Journal of Public Health Policy最新文献

Several jurisdictions have implemented legalization policies for non-medical cannabis, mainly towards improving public health and reducing illegal cannabis markets and crime. As some legalization initiatives are approaching maturity, conducting policy impact assessments has become timely. Emerging data, however, suggest rather mixed pictures for key outcomes and indicators. While many key health-related indicators show increases in adverse outcomes, improvements are shown for main crime-related outcomes associated with legalization. However, legalization policies are evaluated predominantly by utilizing separate approaches for the health outcomes and crime-related indicators, while comprehensive policy assessments require meaningful integration of all related indicators. We provide suggestions for an integrated approach to assessing cannabis legalization policies concerning health and crime-related outcomes. This approach is also valuable for policymakers and other stakeholders to create an empirical basis for relative valuations and choices regarding cannabis legalization's main policy outcomes.

In Ghana and many other sub-Saharan African countries gambling advertising has become pervasive due to weak regulations that allow gambling operators to zealously promote their products as a risk-free way to make money. In this commentary, we provide a public health perspective based on document analysis of the Ghana Gaming Commission's guidelines on advertisements, and recommendations for strengthening Ghana's gambling regulatory environment. With the industry intensifying its focus on new markets to grow and sustain profits, and new global players entering Ghana's market, the competition for market share will most likely intensify with an associated and aggressive increase in gambling advertising. Accordingly, a strengthened gambling advertising regulation underpinned by public health principles is required to restrict advertising across all forms of media and regulate advertising content. The next step for public health action should focus on advocating for new gambling advertising regulations and a review of the Gaming (gambling) Act.

Intimate partner violence (IPV) is common, and almost half of all IPV takes place in relationships with children in the home. We inventoried laws in the 50 states and the District of Columbia in the United States of America (USA) focused on addressing IPV committed in the presence of children, as these laws could help prevent or remediate this critical health and social issue. Using WestLaw, a web-based legal research service, we identified over 1,200 statutes and 500 regulations. We documented the laws' key attributes and heterogeneities and coded 557 laws from 31 states. We determined that the most commonly prescribed penalty was stricter sentencing, followed by mandates to pay for counseling for any child witnesses, separate additional criminal charges, mandated receipt of counseling or intervention services, and a period of supervised parenting. Future research could assess the possible impacts of these laws on children's short- and long-term wellbeing.

In the United States and within Colorado, the number of persons experiencing homelessness has risen, with over 600,000 counted on a single night in 2023. Limited data integration across healthcare and social services hinders understanding of how permanent supportive housing (PSH) affects health outcomes. Our study in partnership with healthcare experts, housing providers, and a community advisory panel aimed to integrate data from health records, the justice system, and housing case manager notes to create a multidimensional measure of PSH success. Metrics not only included housing retention but engagement in care, wellness, housing rule adherence, and overall success. The initial 608 records were reduced to an analytic sample of 180 due to data loss across systems. Findings highlighted case managers' adaptability and the need for dynamic indicators of client progress. This study underscores the importance of a social-health information exchange and partnerships for improving access and understanding success in supportive housing.

Evidence-informed policymaking emphasizes that policy decisions should be informed by the best available evidence from research and follow a systematic and transparent approach. For public health policymaking we can learn from existing practices of transparent, evidence-informed decision-making for clinical practice, medicines, and medical technology. We review existing evidence-to-decision frameworks, as well as frameworks and theories for policymaking to address the political dimension of policymaking, and use this analysis to propose an integrated framework to guide evidence-informed policymaking. The framework includes nine decision-making criteria and allows for the addition of other context-specific criteria. It also emphasizes elements of the decision-making process that can give greater legitimacy, fairness, and transparency to the policy decision, such as the use of deliberative processes and assessment of conflicts of interest. We offer the framework as a tool to help government policy makers use evidence in a structured and transparent way when making decisions about public health policy options.

Politicians often claim to be "following science" but their claims are, reasonably, disputed. To claim to be following the science can mean that scientific evidence affects or legitimates decisions. The evidence that politicians are following science often comes from formal systems of advice that translate science into advice. We study the systems that informed policy in France, Germany, and the UK during the COVID-19 pandemic. We found that while in all three countries politicians had incentive to prefer private advice tailored to their needs, more transparent and independent advice appeared to contribute more to good policymaking and implementation, including by enhancing government's current and future accountability for their decisions.

Tuberculosis (TB) remains a significant global health concern, causing 1.5 million deaths annually. We conducted an ecological analysis to examine TB prevalence in Brazil from 2018 to 2022, focusing on its relationship with the Human Development Index (HDI) and its inequality-adjusted version HDI (IHDI). We determined significant correlation between HDI and TB prevalence for the period of 2018-2021 (P = 0.044 in 2018, P = 0.041 in 2019, P = 0.044 in 2020, and P = 0.043 in 2021). However, an unexpected rise in TB cases in 2022, despite an increase in HDI, disrupted this trend (P = 0.12), indicating additional influencing factors. The IHDI showed correlation with TB prevalence, underscoring the importance of addressing socio-economic inequalities. These findings suggest the need for targeted interventions, particularly for vulnerable populations.

Public health policies can dramatically shape government responses to emerging public health crises. In cases where a response is inadequate, it's natural to seek improvements to these policies to achieve better results in future crises. However, while policies and outcomes are usually visible, the complex dynamics that link them are seldom obvious. Obscure social network structures, power and information asymmetries, and political agendas all influence the translation of policy to action or inaction. Intergovernmental communications are often the only primary sources for researchers investigating these hidden but crucial factors. Public records laws in many countries make such documents available upon request, but their structure, format, and scale are rarely accessible in practice. Fortunately, recent advances in free and open-source data science tools are making this problem tractable. In this visual brief, we demonstrate using such tools to mine a large image dataset and reconstruct decision-making during the Flint Water Crisis in Michigan, USA.

Chagas disease (Trypanosoma cruzi infection) affects ~ 290,000 USA residents and is included in routine blood donation screening panels. Donors are notified of positive T. cruzi-screening results, deferred from donation, and given limited information for next steps. Individuals living with undiagnosed, uncommon infections often face substantial barriers in accessing physicians with infectious disease competency, confirmatory testing, and continuum of care after the point of blood donor deferral. We assessed 46 T. cruzi-deferred donors' experience following deferral, highlight donor challenges, and provide public health institution opportunities to support cases of rare transfusion-transmitted infections in the USA.