Improve Population Health Research Articles

9.B. Scientific session: Promoting health in the digital age: a room to improve health literacy and digital health literacy?

Abstract The workshop aims to explore innovative approaches to promoting health literacy and digital health literacy and their impact on individual and community health outcomes at different stages of life. This initiative is driven by the recognition that digital platforms and tools offer unprecedented opportunities to improve population health through health education and behavior change. The workshop will feature a dynamic and interactive format starting from plenary sessions in which speakers will provide insights into digital health promotion best practices and their outcomes, offering diverse perspectives. The added value of organizing this workshop lies in its comprehensive approach to integrating digital tools into health prevention strategies, particularly for addressing childhood smoking. By examining innovative digital interventions, the workshop provides a platform for sharing insights and strategies that leverage technology to promote healthier lifestyles among youth. This is increasingly pertinent as digital platforms become central in the daily interactions of young people. The coherence between the presentations revolves around the theme of enhancing digital health literacy as a preventive measure against health issues. The first presentation sets the stage by exploring digital tools that educate and engage young people about the dangers of smoking. The subsequent session builds on this by assessing the current state of digital health education and literacy, emphasizing the need for curriculum integration and better training for educators to support these initiatives effectively. Finally, the meta-analysis presentation ties everything together by evaluating the effectiveness of these digital interventions across various demographics, offering evidence-based recommendations for tailoring health literacy programs to diverse needs. Together, these presentations form a cohesive narrative on the critical role of digital literacy in health prevention, illustrating a clear pathway from educational content to educational infrastructure, and culminating in broad-based intervention strategies that can be adapted to different settings and populations. This coherence enhances the workshop’s impact, providing attendees with a well-rounded understanding of how digital tools can be harnessed to foster long-term health improvements from an early age. Live Q&A sessions will encourage dialogue between speakers and attendees, enhancing the learning experience. By combining expert knowledge with interactive discussions, the workshop aims to share insights needed to implement effective digital health promotion strategies. Key messages • The role of health literacy and digital health literacy in improving health outcomes demands that the efficacy of the most effective strategies be evaluated. • Digital tools offer opportunities for innovative health promotion approaches and tools.

The Welsh Health Equity Solutions Platform – a mechanism for health equity solutions

Abstract Health inequities are a longstanding issue in Wales, as they are across the globe. They disproportionately affect the health and wellbeing outcomes of disadvantaged groups, restricting opportunities to live full and prosperous lives. Post COVID-19 new groups are emerging with disproportionately higher risk of poor health and premature death and disease, especially those with unmet needs and vulnerabilities, with the rising cost of living amplifying health inequities. Despite their prevalence, health inequities are avoidable. Efforts to reduce health inequities require action on all the social determinants of health across the life course. Improved understanding of the key drivers of health gaps is needed to address the problem and provide support for solutions-driven action to break down the barriers to health equity. The Welsh Health Equity Solutions Platform (WHESP) launched on 22nd June 2023, a collaboration between Public Health Wales, Welsh Government and WHO European Office for Investment in Health and Development. The WHESP is an innovative digital tool developed around the WHO Health Equity Status Report initiative framework of the ‘five essential conditions’ for healthy, prosperous lives for all. It is a mechanism for health equity solutions and aims to inform and facilitate policy and decision making to improve population health and address the increasing health gap through an online gateway to data, health economics, policies, and innovative health equity tools. Emerging evidence is highlighted to identify solutions for achieving healthy equity, which informs evidence-based decision making to reduce the health gap, improve overall population health and wellbeing, and achieve inclusive and sustainable economic growth and prosperity for all. Collating and sharing health equity solutions, evidence, data and best practice both across Wales and globally supports equitable, long-term action to improve the health and wellbeing of the population. Key messages • Highlighting health equity solutions informs best practice on tackling health inequalities. • WHESP provides extensive evidence to facilitate cross-sectoral action and policy change.

