Public Health Paradigm Research Articles

Gambling to public health in ageing populations: a life expectancy evaluation perspective

ObjectiveGambling is a complex topic in relation to health systems. It is always unclear how to strike a balance between the gambling economy and the impact of gambling on public health or social wellbeing at any age. There are limited studies considering the association between determinants of gambling and the life expectancy of the ageing population in a country. From an evaluation perspective, this article aims to demonstrate the correlation between life expectancy and gambling and public health systems. MethodsThe approach of analysis has two parts. One is the influence of gambling prevalence in populations on life expectancy among old adults. Another is the association between the effect of changes in legal gambling provisions within public health systems and life expectancy among old adults. Healthy adjusted life expectancy (HALE) at age 60 from the World Health Organization and gross gambling yield were used. ANOVA was performed with SPSS. ResultsThe population groups with HALE at age 60 of 15 years or over are likely more active in gambling than the population groups with smaller HALE at age 60 of 14 years or less. On the other hand, the influence of a health policy may be sidelined when it is implemented for older adult populations because the resource distribution magnitude or number of strategical techniques may not be the same for younger adult populations. The study here is marked as a good practical start, and there is room for further research with big data analysis on additional gambling variables against other life expectancy variables, quality of life variables or public health system variables. ConclusionAssociations between the determinants of gambling and the life expectancy of the ageing population in a country have not yet been identified. Continuous measurements of policy implementation and effectiveness and assessments of health equity, while gambling policies worldwide continue to change, have not yet been performed. Researchers and policy makers should understand the importance of holistic integration of the gambling economy and policy within a public health and social paradigm with the help of big data insights to achieve sustainability in their cities and health equity in their communities.

Analyzing the Public Health Impact of Adopting Telehealth after a Pandemic: A Business Model

Abstract: In response to the global shift in healthcare delivery due to the COVID-19 pandemic, this study investigates the adoption of telehealth technologies and assesses their long-term sustainability within new public health paradigms. Telehealth, accelerated by the pandemic's demands, offers a unique perspective on evolving healthcare delivery methods that emphasize accessibility and efficiency. By employing a mixed-methods approach, which synthesizes quantitative data with qualitative insights from various stakeholders, this research evaluates how telehealth has enhanced the delivery of medical services, especially in remote and underserved communities. Despite challenges related to technological infrastructure and regulatory constraints, our analysis of revenue models and cost-benefit evaluations suggests that telehealth is economically feasible and possesses significant market potential. The findings advocate for robust policy support and technological investment to enhance global telehealth accessibility and implementation. Additionally, the study highlights the necessity of expanding educational training for healthcare professionals to effectively adapt to telehealth systems. These strategic measures are pivotal for promoting the widespread application and sustainable development of telehealth, positioning it as a cornerstone in the future landscape of global healthcare. Continued research is recommended to further refine telehealth models and develop comprehensive frameworks that address emerging healthcare challenges and disparities.

Media Portrayals of Suicide's Risk and Protective Factors in Slovenia (1959 – 1999)

This study examined the historical shifts in Slovenian public attitudes towards suicide by analyzing media coverage in two major Slovenian newspapers from 1959 to 1999. We conducted a database search and analyzed 1,785 relevant articles from an initial pool of 13,042 hits. Our findings reveal that the media reported more frequently on risk factors for suicide than on protective factors across the decades. The most frequently mentioned risk factors included individual characteristics such as gender and mental health issues, with community factors becoming more prominent over time. Regarding protective factors, the focus paralleled the emphasis on individual risk factors, with interpersonal factors primarily reported in the 1960s and a growing recognition of community factors by the 1990s. This underscores a broader shift towards holistic understanding of risk and protecitve factors, with community-based approaches in suicide prevention, reflecting evolving public health paradigms.

Community-led transformation principles: Transforming public health learning systems by centering authentic collaboration with community-based organizations.

In the face of evolving public health challenges, including emerging diseases, pervasive health disparities, and escalating environmental threats, the integration of learning health system (LHS) principles emerges as a vital strategy for enhancing the adaptability and efficacy of public health initiatives. Traditional approaches within these systems often overlook the potential to deeply involve community-based organizations (CBO) that are led and staffed by the communities they serve as equal and essential partners in the public health discourse. This commentary proposes a suite of nine community-led transformation (CLT) principles aimed at reimagining LHS frameworks to authentically incorporate CBOs at their core. Drawing on the experiences from initiatives supporting Afghan refugees, we illustrate the application of these principles through two detailed case studies. These examples demonstrate the CLT principles in action and spotlight the enhanced cultural competency, effectiveness, and equitable power distribution that arise from such partnerships. Centering small to mid-sized CBOs including ethnic-led and/or faith based within LHS structures enables the system to access invaluable cultural insights, strengthen community bonds, and empower those communities to spearhead their transformative journey toward sustainable health, equity, and well-being improvements. The CLT principles herald a shift toward a more inclusive and co-led public health paradigm by offering a blueprint for stakeholders eager to forge strong, trust-based coalitions and cocreate initiatives with community leaders including Black, Indigenous, and People of Color (BIPOC) leaders from ethnic-led and/or faith-based CBOs. By embracing these principles, public health systems can evolve into truly inclusive, responsive, and sustainable entities poised to advance health equity for all community members.

