Journal of Public Health Policy最新文献

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.

Global climate change has increased the risk of wildfires, which pose serious short and long-term mental health problems. Emotional well-being and access to specialized health services are among the most challenging health concerns of those affected by wildfires. In this overview, I discuss the mental health burdens of wildfires and the need for programmatic solutions and resources for developing mental health support infrastructure, including access to care, Skills for Psychological Recovery training programs, and digital health tools. These specialized programs and tools have the potential to improve community resilience and reduce the negative impacts of wildfires on mental health.

Primary healthcare is one of the most important components of the health system worldwide, facilitating people's access to essential healthcare, especially vulnerable groups. Integrating nutrition services into a primary healthcare (PHC) network is critical for effective health promotion. We investigated nutrition services provided through PHC in high-income and low- and middle-income countries. In this scoping review, we examined 37 studies that involved nutrition care at PHC, indexed by PubMed, MEDLINE, Web of Science, Scopus, Google Scholar, and Sid. Nutritional services provided at the PHC level mainly included nutritional assessment, nutrition counseling and education, child and maternal nutritional care, provided by healthcare workers, nurses, physicians, and dietitians. Nutrition services provided by health systems varied by the degree of diet- and nutrition-related problems, such as diabetes and obesity, as well as maternal and newborn health, and the level of income and development of the countries.

The Israel-Hamas war that began on 7 October 2023 may have spurred anti-Jewish hate crimes, which are associated with measurable health harms including worsened cardiometabolic biomarkers. This study evaluated whether anti-Jewish hate crimes in New York City increased during the Israel-Hamas war using administrative data representing 3255 hate crimes between 2019 and 2024. In 26 of 72 observed months, anti-Jewish hate crimes outnumbered the combined total of all other hate crimes. Compared with other hate crimes, anti-Jewish hate crimes were more likely to be felonies (63% versus 38%, p < 0.001) and less likely to result in arrest (30% versus 57%, p < 0.001). Monthly anti-Jewish hate crimes were on average twice as common during the first year of the Israel-Hamas war than the previous 5 years, adjusting for each borough's Jewish population (PR = 1.97, 95% CI (1.64, 2.35)). The disproportionate frequency of anti-Jewish hate crimes suggests further unmeasured major and minor antisemitic discrimination.

This study evaluates the impact of California's specific per- and polyfluoroalkyl substances (PFAS) legislation on perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) contamination levels in public drinking water. We conducted a comparative statistical analysis using data collected by the United States Environmental Protection Agency (US EPA) Unregulated Contaminant Monitoring Rules (UCMRs), specifically UCMR 3 and UCMR 5. To assess PFOA and PFOS levels in active public water systems during the pre-legislation period (2017) and the post-legislation period (2023) we applied Levene's test to assess differences in variances, followed by unpaired and Welch's t-tests to compare mean PFAS concentrations between the two time periods. We detected a significant decline in both PFOA and PFOS levels post-legislation, suggesting that robust state-level regulatory measures can effectively reduce PFAS contamination. Findings highlight the potential for California's comprehensive approach to serve as a model for national policy to mitigate PFAS exposure and protect public health.