Journal of Public Health Policy最新文献

Migrants living in large urban areas are disproportionately impacted by health crises such as pandemics. This policy brief explores how urban areas mitigate and/or exacerbate the impact of COVID-19 on migrant groups and provides policy recommendations. We conducted a policy review to focus on the effects of COVID-19 on migrants living in cities with > 500,000 residents. We found that structural inequity, lack of migrants' inclusion in as relief programs, and residential segregation exacerbated COVID-19 impacts. Engagement of Civil Society Organizations (CSOs) and e-governance showed promising effects mitigating the impact of COVID-19 on these groups; yet the use of technology introduced additional barriers such as access to devices and internet connection. We recommend increasing policy attention to systemic social inequities faced by migrant groups in urban areas and supporting innovative and inclusive implementation of public health policies, urban design, and greater engagement of CSOs in the delivery of services to migrants.

In the United States, there are nearly 53 million informal or unpaid caregivers, many of whom experience mental and physical stress related to their caregiving duties and increased financial responsibility. We identified federal and state informal caregiver support policies authorized by specific legislation along with their key provisions and conducted a systematic review of the academic literature related to quantitative evaluations of these policies. Twenty policies, eight academic studies, and four gray literature reports were included in the study, with half of the policies introduced since 2000. Our study criteria yielded few academic valuations tied to caregiver policies and few policies including research provisions. Of the provision areas identified in policies, respite services, caregiver training, and workplace protections appeared the most. Future policies and the studies examining them should incorporate cost outcomes and equity as focus areas and disaggregate data by vulnerable groups to ensure value and equity in caregiver support legislation. KEY MESSAGES: Increased legislation to support informal caregivers may be warranted. The limited academic research examining existing caregiver policies identifies mixed outcomes for caregivers. Prioritizing vulnerable populations in such policy research examining outcomes could help improve caregiver support efforts. The included studies investigated the outcomes of three policies and identified more negative than positive outcomes for caregivers.

COVID-19 translated African Americans' greater social, economic, and health-related risk, reflecting adverse Social Determinants of Health (SDOH), into greater COVID morbidity, hospitalization, and mortality, and it threatened to enlarge the very risks causing greater COVID suffering. However, following a federal policy response injecting trillions of dollars into the US economy, longstanding African American-White disparities in economic well-being, insurance coverage, vaccination rates, and evictions declined. On the other hand, troubling and consequential disparities in k-12 academic achievement and college attendance disparities widened. Continuous monitoring and careful research are needed to document and explain trajectories in social determinant disparities and to offer insight into how policy intervention can decrease continuing disparities in economic well-being, health care, and housing stability.

Cardiovascular diseases (CVD) are the leading cause of death in the United States and may be prevented through improved working conditions. The United States does not guarantee paid sick leave (PSL) at the federal level. We used quasi-experimental event study methods to examine the relationship between state-level PSL policies and county-level CVD mortality among working-age adults aged 15 to 64 over time (2008 to 2019). We examined the annual CVD mortality rates in 1054 counties from all 50 states and Washington D.C.. In the Northeastern region of the United States, there were drops in the CVD mortality rate in all years after PSL was adopted. We found no effect of PSL in the Western United States with a strong presence of pretreatment effects, making the results for that region uninterpretable. Our results support the use of state-level PSL policies to reduce county-level CVD mortality rates in the Northeastern United States.

Individuals with inflammatory bowel disease (IBC) and high-risk individuals are advised to discuss participation with their doctor and not to participate in colorectal cancer (CRC) screening. Yet a substantial proportion still participate in the Danish faecal immunochemical test (FIT) screening and have a higher positive FIT rate than the average-risk population. We estimated the risk of false-positive screening among individuals with inflammatory bowel disease and high-risk individuals to improve recommendations regarding screening participation. We included 71,871 FIT-positive participants (2014-2017) who had a subsequent colonoscopy within 3 months. Screening outcome within 180 days was established by using registers. We determined that 26,591 of the included participants had a false-positive screening. Participants with IBC or high CRC risk had a significantly higher risk of getting a false-positive screening than the average risk population, resulting in too many screening-related colonoscopies being performed among these individuals, indicating a need to update the screening protocols.

Many countries are experiencing a post-pandemic surge in hospital utilization along with accelerating population aging. Maximal hospital efficiency is required, with utilization evidence essential for identifying appropriate hospital or broader health system reforms. We offer an investigation of the most recent pre-COVID year (2019-2020) of complete population-based hospital utilization data to describe and compare the use of hospitals by older (65+) and younger (0-64) people admitted for inpatient services in Canada. We found that 35.7% of all 1,888,133 admitted individuals and 39.8% of all 2,543,227 hospital episodes involved people aged 65+, representing 4,963,766 or 17.1% of the study population. This study, as do previous Canadian and other ones, found hospitals admit more younger people than older people. The admission and care patterns of both younger and older patients reveal a need for more community-based services to shorten older patient hospitalizations and prevent avoidable hospitalizations by both younger and older people.