Public Health Framework Research Articles

Reflections on Developing a Career in Kinesiology and Public Health

This paper provides reflections on my academic career in kinesiology and public health from an autobiographical perspective. Themes include the importance of movement and physical activity in my development and career choices, a recognition of the importance of physical activity for health outcomes, experiences in studying physical activity in a public health framework, and observations on kinesiology in higher education. I also reflect on the importance of the physical education and physical activity environment that brought me a sense of belonging, enjoyment, and accomplishment that has lasted throughout my career. As in sports and professional activities, I have tried my best and never given up until I felt the task was done.

Salmonella spp. in Pet Reptiles in Portugal: Prevalence and Chlorhexidine Gluconate Antimicrobial Efficacy.

A fraction of human Salmonella infections is associated with direct contact with reptiles, yet the number of reptile-associated Salmonellosis cases are believed to be underestimated. Existing data on Salmonella spp. transmission by reptiles in Portugal is extremely scarce. The aim of the present work was to evaluate the prevalence of Salmonella spp. in pet reptiles (snakes, turtles, and lizards), as well as evaluate the isolates’ antimicrobial resistance and virulence profiles, including their ability to form biofilm in the air-liquid interface. Additionally, the antimicrobial effect of chlorhexidine gluconate on the isolates was tested. Salmonella was isolated in 41% of the animals sampled and isolates revealed low levels of antimicrobial resistance. Hemolytic and lypolytic phenotypes were detected in all isolates. The majority (90.63%) of the Salmonella isolates were positive for the formation of pellicle in the air-liquid interface. Results indicate chlorhexidine gluconate is an effective antimicrobial agent, against the isolates in both their planktonic and biofilm forms, demonstrating a bactericidal effect in 84.37% of the Salmonella isolates. This study highlights the possible role of pet reptiles in the transmission of non-typhoidal Salmonella to humans, a serious and increasingly relevant route of exposure in the Salmonella public health framework.

Quantifying opioid use disorder Cascade of Care outcomes in an American Indian tribal nation in Minnesota

American Indian communities in Minnesota have been disproportionately impacted by the opioid use disorder (OUD) epidemic, which tribal communities have taken numerous steps to address. The Cascade of Care is a public health framework for measuring population-level OUD risk, treatment engagement, treatment retention, and recovery outcomes, which can help communities monitor the impact of responses to the OUD epidemic and identify where treatment- and recovery-related barriers and facilitators may exist. However, no studies have quantified the Cascade of Care stages within tribal communities and the extent to which these stages can be quantified using existing data sources is unknown. We utilized data from the Minnesota Drug and Alcohol Abuse Normative Evaluation System (DAANES) to quantify OUD Cascade of Care stages for an American Indian tribal nation in Minnesota and for the entire state. DAANES data indicated 269 individuals in the tribal community received treatment for opioid-related problems in 2018. Among them, an estimated 65–99 % initiated medications for OUD and an estimated 13–41 % were retained in treatment for at least 180 days. Existing state-level data can provide information about Cascade of Care stages for American Indian communities, particularly with regard to treatment admission, initiation of medications for OUD, and treatment retention. Additional data sources are needed to measure population-level OUD risk, recovery, and cultural and contextual factors that may impact treatment and recovery.

Examining public knowledge, attitudes and perceptions towards palliative care: a mixed method sequential study

