Population Health: Assessing Gains and Addressing Challenges Ahead

Abstract

In 2015 we published the volume Disaster Response: Medical and Health Policies, a compilation of articles from World Medical & Health Policy offering research and insights from medical professionals and policy scholars to help improve interventions and reduce suffering when disasters occur, whether they result from natural or human-made threats (Nicogossian & Stabile, 2015). In this first issue of 2016 we continue that initiative, begun in collaboration with our colleague Dr. David McCann, to whose memory Disaster Response is dedicated, by adding several articles to the existing body of literature. Drs. Lisa Moreno-Walton and Kristi Koenig apply their expertise in emergency medicine to a consideration of the question of how gender impacts disaster resilience and survival within diverse populations through a review of the relevant literature in their article “Disaster Resilience: Addressing Gender Disparities.” They identify five categories of gender-related disparities: biology, responsibility for dependents, development of skills, clothing, and vulnerability to assault and trafficking. Identification of gender disparities is a first step in improving policy to enhance survival across a wide range of disaster scenarios when future events occur. A consideration of the effectiveness of integrated care teams, one approach humanitarian organizations may use to support community resilience following mass fatality disasters, is offered by Professor Lavonne M. Adams of the Harris College of Nursing & Health Sciences at Texas Christian University in “Promoting Disaster Resilience through Use of Interdisciplinary Teams: A Program Evaluation of the Integrated Care Team Approach.” And in “State Mandate Influences on FEMA-Approved Hazard Mitigation Plans Under the Disaster Management Act of 2000” Professor Oluponmile Olonilua of Texas Southern University addresses the question of whether or not such mandates materially impact policy outcomes of interest. Emergency departments are a critical component of the health-care infrastructure, so understanding influences on their capacity could help in crafting policy to enhance preparedness for both disaster scenarios and more routine crises. In the United States, emergency department utilization has increased nationally, leading to overcrowding, which in turn increases wait times, adverse clinical outcomes, and costs. Niyousha Hosseinichimeh, Erika G. Martin, and Stephen Weinberg investigate one potential factor in their article, “Do Changes in Health Insurance Coverage Explain Interstate Variation in Emergency Department Utilization?” More slow moving, but no less impactful crises loom on the public-health horizon in the form of widespread obesity and antibiotic resistance. The policy implications of therapies designed to mitigate or work around the negative impacts of these are considered in articles on bariatric surgery and fecal microbiota therapy, a non-antibiotic treatment alternative for Clostridium (C.) difficile infection (CDI). David B. Muhlestein, Thomas Wickizer, and Abigail Shoben examine effects of regulations regarding bariatric surgery procedures in the United States in “The Spillover Effect of a Change in Medicare Reimbursements on Provider Behavior in the Non-Medicare Population for Bariatric Surgery.” Shahad Salman, George Vardatsikos, Denise Avard, Nicole Palmour, Ken Dewar, and Ma'n H. Zawati examine implications of emerging Canadian policy in “FMT Happens: Regulating Fecal Microbiota Therapy in Canada; What You Need to Know.” All adverse health outcomes represent potential disasters to those who suffer them. This point is raised in Kristi Heather Kenyon's review of The AIDS Generation: Stories of Survival and Resilience, in which the book's author Perry N. Halkitis refers to the AIDS pandemic as “our natural disaster.” Health-care providers and policymakers must continuously confer and collaborate to devise health-improving and life-saving solutions. Health Behavior Change in Populations, a textbook edited by Scott Kahan, Andrea C. Gielen, Peter J. Fagan, and Lawrence W. Green, and reviewed in this issue by Michael Plouffe and Liang-Kim Ong of University College, London, offers some tools for improving population health outcomes. Our journal remains dedicated to this ongoing pursuit. We encourage physicians and all health-care professionals to actively engage in all aspects of policy formulation to ensure that community health and rights are protected and included in the debates leading to responsible and effective legislation.