Changes In Population Health Research Articles

Изменения климата и лесные пожары как факторы риска здоровью (аналитический обзор)

Climate change in Russia contributes to an increase in the number of forest fires, especially in Siberia and the Far East, leading to the rise in the forest fire danger index. Increased air pollution, which is typical for a number of cities in these regions, is the reason for changes in population health due to the influx of significant volumes of smoke gases from forest fires into populated areas. Smoke from forest fires, consists of aerosols and gases and contains more than 40 pollutants. During fires, frequency of calls for emergency medical care for children tends to increase due to exacerbation of upper respiratory tract diseases, including laryngitis, pharyngitis and acute respiratory infections, as well as attacks of bronchial asthma, and longer exacerbation periods of this disease. Such respiratory dysfunctions appear a few days after fires, which should be taken into account when organizing health monitoring in such situations. Among adult population, an increase in the number of deaths from cardiovascular and respiratory diseases has been proven during forest fires, and there tends to be an increase in the number of requests for medical care for COPD, bronchial asthma, myocardial infarction, coronary heart disease and other diseases. Fires in forest highlands in the Khabarovsk Krai result in deteriorating health of patients with neurological diseases. The generalization of the results obtained by domestic and foreign studies on this issue confirms the need to improve the air pollution monitoring system during forest fires with the determination of PM for timely preventive measures by health systems, Rospotrebnadzor, FMBA and other agencies. It also seems necessary to develop modeling of pollutant spread in ambient air in settlements exposed to them, with assessments of population health risks and development of preventive measures. Given the relevance of these studies, it is advisable to hold seminars with BRICS countries within the framework of international cooperation.

Climate change and forest fires as health risk factors (Analytical review)

Climate change in Russia contributes to an increase in the number of forest fires, especially in Siberia and the Far East, leading to the rise in the forest fire danger index. Increased air pollution, which is typical for a number of cities in these regions, is the reason for changes in population health due to the influx of significant volumes of smoke gases from forest fires into populated areas. Smoke from forest fires, consists of aerosols and gases and contains more than 40 pollutants. During fires, frequency of calls for emergency medical care for children tends to increase due to exacerbation of upper respiratory tract diseases, including laryngitis, pharyngitis and acute respiratory infections, as well as attacks of bronchial asthma, and longer exacerbation periods of this disease. Such respiratory dysfunctions appear a few days after fires, which should be taken into account when organizing health monitoring in such situations. Among adult population, an increase in the number of deaths from cardiovascular and respiratory diseases has been proven during forest fires, and there tends to be an increase in the number of requests for medical care for COPD, bronchial asthma, myocardial infarction, coronary heart disease and other diseases. Fires in forest highlands in the Khabarovsk Krai result in deteriorating health of patients with neurological diseases. The generalization of the results obtained by domestic and foreign studies on this issue confirms the need to improve the air pollution monitoring system during forest fires with the determination of PM for timely preventive measures by health systems, Rospotrebnadzor, FMBA and other agencies. It also seems necessary to develop modeling of pollutant spread in ambient air in settlements exposed to them, with assessments of population health risks and development of preventive measures. Given the relevance of these studies, it is advisable to hold seminars with BRICS countries within the framework of international cooperation.

Uncertainty and instability in social and health services impact well‐being of mothers with lived and living history of substance use

AbstractMothers who use substances often experience gender‐based and structural inequities that can jeopardize maternal and family wellness. Instability in the availability of services, particularly during public health crises (e.g., COVID‐19 pandemic), often results in changes in population health needs/funding/services, which may magnify experiences of disadvantage. Limited research has focused on times of change/crisis and its impact on maternal and family wellness. We examined the experiences of structural disadvantage, service access, and well‐being among mothers who use or formerly used substances during the first year of the COVID‐19 pandemic. Semi‐structured interviews were conducted with 26 mothers with current or past engagement in outpatient substance use treatment programs for pregnant and parenting women in Ontario, Canada. Transcripts were analysed using reflexive thematic analysis, revealing that instability of services and decreased access to/quality of informal and formal relationships often magnified the mental and affective toll of stressors, both pre‐existing and new. The impact on well‐being appeared to be greater for families who were actively engaged with child protective services. Findings are discussed in relation to literature examining systemic and societal factors that perpetuate gender‐based and structural inequities experienced by mothers with lived and living histories of substance use. The potential impact of changes in public health service delivery requires thoughtful and proactive attention for and by all stakeholders, including integrated attention across systems (e.g., health, social, education) that provide services to support maternal and family well‐being.