BackgroundPalliative care is recognised as a public health issue with the need for earlier integration in the wider healthcare system. However, research indicates that it continues to be accessed late in the course of an illness, public understanding of palliative care is limited, and common misconceptions prevail. Strategies to address this are needed in order to reduce barriers to palliative care delivery and improve access.MethodsAn explanatory sequential mixed methods study, comprising a cross-sectional survey and interviews was undertaken. Sociodemographic characteristics, public awareness, knowledge and perceptions of palliative care were examined and strategies to raise awareness and overcome barriers within a public health framework were identified. Survey data were analysed using SPSS v25 with factor analysis and non-parametric statistics and qualitative data were analysed using thematic analysis.ResultsA total of 1201 participants completed the survey (58.3% female, mean age 61 years) and 25 took part in interviews. A fifth of participants (20.1%) had previously heard about palliative care and had an accurate understanding of the term. Being female, higher educated, married, and older, increased respondents’ levels of awareness. The three most commonly held misconceptions included: Palliative care is exclusively for people who are in the last 6 months of life (55.4% answered incorrectly); A goal of palliative care is to address any psychological issues brought up by serious illness (42.2% answered incorrectly); and a goal of palliative care is to improve a person’s ability to participate in daily activities (39.6% answered incorrectly). Talking about palliative and end of life care was advocated but societal taboos restricted this occurring with exposure limited to personal experience.ConclusionsCurrent knowledge gaps and misconceptions derived from limited ad hoc personal experiences and fear of engaging in taboo conversations may deter people from accessing integrated palliative care services early in a disease trajectory. The results indicate the need for public education programmes that move beyond merely raising awareness but provide key messages within a public health approach, which may change attitudes to palliative care thus ultimately improving end of life outcomes.

Gambling Interventions in Indigenous Communities, from Theory to Practice: A Rapid Qualitative Review of the Literature.

Indigenous populations globally experience problem gambling at higher rates than mainstream communities, often leading to adverse outcomes in social, cultural, and health domains (The term 'indigenous' within this paper refers to all first nations people from the specified countries. When capitalised, this refers to Australian Indigenous people specifically.). Problem gambling in indigenous communities has been linked to relative poverty and social disadvantage. The sweeping impacts of problem gambling for indigenous communities are holistic in nature and are felt throughout many aspects of the community, including the local economy, education, employment, and cultural kinship obligations. The social links inherent in many gambling activities in addition to the motivations of players and complex socio-cultural milieu can make it very difficult to renounce the practice. This paper aims to evaluate the indigenous gambling literature to discern appropriate and effective principles to guide intervention development in the context of problem gambling pertaining to the Australian Indigenous population. A rapid review will be undertaken to gather, analyse, and interpret appropriate theoretical and empirical literature relating to gambling interventions for indigenous populations. Papers from Canada, Australia, New Zealand, and U.S.A (CANZUS) will be considered in the review and thematic analysis will be undertaken to ascertain a broad understanding of effective and appropriate problem gambling intervention principles applicable to these population groups. Despite the relative dearth of empirical evidence within this field, approaches to problem gambling intervention within indigenous populations must be culturally-centred and underpinned by a public health framework that considers the broad socio-politico-cultural context of the whole community. The importance of community-control, collaboration, community capacity building, workforce competence, a holistic approach, and gambling regulation cannot be overstated. The available literature focusses on an alternative approach to addressing problem gambling in indigenous communities, with much of the findings highlighting key indigenist principles within a context-based method of engagement and intervention, including addressing the social, political, and cultural determinants of problem gambling at a community-level.

Human rights in domestic responses to the COVID-19 pandemic: preliminary findings from a media-coverage database to track human rights violations

BackgroundAs COVID-19 has spread throughout the world, domestic public health responses have neglected human rights. Human rights are crucial to public health promotion, yet there are significant gaps in how human rights are being monitored during the pandemic response. Existing efforts to track potential human rights violations in domestic responses to COVID-19 are neither comparative nor comprehensive. To fill this gap, we developed a novel, comparative database to systematically track media coverage of potential human rights violations. Using these data, we examine how public health policies impacted human rights realisation across countries during the first 3 months of the pandemic. MethodsWe used a systematic qualitative coding methodology to examine the extent and range of media coverage at the intersection of COVID-19, public health, and human rights. Using a structured key-term search strategy, we searched the NexisUni news database for English-language media reports. Results were screened based on pre-determined eligibility criteria, such as whether the report discussed a public health action (or inaction) in response to COVID-19 and described the human rights implications of that action (or inaction). Reports were coded by geographic location, type of public health response, human rights implications, and populations impacted. To guide the coding process, we developed a codebook based on WHO frameworks in public health and UN frameworks in human rights. FindingsIn the first 3 months of the pandemic, media coverage of domestic public health responses to COVID-19 increased rapidly as the crisis escalated. This coverage included a wide range of public health actions that impacted human rights across six geographic regions. We identified 17 public health actions that impact 24 distinct human rights, and noted that domestic public health responses were reported to have consequences for the range of civil, political, economic, and social rights that underlie public health. For example, domestic actions to implement lockdown measures were reported to have implications for the human rights to life, liberty and security of person, health, work, and education. These effects were reported to have been experienced differently across national contexts and disproportionately impacted the human rights of particular groups, including women and minority populations. InterpretationPublic health and human rights are inextricably linked in the COVID-19 pandemic. Ongoing data collection and comparative analysis can inform domestic best practices and future pandemic preparedness efforts. Our comparative database provides a foundation for future research that examines the public health impacts of human rights violations in the pandemic response. FundingNone.

