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Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example. 呼吸道病毒性疾病对医护人员的传播:以COVID-19为例
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2022-01-07 DOI: 10.1146/annurev-publhealth-052120-110009
Amanda M Wilson, Darrah K Sleeth, Camie Schaefer, Rachael M Jones

Health care workers (HCWs) can acquire infectious diseases, including coronavirus disease 2019 (COVID-19), from patients. Herein, COVID-19 is used with the source-pathway-receptor framework as an example to assess evidence for the roles of aerosol transmission and indirect contact transmission in viral respiratory infectious diseases. Evidence for both routes is strong for COVID-19 and other respiratory viruses, but aerosol transmission is likely dominant for COVID-19. Key knowledge gaps about transmission processes and control strategies include the distribution of viable virus among respiratory aerosols of different sizes, the mechanisms and efficiency by which virus deposited on the facial mucous membrane moves to infection sites inside the body, and the performance of source controls such as face coverings and aerosol containment devices. To ensure that HCWs are adequately protected from infection, guidelines and regulations must be updated to reflect the evidence that respiratory viruses are transmitted via aerosols.

卫生保健工作者(HCWs)可能从患者那里感染传染病,包括2019冠状病毒病(COVID-19)。本文以COVID-19与源-途径-受体框架为例,评估气溶胶传播和间接接触传播在病毒性呼吸道传染病中作用的证据。对于COVID-19和其他呼吸道病毒来说,这两种途径都有强有力的证据,但对于COVID-19来说,气溶胶传播可能占主导地位。关于传播过程和控制策略的主要知识差距包括:活病毒在不同大小的呼吸道气溶胶中的分布、沉积在面部粘膜上的病毒向体内感染部位移动的机制和效率,以及诸如面罩和气溶胶密封装置等源头控制的性能。为确保卫生保健工作者得到充分保护,免受感染,必须更新指南和法规,以反映呼吸道病毒通过气溶胶传播的证据。
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引用次数: 18
Social Epidemiology: Past, Present, and Future. 社会流行病学:过去、现在和未来。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2022-01-04 DOI: 10.1146/annurev-publhealth-060220-042648
Ana V Diez Roux

In a context where epidemiologic research has been heavily influenced by a biomedical and individualistic approach, the naming of "social epidemiology" allowed explicit emphasis on the social production of disease as a powerful explanatory paradigm and as critically important for interventions to improve population health. This review briefly highlights key substantive areas of focus in social epidemiology over the past 30 years, reflects on major advances and insights, and identifies challenges and possible future directions. Future opportunities for social epidemiology include grounding research in theoretically based and systemic conceptual models of the fundamental social drivers of health; implementing a scientifically rigorous yet realistic approach to drawing conclusions about social causes; using complementary methods to generate valid explanations and identify effective actions; leveraging the power of harmonization, replication, and big data; extending interdisciplinarity and diversity; advancing emerging critical approaches to understanding the health impacts of systemic racism and its policy implications; going global; and embracing a broad approach to generating socially useful research.

在流行病学研究受到生物医学和个人主义方法严重影响的背景下,“社会流行病学”的命名可以明确强调疾病的社会产生是一种强有力的解释范式,对改善人口健康的干预措施至关重要。本文简要介绍了过去30年来社会流行病学的主要实质性重点领域,反映了主要进展和见解,并确定了挑战和可能的未来方向。社会流行病学的未来机会包括对健康基本社会驱动因素的理论基础和系统概念模型进行基础研究;采用科学严谨而现实的方法得出社会原因的结论;使用互补的方法产生有效的解释和确定有效的行动;利用协调、复制和大数据的力量;扩大跨学科和多样性;推进新兴的关键方法来理解系统性种族主义对健康的影响及其政策影响;走向全球;并采用广泛的方法来产生对社会有用的研究。
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引用次数: 22
Health-Related Quality of Life Measurement in Public Health. 公共卫生中与健康相关的生活质量测量。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2021-12-09 DOI: 10.1146/annurev-publhealth-052120-012811
Robert M Kaplan, Ron D Hays

Patient-reported outcomes are recognized as essential for the evaluation of medical and public health interventions. Over the last 50 years, health-related quality of life (HRQoL) research has grown exponentially from 0 to more than 17,000 papers published annually. We provide an overview of generic HRQoL measures used widely in epidemiological studies, health services research, population studies, and randomized clinical trials [e.g., Medical Outcomes Study SF-36 and the Patient-Reported Outcomes Measurement Information System (PROMIS®)-29]. In addition, we review methods used for economic analysis and calculation of the quality-adjusted life year (QALY). These include the EQ-5D, the Health Utilities Index (HUI), the self-administered Quality of Well-being Scale (QWB-SA), and the Health and Activities Limitation Index (HALex). Furthermore, we consider hybrid measures such as the SF-6D and the PROMIS-Preference (PROPr). The plethora of HRQoL measures has impeded cumulative science because incomparable measures have been used in different studies. Linking among different measures and consensus on standard HRQoL measurement should now be prioritized. In addition, enabling widespread access to common measures is necessary to accelerate future progress.

