Why Public Health Needs Human-Centred Innovation: A Design Thinking Agenda for Public Health

Public health need versus sales of antibacterial agents active against multidrug-resistant bacteria: a historical perspective

The historical epidemiology of global disease challenges

Privacy of personal information is a protected human right both under the international human rights and national laws, statutes and regulations, subject to so exceptions that include protecting public health. The COVID-19 pandemic has challenged and overwhelmed the status quo in every human sphere, including the conventional surveillance of infectious diseases, contact tracing, isolation, reporting and vaccination while simultaneously protecting the privacy of personal data. The pandemic had led national governments, institutions and agencies to adopt mobile applications for collecting, analysing, managing and sharing critical personal data of individuals infected with or exposed to COVID-19. These data may be centralized at a central database, or localized in individuals’ phones. While the benefits of sharing private information for achieving public health needs may not be disputed, the risk of breach of personal privacy is, also, enormous. Consequently, it forced the national governments into a dilemma of either succumbing to public health needs, or strictly respecting and protecting the privacy of individuals, or balancing the two conflicting demands. There is a massive body of literature on the security and privacy of such mobile applications, but none has adequately explored and discussed the public interest justifications under the Saudi Arabian laws for the alleged privacy breaches. This paper explored the COVID-19 surveillance mobile app technologies in use in Saudi Arabia for their potential risks of data breaches under the prevailing data protection laws and regulations with a view to understanding if such breaches are obligated, allowed, or justified under the laws. Our findings suggest that any potential risk of a breach to the individuals’ privacy of personal information under the law would seem to have been properly balanced against (justified by) the public health needs to protect the society during the COVID-19 pandemic.

Population ageing is the sought-for outcome of improved public health, education and medical care over the last century. Worldwide, life expectancy is increasing. The health with which people age, given longer lives, has become a critically important determinant of population health and of development agendas as well as the economic well-being of nations. This issue of Public Health Reviews is devoted to the description and the analysis of how increased life expectancy and ageing affect population needs and compel us to modify public health science and leadership. It lays out the transitions in population science and the multilevel public health and policy agenda for the future necessary to support longer lives that are healthy and engaged. The public health consequences of longevity and population ageing do not come as a surprise. The emergence of ageing as a public health issue dates back to the mid-20 century. The demographic transition (as originally expressed in the 1920’s by Warren Thompson) predicted an increase in the proportion of aged people in the post-transitional period, i.e., as a result of the combination of low mortality and low birth rate. The link between the demographic transition and population health was further characterized by Omran in the 1970’s. The so-called epidemiologic transition characterizes the secular change between two epidemiological stages, i.e., from high fertility and a high, unstable frequency of rapidly lethal infectious diseases to a new situation of low fertility and health issues dominated by slowly progressing chronic and degenerative diseases. Cardiometabolic disease, cancer, neuropsychiatric diseases and musculo-skeletal conditions are now predominant (or will be soon) in most parts of the world. Several current observations were, however, unexpected. One is the ever-increasing longevity in most high income countries. Mortality is low,

Prevention better than cure? Health consumer and patients’ organisations and public health

The article “Hypertension in Sub-Saharan Africa” by Addo et al has documented both the high prevalence of hypertension, especially in urban areas, and poor control of hypertension in sub-Saharan Africa.1 In 1992, we reported the high prevalence of hypertensive disease in a population sample from Benin, Nigeria and the strong association with higher socioeconomic class and body weight.2 Previous reports from the World Health Organization (WHO) and other groups have warned of the growing epidemic of hypertension and vascular disease and, most important, the need for both population-based approaches to reduce the epidemic, including the reduction of salt in the diet and treatment of BP using inexpensive drug therapies.3,4 There is a need for better data on the prevalence of hypertension and risk factors related to both hypertension and vascular disease in sub-Saharan Africa. The most important imperative at the present time is to effectively blunt this growing epidemic of vascular disease. This epidemic of vascular disease is following the path characteristic of many other countries and especially in the United States, with initial high rates of hypertension and vascular disease among the upper socioeconomic groups and then explosive epidemics of both hypertension and vascular disease among lower income populations, especially the black population in the United States.5 The key variables that drive the epidemics are the greater use of processed foods, higher intake of calories, decreased physical activity leading to weight gain, and the reduction of foods high in potassium.6 The epidemic, as noted, has begun in the upper social classes and in urban …

There are many elements of the global medical research and development enterprise that contribute to the discovery, development, manufacture, distribution and regulation of vaccines. These include academic scientists, government funding and regulatory agencies, commercial vaccine manufacturers in the western world and essentially generic vaccine manufacturers in the developing world. The central tenets of our system as it exists today are 1) that public health need will drive fundamental research supported by government at academic institutions, and 2) that the resulting discoveries will be translated into useful products, because public health need can be converted into an economic return for the vaccine industry and its shareholders. In those instances where public health need exists in parallel with potential economic return, the system works surprisingly well.