Science, practice, and policy related to adverse childhood experiences: Framing the conversation.

Adverse childhood experiences (ACEs) detrimentally affect health outcomes in childhood, adolescence, and adulthood. Over the past 2 decades, the recognition of ACEs by scientists and professionals across disciplines, policymakers, and the public has evolved and expanded. Although the initial articulation of ACEs in Felitti et al.'s landmark study has formed the basis of subsequent investigations on the long-term impact of childhood adversities on health and health risk behaviors, a wider public health framework, inclusive of psychology and other social sciences, also shapes current conceptualizations, research, practice, and policies. This article provides an overview of the special issue Adverse Childhood Experiences: Translating Research to Action. Given the rapid expansion and widespread application of ACEs, this special issue was developed to articulate critical concepts, to demonstrate the significance and relevance of psychological research and practice, and to catalyze further efforts to develop effective programs and policies informed by science. The 15 articles included reflect the continuum of critical work being conducted in research, practice, intervention and prevention programs, and public policy and serve to synthesize the growing body of empirical evidence. The overarching themes that emerged are framed as 3 essential questions: (a) How broadly should ACEs be defined?, (b) How should ACEs be assessed?, and (c) How can ACEs science translate into high quality services? As illustrated in these articles, policy and practice applications deriving from psychology as a hub science can substantially benefit the health and mental health of children, adolescents, and adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Public Health Framework for Preventing Mental Disorders in the Context of Pandemics

The COVID-19 pandemic has universally threatened the building blocks of mental health, well-being, and quality of life, namely, expectations of safety, connectedness, hope, and individual and societal efficacy. Consequently, unprecedently large numbers of individuals are significantly stressed and many are at risk for relapse of mental health problems, exacerbations of existing mental and behavioral health problems, and new onset clinical problems. Because of the scope of the problem, a population-based public health perspective is needed, which in the context of disasters has well-established theories and prevention approaches. Public health approaches to disasters and pandemics focus on preventing subclinical problems from becoming clinical disorders, in comparison to clinical care approaches that focus on treating established disorders. Fortunately, specialty care clinicians who typically think about assessing and treating established disorders have the training and clinical competencies to deliver prevention-focused interventions. This paper is designed to help specialty care clinicians who use cognitive-behavioral strategies to understand the biopsychosocial impacts and resource deficits associated with COVID-19-related stressors and the public health perspective to address them. We also provide ways clinicians can help people who are suffering from significant stress and resource deficits bounce back and regain functioning. We describe psychological first aid, stress management, repeated ecological assessment, writing about stressors, problem-solving, and behavioral activation approaches to assist individuals at risk for enduring stress-linked problems.

