI) 2.40-4.18) compared with women with primary education/similar and no fear of crime (OR 2.90; CI 1.90-3.20). A statistically significant relationship persisted in the multivariate analysis after controlling for other covariates, although the odds were reduced (OR 1.70; CI 1.14-2.53 and 1.73; CI 1.21-2.48, respectively). Similarly, in the bivariate analysis, women who reported fear of crime and who only had primary education had statistically significant odds of anxiety (OR 2.12; CI 1.64-2.74); the significance was removed, and the odds were reduced (OR 1.30; CI 0.93-1.82) after adjusting for demographic, socioeconomic, and health-related covariates. Women with only primary education or similar who reported fear of crime had higher odds of poor health and anxiety compared with those with university education or similar, with and without fear of crime. Future studies (including longitudinal ones) are warranted-on the one hand, to understand possible mechanisms of the relationship between educational attainment and fear of crime and its consequences to health, and on the other, to explore low-educated women's own perceptions regarding factors underlining their fear of crime (qualitative studies).

Coping with COVID-19 Pandemic and Sustained Health Behavior: A Cross-Sectional Study in Bangladesh.

During the COVID-19 pandemic, people's health behavioral changes have been transposed into a new dimension. Coping with the COVID-19 pandemic may have an impact on sustained health behavior (SHB). Therefore, this study aimed to explore the validity and reliability of the COVID-19 Coping Scale among working-age individuals and to assess whether coping with COVID-19-related stress could influence SHB in this population. A cross-sectional study was conducted based on the population of the city of Dhaka in Bangladesh. A total of 263 working-age individuals (19-65 years) participated in the study. The present study results confirmed the COVID-19 Coping Scale was a valid and reliable instrument for this population. Moreover, the present finding indicated decreased odds of SHB for individuals who rated lower scores on coping with COVID-19 compared to individuals who rated higher scores; the result remained significant after controlling for gender and education (OR 0.68, 95% CI: 0.54-0.87). The present study suggests two important findings: (i) the instrument used in this study was valid and reliable in this population, and (ii) coping with COVID-19-related stress may be an important aspect of practicing SHB. Policymakers may use the highlighted findings to facilitate sustainable health behavior for long-term health benefits and to tackle future pandemics like COVID-19 or in a similar context.

Interpersonal Violence Is Associated with Self-Reported Stress, Anxiety and Depression among Men in East-Central Sweden: Results of a Population-Based Survey.

Background and Objectives: Interpersonal violence is a social and public health problem globally, and though it is related to poor health outcomes across all genders, most research has been directed towards violence against women. As a result, the health consequences of men's victimization may be underreported and unaddressed. The purpose of this study was to assess the relationship between interpersonal violence and the psychological health outcomes of self-reported stress, anxiety, and depression among men. Materials and Methods: The study used data from the male sample (n = 2597) of the 2018 Health on Equal Terms Survey conducted in Gävleborg County in East-Central Sweden. Regression analysis was carried out to study the relationship between interpersonal violence and self-reported stress, anxiety, and depression. Results: The bivariate analysis showed that there was a statistically significant association between interpersonal violence and self-reported stress (OR 2.35; CI 1.45-3.81), anxiety (OR 1.54; CI 1.06-2.25), and depression (OR 2.30; CI 1.48-3.57). Controlling for other variables in the multivariate analysis removed the statistically significant relationship and reduced the odds ratios for stress (OR 1.46; CI 0.57-3.74), anxiety (OR 0.86; 0.40-1.84), and depression (OR 1.40; CI 0.67-3.32) respectively. Conclusions: The study found that interpersonal violence among men was associated with stress, anxiety and depression which was largely explained by demographic, socioeconomic, and health/behavior-related factors. The findings suggest the need for longitudinal studies to assess causal links between male victimization and psychological health outcomes at the county level.

Managers' and employees' experiences of how managers' wellbeing impacts their leadership behaviours in Swedish small businesses.

BACKGROUND: There is a growing interest in managers' wellbeing due to the observed associations between their wellbeing and leadership behaviours, and between leadership behaviours and employees' wellbeing. However, it is still unclear how managers' wellbeing influences their practiced leadership across different workplace contexts, which specific behaviours are affected, and how this varies across time. OBJECTIVE: The purpose of this study was therefore to explore managers' and employees' experiences and perceptions regarding the consequences of managers' wellbeing for their leadership behaviours in small businesses. METHODS: Semi-structured interviews were conducted with 39 participants (20 managers and 19 employees) working at 12 Swedish small firms, and analysed using content analysis. RESULTS: The findings show that managers were more constructive when they felt well, and more passively destructive when unwell. Variations in managers' wellbeing influenced their mood, energy level, and performance, as well as the company's working climate. However, these destructive leadership variations did not have a substantial impact, because several protective factors were present. CONCLUSION: This study shows that the wellbeing of managers in small businesses has perceptible consequences for their leadership behaviours. The study also shows that sustained leadership behaviours may coexist with temporary variations of these behaviours on a constructive-destructive continuum depending on the leader's wellbeing. Overall, the findings contribute to a more nuanced and dynamic understanding of how the interaction between managers' wellbeing and their behaviours unfolds in the particular context of small companies.