Estimating Eye Care Workforce Supply and Requirements

Complex and continuous developments in health and healthcare require innovative changes in programs that educate public health scientists and professionals. Public health change agents need critical competencies to confront today and tomorrow's leading problems including leadership, communication, interprofessional practice, and systems thinking. Public Health training programs teach competencies through their applied field experience and culminating project, typically late in the program, and often implemented in isolation from peers and faculty. Objectives and skills do not always align closely with community-based program needs. Students pursuing a degree in science in public health need to deeply comprehend multi-dimensional and interconnected systemic problems and communicate with diverse stakeholders across disciplines to produce relevant community-engaged research. The University of Miami Public Health Learning Collaboratory (LC) was established to transform the learning experience of public health master's students by providing opportunities to develop necessary core skills for effective public health practice early in their training, while applying these skills to address real-world public health needs in the community. Spanning an average of 3 semesters, the LC promotes student involvement in collaborative and impactful capstone and thesis projects. Practice-based teaching and service learning are central approaches to teaching cross-cutting competencies of leadership, communication, problem solving, collaboration, and systems thinking in public health. Significant to the approach is the engagement of previous cohorts of senior students to teach back to junior students, further integrating concepts learned. Long term alumni feedback recognized strengths of the program, including its structure, teamwork & collaboration, critical thinking & problem solving, guidance, nurture & support, teaching back, and content & curriculum. Community partners agreed the LC prepared students to practice in the field of public health. The LC is a promising model for master's level public health education and community application, given the opportunities it provides to strengthen and integrate students' public health skills in a supportive environment, and enhance the transferability and sustainability of student and faculty's community public health work.

Hepatitis means inflammation of the liver and can be caused by several types of viruses. In the world today, the hepatitis B virus (HBV) is the most frequently occurring serious liver infection. Globally, 2 billion people are estimated to be infected with HBV. Yearly, the death toll from HBV and HBV related complications is roughly 900,000. The problem is twofold, the lack of knowledge about hepatitis B infection and how to prevent it, and the limitations of the currently existing public health education approaches. Consequently, there continues to be a lack of knowledge among the general population on how to prevent hepatitis B infection. Therefore, there is a need to explore new approaches to educate the general public about how to prevent acquiring hepatitis B infection and its life-threatening complications. Visual novels (VNs) are currently being studied and used as a means of providing information and education. In this project, a VN was developed for the purpose of public health education on HBV infection and its prevention. This thesis project concerns the development of a new product and was therefore accomplished using a new product development approach with a customer discovery interview process, and an assessment of the types of mobile applications that exist for public health education about hepatitis B. Therefore, this project set out to determine the topics public health workers believe would have the greatest impact on improving hepatitis B awareness in the general public if made available in a mobile digital application. To determine what mobile apps focusing on public health education on HBV exist, the Apple and Google Play App Stores were searched. Eight public health workers who address HBV patients on a regular basis were interviewed as potential customers. Of the potential customers, 100% of them specifically addressed challenges they face serving patient populations. 100% of them spoke on barriers to patient care, including cultural barriers, stigma, language barriers, linkage to care, and access issues. 50% spoke about awareness as a public health need, and 100% spoke on education on HBV infection as a public health need. 37.5% spoke of Asian population being highly affected by HBV. The apps on public health education about hepatitis B found on the Google Play and Apple app stores and assessed had a greatly varying number of downloads (10-10,000 downloads). Most of them had high customer ratings (4-5 stars), or no customer ratings. In addition, mobile phones are heavily used by the general population for entertainment purposes, and storytelling has the potential to surmount cultural barriers. Moreover, VNs are very popular in Asia, and are growing in popularity in China and the US. Taking this and the interview data into consideration, the author and the committee felt that a highly suitable approach to designing a public health education intervention to meet the potential customers' needs was to develop a VN. The design approach taken included the drafting of a screenplay, creation of cel-shaded character art, painterly smooth shaded background art, and use of Unity 3D's scripting API. While VNs can be engaging storytelling mediums and useful educational tools, and have potential to surmount certain cultural barriers, they rely heavily on text. Therefore, they have limitations in overcoming language barriers. Ways around this could be to include more informative or animated visuals and artwork, or create multiple text or audio translations. Future directions include the simplification of the screenplay from the 8th grade reading level down to the 5th grade reading level according the Flesch Reading Ease Score, and the development of multiple text and audio translations in Mandarin, Korean, Vietnamese, Swahili, and French.

