Journal of Public Health Policy最新文献

Vaccination during pregnancy is crucial due to increased maternal vulnerability to infectious diseases. However, uptake of recommended vaccines (influenza, pertussis, COVID-19) remains suboptimal, particularly among disadvantaged groups. This qualitative study explored healthcare professionals' (HCPs) perspectives, selected purposively, on factors influencing maternal vaccination in London. Data from a workshop transcript and an online quality improvement survey involving 15 GPs, two midwives, two obstetricians and one pharmacist were thematically analysed. HCPs highlighted that pregnant women perceive the benefits of pertussis vaccination more positively than other vaccines. Clear, consistent communication and integrating vaccinations into routine antenatal care were identified as essential for improving accessibility and convenience. The critical role of midwives influencing vaccination decisions was emphasised. While recognising the potential of AI-based technologies to disseminate vaccine information, concerns were raised about trust, digital literacy and information quality, highlighting the need for tailored, reliable strategies to boost maternal vaccination rates and improve health outcomes.

Developing a women's health index is particularly important in the Indian context due to the pronounced disparities in women's health across various social, economic, and geographical segments. This paper focuses on the development and validation of a comprehensive Women's Health Index (WHI) for India. In contrast to previous efforts that predominantly focused on indicators related to pregnancy, childbirth, and the postpartum period, often limited to reproductive or maternal health services, our index adopts a multi-dimensional approach. The WHI comprises 17 variables, representing life stages of women and encompassing a diverse range of factors. Utilizing Principal Component Analysis, we computed the index and conducted statistical tests for internal and external validation. The spatial pattern of WHI reveals substantial inter-district and inter-state disparities. This study thus provides a valuable tool for characterizing women's health and identifying health inequalities at a smaller administrative level in India.

While scientific understanding of the COVID-19 pandemic increased, conspiracy theories undermined the foundations of public health policy, making it significantly more difficult both to discuss and to implement. Popular alternative narratives include the claim that government was using restrictions to control people's behavior, and that the pandemic was caused by 5G cellular technology. We examine the extent to which alternative beliefs were associated with sociodemographic characteristics and the sources through which people acquired information during the pandemic. Our analysis uses a demographically balanced online survey of 10,022 participants from 50 US states, collected during August of 2021. Results indicate that those holding alternative theories tended to be right leaning, religious, young, male, and unvaccinated individuals. Sources of information were also strong predictors of such beliefs, specifically the extent to which social media were considered reliable.

We conducted a comprehensive analysis of the usefulness of the Delphi technique for facilitating community participation in local health needs assessments within the Andalusian Local Health Action Network, Spain. We developed an ad hoc online questionnaire based on the Social Determinants of Health model and applied it to a panel of experts in two municipalities in the province of Seville (Andalusia, Spain) between May and June 2021. Our results reflected good panelist participation. The questionnaire successfully enabled the prioritization of both new and original items, some of which were incorporated into local health policies. We concluded that the Delphi method was effective for facilitating participation in local health needs assessments offering a replicable, cost-effective approach that accelerated local policy development and supported the implementation of Health in All Policies within local government.

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.

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.

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.