患者报告的结果被认为是评估医疗和公共卫生干预措施的关键。在过去的50年里,与健康相关的生活质量(HRQoL)研究呈指数增长,从0到每年发表超过17,000篇论文。我们概述了在流行病学研究、卫生服务研究、人口研究和随机临床试验中广泛使用的通用HRQoL测量方法[例如,医学结果研究SF-36和患者报告的结果测量信息系统(PROMIS®)-29]。此外,我们回顾了用于经济分析和计算质量调整生命年(QALY)的方法。这些包括EQ-5D、健康效用指数(HUI)、自我管理的幸福质量量表(QWB-SA)和健康和活动限制指数(HALex)。此外,我们考虑混合措施,如SF-6D和promise - preference (PROPr)。过多的HRQoL测量方法阻碍了科学的积累,因为在不同的研究中使用了不可比较的测量方法。现在应优先考虑不同措施之间的联系和对标准HRQoL测量的共识。此外,为了加快今后的进展,有必要使广泛获得共同措施。
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引用次数: 29
Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. 消除卫生保健中的显性和隐性偏见:证据和研究需求。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2022-01-12 DOI: 10.1146/annurev-publhealth-052620-103528
Monica B Vela, Amarachi I Erondu, Nichole A Smith, Monica E Peek, James N Woodruff, Marshall H Chin

Health care providers hold negative explicit and implicit biases against marginalized groups of people such as racial and ethnic minoritized populations. These biases permeate the health care system and affect patients via patient-clinician communication, clinical decision making, and institutionalized practices. Addressing bias remains a fundamental professional responsibility of those accountable for the health and wellness of our populations. Current interventions include instruction on the existence and harmful role of bias in perpetuating health disparities, as well as skills training for the management of bias. These interventions can raise awareness of provider bias and engage health care providers in establishing egalitarian goals for care delivery, but these changes are not sustained, and the interventions have not demonstrated change in behavior in the clinical or learning environment. Unfortunately, the efficacy of these interventions may be hampered by health care providers' work and learning environments, which are rife with discriminatory practices that sustain the very biases US health care professions are seeking to diminish. We offer a conceptual model demonstrating that provider-level implicit bias interventions should be accompanied by interventions that systemically change structures inside and outside the health care system if the country is to succeed in influencing biases and reducing health inequities.

卫生保健提供者对诸如种族和少数民族人口等边缘化群体持有消极的显性和隐性偏见。这些偏见渗透到医疗保健系统中,并通过医患沟通、临床决策和制度化实践影响患者。消除偏见仍然是负责人民健康和福祉的人的一项基本职业责任。目前的干预措施包括对偏见的存在及其在使健康差距持续存在方面的有害作用进行指导,以及对管理偏见进行技能培训。这些干预措施可以提高对提供者偏见的认识,并使卫生保健提供者参与建立保健服务的平等目标,但这些变化是不可持续的,干预措施并没有证明在临床或学习环境中的行为发生变化。不幸的是,这些干预措施的效果可能会受到卫生保健提供者的工作和学习环境的阻碍,这些环境充斥着歧视做法,这些做法维持着美国卫生保健专业人员正在寻求消除的偏见。我们提供了一个概念模型,表明如果一个国家要成功地影响偏见和减少卫生不平等,提供者层面的隐性偏见干预应该伴随着系统地改变卫生保健系统内外结构的干预。
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引用次数: 42
Advances in Gender-Transformative Approaches to Health Promotion. 促进健康的性别变革方法的进展。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 DOI: 10.1146/annurev-publhealth-121019-053834
J. Fisher, S. Makleff
Gender is an important determinant of health, but explicit attention to gender is often missing in health promotion. We build on Pederson and colleagues' gender-transformative framework for health promotion to propose four guiding principles for gender-transformative health promotion. First, health promotion must address gender norms directly if it is to improve health outcomes. Second, it should move beyond individual change to engage explicitly with structural and social determinants of health. Third, it should address underlying gender-related determinants in order to influence health outcomes. And fourth, it requires complexity-informed design, implementation, and evaluation. We provide background on key concepts that are essential for designing, implementing, and evaluating gender-transformative health promotion: gender norms, socioecological approaches, and the gender system. We give examples of the four principles in practice, using the case of postnatal mental health promotion in Australia and sexuality education in Mexico. These four principles can be applied to health promotion efforts across contexts and outcomes to address the harmful gender norms that contribute to poor health as a part of broader efforts to improve health and well-being.
性别是健康的一个重要决定因素,但在健康促进中往往缺乏对性别的明确关注。在Pederson及其同事提出的促进健康的性别变革框架的基础上,我们提出了促进健康的性别变革的四项指导原则。首先,如果要改善健康结果,健康促进必须直接解决性别规范问题。其次,它应超越个人改变,明确参与健康的结构和社会决定因素。第三,它应处理与性别有关的基本决定因素,以便影响健康结果。第四,它需要基于复杂性的设计、实现和评估。我们提供了设计、实施和评估性别转型健康促进所必需的关键概念的背景:性别规范、社会生态学方法和性别系统。我们以澳大利亚的产后心理健康促进和墨西哥的性教育为例,在实践中举例说明这四项原则。这四项原则可应用于各种情况和结果的健康促进工作,以解决导致健康状况不佳的有害性别规范,作为改善健康和福祉的更广泛努力的一部分。
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引用次数: 6
The Indian Health Service and American Indian/Alaska Native Health Outcomes. 印第安人健康服务与美国印第安人/阿拉斯加原住民的健康成果。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2022-01-26 DOI: 10.1146/annurev-publhealth-052620-103633
Gina Kruse, Victor A Lopez-Carmen, Anpotowin Jensen, Lakotah Hardie, Thomas D Sequist

