Journal of Public Health Policy最新文献

Maternal mortality remains a pressing global challenge, with sub-Saharan Africa (SSA) disproportionately affected. Despite efforts to improve access to skilled delivery services, utilization remains low, especially in rural areas. This paper synthesizes the extant literature and empirical evidence from rural Ghana to highlight the critical issue of low-skilled delivery services uptake in rural SSA. The literature review findings reveal a pooled prevalence of 54.9% skilled delivery services utilization, while the empirical survey in Ghana indicates a lower rate of 48.7%. These findings underscore the urgent need for targeted interventions to improve access to skilled delivery services in rural SSA. We recommend addressing harmful gender norms, evaluating existing interventions, and integrating qualitative and quantitative approaches to better understand barriers to skilled delivery services utilization in rural Africa. Urgent action is needed to ensure safer childbirth experiences and better maternal and child health outcomes in the region.

This article critically examines the Housing First model within the broader context of neoliberal policies impacting homelessness, particularly at the intersection of mental illness, poverty, and addiction. While Housing First is celebrated for its effectiveness in providing immediate housing to chronically homeless individuals, this model's alignment with neoliberal principles prioritizes cost effectiveness and visible outcomes over comprehensive care. As a harm reduction approach, Housing First often overlooks the underlying mental health and addiction issues that maintain homelessness, resulting in a cycle of dependency rather than long-term recovery. In this article, we argue that the reduction in funding for transitional housing and mental health services, driven by neoliberal policies, has exacerbated the challenges faced by marginalized populations. A call is made for a shift toward more holistic and integrated approaches that balance immediate housing solutions with robust mental health care and social support systems, aiming for sustained recovery, independence, and social reintegration for individuals experiencing homelessness.

Various problematic statistical approaches can be used in regression analyses to help find no significant relationship between explanatory variables and response variables-"to find nothing." In an earlier paper, I provided examples of finding nothing from firearm studies, focusing on the lack of statistical power. In this Viewpoint, I offer three examples of "finding nothing" from firearms research and focus on a single hypothesis-that household gun ownership levels affect suicide rates, examining one type of evidence-cross-sectional ecological studies. I discuss studies examining variations in suicide rates across US states, US cities, and nations, highlighting the work of the one firearm researcher who continually "finds nothing."

Healthcare services and outcomes are often not evenly distributed across geographic regions. This study used the harmonized data from the Research on Early Life and Trends and Effects (RELATE) to compare the health outcomes of older adults across the North-South divide of Ghana and identify the factors underlying these differences. Although the literature indicates that the South has more health resources and better health indicators, the current study revealed that, for older adults, health outcome in the North was comparatively better than that in the South. The optimal health index scores show that older adults in the North are living at 86% of their optimal health compared with 82% in the South. Work-related physical activity and age substantially influenced optimal health in both regions. Additionally, healthcare use and gender were influential, particularly in the South. The results of the current study suggest that healthcare service availability can impact health outcomes, but so can behavioral and sociodemographic factors.

We followed the COVID-19 pandemic in Manaus, one of the epicenters of COVID-19 in Brazil, using an epidemiological mathematical model and made five main conclusions. First, in early 2022, the actual cases exceed officially reported data by up to 8 times. Second, despite vaccination campaigns, the collective immunity threshold necessary was insufficient to contain severe cases of COVID-19. Next, the low observed mortality demonstrated the effectiveness of vaccination. Next, the drop in the vaccination rate combined with immune escape by the Omicron sub-variants (BA.2.12.1, BA.4, and BA.5) resulted in new wave after November 2022. Finally, to minimize severe cases of COVID-19, we need to raise vaccination thresholds above 90-95% of the entire population including children aged 6 months and older and require booster doses at least in four-month intervals. This approach would help to prevent severe cases of COVID-19 that cause hospitalizations and deaths.

This study examines the effect of risk communication styles (fear-based versus empowerment-based) on households' earthquake preparedness. An online longitudinal study with intervention and control groups was conducted using a representative sample of the adult population in Israel. The change in the reported level of preparedness was assessed through Repeated Measures ANOVA with interaction effects for both the risk communication style and gender. The Analysis revealed a significant difference in reported levels of earthquake preparedness over time (F(1.697,303.70) = 102.58, p < 0.001; partial η2 = 0.36). However, no statistically significant interaction was found with the risk communication style (p = 0.55). Borderline significance (p = 0.04) was observed in the three-way interaction (time-intervention-gender). Gender (β = 0.19), age (β = 0.21), perceived earthquake likelihood (β = 0.14), and sense of preparedness (β = 0.28) were significant predictors in multivariate regression analysis. While consistently showing that participants exposed to empowering information reported higher earthquake preparedness, the research hypothesis was not substantiated. Recommendations for public health policy are discussed.

This study investigates the prevalence and determinants of readiness for quality antenatal care (ANC) services in Bangladesh using data from the 2017 Bangladesh Health Facility Survey (BHFS). We assessed the association between selected factors and the readiness index using multinomial logistic regression. We identified a significant gap in the availability and quality of ANC services, only 4.26% of health facilities provide quality ANC services, with rural facilities showing lower readiness compared to urban facilities (RRR:0.13; 95% CI: 0.06-0.31; p < 0.001). Community clinics and private hospitals have a lower likelihood of medium or high readiness compared to public hospitals or clinics. Health facilities with specialized care are more likely to demonstrate readiness for quality ANC services. Policy recommendations include increased healthcare funding, implementation of ANC guidelines, strengthened monitoring and evaluation of health facilities, and heightened community awareness. These measures should improve ANC, overall health outcomes, and public health policies.

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.

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.