Same term, but unequal understanding: differences in digital public health intervention features

Abstract Digital technologies have transformed healthcare delivery and public health, with many countries integrating interventions such as online consultations, electronic health records, and telemedicine to improve population health and healthcare accessibility. Multinational assessments for benchmarking system maturity ask for the degree of implementation of such tools. However, are these interventions as comparable as they claim to be? This talk presents a qualitative analysis of 179 digital public health (DiPH) interventions described in scientific articles. We categorized interventions based on their implementation stages, public health functions, and reported and non-technical features. Telemedicine, health apps, and electronic health record interventions dominated the diverse landscape. While these technology groups already differed greatly in their functions, we identified equally significant differences in the reported intervention characteristics within the groups. For example, telemedicine was not only used in healthcare settings for patients and health professionals but also in primary prevention and research for researchers, policymakers, and healthy individuals. Different interventions reported varying functions, such as remote monitoring, self-monitoring, alarm systems, patient motivation, and user empowerment modules. So, is there one common telemedical intervention? No. Instead, all individual technologies differed to varying degrees. The analysis underscored the diversity of DiPH interventions among and within intervention groups and highlighted the importance of precise terminology for effective planning and evaluation. Instead of using broad classifications like ‘telemedicine,’ interventions should be defined and communicated based on specific technological functions, non-technical characteristics, use cases, and user groups. This approach will promote cross-disciplinary collaboration and foster international comparability across DiPH systems.

Increased tobacco taxation associated with decreased consumption and bladder cancer incidence.

The temporal relationship between smoking exposure and bladder cancer (BC) diagnosis remains ill-defined. This study aims to cross-correlate and temporally associate changes in United States (US) tobacco tax and consumption with BC incidence. US tobacco consumption, tobacco tax data, and BC incidence rates from 1975-2019 were retrieved. A cross-correlation lag time for tobacco tax and consumption on BC incidence was calculated while controlling for national health expenditure. Proxied lag weighted semi-log linear models to determine the rate of change in BC incidence rates associated with a 1% change in tobacco tax percentages on a national and state level. A 1% increase in tobacco tax was associated with a 1.77% decrease in BC incidence over a 6-year period (R2=0.9687, p=0.00044). 22 states had a statistically significant decline in BC incidences correlated with increasing tobacco taxation. Reduction in BC incidence >0.5% were observed in states along the Western and Eastern US borders. Montana, Utah, Nebraska, Arkansas, and Tennessee did not have decreasing BC incidences from tobacco tax increases. California had the most drastic decline in BC incidence (1.98%). Nationally, tobacco consumption decrease in 1 pack per capita was associated with a 0.47% decrease in BC incidence over a 28-year period (R2=0.984, p=0.00011). Declining US tobacco consumption may indicate significant reduction in BC incidence through 2047. Primary prevention through adaptation of state-legislated tax changes may contribute to a reduction in BC incidence in states lying within the Central US. A national tobacco tax initative can be considered given the improvement in population health.

Modelling the potential impact of a tax on fruit juice in South Africa: implications for the primary prevention of type 2 diabetes and health financing

BackgroundSouth Africa is experiencing a persistent growth in non-communicable diseases. Diabetes is among the top ten causes of mortality, especially among women, which is partly driven by high levels of added sugar consumption and obesity. To reduce obesity rates and the incidence of diabetes, South Africa introduced a tax on sugar sweetened beverages (also known as the Health Promotion Levy (HPL)) in 2018. The tax is applicable to sugar-sweetened beverages but excludes 100% fruit juice. The government is currently considering extending the tax to include fruit juices. This study models the potential health and economic impact of taxing fruit juices at 20% of the retail price of one liter.MethodsTo analyze the distributional impact of the tax, this study uses extended cost-effectiveness analysis methodology. Data on price elasticities, healthcare cost, income, fruit juice consumption were sourced from the literature and representative national surveys. The potential impact of the tax on diabetes incidence, prevalence, mortality, and financial benefits were estimated for each income group (lowest, quintile 1 to highest, quintile 5).FindingsWe estimate that a 20% tax on fruit juice would avert 156,640 incident cases of type 2 diabetes mellitus over 20 years, with most disease averted occurring among the first- and fifth-income groups. Averted deaths from diabetes would average 2,000 deaths per quintile (for quintiles 1 to 4) and about 2,800 in quintile 5. The improved health resulting from averted incidence and deaths will reduce overall healthcare expenditure by R7.5 billion over 20 years, of which R2.3 billion will occur in the fifth quintile. The South African government will also save about R300 million in subsidizing diabetes-related healthcare cost as a result of prevention; and would raise R8.6 billion in tax revenues per annum. Out-of-pocket expenditure savings will be R303 million and a financial risk protection (money-metric value of insurance) of R4.6 billion over the 20-year period.ConclusionWe conclude that an HPL that significantly raises the retail price of fruit juices would reduce consumption and diabetes-related morbidity and mortality. The tax will also provide significant financial benefits in the form of reduced healthcare costs for both government and households as well as providing financial risk protection to individuals. Health taxes are win-win policies that improve population health and generate revenue for governments to fund public health services delivery and thus improve overall health financing activities of the government. Therefore, population level disease prevention measures such as health taxes are important for achieving universal health coverage.

