Pub Date : 2024-05-10DOI: 10.1186/s12992-024-01041-z
Rachel Neill, Angélica López Hernández, Adam D Koon, Abdulgafoor M Bachani
Background: Traffic-related crashes are a leading cause of premature death and disability. The safe systems approach is an evidence-informed set of innovations to reduce traffic-related injuries and deaths. First developed in Sweden, global health actors are adapting the model to improve road safety in low- and middle-income countries via technical assistance (TA) programs; however, there is little evidence on road safety TA across contexts. This study investigated how, why, and under what conditions technical assistance influenced evidence-informed road safety in Accra (Ghana), Bogotá (Colombia), and Mumbai (India), using a case study of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS).
Methods: We conducted a realist evaluation with a multiple case study design to construct a program theory. Key informant interviews were conducted with 68 government officials, program staff, and other stakeholders. Documents were utilized to trace the evolution of the program. We used a retroductive analysis approach, drawing on the diffusion of innovation theory and guided by the context-mechanism-outcome approach to realist evaluation.
Results: TA can improve road safety capabilities and increase the uptake of evidence-informed interventions. Hands-on capacity building tailored to specific implementation needs improved implementers' understanding of new approaches. BIGRS generated novel, city-specific analytics that shifted the focus toward vulnerable road users. BIGRS and city officials launched pilots that brought evidence-informed approaches. This built confidence by demonstrating successful implementation and allowing government officials to gauge public perception. But pilots had to scale within existing city and national contexts. City champions, governance structures, existing political prioritization, and socio-cultural norms influenced scale-up.
Conclusion: The program theory emphasizes the interaction of trust, credibility, champions and their authority, governance structures, political prioritization, and the implement-ability of international evidence in creating the conditions for road safety change. BIGRS continues to be a vehicle for improving road safety at scale and developing coalitions that assist governments in fulfilling their role as stewards of population well-being. Our findings improve understanding of the complex role of TA in translating evidence-informed interventions to country-level implementation and emphasize the importance of context-sensitive TA to increase impact.
{"title":"Translating global evidence into local implementation through technical assistance: a realist evaluation of the Bloomberg philanthropies initiative for global Road safety.","authors":"Rachel Neill, Angélica López Hernández, Adam D Koon, Abdulgafoor M Bachani","doi":"10.1186/s12992-024-01041-z","DOIUrl":"10.1186/s12992-024-01041-z","url":null,"abstract":"<p><strong>Background: </strong>Traffic-related crashes are a leading cause of premature death and disability. The safe systems approach is an evidence-informed set of innovations to reduce traffic-related injuries and deaths. First developed in Sweden, global health actors are adapting the model to improve road safety in low- and middle-income countries via technical assistance (TA) programs; however, there is little evidence on road safety TA across contexts. This study investigated how, why, and under what conditions technical assistance influenced evidence-informed road safety in Accra (Ghana), Bogotá (Colombia), and Mumbai (India), using a case study of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS).</p><p><strong>Methods: </strong>We conducted a realist evaluation with a multiple case study design to construct a program theory. Key informant interviews were conducted with 68 government officials, program staff, and other stakeholders. Documents were utilized to trace the evolution of the program. We used a retroductive analysis approach, drawing on the diffusion of innovation theory and guided by the context-mechanism-outcome approach to realist evaluation.</p><p><strong>Results: </strong>TA can improve road safety capabilities and increase the uptake of evidence-informed interventions. Hands-on capacity building tailored to specific implementation needs improved implementers' understanding of new approaches. BIGRS generated novel, city-specific analytics that shifted the focus toward vulnerable road users. BIGRS and city officials launched pilots that brought evidence-informed approaches. This built confidence by demonstrating successful implementation and allowing government officials to gauge public perception. But pilots had to scale within existing city and national contexts. City champions, governance structures, existing political prioritization, and socio-cultural norms influenced scale-up.</p><p><strong>Conclusion: </strong>The program theory emphasizes the interaction of trust, credibility, champions and their authority, governance structures, political prioritization, and the implement-ability of international evidence in creating the conditions for road safety change. BIGRS continues to be a vehicle for improving road safety at scale and developing coalitions that assist governments in fulfilling their role as stewards of population well-being. Our findings improve understanding of the complex role of TA in translating evidence-informed interventions to country-level implementation and emphasize the importance of context-sensitive TA to increase impact.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11084027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-08DOI: 10.1186/s12992-024-01045-9
Alexandros Kentikelenis, Thomas Stubbs
Background: Countries in the Global South are currently facing momentous economic and social challenges, including major debt service problems. As in previous periods of global financial instability, a growing number of countries have turned to the International Monetary Fund (IMF) for financial assistance. The organization has a long track-record of advocating for extensive fiscal consolidation-commonly known as 'austerity'-for its borrowers. However, in recent years, the IMF has announced major initiatives for ensuring that its loans support social spending, thus aiding countries in meeting their development targets and the Sustainable Development Goals. To assess this track record, we collected spending data on 21 loans signed in the 2020-2022 period, including from all their periodic reviews up to August 2023.