Distributionally sensitive measurement and valuation of population health

We introduce a measure of population health that is sensitive to inequality in both age-specific health and lifespan and can be calculated from a health-extended period life table. By allowing for inequality aversion, the measure generalises health-adjusted life expectancy without requiring more data. A transformation of change in the (life-years) measure gives a distributionally sensitive monetary valuation of change in population health and disease burden. Application to Sub-Saharan Africa between 1990 and 2019 reveals that the change in population health is sensitive to allowing for lifespan inequality but is less sensitive to age-specific health inequality. Allowing for distributional sensitivity changes relative burdens of diseases, reduces convergence between the burdens of communicable and non-communicable diseases, and so could influence disease prioritisation. It increases the value of health improvements relative to GDP.

The role of parental composition in improved birth outcomes during the COVID-19 pandemic in Finland

Abstract Background In some high-income contexts, the COVID-19 pandemic was associated with improved birth outcomes, which was hypothesised to be caused by a positive effect of the pandemic on maternal health. Conversely, an improvement in birth outcomes may have been driven by pandemic-induced compositional changes in parental characteristics, which are associated with health outcomes at birth. Research on this consequence of the COVID-19 pandemic is critical for understanding pandemic-induced changes in population health (inequalities) and planning of public service provision. Methods We analysed population-wide data on birth outcomes and parental sociodemographic characteristics from Finland collected between January 2015 and December 2021 (n = 336,000). The total effect of pandemic-induced compositional changes on birth weight and preterm birth rate was estimated by segmented regression models using three conception cohorts: a) conceived prior to May 2019, b) conceived between June 2019 and February 2020 (to account for in-utero exposure to the pandemic), and c) conceived during the pandemic between March 2020 and February 2021 (to prevent selection bias). Preliminary Results Adjusting for secular trends and seasonality, and accounting for in-utero exposure to the pandemic, the estimated effect of parental compositional change on average birth weight was 36.5 grams [95%CI: 24.8; 48.3]. Correspondingly, this compositional change was associated with a 16.2% [95%CI: 8.8%; 23%] lower risk of preterm birth for babies conceived during the pandemic. Conclusions Pandemic-induced changes in parental composition drove the modest increase in birth weight and substantial reduction in preterm births for babies conceived during the pandemic. Should the postponed pregnancies among population groups at risk for worse birth outcomes eventually realise post-COVID-19, health care and educational systems may need to prepare for cohort-specific variations in service demand. Key messages • Improvement in birth weight and preterm birth rate among babies conceived during the COVID-19 pandemic were driven by pandemic-induced changes in parental composition. • Further research using natural experimental designs on this compositional change and health outcomes can inform future public service provision.

85.1 The PAX Good Behavior Game: Promoting Population Health Change Through Early Behavioral Skills

85.1 The PAX Good Behavior Game: Promoting Population Health Change Through Early Behavioral Skills

Supervenience and the Public Health Standard for Psychoactive Substances

This paper uses Geoffrey Rose’s theory of population health change to identify that part of lack of resolution of the harm reduction debates emerges from the philosophical question of the possibility of group-level causation. Group-level causation, otherwise known as the supervenience of higher levels onto lower levels, has been a core matter of philosophical and ethical debate. This paper argues that there, the public health standard depends crucially on the contextual environment rather than the individual product’s intrinsic properties. Interpretation of the benefits or the harms of e-cigarettes or other harm reduction products depends on the often unstated assumptions of the potential policy and cultural environments in which e-cigarettes exist, as well as the separate debate over the absolute or relative level of harm of e-cigarettes. Unfortunately, most of the research conducted will not contribute to our understanding of the potential impact of e-cigarettes until we focus on the potential changes to the social and political environment.