Cost-effectiveness analysis of genotype-guided optimization of major depression treatment in Qatar.

Pharmacogenetic testing improves the efficacy and safety of antidepressant pharmacotherapy for moderate-severe major depressive disorder by identifying genetic variations that influence medication metabolism, and adjusting treatment regimens accordingly. This study aims to assess the cost-effectiveness of implementing a pharmacogenetic testing approach to guide the prescription of antidepressants. From the public hospital perspective, we developed a two-stage decision tree diagram of a short-term 6-week follow up, and a lifetime Markov model with 3-month cycles. The analysis compared the current standard of care with the alternative strategy of Pharmacogenetic-guided (multi-gene panel) testing in adult patients with moderate-severe major depressive disorder. Clinical outcomes and utilities were obtained from published studies, while healthcare costs were locally available. The short-term incremental cost-effectiveness ratio was against treatment response without side effects and without relapse, and against treatment response with/without side effects and without relapse. The long-term incremental cost-effectiveness ratio was against the quality-adjusted life year gained and years of life saved. Adopting the pharmacogenetic-guided therapy for adult patients with moderate-severe major depressive disorder in Qatar resulted in cost savings of Qatari Riyal 2,289 (95% confidence interval, -22,654-26,340) for the health system. In the short term, the pharmacogenetic-guided testing was associated with higher response rates without side effects and without relapse (mean difference 0.10, 95% confidence interval 0.09-0.15) and higher response rates with or without side effects and without relapse (mean difference 0.05, 95% confidence interval 0.04-0.06). For long term, the pharmacogenetic-guided testing resulted in 0.13 years of life saved and 0.06 quality-adjusted life year gained, per person, along with cost savings of Qatari Riyal 46,215 (95% confidence interval-15,744-101,758). The sensitivity analyses confirmed the robustness of the model results. Implementing pharmacogenetic testing to guide antidepressant use was found to improve population health outcomes, while also significantly reducing health system costs.

Elevating recreational soccer to improve population health in the United States: the time is now.

Elevating recreational soccer to improve population health in the United States: the time is now.

Social inequalities in adult mortality across Europe (18th-21st centuries): A critical analysis of theories and evidence

This study examines the historical evolution of socioeconomic disparities in adult mortality, with a focus on European societies. Despite the widespread improvements in population health, social inequalities in mortality are a pervasive phenomenon nowadays. This paper employs a critical analysis of both theoretical and empirical literature to investigate major international studies and their findings on longevity differences associated with socioeconomic status from the nineteenth century to the early twenty-first century. Findings reveal that adult mortality trajectories have differed notably across social classes and regions, with some areas exhibiting disparities before the demographic transition and others showing inequalities emerging later. Understanding these long-term health inequality trends sheds light on the changing influence of medical advances and their interplay with economic growth, educational disparities, environmental factors, state roles, and production distribution, which have shaped mortality disparities through different development stages. These factors elucidate the international heterogeneity of results until the mid-twentieth century and offer explanatory insights into observed north-south patterns in Europe. Our findings contribute to a deeper understanding of how advancements in public health, economic development, and social policies have shaped health outcomes over centuries. The implications of this research inform ongoing debates and health policy, emphasizing a nuanced interpretation of historical data to craft effective strategies that address health inequalities today.