Results: We find that austerity measures remain a core part of the organization's mandated policies for its borrowers: 15 of the 21 countries studied here experience a decrease in fiscal space over the course of their IMF programs. Against this fiscal backdrop, social spending floors have failed to live up to their promise. There is no streamlined definition of these floors, thus rendering their application haphazard and inconsistent. But even on their own terms, these floors lack ambition: they often do not foresee trajectories of meaningful social spending increases over time, and, when they do, many of these gains are eaten up by soaring inflation. In addition, a third of social spending floors are not implemented-a much lower implementation rate from that for austerity conditions, which the IMF prioritizes. In several instances, where floors are implemented, they are not meaningfully exceeded, thus-in practice-acting as social spending ceilings.
Conclusions: The IMF's lending programs are still heavily focused on austerity, and its strategy on social spending has not represented the sea-change that the organization advertised. At best, social spending floors act as damage control for the painful budget cuts: they are instruments of social amelioration, underpinned by principles of targeted assistance for highly disadvantaged groups. Alternative approaches rooted in principles of universalism can be employed to build up durable and resilient social protection systems.
{"title":"Social protection and the International Monetary Fund: promise versus performance.","authors":"Alexandros Kentikelenis, Thomas Stubbs","doi":"10.1186/s12992-024-01045-9","DOIUrl":"10.1186/s12992-024-01045-9","url":null,"abstract":"<p><strong>Background: </strong>Countries in the Global South are currently facing momentous economic and social challenges, including major debt service problems. As in previous periods of global financial instability, a growing number of countries have turned to the International Monetary Fund (IMF) for financial assistance. The organization has a long track-record of advocating for extensive fiscal consolidation-commonly known as 'austerity'-for its borrowers. However, in recent years, the IMF has announced major initiatives for ensuring that its loans support social spending, thus aiding countries in meeting their development targets and the Sustainable Development Goals. To assess this track record, we collected spending data on 21 loans signed in the 2020-2022 period, including from all their periodic reviews up to August 2023.</p><p><strong>Results: </strong>We find that austerity measures remain a core part of the organization's mandated policies for its borrowers: 15 of the 21 countries studied here experience a decrease in fiscal space over the course of their IMF programs. Against this fiscal backdrop, social spending floors have failed to live up to their promise. There is no streamlined definition of these floors, thus rendering their application haphazard and inconsistent. But even on their own terms, these floors lack ambition: they often do not foresee trajectories of meaningful social spending increases over time, and, when they do, many of these gains are eaten up by soaring inflation. In addition, a third of social spending floors are not implemented-a much lower implementation rate from that for austerity conditions, which the IMF prioritizes. In several instances, where floors are implemented, they are not meaningfully exceeded, thus-in practice-acting as social spending ceilings.</p><p><strong>Conclusions: </strong>The IMF's lending programs are still heavily focused on austerity, and its strategy on social spending has not represented the sea-change that the organization advertised. At best, social spending floors act as damage control for the painful budget cuts: they are instruments of social amelioration, underpinned by principles of targeted assistance for highly disadvantaged groups. Alternative approaches rooted in principles of universalism can be employed to build up durable and resilient social protection systems.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1186/s12992-023-01012-w
Greg Lyle, Delia Hendrie
Background: In response to the harm caused by tobacco use worldwide, the World Health Organization (WHO) World Health Assembly actioned the WHO Framework Convention on Tobacco Control (FCTC) in 2005. To help countries meet their FCTC obligations, the WHO introduced in 2008 the MPOWER policy package and by 2020 the FCTC had been ratified by 182 parties. The package consists of six evidence-based demand reduction smoking cessation policies to assist countries to achieve best practice. We used published evaluation results and replicated the published model to estimate current policy achievement and demonstrate the impact and equity of the MPOWER policy package in reducing the global number of smokers and smoking-attributable deaths (SADs) between 2007 and 2020.