Nalysis of Government Measures for Economic Support in the Covid-19 Pandemic Crisis: The Case of Northern Macedonia

The beginning of 2020 brought a new and surprising direction for countries all over the world, especially for their economies. This is a result of the declaration of a state of emergency or civil emergency by governments to deal with pandemics caused by Covid19. As a result, governments passed decisions restricting the free movement of citizens and their rights, particularly disabling the right to work. These austerity measures attacked workers and businesses, resulting in large-scale layoffs, staggering unemployment, business closures, and so on. Restrictive measures that had the logic of preserving public health, but attacked the country's economy, forced governments to seek solutions to the consequences of this situation, especially measures to mitigate the negative effect on the country's economy. The paper aims to analyze the measures of economic support of the Government of the Republic of Northern Macedonia (RNM), which it has approved in several cycles to deal with the crisis caused by the state of emergency. Exactly how did these measures affect the mitigation of the negative effect on the country's economy, how effective and appropriate were they, and did they serve to mitigate the consequences of anti-covid measures? However, in the framework of this paper, we will not analyze the political effect of decisions about the protection of public health. Specifically, government economic packages for financial support of workers will be analyzed, which were conceived to mitigate the negative effects caused by the implementation of measures for the protection of harsh public health. Anti-Covid19 measures, with serious consequences on the business sector and the socio-economic status of citizens. The paper has its limitations in time and territory, so it focuses on the analysis of government measures as long as the state of emergency lasted. This paper will use descriptive, historical, analytical, comparative, and empirical methods (citizen surveys). The paper concludes the effect of economic measures in conditions of civil emergency and the level of their implementation in practice. As a result of the analysis of measures for economic support, it results that the government was late in implementing them in practice, while the same is considered insufficient to deal with the crisis. Delayed political decisions on economic measures, non-immediate inclusion of all categories in need of financial support, their delayed implementation, and the political effect of some decisions by the President and the Government in certain cases were not within the framework of socioeconomic support and public health. Finally, the paper brings as a novelty the conclusion that government measures in such cases should be used correctly without distorting them, respecting deadlines, and finding the right institutional path to their users.

Using Infoveillance to Identify Community Concerns/Literacy, Reduce Risk, and Improve Response in Pollution and Health Emergencies

Contextualised in public health and environmental literacy frameworks, this interdisciplinary research applies the epidemiological concept ‘infoveillance’ to show how major pollution events can be mitigated by better use of information communication technologies (ICTs). Findings from statistical analysis of Google Trends™ data during a major Australian air pollution event (2019–2020 Summer bushfires) are presented to compare community environmental and health concerns, as manifested by Google searches, in three affected states. Internet searches related to air purifiers, air quality, and P2 face masks increased as the measured air quality decreased. The commonality of internet search activity found across states, in response to pollution emergencies, presents a valuable, yet underutilised, information source for disaster management and response by health authorities and businesses. Significant correlations between the public’s keyword searches and pollution risk suggest Google Trends™ are an underutilised ICT for identifying public health literacy, needs, and emergency response. The 2019-2020 bushfire infoveillance analysis suggests earlier intervention/awareness of predictable community response to risk-management may mitigate insufficient supply of personal protective equipment (i.e., air purifiers) and alert authorities of illiteracies requiring immediate, urgent ramification to reduce public health risk and improve emergency response, including for vulnerable populations.

The Politics of LGBT+ Health Inequality: Conclusions from a UK Scoping Review.

This scoping review of UK evidence aimed to describe what is known about Lesbian, Gay, Bisexual, and Trans (LGBT+) health inequalities in relation to cancer, mental health, and palliative care to inform research, policy and public health interventions. Using a scoping review methodology, we identified studies from database searches, citation tracking, and expert consultation. The in/exclusion criteria was based on the PICOS framework. The data were charted and then summarised to map the theoretical approaches and the main types of evidence and identify knowledge gaps. In total, 279 articles were screened and 83 were included in the final review. We found that there is limited UK research examining LGBT+ health inequality in cancer, mental health and palliative care. We would argue that this thin evidence base is partly due to national policy discussions of LGBT+ health inequality that are framed within a depoliticised ‘it’s getting better’ narrative, and an unwillingness to adequately acknowledge the unjust social and economic relations that produce LGBT+ health inequality. In addition, LGBT+ health inequality is depoliticised by existing public health explanatory theories, models and frameworks that exclude sexual orientation and gender diversity as dimensions of power that interlock with those of socio-economic, race and ethnicity. This is a barrier to developing public health interventions that can successfully tackle LGBT+ health inequality