Rehabilitation - Is an Important Aspect of Universal Health Coverage

Rehabilitation is important, as are other facets of universal health coverage such efficient illness prevention, treatment, and palliative care. A person who has undergone rehabilitation can participate in school, job, recreation, and important life responsibilities including caring for family members. Rehabilitation enables a child, adult, or senior to be as independent as possible in daily activities. A health issue that could be treated by rehabilitation affects an estimated 2.4 billion individuals worldwide. The need for rehabilitation services is anticipated to increase globally as a result of changes in population health and features. People are living longer but with more chronic illness and incapacity, for instance. Rehabilitation needs are now mostly unmet. More than half of the population does not obtain the necessary rehabilitation services in several low- and middle-income nations. Rehabilitation and other healthcare programs have been severely impacted by the COVID-19 pandemic.

Rehabilitation- Is a Vital Component of Universal Health Coverage

Rehabilitation is important, as are other facets of universal health coverage such efficient illness prevention, treatment, and palliative care. A person who has undergone rehabilitation can participate in school, job, recreation, and important life responsibilities including caring for family members. Rehabilitation enables a child, adult, or senior to be as independent as possible in daily activities. A health issue that could be treated by rehabilitation affects an estimated 2.4 billion individuals worldwide. The need for rehabilitation services is anticipated to increase globally as a result of changes in population health and features. People are living longer but with more chronic illness and incapacity, for instance. Rehabilitation needs are now mostly unmet. More than half of the population does not obtain the necessary rehabilitation services in several low- and middle-income nations. Rehabilitation and other healthcare programs have been severely impacted by the COVID-19 pandemic.

Iodine Concentration in Brazilian Drinking Water and Its Possible Contribution to Iodine Intake for Different Physiological Groups.

The objective is to analyze the concentration of iodine in Brazilian drinking water and its possible contribution to iodine intake for different groups. Water samples collected from primary healthcare units in eight locations distributed across all five macroregions of Brazil were analyzed. The quantification of iodine in the water samples was done by spectrophotometry (leuco crystal violet method). To classify the degree of iodine concentration, the recommendation of the Ministry of Health (China) was followed since Brazil lacks a classification standard. To verify the possible contribution of drinking water to iodine intake for different groups, the recommended water intake for each group according to the United States Institute of Medicine (2004) was considered. The percentage of iodine in drinking water and its contribution to iodine intake for different physiological groups were calculated based on the estimated average requirement (EAR) of iodine. A descriptive statistical analysis was performed using SPSS version 21.0 and Statistical Analysis Systems (SAS) version 9.2. Significant differences were found between the maximum and minimum concentrations of iodine in water samples from the same location. In Pinhais (south region), the difference was 44.32 μg· L-1; in Viçosa (southeast region), it was 27.86 μg·L-1; in Rondonópolis (midwest region), it was 12.66 μg·L-1; in São Luís (northeast region), it was 11.82 μg·L-1; in Brasilian Federal District (midwest region), it was 10.98 μg·L-1; in Macaé (southeast region), it was 10.14 μg· L-1; in Palmas (north region), it was 4.22 μg·L-1; and in Vitória (southeast region), it was 1.69 μg·L-1. The maximum concentrations of iodine found in the drinking water of Pinhais and Viçosa can contribute more than 70.0% and 50.0%, respectively, to daily iodine intake for all groups. Monitoring the concentration of iodine in drinking water from different locations in each city or Federal District is a preventive measure against inadequate iodine intake and possible adverse changes in population health.

Dynamics of life expectancy change during the transition to democracy in the ex-Yugoslav countries