Methods: We replicated an evaluation model (the Abridged SimSmoke model) used previously for country impact assessments and validated our replicated reduction in SADs for policies between 2014 and 2016 against the published results. The replicated model was then applied to report on the country level SADs averted from achieving the highest level of implementation, that is best practice in MPOWER policies, between 2016 and 2020. The latest results were then combined with past published results to estimate the reduction in SADs since the commencement of the MPOWER policy package. Country level income status was used to investigate the equity in the uptake of MPOWER policies worldwide.
Results: Identical estimates for SADs in 41 out of 56 MPOWER policies implemented in 43 countries suggested good agreement in the model replication. The replicated model overestimated the reduction in SADs by 159,800 (1.5%) out of a total of 10.5 million SADs with three countries contributing to the majority of this replication discrepancy. Updated analysis estimated a reduction of 8.57 million smokers and 3.37 million SADs between 2016 and 2020. Between 2007 and 2020, 136 countries had adopted and maintained at least one MPOWER policy at the highest level which was associated with a reduction in 81.0 million smokers and 28.3 million SADs. Seventy five percent of this reduction was in middle income countries, 20% in high income and less than 5% in low income countries.
Conclusions: Considerable progress has been made by MPOWER policies to reduce the prevalence of smokers globally. However, there is inequality in the implementation and maintenance, reach and influence, and the number of SADs averted. Future research to modify the model could provide a more comprehensive evaluation of past and future progress in tobacco control policies, worldwide.
{"title":"Global smoking-related deaths averted due to MPOWER policies implemented at the highest level between 2007 and 2020.","authors":"Greg Lyle, Delia Hendrie","doi":"10.1186/s12992-023-01012-w","DOIUrl":"10.1186/s12992-023-01012-w","url":null,"abstract":"<p><strong>Background: </strong>In response to the harm caused by tobacco use worldwide, the World Health Organization (WHO) World Health Assembly actioned the WHO Framework Convention on Tobacco Control (FCTC) in 2005. To help countries meet their FCTC obligations, the WHO introduced in 2008 the MPOWER policy package and by 2020 the FCTC had been ratified by 182 parties. The package consists of six evidence-based demand reduction smoking cessation policies to assist countries to achieve best practice. We used published evaluation results and replicated the published model to estimate current policy achievement and demonstrate the impact and equity of the MPOWER policy package in reducing the global number of smokers and smoking-attributable deaths (SADs) between 2007 and 2020.</p><p><strong>Methods: </strong>We replicated an evaluation model (the Abridged SimSmoke model) used previously for country impact assessments and validated our replicated reduction in SADs for policies between 2014 and 2016 against the published results. The replicated model was then applied to report on the country level SADs averted from achieving the highest level of implementation, that is best practice in MPOWER policies, between 2016 and 2020. The latest results were then combined with past published results to estimate the reduction in SADs since the commencement of the MPOWER policy package. Country level income status was used to investigate the equity in the uptake of MPOWER policies worldwide.</p><p><strong>Results: </strong>Identical estimates for SADs in 41 out of 56 MPOWER policies implemented in 43 countries suggested good agreement in the model replication. The replicated model overestimated the reduction in SADs by 159,800 (1.5%) out of a total of 10.5 million SADs with three countries contributing to the majority of this replication discrepancy. Updated analysis estimated a reduction of 8.57 million smokers and 3.37 million SADs between 2016 and 2020. Between 2007 and 2020, 136 countries had adopted and maintained at least one MPOWER policy at the highest level which was associated with a reduction in 81.0 million smokers and 28.3 million SADs. Seventy five percent of this reduction was in middle income countries, 20% in high income and less than 5% in low income countries.</p><p><strong>Conclusions: </strong>Considerable progress has been made by MPOWER policies to reduce the prevalence of smokers globally. However, there is inequality in the implementation and maintenance, reach and influence, and the number of SADs averted. Future research to modify the model could provide a more comprehensive evaluation of past and future progress in tobacco control policies, worldwide.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: As a recognized win-win-win approach to international debt relief, Debt-to-Health(D2H)has successfully translated debt repayments into investments in health-related projects. Although D2H has experienced modifications and periodic suspension, it has been playing an increasingly important role in resource mobilization in public health, particularly for low-and middle-income countries deep in debt.