Culture of health as a strategy for designing and developing corporate welfare models

Improving population health requires the commitment of a multitude of community partners, including employers. Since 2008, successive economic crises have reduced the national health system's capacity to meet the needs of its citizens in Italy. ENI is an Italian oil company employing over 31,000 people in nearly 62 countries. In the Italian community of ENI, there are about 20,000 employees. Between 2022 and 2023, ENI made relevant services and goods available for each employee. This work aims to identify a framework to measure the culture of health in ENI. It is the first step in developing an in-depth analysis of the culture of health in ENI, which will be the subject of in-depth studies after this work. Today, promoting health cannot be the sole purpose of public healthcare systems in Western contexts. Italy is an emblematic context of these phenomena. The development of the corporate welfare case in ENI is an opportunity to reflect on the evolution of private expenditure concerning the interventions promoted by a multinational oil and gas company such as ENI towards its employees. In all this, the culture of health represents a valid approach to the design and the evolution of corporate welfare models over time. The idea of the culture of health is an essential framework that can support why companies must work towards complementarity in providing services and interdependence with public health systems. By incorporating strategies such as inclusive health education, community engagement and partnering with public health systems to address social determinants of health, companies can contribute to building a culture of health rooted in equity, providing employees with the resources and support needed for a better and more equitable life.

Application of digital transformation tools in dairy cattle farming and their role in improving population health and animal productivity

The aim of the study is to explore the ways of implementing digital technologies and modern technical solutions to ensure the population health of animals in the context of contemporary dairy farming. The paper discusses modern digital technical tools and automated processes in dairy farming facilitated by these tools. In the course of the study, the main tasks for successful digital transformation and ensuring the population health of animals in dairy farming were identified: searching for biomarkers of pathological and physiological states of animals, developing methods for determining found biomarkers, developing technical solutions for parameter registration and their implementation into production. At the moment, automatic systems for diagnosing the state of the animal’s body have been implemented using sound sensors, devices for determining the activity of the animal and the position of the body in space. Sensors for determining the electrical conductivity of milk make it possible to determine mastitis at the initial stage of the pathological process. Sensors for determining the concentration of hormones in milk make it possible to determine the period of the sexual cycle. ICS cameras allow you to determine areas of inflammation on the animal’s body. A modern 3-D camera system, combined with software, allows automatic measurement of animal body parameters on a daily basis. Thus, the implemented automated systems make it possible to reduce the time of human contact with an animal, which has a positive effect on the health of the animal. On the other hand, constant monitoring of important indicators of animal health allows timely detection of the onset of the disease. All of the above helps ensure population health on dairy farms.

EVs meet health: A complex-systems policy integration approach for electric vehicle adoption and its impact on respiratory and cardiovascular disease

The transition from gasoline-combustion to zero-emission vehicles represents one of the most ambitious public and private enterprises around the globe to mitigate air pollution and its subsequent effects on climate change. The present study uses the rapid transition in the state of California to analyze the connections between the increasing utilization of electric vehicles (EVs) and two critical health outcomes: Asthma and acute myocardial infarction (AMI) emergency department (ED) visits. We fit simultaneous quantile and interquartile-range regression models to health and sociodemographic data from the California Office of Health and Hazard Assessment and electric vehicles registration data, 2011–2017. Results show that changes in EV utilization, from 2011 to 2013 to 2015–2017, have larger and more favorable effects as asthma and AMI deteriorate across zip codes. Looking at zip codes located at the 75th and 25th percentiles of the change in the asthma- and AMI-related ED visits distribution, a 5-percentage points change in the EV-to-gasoline combustion utilization ratio is associated with a 25-percentage points (p<.01) and 12.5-percentage points (p<.01) decline in asthma- and AMI-related ED visits, respectively. Our findings also suggest that, should the U.S. meet the goals of Executive Order N-79-20 by 2035, we could observe about 37,000 fewer asthma-related ED visits (95% CI: 16,154–59,280) per year, with an overall possible annual savings of about $65.5 million dollars (95% CI: $29.1M – $106.7M), and a possible decline of about 19,292 AMI-related hospitalizations, with possible annual savings of about $425 million dollars (95% CI: $365M – $509M). Our findings are optimistic in that spillover effects from increasing EV utilization can reduce healthcare costs while improving population health. Research should point toward the development of public-private coalitional strategies to effectively bridge usually disparate sectors of the economy and policy-making like energy and health.