The Indian Health Service (IHS) has made huge strides in narrowing health disparities between American Indian and Alaska Native (AI/AN) populations and other racial and ethnic groups. Yet, health disparities experienced by AI/AN people persist, with deep historical roots combined with present-day challenges. Here we review the history of the IHS from colonization to the present-day system, highlight persistent disparities in AI/AN health and health care, and discuss six key present-day challenges: inadequate funding, limited human resources, challenges associated with transitioning services from federal to Tribal control through contracting and compacting, evolving federal and state programs, the need for culturally sensitive services, and the promise and challenges of health technology.

印第安人健康服务局(IHS)在缩小美国印第安人和阿拉斯加原住民(AI/AN)与其他种族和民族群体之间的健康差距方面取得了巨大进步。然而,美国印第安人和阿拉斯加原住民在健康方面的差距依然存在,这既有深厚的历史渊源,也有当今的挑战。在此,我们回顾了美国印第安人和阿拉斯加原住民医疗服务体系从殖民化到今天的发展历程,强调了美国印第安人和阿拉斯加原住民在健康和医疗保健方面持续存在的差距,并讨论了当今面临的六大挑战:资金不足、人力资源有限、通过合同和契约将服务从联邦控制过渡到部落控制所面临的挑战、不断发展的联邦和州计划、对文化敏感服务的需求以及医疗技术的前景和挑战。
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引用次数: 19
Social Connection as a Public Health Issue: The Evidence and a Systemic Framework for Prioritizing the "Social" in Social Determinants of Health. 社会联系作为一个公共卫生问题:证据和优先考虑健康的社会决定因素中的“社会”的系统框架。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2022-01-12 DOI: 10.1146/annurev-publhealth-052020-110732
Julianne Holt-Lunstad

There is growing interest in and renewed support for prioritizing social factors in public health both in the USA and globally. While there are multiple widely recognized social determinants of health, indicators of social connectedness (e.g., social capital, social support, social isolation, loneliness) are often noticeably absent from the discourse. This article provides an organizing framework for conceptualizing social connection and summarizes the cumulative evidence supporting its relevance for health, including epidemiological associations, pathways, and biological mechanisms. This evidence points to several implications for prioritizing social connection within solutions across sectors, where public health work, initiatives, and research play a key role in addressing gaps. Therefore, this review proposes a systemic framework for cross-sector action to identify missed opportunities and guide future investigation, intervention, practice, and policy on promoting social connection and health for all.

在美国和全球,人们对优先考虑公共卫生中的社会因素越来越感兴趣,并重新获得支持。虽然健康有多种被广泛承认的社会决定因素,但社会联系的指标(如社会资本、社会支持、社会孤立、孤独)往往明显缺席讨论。本文提供了一个概念化社会联系的组织框架,并总结了支持其与健康相关的累积证据,包括流行病学关联、途径和生物学机制。这一证据指出了在跨部门解决方案中优先考虑社会联系的若干影响,其中公共卫生工作、倡议和研究在解决差距方面发挥着关键作用。因此,本综述提出了一个跨部门行动的系统框架,以确定错过的机会,并指导未来的调查、干预、实践和政策,以促进社会联系和全民健康。
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引用次数: 55
The Role of Citizen Science in Promoting Health Equity. 公民科学在促进健康公平中的作用。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2021-11-01 DOI: 10.1146/annurev-publhealth-090419-102856
Lisa G Rosas, Patricia Rodriguez Espinosa, Felipe Montes Jimenez, Abby C King

While there are many definitions of citizen science, the term usually refers to the participation of the general public in the scientific process in collaboration with professional scientists. Citizen scientists have been engaged to promote health equity, especially in the areas of environmental contaminant exposures, physical activity, and healthy eating. Citizen scientists commonly come from communities experiencing health inequities and have collected data using a range of strategies and technologies, such as air sensors, water quality kits, and mobile applications. On the basis of our review, and to advance the field of citizen science to address health equity, we recommend (a) expanding the focus on topics important for health equity, (b) increasing the diversity of people serving as citizen scientists, (c) increasing the integration of citizen scientists in additional research phases, (d) continuing to leverage emerging technologies that enable citizen scientists to collect data relevant for health equity, and (e) strengthening the rigor of methods to evaluate impacts on health equity.