Ethical implications of the National Tuberculosis Elimination Programme in India: A framework-based analysis

Tuberculosis (TB), an infectious disease, is transmitted by inhalation of droplet nuclei discharged in the air. Revised National Tuberculosis Control Programme (RNTCP), now National Tuberculosis Elimination Program (NTEP) of India, has made significant gains in strengthening the support structures, program architecture, and implementation environment for TB control in India. Kass's framework for public health includes an analytic tool that consists of a step-by-step list of six questions for deciding how the burdens and benefits of an intervention can be fairly balanced. We have tried to apply each of the elements addressed in the framework with context to RNTCP/NTEP measures, reviewing relevant literature evidence and attempt to view from the “ receiver's” perspective instead of looking at from “ provider's” perspective. We feel the NTEP provides a sound delivery of ethical principles in the program. Involvement of private sectors into the program for TB control, which is a challenging task, is a requirement for a fair provision of uniform TB care across the nation.

SELF-ASSESSMENT OF THE CONTENT OF THE PUBLIC HEALTH MASTER'S EDUCATIONAL PROGRAM FOR COMPLIANCE WITH THE EUROPEAN PUBLIC HEALTH CORE COMPETENCES PROGRAMME

The aim: Determining the compliance of the developed Public Health Educational Program with the principles and basic provisions of the WHO-ASPHER Competency Framework for Public Health Workforce in the European Region. Materials and methods: The study used bibliographic and information-analytical methods and content analysis. A comparative analysis compliance of the content of the Public Health Master's Educational Program, developed in Bogomolets National Medical University, with the provisions of the WHO-ASPHER Competency Framework for Public Health Workforce in the European Region in terms of providing academic disciplines in the ECTS credits (European credit transfer and accumulation system), has been carried out. Results: Comparative analysis of the components of the University Public Health Master's Educational Program and regulations of the WHO-ASPHER Competency Framework for Public Health Workforce in the European Region has identified a high level of their compliance in all areas of competence formation, including science and practice, health promotion, legislation, policy, ethics, common health and safety in health, leadership and operational mind-set, cooperation and partnership, communication, culture and advocacy, strategic and resource management, professional development, organizational training and adaptability. The competence-based educational program provides future professionals with theoretical knowledge and practical skills for a clear understanding of public health problems, a reasonable choice of methods for solving them, taking into account modern practices; forming partnerships, effective communication and cooperation on a cross-sectoral basis, developing leadership skills, organizing and providing people-centred public health services. Conclusions: Self-assessment of the content of Public Health Master's Educational Program for compliance with European educational standards for the formation of the necessary competencies is an important tool for its quality formation and improvement. A comparative analysis of the university's Public Health Master's Educational Program, with the European Competency Framework for Public Health Workforce, has identified a high level of compliance.

Ethical dimensions of neglected tropical disease programming.

The global movement to control and eliminate neglected tropical diseases (NTDs) is grounded in an ethic of social justice, solidarity and health equity. NTD programmes deliver significant health benefits in socially complex environments characterized by poverty and economic disparity. We used two ethics frameworks—principlism and Upshur's public health framework—to examine ethical challenges faced by NTD programmes. They include management of serious adverse reactions associated with preventive chemotherapy, centralization of decision-making, ‘opt-out’ policies for school-based deworming, incomplete evidence for ‘pro-poor’ impact and persistent inequities in global partnerships. NTD programmes must actively address ethical challenges while pursuing global health goals.

Preventing the Spread of COVID-19 in Immigration Detention Centers Requires the Release of Detainees.

Immigration detention centers are densely populated facilities in which restrictive conditions limit detainees' abilities to engage in social distancing or hygiene practices designed to prevent the spread of COVID-19. With tens of thousands of adults and children in more than 200 immigration detention centers across the United States, immigration detention centers are likely to experience COVID-19 outbreaks and add substantially to the population of those infected.Despite compelling evidence indicating a heightened risk of infection among detainees, state and federal governments have done little to protect the health of detained im-migrants. An evidence-based public health framework must guide the COVID-19 response in immigration detention centers.We draw on the hierarchy of controls framework to demonstrate how immigration detention centers are failing to implement even the least effective control strategies. Drawing on this framework and recent legal and medical advocacy efforts, we argue that safely releasing detainees from immigration detention centers into their communities is the most effective way to prevent COVID-19 outbreaks in immigration detention settings. Failure to do so will result in infection and death among those detained and deepen existing health and social inequities.