The break-up of Yugoslavia led to political turmoil, accompanied by socio-economic changes, wars and civil unrest. Health as a social phenomenon is directly and indirectly affected by such changes. To give an overview of the changes in life expectancy, as a measure of population health, during times of crisis and large societal changes. The dynamics of change of life expectancy in the different Balkan countries are analysed by calculating the contributions of age and cause specific mortality to the observed changes of life expectancy.An original dataset of life-tables is used to calculate life expectancy, created based on mortality data from national civil registers from the 6 ex-Yugoslav republics, assessed for accuracy and completeness. Arriaga’s method is used to decompose the contributions of age groups and causes of death to the observed changes in life expectancy during three time periods: Socialist Federation (1975-1985), Transition (1988-2000), Independence (2007-2017). Large improvements in life expectancy at birth are noted in all countries, although there is heterogeneity in the dynamics of change. During the Socialist Federation period, life expectancy increased consistently across countries mainly due to reductions in infant and child mortality, as well as reduction in infectious diseases mortality. During the Transition there was a divergence of trends and some countries noted continuous increase in life expectancy, contrasting the decrease in life expectancy in Serbia and Montenegro. In all countries life expectancy increased during the Independence period, due to a reduction in mortality from non-communicable diseases among the older population.The findings of this study are important not only because they create an understanding of changes in population health during a period of crisis, but also because they provide accurate estimates of life-expectancy and dynamics of mortality change, allowing for further analysis on the social determinants of health.

Education and development of rehabilitation therapy in China under the background of aging.

The World Health Organization (WHO) estimates that about one-third of people worldwide currently have a need for rehabilitation. This demand is expected to increase in the coming years due to changes in population health and characteristics. For example, with the intensification of global aging, the rehabilitation needs of patients with chronic diseases and disabilities, postoperative dysfunction, and cognitive impairment continue to grow, and emergencies such as conflicts, disasters, and epidemics may lead to a surge in rehabilitation needs. Early and sustained rehabilitation could reduce complications, improve function, and reduce disability in affected populations, but rehabilitation services are often underestimated due to underfunding and poor short-term outcomes. WHO sees rehabilitation as an essential part of achieving universal health coverage and the Sustainable Development Goals. With the development of China's economy and society and the trend of an aging population, the demand for rehabilitation therapists is growing rapidly. Since the development of rehabilitation education in China at the beginning of this century, great progress has been made in both the training mode and the number of people trained, especially in the construction of higher education of rehabilitation in related colleges and universities. Through descriptive qualitative analysis, this study collected information from national policy documents and official websites of colleges and universities on policies concerning degree systems, cultivating goals and ideas, courses, education internationalization, continuing education in practice, standardized training after graduation, the number of colleges and universities with rehabilitation therapy related majors in China, and summarizes the current situation of the development of rehabilitation personnel education in Chinese colleges and universities. Judging from the results, during the development of rehabilitation education, China has continuously improved in terms of policy support, educational goals and concepts, the number and quality of institutions, degree systems, and internationalization, while gradually adapting to China's development status. This also provides direction and feasible suggestions for China to improve the rehabilitation education development system and formulate a national rehabilitation education plan in the future to deal with the challenge of aging.

The role of modeling in evaluation of maternal and child health programs: using the lives saved tool to help answer core evaluation questions

ABSTRACT This paper explains how The Lives Saved Tool (LiST), a computer-based model that estimates the impact of scaling up interventions on stillbirths, maternal, neonatal and child health, can contribute to evaluations of programs being delivered at scale to improve maternal and child health. LiST can be used to estimate the impact of a program in advance, allowing planners to refine, streamline and set appropriate program targets. LiST can also be used to estimate the impact of a program, which is particularly useful given the high costs of measuring changes in population health. Finally, LiST can be used to estimate the relative contributions of different interventions or sets of interventions within programs that are found to have a positive impact. The latest version of LiST allows users to manipulate both utilization and quality of service to generate estimates of effective coverage. In addition, a new, web-based version of LiST is now available, with a simpler and more streamlined interface designed to increase accessibility to beginning users. LiST modeling can help program planners, evaluators and funders respond to core evaluation questions related to program design and impact, providing evidence to support decisions about how best to use available resources to save the lives of women and children.

Rehabilitation - is an Essential Part of Universal Health Coverage

Rehabilitation, like promotion of good health, disease prevention, treatment, and palliative care, is an important aspect of universal health coverage. Rehabilitation enables a child, adult, or elderly person to be as self-sufficient as possible in daily activities, allowing them to participate in education, job, recreation, and meaningful life tasks such as caring for family members. An estimated 2.4 billion people worldwide suffer from a health condition that could benefit from rehabilitation. Changes in population health and features are expected to increase the demand for rehabilitation services around the world. People are living longer, for example, but with more chronic disease and incapacity. The requirement for rehabilitation is now largely unmet. More than half of people in several low- and middle-income nations do not obtain the rehabilitation services they require. The COVID-19 pandemic has wreaked havoc on rehabilitation programmes, as well as other health services1.