Main text: D2H, as a practical health financing instrument, is not fully evidenced and gauged by academic literature though. We employed a five-step scoping review methodology. After posing questions, we conducted comprehensive literature searches across three databases and one official website to identify relevant studies.We also supplemented our research with expert interviews. Through this review and interviews, we were able to define the concept and structure of D2H, identify stakeholders, and assess its current shortcomings. Finally, we proposed relevant countermeasures and suggestions.
Conclusion: This paper examines the D2H project's implementation structure and influencing variables, as well as the current research plan's limitations, with a focus on the role health funding institutions have played during the project's whole life. Simultaneously, it examines the interdependencies between debtor nations, creditor nations, and health financing establishments, establishing the groundwork for augmenting and revamping D2H within the ever-changing worldwide context of health development assistance.
{"title":"Redefining Debt-to-Health, a triple-win health financing instrument in global health.","authors":"Yunxuan Hu, Zhebin Wang, Shuduo Zhou, Jian Yang, Ying Chen, Yumeng Wang, Ming Xu","doi":"10.1186/s12992-024-01043-x","DOIUrl":"10.1186/s12992-024-01043-x","url":null,"abstract":"<p><strong>Background: </strong>As a recognized win-win-win approach to international debt relief, Debt-to-Health(D2H)has successfully translated debt repayments into investments in health-related projects. Although D2H has experienced modifications and periodic suspension, it has been playing an increasingly important role in resource mobilization in public health, particularly for low-and middle-income countries deep in debt.</p><p><strong>Main text: </strong>D2H, as a practical health financing instrument, is not fully evidenced and gauged by academic literature though. We employed a five-step scoping review methodology. After posing questions, we conducted comprehensive literature searches across three databases and one official website to identify relevant studies.We also supplemented our research with expert interviews. Through this review and interviews, we were able to define the concept and structure of D2H, identify stakeholders, and assess its current shortcomings. Finally, we proposed relevant countermeasures and suggestions.</p><p><strong>Conclusion: </strong>This paper examines the D2H project's implementation structure and influencing variables, as well as the current research plan's limitations, with a focus on the role health funding institutions have played during the project's whole life. Simultaneously, it examines the interdependencies between debtor nations, creditor nations, and health financing establishments, establishing the groundwork for augmenting and revamping D2H within the ever-changing worldwide context of health development assistance.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.1186/s12992-024-01048-6
Lijuan Yang
Background: The COVID-19 pandemic has highlighted the importance of designing effective trade recovery measures in response to global health events (GHEs). This study combines international trade risk management theory and multi-case comparative analysis of past GHEs to present a theoretical framework for designing national trade recovery measures for future events.
Results: The research finds that during GHEs, trade risks shift to fundamental uncertainty, requiring spatial-temporal-subject dimension recovery measures. The study suggests changing the focus of trade recovery policy design from emergency-oriented and single-dimension measures to reserve-oriented and enduring-effect measures of comprehensive dimensions at micro- and macroeconomic levels.
Conclusion: The study contributes to the debate on managing trade risks in times of crisis, where there is a need to develop effective trade recovery measures that account for the complexities of global trade and the unique challenges of GHEs. The findings provide practical guidance for trade officials and policymakers to design measures in response to GHEs to improve a country's overall trade recovery.
背景:COVID-19 大流行凸显了针对全球健康事件 (GHE) 设计有效贸易恢复措施的重要性。本研究结合国际贸易风险管理理论和对以往全球卫生事件的多案例比较分析,提出了为未来事件设计国家贸易恢复措施的理论框架:研究发现,在 GHE 期间,贸易风险转向基本不确定性,需要采取空间-时间-主体维度的恢复措施。研究建议将贸易恢复政策设计的重点从以应急为导向的单一维度措施转变为以储备为导向、在微观和宏观经济层面采取综合维度的持久效应措施:本研究有助于就危机时期的贸易风险管理展开讨论,因为危机时期需要制定有效的贸易恢复措施,以应对全球贸易的复杂性和全球温室气体的独特挑战。研究结果为贸易官员和政策制定者提供了切实可行的指导,帮助他们制定应对全球经济危机的措施,从而改善国家的整体贸易复苏状况。
{"title":"From isolation to revival: trade recovery amid global health crises.","authors":"Lijuan Yang","doi":"10.1186/s12992-024-01048-6","DOIUrl":"10.1186/s12992-024-01048-6","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has highlighted the importance of designing effective trade recovery measures in response to global health events (GHEs). This study combines international trade risk management theory and multi-case comparative analysis of past GHEs to present a theoretical framework for designing national trade recovery measures for future events.</p><p><strong>Results: </strong>The research finds that during GHEs, trade risks shift to fundamental uncertainty, requiring spatial-temporal-subject dimension recovery measures. The study suggests changing the focus of trade recovery policy design from emergency-oriented and single-dimension measures to reserve-oriented and enduring-effect measures of comprehensive dimensions at micro- and macroeconomic levels.</p><p><strong>Conclusion: </strong>The study contributes to the debate on managing trade risks in times of crisis, where there is a need to develop effective trade recovery measures that account for the complexities of global trade and the unique challenges of GHEs. The findings provide practical guidance for trade officials and policymakers to design measures in response to GHEs to improve a country's overall trade recovery.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1186/s12992-024-01040-0
Amir Hossein Khoshakhlagh, Mahdiyeh Mohammadzadeh, Agnieszka Gruszecka-Kosowska, Evangelos Oikonomou
Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics. A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle–Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study. Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016–2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014. Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.