Exploring the equity of distribution of general medical services funding allocations in Wales: a time-series analysis.

Good access to quality primary care in high-income countries can improve population health. Access to primary care is however often not equal among socioeconomic groups; our analysis sought to explore whether funding, a determinant of service supply, is equitably distributed among GP practices in Wales. We sought to explore the relationship between funding and deprivation among GP practices in Wales, to understand the equity of current funding policies. We obtained funding data for general practices in Wales between 2014 and 2022 and explored the equity of distribution using the percentage of practice patients living in the 20% most deprived small areas in Wales. We generated a linear regression model exploring the relationship between practice funding and deprivation, with an interaction term with time in years. Practice funding rose for all practices between 2014 and 2022. Practice deprivation and time in years were both associated with practice funding, with increases in practice deprivation associated with reduced funding allocations, and time being associated with a small increase in funding over the study period. Over the period of analysis of 2004-2022, for every 10% increase in patients living in the most deprived LSOAs, funding per patient decreases on average by 1%. Primary cares in Wales in more deprived areas receive discernibly less funding per patient than those in less deprived areas. Given the potential and likelihood primary care can affect population health outcomes, this underinvestment may be contributing to existing health inequalities and requires urgent further analysis and action.

Navigating the complexity of a collaborative, system-wide public health programme: learning from a longitudinal qualitative evaluation of the ActEarly City Collaboratory

BackgroundAddressing the upstream social determinants of health (e.g. built environment, education) can reduce the burden of non-communicable diseases. To do so effectively often requires system-wide collaboration. However, collaborating across multiple sectors, organizations and disciplines within a complex system can be challenging. ActEarly was a public health research consortium that aimed to improve child health by building an interdisciplinary, cross-city partnership to develop and/or evaluate upstream interventions, increase research capacity and improve collaboration between researchers, local authorities and communities. This paper explores ActEarly’s experiences of navigating complexity to identify mechanisms that supported its implementation and proposes recommendations for future intersectoral and interdisciplinary population health research collaborations.MethodsWe conducted a longitudinal qualitative study of ActEarly, integrating findings from inductive documentary analysis of internal documents (mainly meetings minutes and reports) (n = 114) and interviews (n = 70) with 45 consortium members at three different timepoints (2018, 2021, 2023). Participants worked across different organizations, cities, roles and levels of seniority in the consortium.FindingsClarity, Unity, Flexibility and Feasibility were seen as the key mechanisms required to support ActEarly’s implementation. Clear aims, governance structures and communication were necessary to manage the uncertainty of the complex system. A unified approach, characterized by strong relationships, having a shared vision and communal access to resources supported effective collaboration. Flexibility was required to adjust to different ways of working, respond to wider system events and manage the consortium. Establishing feasible aims that responded to the limitations of the system, the available resources and research infrastructure was required for teams to deliver the work.ConclusionsImplementing multi-faceted programmes in a complex system can be challenging. We recommend that future whole-systems consortia seeking to improve population health build Clarity, Unity, Flexibility and Feasibility into their programmes, noting the complex interrelationships between these factors. Iterative reflections from all parties should support delivery amidst the uncertainty that comes with running a population health research collaboration, and strong leadership and governance should play a key role in ensuring that these are built into foundations the programme.

Diminishing marginal returns and sufficiency in health-care resource use: an exploratory analysis of outcomes, expenditure, and emissions