The macro-level effect of religiosity on health.

An issue that has not yet been explored in the religiosity-health literature is the macro-level effect of religiosity on health-the effect of the religiosity of a society on the absolute health of the population of that society as a whole. We address this issue using two panel datasets: The first is a time-series cross-sectional panel dataset for 17 countries from 1925 to 2000. The second is a cross-sectionally dominated panel dataset of up to 92 countries for the period 1981-2016. Our main findings are as follows: first, religiosity has a significant negative causal effect on health at the macro level; second, a substantial part of this effect can be attributed to an indirect effect via public health expenditures; and third, changes in population health do not cause significant changes in societal religiosity.

Cetacean Strandings in the US Pacific Northwest 2000–2019 Reveal Potential Linkages to Oceanographic Variability

Studying patterns in marine mammal stranding cases can provide insight into changes in population health, abundance, and distribution. Cetaceans along the United States West coast strand for a wide variety of reasons, including disease, injury, and poor nutritional status, all of which may be caused by both natural and anthropogenic factors. Examining the potential drivers of these stranding cases can reveal how populations respond to changes in their habitat, notably oceanographic variability and anthropogenic activities. In this study, we aim to synthesize recent patterns in 1,819 cetacean strandings across 26 species in the Pacific Northwest from 2000 to 2019 to compare with previous findings. Additionally, we aim to quantify the effects of localized and basin-scale oceanographic conditions on monthly stranding cases for five focal species using generalized additive models in order to explore potential relationships between strandings and changes in biophysical features that could affect foraging conditions or other important physiological cues. Our results suggest that strandings of harbor porpoises, gray whales, humpback whales, Dall’s porpoises, and striped dolphins are correlated with certain environmental variables, including sea surface temperature, chlorophyll concentration, and the Pacific Decadal Oscillation depending on the species. While it remains challenging to identify the causal mechanisms that underlie these relationships for a given species or population based on its utilization of such a complex ecosystem, improving our understanding of periods of increased strandings can enhance our knowledge of how these species interact with their environment and assist conservation and management efforts. This study enhances the utility of stranding records over time beyond simply reporting trends and has broader applicability to other geographic regions amid global climate change.

Healthy Eating in Hard Times?

Do economic recessions harm human health? Researchers and policy makers have long been interested in this question as part of a broader area of inquiry around how social and economic conditions influence population health. Economic-related factors, including income, employment, and wealth, are consistently tied to health status and life expectancy, as well as obesity and other risk factors.1,2 Beyond simply measuring associations between these indicators of socioeconomic position (SEP) and health, researchers have studied economic cycles—including recessions and recoveries—to see whether these fluctuations are correlated with similar changes in population health.

Changes in disease burden in Poland between 1990-2017 in comparison with other Central European countries: A systematic analysis for the Global Burden of Disease Study 2017.