据估计,心血管疾病(CVD)是导致全球死亡的主要原因。空气污染是全球公共健康面临的最大环境威胁。空气污染被认为是心血管疾病潜在的可改变的环境风险因素,因为它可以通过采取正确的国家和国际政策来预防。本研究旨在综合现有关于空气污染导致心血管疾病负担的研究结果,即发病率、住院率、残疾率、死亡率和成本特征。本研究在 Scopus、PubMed 和 Web of Science 数据库中进行了系统检索,以确定截至 2023 年 6 月 13 日的无时间限制的研究。排除标准包括产前暴露、室内空气污染暴露、综述研究、会议、书籍、致编辑的信以及动物和实验室研究。文章的质量根据医疗保健研究与质量机构评估表、纽卡斯尔-渥太华量表和德拉蒙德标准进行评估,采用的是自制的量表。达到 A 类和 B 类标准的文章被纳入研究范围。在获得的 566 项研究中,根据纳入/排除标准,有 92 项研究被界定为符合本系统综述的要求。这些调查结果表明,长期暴露于各种浓度的空气污染物,会增加心血管疾病的发病率、住院率、残疾率、死亡率和成本,即使在相对较低的水平上也是如此。调查结果显示,与高血压密切相关的主要污染物是 PM2.5。此外,与 2014 年相比,2016-2019 年期间与中风有关的全球残疾调整寿命年数增加了 1.8 倍,2023 年与心血管疾病有关的住院治疗增加了 8.5 倍。环境空气污染是造成心血管疾病负担和公共卫生成本的一个被低估但可改变的重要因素。这不仅是一个环境问题,也是心血管疾病病例和死亡率大幅增加的重要风险因素。系统综述的研究结果强调了在公共卫生部门采取更多预防措施的机会,以减少心血管疾病在人类社会中的足迹。
{"title":"Burden of cardiovascular disease attributed to air pollution: a systematic review","authors":"Amir Hossein Khoshakhlagh, Mahdiyeh Mohammadzadeh, Agnieszka Gruszecka-Kosowska, Evangelos Oikonomou","doi":"10.1186/s12992-024-01040-0","DOIUrl":"https://doi.org/10.1186/s12992-024-01040-0","url":null,"abstract":"Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics. A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle–Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study. Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016–2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014. Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26DOI: 10.1186/s12992-024-01042-y
Jennifer Benson, M. Lakeberg, Tilman Brand
{"title":"Exploring the perspectives and practices of humanitarian actors towards the Participation Revolution in humanitarian digital health responses: a qualitative study","authors":"Jennifer Benson, M. Lakeberg, Tilman Brand","doi":"10.1186/s12992-024-01042-y","DOIUrl":"https://doi.org/10.1186/s12992-024-01042-y","url":null,"abstract":"","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-25DOI: 10.1186/s12992-024-01039-7
Y. Adebisi, Nafisat Dasola Jimoh, A. Bassey, Hassan Olayemi Alaka, Mohamed Marah, Chimwemwe Ngoma, Isaac Olushola Ogunkola, O. Bouaddi, Idahor Courage, Radwa Abdalla Abdelatif El-Abasiri, Rime Boutahar, Molly Unoh Ogbodum, A. Ekpenyong, Theogene Uwizeyimana, Oviri Edith Oghenerukevwe, D. B. Olawade
{"title":"Harnessing the potential of African youth for transforming health research in Africa","authors":"Y. Adebisi, Nafisat Dasola Jimoh, A. Bassey, Hassan Olayemi Alaka, Mohamed Marah, Chimwemwe Ngoma, Isaac Olushola Ogunkola, O. Bouaddi, Idahor Courage, Radwa Abdalla Abdelatif El-Abasiri, Rime Boutahar, Molly Unoh Ogbodum, A. Ekpenyong, Theogene Uwizeyimana, Oviri Edith Oghenerukevwe, D. B. Olawade","doi":"10.1186/s12992-024-01039-7","DOIUrl":"https://doi.org/10.1186/s12992-024-01039-7","url":null,"abstract":"","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140657592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-19DOI: 10.1186/s12992-024-01031-1
Duncan Stewart, Mary Madden, Jim McCambridge
Alcohol problems are increasing across the world and becoming more complex. Limitations to international evidence and practice mean that the screening and brief intervention paradigm forged in the 1980s is no longer fit for the purpose of informing how conversations about alcohol should take place in healthcare and other services. A new paradigm for brief interventions has been called for. We must start with a re-appraisal of the roles of alcohol in society now and the damage it does to individual and population health. Industry marketing and older unresolved ideas about alcohol continue to impede honest and thoughtful conversations and perpetuate stigma, stereotypes, and outright fictions. This makes it harder to think about and talk about how alcohol affects health, well-being, and other aspects of life, and how we as a society should respond. To progress, brief interventions should not be restricted only to the self-regulation of one’s own drinking. Content can be