虽然公民科学有许多定义,但这个术语通常指的是普通公众与专业科学家合作参与科学过程。公民科学家一直致力于促进健康公平,特别是在环境污染物暴露、体育活动和健康饮食等领域。公民科学家通常来自经历卫生不平等的社区,并使用一系列策略和技术收集数据,例如空气传感器、水质工具包和移动应用程序。在我们审查的基础上,为了推动公民科学领域解决卫生公平问题,我们建议(a)扩大对卫生公平重要主题的关注,(b)增加公民科学家的多样性,(c)增加公民科学家在其他研究阶段的整合,(d)继续利用使公民科学家能够收集与卫生公平相关的数据的新兴技术。(e)加强评估对卫生公平的影响的方法的严谨性。
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引用次数: 21
Shifting the Demand for Vaccines: A Review of Strategies. 转移疫苗需求:战略回顾。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2022-01-26 DOI: 10.1146/annurev-publhealth-052620-093049
Neeraj Sood, Tahmina Nasserie, Sushant Joshi, Eran Bendavid

Vaccines prevent millions of deaths, and yet millions of people die each year from vaccine-preventable diseases. The primary reason for these deaths is that a significant fraction of the population chooses not to vaccinate. Why don't people vaccinate, and what can be done to increase vaccination rates besides providing free and easy access to vaccines? This review presents a conceptual framework, motivated by economic theory, of which factors shift the demand for vaccines. Next, it critically examines the literature on these demand shifters and interventions that target these demand shifters. The review concludes with offering directions for future research and lessons for public health decision making.

疫苗可防止数百万人死亡,但每年仍有数百万人死于疫苗可预防的疾病。造成这些死亡的主要原因是很大一部分人口选择不接种疫苗。为什么人们不接种疫苗?除了提供免费和便捷的疫苗接种途径外,还可以做些什么来提高疫苗接种率?这篇综述提出了一个由经济理论驱动的概念框架,其中的因素改变了疫苗的需求。接下来,它批判性地检查了这些需求转移和针对这些需求转移的干预措施的文献。本文最后提出了未来研究的方向和公共卫生决策的经验教训。
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引用次数: 3
Health and Health Care Among Transgender Adults in the United States. 美国跨性别成年人的健康和医疗保健。
IF 20.8 1区 医学 Q1 Medicine Pub Date : 2022-04-05 Epub Date: 2021-12-09 DOI: 10.1146/annurev-publhealth-052620-100313
Ayden I Scheim, Kellan E Baker, Arjee J Restar, Randall L Sell
Transgender (trans) communities in the USA and globally have long organized for health and social equity but have only recently gained increased visibility within public health. In this review, we synthesize evidence demonstrating that trans adults in the USA are affected by disparities in physical and mental health and in access to health care, relative to cisgender (nontrans) persons. We draw on theory and data to situate these disparities in their social contexts, explicating the roles of gender affirmation, multilevel and intersectional stigmas, and public policies in reproducing or ameliorating trans health disparities. Until recently, trans health disparities were largely made invisible by exclusionary data collection practices. We highlight the importance of, and methodological considerations for, collecting inclusive sex and gender data. Moving forward, we recommend routine collection of gender identity data, an emphasis on intervention research to achieve trans health equity, public policy advocacy, and investment in supporting gender-diverse public health leadership. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
美国和全球的跨性别(跨性别)社区长期以来一直为健康和社会公平组织起来,但直到最近才在公共卫生领域获得越来越多的关注。在这篇综述中,我们综合了证据,证明美国的跨性别成年人受到生理和心理健康以及获得医疗保健方面的差异的影响,相对于顺性别(非跨性别)的人。我们利用理论和数据将这些差异置于其社会背景中,阐明性别肯定、多层次和交叉污名以及公共政策在再现或改善跨性别健康差异中的作用。直到最近,由于排他性的数据收集做法,跨性别健康差异在很大程度上被掩盖了。我们强调收集包容性性别和社会性别数据的重要性和方法考虑。展望未来,我们建议定期收集性别认同数据,强调干预研究以实现跨性别健康平等,公共政策倡导,并投资于支持性别多元化的公共卫生领导。
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引用次数: 26
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