BackgroundSystematic collection of mortality/morbidity data over time is crucial for monitoring trends in population health, developing health policies, assessing the impact of health programs. In Poland, a comprehensive analysis describing trends in disease burden for major conditions has never been published. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides data on the burden of over 300 diseases in 195 countries since 1990. We used the GBD database to undertake an assessment of disease burden in Poland, evaluate changes in population health between 1990–2017, and compare Poland with other Central European (CE) countries.MethodsThe results of GBD 2017 for 1990 and 2017 for Poland and CE were used to assess rates and trends in years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs). Data came from cause-of-death registration systems, population health surveys, disease registries, hospitalization databases, and the scientific literature. Analytical approaches have been used to adjust for missing data, errors in cause-of-death certification, and differences in data collection methodology. Main estimation strategies were ensemble modelling for mortality and Bayesian meta-regression for disability.ResultsBetween 1990–2017, age-standardized YLL rates for all causes declined in Poland by 46.0% (95% UI: 43.7–48.2), YLD rates declined by 4.0% (4.2–4.9), DALY rates by 31.7% (29.2–34.4). For both YLLs and YLDs, greater relative declines were observed for females. There was a large decrease in communicable, maternal, neonatal, and nutritional disease DALYs (48.2%; 46.3–50.4). DALYs due to non-communicable diseases (NCDs) decreased slightly (2.0%; 0.1–4.6). In 2017, Poland performed better than CE as a whole (ranked fourth for YLLs, sixth for YLDs, and fifth for DALYs) and achieved greater reductions in YLLs and DALYs than most CE countries. In 2017 and 1990, the leading cause of YLLs and DALYs in Poland and CE was ischaemic heart disease (IHD), and the leading cause of YLDs was low back pain. In 2017, the top 20 causes of YLLs and YLDs in Poland and CE were the same, although in different order. In Poland, age-standardized DALYs from neonatal causes, other cardiovascular and circulatory diseases, and road injuries declined substantially between 1990–2017, while alcohol use disorders and chronic liver diseases increased. The highest observed-to-expected ratios were seen for alcohol use disorders for YLLs, neonatal sepsis for YLDs, and falls for DALYs (3.21, 2.65, and 2.03, respectively).ConclusionsThere was relatively little geographical variation in premature death and disability in CE in 2017, although some between-country differences existed. Health in Poland has been improving since 1990; in 2017 Poland outperformed CE as a whole for YLLs, YLDs, and DALYs. While the health gap between Poland and Western Europe has diminished, it remains substantial. The shift to NCDs and chronic disability, together with marked between-gender health inequalities, poses a challenge for the Polish health-care system. IHD is still the leading cause of disease burden in Poland, but DALYs from IHD are declining. To further reduce disease burden, an integrated response focused on NCDs and population groups with disproportionally high burden is needed.

Dynamics of over body weight among women of young and mature age of open city population: twenty years of trends

Introduction Epidemiological studies indicate a high prevalence of overweight in all economically developed countries of the world, its growth was registered everywhere by the beginning of the century. According to the World Health Organization, over 30 % of the world’s inhabitants have overweight, and therefore, WHO has recognized it as a new non-infectious «21st century epidemic». The aim of the study was to determine the twenty-year dynamics of the prevalence of overweight among young and mature women in the open population of the mid-urban city of Western Siberia. Material and methods. Simultaneous epidemiological studies were conducted on representative samples in 1996 and 2016 among women of 25–64 years old with the allocation of categories of young and mature age. Overweight was determined based on body mass index (BMI), with BMI ≥ 30.0 obesity was recorded, with BMI ≥ 25.0 – overweight. Results. Over 20 years of monitoring the open population of the mid-urbanized city of Western Siberia, a positive trend has been established to reduce the prevalence of overweight in the category of young women. In the age range in relation to the prevalence of BMI according to the first and second screenings in the open urban population, a negative trend has been established for an increase in the prevalence of obesity and overweight among young women during the transition from the third to the fourth decade of life. According to the first screening in an open urban population, a negative trend was found to increase the prevalence of obesity and overweight among mature women during the transition from the fifth to the sixth decade of life, according to the second screening in the same groups, to an increase in the prevalence of overweight. Conclusion. Changes in population health at certain time intervals, depending on socio-economic, environmental, and behavioral factors, in each time period and in each individual population require specific, epidemiologically-related preventive measures.

Military Technology and Sample Selection Bias

AbstractMilitary enlistment is highly selective for reasons of both labor demand and supply. An early-twentieth-century evolution of military technology that shifted the demand for workers of different stature illustrates the importance of labor demand beyond the commonly discussed influences originating with labor supply. English-born soldiers in the Anglo-Boer War (1899–1902) were taller, on average, than those of World War I (1914–18), yet these differences cannot be attributed to standard of living or business cycle influences on the labor market. Rather, we argue, the mechanization and bureaucratization of warfare increased the relative value of shorter people permitting a decline in the average height of soldiers. Technological change over the period of these two wars affected labor demand in a way that must be recognized before using this evidence to test hypotheses about changes in population health.