Increasing health expenditure in low-income countries is associated with rapid gains in health status. Less attention has been paid to the possibility of diminishing marginal returns to health expenditure at high levels of spending, or to the relationship between health-care greenhouse gas emissions and outcomes. Our study aimed to investigate the existence, scale, and implications of diminishing marginal returns to health-care expenditure and emissions. Segmented (piecewise) regression analysis was used to explore the relationship between two measures of health outcome from the Global Burden of Disease project (mortality amenable to health care [MAH] and health-adjusted life expectancy [HALE]), four aggregates of health expenditure per capita from the WHO Global Health Expenditure Database, and health-care sector greenhouse gas emissions per capita derived from a 2020 study by Lenzen and colleagues. Turning point knots-points at which the elasticity or velocity of increasing returns to expenditure and emissions changed substantially-were estimated and countries in the vicinity of these knots identified. Rapidly increasing returns (improvements in population health as measured by MAH and HALE) to health expenditure were estimated in low-income and lower-middle-income countries; at levels of spending above approximately US$500 per capita, these returns start to slow. At levels of spending above those seen in high-income countries such as Italy (approximately US$3400), there is little or no evidence of further health returns to additional spending or to increasing health-care greenhouse gas emissions. Dramatic improvements in population health outcomes could be achieved by additional investment in health expenditure in low-income countries. Conversely, continuing growth in health expenditure in high-income countries will, by itself, be unlikely to yield rapid improvements in health outcomes. Our findings inform the emerging debate on the importance of sufficiency within planetary boundaries-low-income countries need rapid growth in health expenditure, whereas high-income countries could potentially achieve better health outcomes at substantially lower levels of resource use. None.

Planning guidance to limit hot food takeaways: Understanding the possible economic impacts

Local and national policymakers are seeking innovative solutions to create healthier food environments around the world. Between 2009 and 2017, 35 local authorities across England (UK) adopted planning guidance designed to limit the proliferation of hot food takeaways near schools. Whilst these policies are intended to improve population health, they are also likely to have economic impacts. Often a decision to introduce such policies comes down to consideration of whether the short-term economic imperatives of allowing new takeaway outlets to open outweighs the potential long-term public health implications and associated economic consequences. These potential negative and positive economic impacts have not previously been clearly described and are summarised here. The aim of this paper is to provide an overview of the potential economic impacts of takeaway management zones. In particular, we present a Causal Loop Diagram (CLD) that outlines the possible economic impacts of takeaway management zones based on researcher knowledge of the interventions and the industry. Potential negative impacts fall across sectors and may include a loss of employment opportunities and reductions in local and national tax receipts, and may impact the economic vitality of local communities. In the longer term, there is the potential for positive impacts such as reductions in healthcare resource utilisation, social care expenditure and sickness-related absence from work. Part of a robust case would a better economic understanding, that would enable local authorities to improve understanding of the trade-offs associated with the policy, such as short-versus long-term, and business-related versus society-related health benefits and costs.

Accelerating a learning public health system: Opportunities, obstacles, and a call to action.

Public health systems worldwide face increasing challenges in addressing complex health issues and improving population health outcomes. This experience report introduces the concept of a Learning Public Health System (LPHS) as a potential solution to transform public health practice. Building upon the framework of a Learning Health System (LHS) in healthcare, the LPHS aims to create a dynamic, data-driven ecosystem that continuously improves public health interventions and policies. This report explores the definition, benefits, challenges, and implementation strategies of an LPHS, highlighting its potential to revolutionize public health practice. This report employs a comparative analysis approach, examining the similarities and differences between an LPHS and an LHS. It also identifies and elaborates on the potential benefits, challenges, and barriers to implementing an LPHS. Additionally, the study investigates promising national initiatives that exemplify elements of an LPHS in action. An LPHS integrates data from diverse sources to inform knowledge generation, policy development, and operational improvements. Key benefits of implementing an LPHS include improved disease prevention, evidence-informed policy-making, and enhanced health outcomes. However, several challenges were identified, such as interoperability issues, governance concerns, funding limitations, and cultural factors that may impede the widespread adoption of an LPHS. Implementation of an LPHS has the potential to significantly transform public health practice. To realize this potential, a call to action is issued for stakeholders across the public health ecosystem. Recommendations include investing in informatics infrastructure, prioritizing workforce development, establishing robust data governance frameworks, and creating incentives to support the development and implementation of a LPHS. By addressing these key areas, public health systems can evolve to become more responsive, efficient, and effective in improving population health outcomes.