Mortality from Acute Coronary Syndrome: Does Place of Residence Matter?

Background : Current evidence shows inequality in the outcomes of rural and urban patients treated at their place of residence. This study compared in-hospital mortality between rural and urban patients with acute coronary syndrome (ACS) to find whether there were differences in the outcome and received treatment. Methods : Between May 2007 and January 2018, patients admitted with ACS were included. The patients' demographic, clinical, and laboratory data, as well as their in-hospital medical courses, were recorded. The association between place of residence (rural/urban) and in-hospital mortality due to ACS was evaluated using logistic regression adjusted for potential confounders. Results: Of 9088 recruited patients (mean age =61.30±12.25 y; 5557 men [61.1%]), 838 were rural residents. A positive family history of coronary artery disease (P=0.003), smoking (P=0.002), and hyperlipidemia (P=0.026), as well as a higher body mass index (P=0.013), was seen more frequently in the urban patients, while the rural patients had lower education levels (P<0.001) and higher unemployment rates (P=0.009). In-hospital mortality occurred in 135 patients (1.5%): 10 rural (1.2%) and 125 urban (1.5%) patients (P=0.465). The Firth regression model, used to adjust the effects of possible confounders, showed no significant difference concerning in-hospital mortality between the rural and urban patients (OR, 1.57; 95% CI, 0.376 to 7.450; P=0.585). Conclusion : This study found no significant differences in receiving proper treatment and in-hospital mortality between rural and urban patients with ACS.

Public Health Aspects of Climate Change Adaptation in Three Cities: A Qualitative Study.

Climate change presents an unprecedented public health challenge as it has a great impact on population health outcomes across the global population. The key to addressing these health challenges is adaptation carried out in cities through collaboration between institutions, including public health ones. Through semi-structured interviews (n = 16), this study investigated experiences and perceptions of what public health aspects are considered by urban and public health planners and researchers when planning climate change adaptation in the coastal cities of Söderhamn (Sweden), Porto (Portugal) and Navotas (the Philippines). Results of the thematic analysis indicated that participating stakeholders were aware of the main climate risks threatening their cities (rising water levels and flooding, extreme temperatures, and air pollution). In addition, the interviewees talked about collaboration with other sectors, including the public health sector, in implementing climate change adaptation plans. However, the inclusion of the public health sector as a partner in the process was identified in only two cities, Navotas and Porto. Furthermore, the study found that there were few aspects pertaining to public health (water and sanitation, prevention of heat-related and water-borne diseases, and prevention of the consequences associated with heat waves in vulnerable groups such as children and elderly persons) in the latest climate change adaptation plans posted on each city's website. Moreover, participants pointed to different difficulties: insufficient financial resources, limited intersectoral collaboration for climate change adaptation, and lack of involvement of the public health sector in the adaptation processes, especially in one of the cities in which climate change adaptation was solely the responsibility of the urban planners. Studies using larger samples of stakeholders in larger cities are needed to better understand why the public health sector is still almost absent in efforts to adapt to climate change.

Food Insecurity and Health Outcomes Other than Malnutrition in Southern Africa: A Descriptive Systematic Review.

Food insecurity (FI) is one of the major causes of malnutrition and is associated with a range of negative health outcomes in low and middle-income countries. The burden of FI in southern Africa is unknown, although FI continues to be a major public health problem across sub-Saharan Africa as a whole. Therefore, this review sought to identify empirical studies that related FI to health outcomes among adults in southern Africa. Altogether, 14 publications using diverse measures of FI were reviewed. The majority of the studies measured FI using modified versions of the United States Department of Agriculture Household Food Security Survey Module. A wide range in prevalence and severity of FI was reported (18-91%), depending on the measurement tool and population under investigation. Furthermore, FI was mostly associated with hypertension, diabetes, anxiety, depression and increased risk of human immunodeficiency virus (HIV) acquisition. Based on the findings, future research is needed, especially in countries with as yet no empirical studies on the subject, to identify and standardize measures of FI suitable for the southern African context and to inform public health policies and appropriate interventions aiming to alleviate FI and potentially improve health outcomes in the region.

Can domestic medical tourism contribute to healthcare equity? A commentary.

Pupose - This essay uses service marketing concept to discuss how domestic medical tourism (DMT) can contribute to healthcare equity in developed countries. Approach - The authors take up several vital issues. First, the potential benefits of DMT are outlined from a healthcare equity perspective; second, the challenges that DMT confronts in reaching its aim are identified; and finally, a few research areas are suggested. Finding - It is suggested that increased awareness about the healthcare service and proper service delivery are required to improve healthcare equity. Practical implication - This paper raises several research issues from service marketing to deal with delivery, communication, efficiency, and insurance practices regarding healthcare. Social implication - From a societal point of view, it explores how healthcare equity can be improved by DMT.

Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study.