TEST SEIRCRT |ˈsəːkrɪt |: For the Health of Our Communities

The 2019 coronavirus disease (COVID-19) cases that are being confirmed in Canada provide an opportunity to expand the epidemic model for the simulation of disease infection spread: Susceptible- Exposed-Infectious-Recovered (SEIR). This paper develops a SEIRCRT |ˈsəːkrɪt | model that integrates the Institute for Disease Modeling’s SEIR model and Critical Race Theory (CRT) to answer the question: What is in a SEIRCRT model? SEIRCRT provides a basic modeling structure from a CRT lens to simulate, predict and forecast COVID-19 cases, comorbidities affecting African Canadians, and deaths through predictive modeling. Knowledge of SEIRCRT is critical to characterize the severity of COVID-19 in this early stage. To this end, the purpose of this paper is to describe SEIRCRT’s model and summarize its key characteristics. SEIRCRT as a public health framework provides insight into the conclusions drawn about race and COVID-19, and expands our thinking about what health disparities mean for African Canadian communities.

The Ethics of Tobacco Harm Reduction: An Analysis of E-Cigarette Availability From the Perspectives of Utilitarianism, Bioethics, and Public Health Ethics.

Much evidence suggests e-cigarettes are substantially less harmful than combustible cigarettes. Assuming this is true, we analyze the ethical case for a policy of e-cigarette availability (ECA) as a tobacco harm reduction strategy. ECA involves making e-cigarettes available to allow smokers to switch to them, and informing smokers of the lower risks of e-cigarettes vis-à-vis smoking. After suggesting that utilitarian/consequentialist considerations do not provide an adequate ethical analysis, we analyze ECA using two other ethical frameworks. First, ECA is supported by a public health ethics framework. ECA is a population-level intervention consistent with respecting individual autonomy by using the least restrictive means to accomplish public health goals, and it supports equity and justice. Second, ECA is supported by four principles that form a biomedical ethics framework. By reducing smokers' health risks and not harming them, ECA fulfills principles of beneficence and non-maleficence. Because ECA allows smokers to make informed health decisions for themselves, it fulfills the principle requiring respect for persons and their autonomy. Here, we consider whether nicotine addiction and thus ECA undermine autonomy, and also discuss the ethical warrant for special protections for youth. Finally, ECA can also advance justice by providing a harm reduction alternative for disadvantaged groups that disproportionately bear the devastating consequences of smoking. Policies of differential taxation of cigarettes and e-cigarettes can facilitate adoption of less harmful alternatives by those economically disadvantaged. We conclude that public health and biomedical ethics frameworks are mutually reinforcing and supportive of ECA as a tobacco harm reduction strategy. Implications: Making e-cigarettes and information about them available is supported as ethical from multiple ethical perspectives.

Use of Alcohol in Long Term Care Settings: A Comparative Analysis of Personal Choice, Public Health Advice and the Law

Alcohol is one of the most widely available psychoactive substances globally. Many accept the risks associated with alcohol consumption for reasons such as social engagement and feelings of pleasure. Alcohol consumption in a nursing home (NH) setting highlights the moral and logistical challenges of balancing the need for a safe living and working environment with the dignity of risk (DoR) and personal autonomy of residents.This analysis explores public health, human rights, and legal frameworks in their approach to a NH resident's choice to drink alcohol. Key issues under the public health framework include the medical risks associated with alcohol consumption, whether residents with impaired cognitive functioning have the capacity to make a decision about alcohol consumption, and the practical and ethical implications of supplying alcohol to residents. Under a legal framework, NHs must consider the legal imperative to respect residents' rights, the possibility of liability in negligence, duties owed to employees, the existence of substitute decision-makers, and liquor licensing laws. Fundamental considerations under the human rights framework include the damaging psychological effects of risk-avoidance and the importance of inclusive risk assessment processes.Alcohol policies should incorporate elements from all 3 frameworks. There is limited data publicly available about alcohol policies in NHs. Further research is needed to establish current practice and to evaluate the merits and disadvantages of different policies. Establishing inclusive and thorough decision-making processes is key to achieving better consumer-directed care.