LETUS TURN from general considerations of j community health to a specific unmet community public health need—a community problem that has been skirted, consigned to the already too-busy eye specialist, or given a public health lick and a promise for too many years. There are many agencies dealing with care and welfare of the blind, most of them doing excellent and much-needed work. But with rare exceptions, none are geared to prevention of blindness. Most remain essentially social-welfare groups oriented to the problems of the blind. Public health departments are medically oriented units, and prevention and restoration are essentially medical problems rather than responsibilities of social welfare agencies. Visual disorders cost America a staggering $4.5 billion in care and loss of national productivity every year. That's more than 10 times what it cost to put an astronaut into orbit around the world. I'd like to discuss the 4 most

BackgroundOver recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Although psychologists have completed important work on mental health responses to disaster exposure including terrorist attacks, the mental health impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council’s pioneering public mental health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to explore perceptions of the mental health impact of the incident by those living and working in the borough.MethodsA rapid qualitative evaluation informed by the logic underpinning Southwark Council’s response was conducted. Seven formative interviews were undertaken with individuals involved in the response planning and/or delivery, enabling the evaluation team to establish the response’s theoretical basis. Subsequently, nineteen semi-structured interviews with consenting Council employees, residents, business owners, and workers from the Borough were conducted to understand perceived mental health impacts of the attack and the success of the Council response. Thematic analysis of transcribed interviews was undertaken to evaluate the extent to which the response was implemented successfully.ResultsParticipants reported feeling the attack had a wide-reaching negative impact on the mental health of residents, those working in the borough and visitors who witnessed the attack. Delivering the response was a challenge and response visibility within the community was limited. Participants suggested a comprehensive systematic approach to health needs assessment informed by knowledge and relationships of key Council workers and community stakeholders is imperative when responding to terrorist incidents. Improved communication and working relationships between statutory organisations and community stakeholders would ensure community groups are better supported. Prioritising mental health needs of terror attack responders to mitigate persisting negative impacts was highlighted.ConclusionsThis article highlights a potential public health approach and need for developing robust practical guidance in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.

People ≥ 65 years are expected to live a substantial portion of their remaining lives with a limiting physical condition and the numbers of affected individuals will increase substantially due to the growth of the population of older adults worldwide. The age-related loss of muscle mass, strength, and function is associated with an increased risk of physical disabilities, falls, loss of independence, metabolic disorders, and mortality. The development of function-promoting therapies to prevent and treat age-related skeletal muscle functional limitations is a pressing public health problem. On March 20-22, 2022, the National Institute on Aging (NIA) held a workshop entitled "Development of Function-Promoting Therapies: Public Health Need, Molecular Targets, and Drug Development." The workshop covered a variety of topics including advances in muscle biology, novel candidate molecules, findings from randomized trials, and challenges in the design of clinical trials and regulatory approval of function-promoting therapies. Leading academic investigators, representatives from the National Institutes of Health (NIH) and the U.S. Food and Drug Administration (FDA), professional societies, pharmaceutical industry, and patient advocacy organizations shared research findings and identified research gaps and strategies to advance the development of function-promoting therapies. A diverse audience of 397 national and international professionals attended the conference. Function-promoting therapies to prevent and treat physical disabilities associated with aging and chronic diseases are a public health imperative. Appropriately powered, well-designed clinical trials and synergistic collaboration among academic experts, patients and stakeholders, the NIH and the FDA, and the pharmaceutical industry are needed to accelerate the development of function-promoting therapies.

Precision medicine aims to tailor medical treatment to match individual characteristics and to stratify individuals to concentrate benefits and avoid harm. It has recently been joined by precision public health-the application of precision medicine at population scale to decrease morbidity and optimise population health. Newborn preventive genomic sequencing (NPGS) provides a helpful case study to consider how we should approach ethical questions in precision public health. In this paper, I use NPGS as a case in point to argue that both precision medicine and precision public health need public health ethics. I make this argument in two parts. First, I claim that discussions of ethics in precision medicine and NPGS tend to focus on predominantly individualistic concepts from medical ethics such as autonomy and empowerment. This highlights some deficiencies, including overlooking that choice is subject to constraints and that an individual's place in the world might impact their capacity to 'be responsible'. Second, I make the case for using a public health ethics approach when considering ethics and NPGS, and thus precision public health more broadly. I discuss how precision public health needs to be construed as a collective enterprise and not just as an aggregation of individual interests. I also show how analysing collective values and interests through concepts such as solidarity can enrich ethical discussion of NPGS and highlight previously overlooked issues. With this approach, bioethics can contribute to more just and more appropriate applications of precision medicine and precision public health, including NPGS.

The notion of public health started some 400 years ago with disease control to prevent the further spread of diseases. Since then, public health has evolved and these days includes health promotion as well as health protection. Now, as we stand on the verge of the 21st century, public health professionals are aware of the imbalance between the global magnitude of factors that affect human health and the inadequate structures in place to address them. Global integration is moving at a rapid pace, fuelled by faster communication and greater movement of people and ideas, yet the world continues to use nineteenth century structures based on individual nation states. These changes require new solutions, with effective international co-operative action, with devolved decision making that ensures implementation. Effective policies to ameliorate them will require concerted international action and public health professionals can make a difference to this process, as researchers identifying the health effects of these factors, as advocates for action, and as agents for communicating to the public the nature and scale of threats to health. If the ‘new’ public health defines health as an investment factor for a good community life focusing on the behaviour of individuals and the conditions of life that influence behaviour the questions where we stand now and how we are going to achieve this ‘new’ public health need answering. The European Public Health Association (EUPHA) is an umbrella organisation for public …