Institutional delivery at birth is an important indicator of improvements in maternal health, which remains one of the targets of sustainable development goals intended to reduce the maternal mortality ratio. The purpose of the present study was to identify the determinants of utilization of institutional delivery in Zambia. A population-based cross-sectional study design was used to examine 9841 women aged 15-49 years from the 2018 Zambia Demographic and Health Survey. A multiple logistic regression was applied to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to identify determinants of utilization of institutional delivery. Sociodemographic factors were significantly associated with institutional delivery: woman's (OR: 1.76; 95% CI: 1.04-2.99) and husband's (OR: 1.83; 95% CI: 1.09-3.05) secondary/higher education, higher wealth index (OR: 2.31; 95% CI: 1.27-4.22), and rural place of residence (OR: 0.55; 95% CI: 0.30-0.98). Healthcare-related factors were also significantly associated with institutional delivery: 5-12 visits to antenatal care (OR: 2.33; 95% CI: 1.66-3.26) and measuring blood pressure (OR: 2.15; 95% CI: 1.32-2.66) during pregnancy. To improve institutional delivery and reduce maternal and newborn mortality, policymakers and public health planners should design an effective intervention program targeting these factors.

Social Enterprise, Population Health and Sustainable Development Goal 3: A Public Health Viewpoint.

Although there is no consensus on the definition of "social enterprises (SEs)," various scholars have agreed that SEs are "sustainable ventures that combine business principles with a passion for social impact." Using a public health lens, this viewpoint paper attempts to discuss the potential role SEs might play in the achievement of sustainable population health and Sustainable Development Goal 3 (SDG 3): "Health for all at all ages." Through their impact on social determinants of health (the conditions in which people are born, grow, work, and age), SEs have a potential to contribute to SDGs, specifically SDG 3. They can do so by acting on and modifying the economic, social and environmental challenges communities face, to help promote health and wellbeing and improve the quality of life among children, adolescents, working adults and elderly across countries, societies and generations. Social enterprises present an opportunity to engage business as partners in health promotion - which is yet to materialize in all societies globally.

Structural Violence and Health-Related Outcomes in Europe: A Descriptive Systematic Review.

In recent years, there has been a revival of the term "structural violence (SV)" which was coined by Johan Galtung in the 1960s in the context of Peace Studies. "Structural violence" refers to social structures-economic, legal, political, religious, and cultural-that prevent individuals, groups and societies from reaching their full potential. In the European context, very few studies have investigated health and well-being using an SV perspective. Therefore, this paper sought to systematically and descriptively review studies that used an SV framework to examine health-related outcomes across European countries. The review included two studies each from Spain and France, one each from the UK, Ukraine and Russia, and another study including the three countries Sweden, Portugal and Germany. With the exception of one mixed-method study, the studies used a qualitative design. Furthermore, the eight studies in the review used different conceptualizations of SV, which indicates the complexity of using SV as a concept in public health in the European context. Future research that attempts to identify and standardize measures of SV is needed; the knowledge gained is hoped to inform appropriate interventions aiming to reduce the effects of SV on population health.

The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey.

BACKGROUND: Elder abuse is a growing public health question among policy makers and practitioners in many countries. Research findings usually indicate women as victims, whereas male elder abuse still remains under-detected and under-reported. We aimed to investigate the prevalence, severity and chronicity of abuse (psychological, physical, physical injury, sexual, and financial) against older men, and to scrutinize factors (e.g. demographics) associated with high chronicity of any abuse. METHODS: Randomly selected older men (n = 1908) aged 60-84 years from seven European cities (Ancona, Athens, Granada, Kaunas, Stuttgart, Porto, Stockholm) were interviewed in 2009 via a cross-sectional study concerning abuse exposure during the past 12 months. RESULTS: Findings suggested that prevalence of abuse towards older men varied between 0.3% (sexual) and 20.3% (psychological), with severe acts between 0.2% (sexual) and 8.2% (psychological). On the whole, higher chronicity values were for injury, followed by psychological, financial, physical, and sexual abuse. Being from Sweden, experiencing anxiety and having a spouse/cohabitant/woman as perpetrator were associated with a greater "risk" for high chronicity of any abuse. For men, severity and chronicity of abuse were in some cases relatively high. CONCLUSIONS: Abuse towards older men, in the light of severe and repeated acts occurring, should be a source of concern for family, caring staff, social work practice and policy makers, in order to develop together adequate prevention and treatment strategies.

Can sustainable health behaviour contribute to ensure healthy lives and wellbeing for all at all ages (SDG 3)? A viewpoint.

Sustainable health behaviours and, specifically, eating a sustainable diet and engaging in regular physical activity are health-promoting behaviours that can simultaneously contribute to reduction of greenhouse gases which are known to contribute to climate change. Good health usually facilitates societal development, and development often promotes improved health. However, while good health may be a prerequisite for societal development, some behavioural determinants of health, such as attitudes towards the environment, and people's lifestyles and consumption patterns, can impede the sustainability of the development process in the longer term. This perspective paper argues that there is a need to rethink 21st century health promotion practices by pairing sustainability literacy with health promotion for changing dietary and physical activity behaviour patterns to improve population health and contribute to the achievement of Sustainable Development Goal 3 (to ensure healthy lives and promote wellbeing for all at all ages).