Journal of Public Health Policy最新文献

This study investigates the roles of women empowerment on the prevalence, awareness, and treatment of hypertension among ever-married Nepalese women aged 15-49 years using 2016 Nepal Demographic and Health Survey data. We assessed women empowerment using the Survey-based Women emPowERment (SWPER) index in the domains of 'social independence', 'decision-making', and 'attitudes towards violence'. We assessed associations of domains of women empowerment with hypertension using multiple logistic regression models. Among 4919 women, 568 (12%) had hypertension, 35% were aware of their condition, and 14% were taking anti-hypertensive medication. Majority (72%) of women had high empowerment in ''attitude to violence' domain, 14%-in 'decision-making' domain, and 25%-in the 'social independence' domain; the latter group was also less likely to suffer from hypertension (aOR = 0.68, 95% CI 0.49-0.94). Our findings suggest the need to integrate empowerment initiatives into strategies to prevent hypertension among women in Nepal and similar low- and middle-income settings.

We assessed the association of participation in the Community Eligibility Provision, a universal free school meals policy in the United States, with school and area-level characteristics, and how these associations changed between 2014 and 2020. Using logistic regression models with district-clustered standard errors, in 53,391 eligible schools nationwide, adjusted prevalence of participation was 3.8 percentage points (pp) lower among high schools relative to elementary schools (95% CI: 1.6, 6.0), 8.9 pp lower in small relative to large school districts (95% CI: 4.8, 13.0), 10.9 pp lower in suburban relative to urban schools (95% CI: 6.9, 14.8), and 13.3 pp lower in schools in non-Medicaid expansion relative to expansion states (95% CI: 17.1, 20.7). Over time prevalence of participation in majority Hispanic schools increased to a lesser extent than participation in majority Black schools. Addressing barriers to policy adoption in schools with persistently lower participation will be critical to increase equitable access to universal free school meals.

Tackling the complex drivers of childhood obesity requires action across sectors and at all levels of government. Elected officials in local government can influence policies targeting communities to prevent childhood obesity, but little is known about their views on local government accountability for tackling the issue. Accountability is the obligation to justify actions on a topic and it could strengthen policy implementation. A qualitative study was conducted involving semi-structured interviews with sixteen Southampton City Council local government councillors. Factors limiting accountability included low citizen engagement, the lack of a national mandate to support local action and unachievable targets. Factors that improved accountability included setting a local mandate, public health officers proactively keeping the issue on the agenda and oversight from other system leaders. The findings from this study inform how public health officers and other stakeholders can work within the local system to progress childhood obesity prevention policies.

Singapore's shift toward a more collectivist model of healthcare marks a significant departure from its traditionally neoliberal approach, particularly in addressing the needs of its rapidly ageing population. The CareShield Life and Long-Term Care reforms aim to enhance financial protection, expand community-based services, and align health policy with evolving societal expectations. Nevertheless, questions remain about the adequacy of coverage, particularly in the context of rising chronic disease and long-term care costs. The move toward community care introduces important logistical and quality challenges. Singapore's approach is unique in its extensive stakeholder engagement and values-based design. It reflects a pragmatic effort to reconcile long-standing principles of personal responsibility with growing demand for collective security in later life. Though outcomes will take time to manifest, the reform represents a notable case of policy realignment and offers transferable lessons for health systems navigating ageing and sustainability challenges.

This viewpoint examines the inadequate protection of informal workers against climate change hazards under new legislation in Ecuador. The recent Executive Decree No. 255 (Regulation on Occupational Safety and Health), enacted in May 2024, explicitly excludes informal sector workers, who are at elevated risk due to climate change impacts such as rising extreme temperatures. Based on national survey data, it is estimated that 52.5% of the Ecuadorian workforce is informally employed, with figures exceeding 80% in sectors like agriculture and construction. This analysis highlights the most vulnerable workers and emphasizes the need to review and extend social security coverage to include informal workers. Integrating these considerations into the forthcoming National Occupational Safety and Health Policy is crucial.

Plastic pollution has become a significant environmental challenge in India, causing adverse effects on human health, wildlife, and ecosystems. Although there are policies and regulations in place to address the issue, the problem persists, indicating a gap in their implementation. We examined the existing policies, the role of law enforcement agencies, the potential impact of environmental criminal law enforcement on plastic pollution in India, and the challenges of policy implementation. This paper contributes to the ongoing dialogue on addressing plastic pollution in India and provides recommendations for policymakers and stakeholders to implement measures for a cleaner, healthier environment.

Hospital resilience is a critical determinant of health system function during emergencies and disasters, as hospitals are often the last line of healthcare. Strengthening hospital resilience is a way to ensure uninterrupted, safe, and effective care when crises strike. However, the varied interpretations of resilience hinder its operationalization and evaluation. The lack of standardized, measurable indicators highlights the complexity of hospital resilience and the inadequacy of current assessment tools. This viewpoint explores existing gaps and challenges in effectively assessment of hospital resilience, including failures to measure dynamic capacities, community engagement, and external risk factors. We suggest the urgent development of a participatory, evidence-based tool to guide hospital administrators, policymakers, and researchers. Such a tool would aid in informing focused interventions, enhancing system-wide readiness, and enhancing global response capacity to respond to future disasters.

Since the 2022 Dobbs decision, 15 states have criminalized abortion for the first time in 50 years. Experts fear that bans will exacerbate the maternal mortality crisis in the country, especially for women of color. One of the top causes of maternal death in the United States is homicide. The relationship between violence and pregnancy is bi-directional; intimate partner violence is associated with unwanted pregnancies and unwanted pregnancies are associated with more intimate partner violence. Researchers have documented stories from women who report seeking an abortion because their partner is abusive, and they do not want to be "tethered" to that partner. With decreased abortion access, more children will likely be born into violent homes, increasing childhood exposure to household and lifetime violence. Our work explores the impact of the Dobbs decision and emphasizes the need for multidisciplinary and trauma informed strategies for preventing unplanned pregnancies and safeguarding families in this new political environment.