orientated to the properties of the drug itself and the overlooked problems it causes, the policy issues and the politics of a powerful globalised industry. This entails challenging and reframing stigmatising notions of alcohol problems, and incorporating wider alcohol policy measures and issues that are relevant to how people think about their own and others' drinking. We draw on recent empirical work to examine the implications of this agenda for practitioners and for changing the public conversation on alcohol. Against a backdrop of continued financial pressures on health service delivery, this analysis provokes debate and invites new thinking on alcohol. We suggest that the case for advancing brief interventions version 2.0 is both compelling and urgent.
{"title":"Brief interventions 2.0: a new agenda for alcohol policy, practice and research","authors":"Duncan Stewart, Mary Madden, Jim McCambridge","doi":"10.1186/s12992-024-01031-1","DOIUrl":"https://doi.org/10.1186/s12992-024-01031-1","url":null,"abstract":"Alcohol problems are increasing across the world and becoming more complex. Limitations to international evidence and practice mean that the screening and brief intervention paradigm forged in the 1980s is no longer fit for the purpose of informing how conversations about alcohol should take place in healthcare and other services. A new paradigm for brief interventions has been called for. We must start with a re-appraisal of the roles of alcohol in society now and the damage it does to individual and population health. Industry marketing and older unresolved ideas about alcohol continue to impede honest and thoughtful conversations and perpetuate stigma, stereotypes, and outright fictions. This makes it harder to think about and talk about how alcohol affects health, well-being, and other aspects of life, and how we as a society should respond. To progress, brief interventions should not be restricted only to the self-regulation of one’s own drinking. Content can be orientated to the properties of the drug itself and the overlooked problems it causes, the policy issues and the politics of a powerful globalised industry. This entails challenging and reframing stigmatising notions of alcohol problems, and incorporating wider alcohol policy measures and issues that are relevant to how people think about their own and others' drinking. We draw on recent empirical work to examine the implications of this agenda for practitioners and for changing the public conversation on alcohol. Against a backdrop of continued financial pressures on health service delivery, this analysis provokes debate and invites new thinking on alcohol. We suggest that the case for advancing brief interventions version 2.0 is both compelling and urgent.","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140628730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-18DOI: 10.1186/s12992-024-01038-8
Alessandro Connor Crocetti, Troy Walker, Fiona Mitchell, Simone Sherriff, Karen Hill, Yin Paradies, Kathryn Backholer, Jennifer Browne
The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination. Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.
{"title":"Making Big Business Everybody’s Business: Aboriginal leaders’ perspectives on commercial activities influencing aboriginal health in Victoria, Australia","authors":"Alessandro Connor Crocetti, Troy Walker, Fiona Mitchell, Simone Sherriff, Karen Hill, Yin Paradies, Kathryn Backholer, Jennifer Browne","doi":"10.1186/s12992-024-01038-8","DOIUrl":"https://doi.org/10.1186/s12992-024-01038-8","url":null,"abstract":"The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination. Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":null,"pages":null},"PeriodicalIF":10.8,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140617762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}