An innovative benefit‐of‐the‐doubt approach for health system effectiveness: a global case study on amenable mortality

AbstractHealth system performance assessment (HSPA) is essential for health planning and to improve population health. One of the HSPA domains is related to effectiveness, which can be represented considering different dimensions. Composite indicators can be used to summarize complex constructs involving several indicators. One example of such efforts is the Healthcare Access and Quality Index from the Global Burden of Diseases Study, in which different causes of mortality amenable to health care are summarized in this index through principal component analysis and exploratory factor analysis. While these approaches use the variance of the indicators, marginal improvement is not considered, that is, the distance to the best practice frontier. In this study we propose an innovative benefit‐of‐the‐doubt approach to combine frontier analysis and composite indicators, using amenable mortality estimates for 188 countries. In particular, we include flexible aggregating weighting schemes and a robust and conditional approach. The dual formulation gives information on the peers and the potential mortality rate reduction targets considering the background conditions. In absolute terms, Andorra and high‐income countries are the most effective regarding healthcare access and quality, while sub‐Saharan African and South Asian countries are the least effective. North African and Middle Eastern countries benefit the most when epidemiological patterns, geographical proximity, and country development status are considered.

Geospatial Data Aggregation Methods for Novel Geographies: Validating Congressional District Life Expectancy Estimates.

Place is a critical determinant of health. Recent novel analyses have explored health outcome estimation for small geographies, such as census tracts, as well as health outcome aggregation to geopolitical geographies with accountable political representatives, such as congressional districts. In one such application, combining these approaches, researchers aggregated census tract estimates of life expectancy to the congressional district level to derive local estimates, but such an approach has not been validated. Here, we compared two sources and approaches to calculating life expectancy data for Pennsylvania congressional districts. We used 2010-2015 census tract life expectancy estimates from the US Small-area Life Expectancy Estimates Project (LEEP) and dasymetric methods to compute population-weighted life expectancy aggregated to the congressional district level. Using georeferenced Vital Statistics data, we aggregated age-specific census tract death and population counts to congressional districts and used abridged life tables to estimate life expectancy. To validate the dasymetric aggregated estimates we compared absolute differences, assessed the correlation, and created Bland-Altman plots to visualize the agreement between the two measures. We found strong agreement between congressional district estimates of life expectancy at birth derived using the dasymetric LEEP model-based approach and Vital Statistics direct estimates approach, though life expectancy at older ages (75 and older) showed weak correlations. This validation contributes to our understanding of geospatial aggregation methods for novel geographies including congressional districts. Health outcome data aggregated to the congressional district geography can support congressional policy making aimed at improving population health outcomes.

The Impact of Public Health on Population Health

Public health is a broad profession that seeks to protect and improve population health through preventative treatments and policy. It goes beyond clinical care to address broader social, economic, and environmental factors influencing community well-being. This study looks into the historical evolution of public health programs, essential concepts such as health equity and epidemiology, and the importance of preventive medicine in the field. Case studies of successful public health programs shed light on viable ways to improve population health. By studying these components, the research emphasizes the critical role public health plays in improving population health, particularly through the integration of community-based interventions and policies. Keywords: Public health, population health, preventive medicine, health equity, epidemiology

Addressing the Digital Divide in Health Education: A Systematic Review.

The disparity in access to essential healthcare resources and services is exacerbated by the digital divide, which presents a significant obstacle to health education. Effective tactics to advance digital equity and provide equitable access to resources for telehealth and digital health are needed to close this gap. Digital databases such as PubMed, MEDLINE, Scopus, Web of Science, and Google Scholar were used to conduct a systematic review. Keywords and Boolean operators including "digital divide," "health education," "digital equity," "telehealth," "digital health literacy," and "strategies" were used in the literature search process. Only peer-reviewed English-language papers that addressed methods for bridging the digital divide in health education were accepted after being screened in accordance with the preset inclusion and exclusion criteria. The results were compiled using a narrative synthesis method after data were retrieved and synthesized with the aid of suitable quality assessment tools. After satisfying the inclusion criteria, seven papers were added to the systematic review. The results emphasized the complexity of the digital divide in health education and provided a range of approaches to mitigate disparities in access to digital health technologies and resources. The importance of digital equality and universal design, continuous intervention evaluation and monitoring, and enduring obstacles to Internet access and healthcare technology availability were among the major themes. This systematic study emphasizes how critical it is to put evidence-based tactics into practice in order to close the digital divide in health education. Through the promotion of universal design principles, ongoing evaluation of treatments, and digital equity, stakeholders can mitigate health disparities, improve population health, and guarantee equitable access to telehealth and digital health services.