Journal of Public Health Policy最新文献

International Organization for Standardization and Codex Alimentarius Commission emphasized the importance of evaluating and monitoring food safety. National food safety standard framework (NFSSF)-a generic term for all national food safety standards of China-is an important part of the country's food control system implemented over ten years. To evaluate NFSSF, the China National Center for Food Safety Risk Assessment developed a quality index with an indicator scale. This study assessed this index with a three-layer evaluation indicator system (NFSSF_eis) based on three dimensions, namely, scientific nature, relevance, and coordination, using 10 s-layer indicators weighed with the Delphi method. We conducted a pilot survey to test the scale built based on NFSSF_eis. Confirmatory factor analyses indicated that items in the scale have acceptable reliability and validity. With the development of the NFSSF_eis, future research is needed to refine this instrument.

Access to healthcare, defined by the Institute of Medicine as "the timely use of personal health services to achieve the best health outcome" represents one of the most critical issues facing modern societies. However, barriers to access are increasingly being recognized across all populations especially as the boundaries between technology, medicine, business, public health, and policy become blurred. Given that resource and infrastructural constraints have been well established to influence access, organizations have the responsibility to continually evaluate this concept in the context of inclusivity and social determinants of health. Ultimately, improving access requires thoughtful engagement from a myriad of stakeholders with the goal of prioritizing timely, equitable, personalized, and high-quality care, while empowering patients to take charge of their own health. While a profound challenge, the journey toward bridging the many gaps is just beginning, and how society re-defines the access imperative in healthcare in an ever-evolving landscape represents one of the foremost issues of the future. Indeed, the implications for society are tremendous given that access is central to quality of care, profoundly impacts the patient experience, and influences health outcomes. The purpose of this review is to outline the core issues that contribute to access focusing on barriers, social determinants, quality of care, and potential interventions.

Medicare Part D innovatively included a market in public health insurance in the United States. Proponents argued that increased competition would drive better value for beneficiaries, but others feared that beneficiaries would struggle to navigate the complex program. Understanding how Part D beneficiaries choose between plans allows us to evaluate the extent to which Medicare Part D succeeds at increasing value to beneficiaries and where there is scope to support beneficiaries. Many Part D beneficiaries are sensitive to price cues in relation to pharmacy choice and medication adherence, yet frequently overpay for their plans. Empirical literature suggests that behavioral aspects including information overload, low salience, low trust, and practical 'sludge' all partly contribute to failure to switch. We propose solutions to address these barriers based on behavioral insights.

Housing-related stress, defined as concerns about not having a place to live, represents a significant correlate of substance use that warrants further investigation. In this cross-sectional analysis of 4358 adults from the national All of Us Research Program we examined associations between housing-related stress and substance use, accounting for demographic factors and mental health status in the United States. We determined that housing-related stress was significantly associated with increased odds of substance use (OR = 1.49, 95% CI 1.31-1.70). Males, racial and ethnic minorities, and individuals with poor mental health showed high substance use, while being better educated and married had a protective effect. The relationship between housing stress and substance use was amplified among those with poor mental health. Addressing housing instability should be integrated into comprehensive substance use prevention strategies. Given the universality of housing insecurity as a social determinant of health, these findings offer insights that can inform global public health strategies aimed at reducing substance use harms across diverse international contexts.

Birth defects, or congenital anomalies, are important causes of child mortality, morbidity and disability. Guidelines for public health activities to address birth defects is currently unavailable for low- and low-middle- income countries leading to a critical policy and service gap. We used the results of a study conducted in eight villages under a Primary Health Centre in Pune district of India to determine the needed public health interventions to address these disorders. The study identified 90 children with congenital anomalies per 10,000 children under five years [95% CI 62.2-126.8]. Congenital anomalies contributed to 13% of childhood disability. Out-of-pocket expenditure, lack of diagnosis and standard care, disability, and congenital anomaly associated maternal risk factors identified missed opportunities for public health interventions. The implications of the study are synthesized to offer a framework for essential public health interventions for a birth defects services in low- and low-middle- income countries.

Well-trained health workers are vital to achieve global goals of universal access to healthcare services and provide primary care to remote communities. The primary care workforce includes non-physician health workers (NPHWs) who function to increase availability, trust, reach, and assurance to local communities. NPHWs such as mid-level health providers or community health officers have been inducted across high- and low-income countries to overcome the geographic disparity in physician availability and ensure quality of primary care. Training mid-level health providers and community health officers in principles of family medicine have the potential to empower workforce in effectively providing family based care. This integrative review collates recent evidence on the role of non-physician health workers in improving access to primary healthcare services and highlights the need, appropriateness, and relevance of family medicine-orientation to manage family oriented care and holistic management of healthcare needs of the community.

Poor quality obstetric care can harm women's mental health, especially after childbirth. This study examines how the perceived quality of health services during childbirth is related to postpartum depression in Ecuador. Using data from 16,451 women in the 2018 National Health and Nutrition Survey, we applied probit and latent class probit models. We find that higher perceived quality of care during childbirth decreases the likelihood of postpartum depression, with stronger effects in intense and long-lasting cases. The results of the instrumental variables model show that, in the most representative class, comprising 68.15% of the sample, a one-point increase in perceived quality reduces the probability of postpartum depression by 9.1% (CI_95% : -15.2%, -3.0%). This group includes mainly indigenous women, mothers of multiple children, and users of the public health system. These results underscore the urgency of integrating mental health support into maternal care and strengthening policies that improve women's experiences during childbirth in public health facilities.