PTSD / substance use disorder comorbidity: Treatment options and public health needs.

Posttraumatic stress disorder (PTSD) commonly co-occurs with substance use disorder (SUD) and is challenging to treat. We review all behavioral therapy models with at least one randomized controlled trial in a current PTSD/SUD population. We identify factors in selecting a model for clinical use, emphasizing a public health framework that balances the need for evidence with the need for feasibility in frontline settings. Seven published models and 6 unpublished models are reviewed. Public health considerations for choosing a model include: whether it's been studied across a broad range of SUDs and in complex SUD patients; whether it can be conducted in group modality; its appeal to patients and providers; its cost; workforce requirements; and its ability to reduce substance use in addition to PTSD. There are two broad types of models: those that originated in the PTSD field versus the SUD field. Overall, the latter are stronger on public health factors and more feasible in SUD settings. Published models in this category include Relapse Prevention, BRENDA, and Seeking Safety. PTSD/SUD research is at an early stage and there is a need for methodology that quantifies "level of burden" (patients' socioeconomic disadvantages) across trials.

12.K. Workshop: Gender-sensitive and intersectional health monitoring and reporting: putting theory into practice

Abstract Public health monitoring and reporting (PHMR) provides compilations of up-to-date epidemiological data from multiple sources and their interpretation. Health reports are aimed at users in public health policy but should also inform civil society, healthcare professionals, or students. Recently, stakeholders from civil society were increasingly involved in the process of PHMR to identify topics that are relevant for diverse population groups. PHMR inter alia seeks to identify population groups at need of health promotion or healthcare and, thus, to contribute to achieve health equity. High-, middle- and low-income countries alike have developed reporting systems that describe the health of populations according to categories of difference such as sex/gender, race/ethnicity, or socioeconomic status. In the past, most of these reports have focused on single categories and dichotomous presentations. Scholars involved in PHMR have pointed out that health reports focusing on sex/gender should compare disease burden between women and men, display heterogeneity within the groups of women and men, consider the social context and make use of theory to interpret findings in order to be gender-sensitive. We argue that an intersectional framework might be suited to inform gender-sensitive health reporting. Intersectionality posits that categories of difference cannot be thought of independently because systems of power and oppression that create inequalities are mutually constituting and reinforcing. An intersectional perspective, for example, visualises heterogeneity within supposedly homogenous societal groups such as women and men. Moreover, intersectionality was proposed as a ground-breaking theoretical framework for public health because its aim to achieve social justice by considering socio-structural systems of differentiation and subordination and by empowering all parts of society is well in line with the goal of health equity. In this workshop, we aim to discuss implications of intersectionality for the practice of gender-sensitive PHMR. To create a foundation for the panel discussion, we will present a theoretical argument about why PHMR should consider the epistemological and methodological principles of intersectionality, and present suggestions for a gender-sensitive and intersectional practice of PHMR, based on research of the joint project AdvanceGender. AdvanceGender brings together interdisciplinary researchers to translate principles of intersectionality into methods and suggestions for gender-sensitive health reporting and population health research. A panel consisting of members of AdvanceGender and experts in public policy, data analysis and health reporting will draw on research and practice internationally and on a range of methods and applications of intersectionality to research and policy. The panel discussion will focus on the feasibility of suggested methods and applications in PHMR, and their contributions towards health equity. Key messages We will present a theoretical rationale to consider the epistemological and methodological principles of intersectionality in public health monitoring and reporting. A panel will discuss implications of intersectionality for the practice of gender-sensitive public health monitoring and reporting and possible contributions to achieving health equity.