Leveraging Geo-Profiling to Address Rape as a Public Health and Criminal Epidemic in the United States

Abstract Rape, as a pervasive societal issue, transcends the boundaries of public safety, criminal justice, legal jurisprudence, and public health, casting a long shadow of fear, trauma, and profound consequences across communities. This article delves into the multifaceted nature of rape, recognizing it not solely as a criminal phenomenon but as a complex public health crisis demanding comprehensive intervention. In response to the imperative of addressing rape and serial rapists as a criminal and public health epidemic, this study introduces an innovative approach that harnesses the potential of artificial intelligence (AI) and geo-profiling. Through synthesizing criminological and epidemiological insights, this research elucidates the transformative role of geo-profiling in understanding, preventing and solving rape crimes. Geo-profiling data analytics capabilities are harnessed to dissect the intricate details, patterns and dynamics of rape incidents, offering a data-driven foundation for preventive strategies. Moreover, integrating geo-profiling techniques empowers law enforcement and public health agencies to map high-risk behaviors, areas and optimize resource allocation geographically. This holistic approach advances our understanding of rape as a public health crisis and informs targeted, evidence-based interventions to reduce its prevalence. In a contemporary landscape marked by the imperative of innovation and interdisciplinarity, this article contributes a nuanced perspective to the discourse surrounding rape. By unifying law enforcement, criminal justice, legal, and public health paradigms and harnessing geo-profiling as a powerful tool, we embark on a path to address rape comprehensively, recognizing its profound impact on individuals and society.

Building Public Health Workforce Capacity: Longer-Term Effectiveness of a Capacity Building Intervention to Improve Community-Based Public Health Prevention Work

Objective: There is an urgent need to build capacity among existing and incoming public health workers to enhance community-based work focused on prevention and health promotion. Public Health Essentials (PHE), a cohort-based facilitated asynchronous online capacity building intervention, was designed to build public health workers’ strategic skills and professional confidence. Earlier research reported on the short-term learning outcomes of the intervention; here we report on results from a longer-term outcomes evaluation, including skill retention, skill application, and possible indicators of workforce retention and community health improvement.Methods: A sequential mixed-methods research study was used to assess and explore longer-term outcomes among a sample of PHE graduates working in community public health roles.Results: Some 46% of eligible PHE graduates (n=70) completed a skills survey at three timepoints: Pre-PHE, post-PHE, and 3-to-6 months post-PHE completion. Longitudinal analysis of responses showed statistically significant skill gains over baseline (Beginner → Proficient, p<0.005), despite a slight drop in self-perceived ability in the 3-6 months post-PHE completion. Qualitative interviews with respondents and focus groups with their supervisors suggest PHE completion benefits participants’ everyday work by developing strategic skills, and grounding their work in shared public health language, paradigms, and values. Broader reported benefits include the ability to apply new skills to community public health prevention projects and expressed motivation to continue to work in public health.Conclusions: Successful completion of PHE provides learners with durable skills applicable to public health work and may spur interest in continuing to work in the field of public health. The importance of developing and retaining a competent community-focused public health workforce cannot be overstated. Comprehensive facilitated, online asynchronous capacity building programs may be an effective tool.

The Right to Healthcare Must Include the Right to Ease of Physical Access: Exploring Geography-Health Nexus in GIDA Communities in the Philippines.

Using the United Nations' 'leave no one behind' framework for the achievement of sustainable development goals, this article underscores the key role of geography as one of the core factors why certain people are left behind, deprived, and continue to experience inequality in terms of access to (quality) health care facilities and services. This article specifically examines the consequences of physical inaccessibility to health outcomes and health-seeking behavior in geographically isolated and disadvantaged areas (GIDAs) in the Philippines. This article illustrates that physical accessibility is an ignored aspect of the public health paradigm. For that reason, public health facilities, no matter how critical the facility is to a person's care, are not an immediate option for GIDA residents who seek medical aid. Responsive policy measures are vital to address this seemingly paradigmatic error. Subsidizing transportation costs and allocating funds for road improvements are called for, among other changes. The government must act on the people's right to ease of access as part of fulfilling fundamental health-related state obligations. But for the government to act, it will be crucial for claimants to health rights to proactively demand these changes. The latter is key for the fulfillment of the affected people's right to get easier access to meaningful health care.

Advances in the Clinical Application of High-throughput Proteomics.

High-throughput proteomics has become an exciting field and a potential frontier of modern medicine since the early 2000s. While significant progress has been made in the technical aspects of the field, translating proteomics to clinical applications has been challenging. This review summarizes recent advances in clinical applications of high-throughput proteomics and discusses the associated challenges, advantages, and future directions. We focus on research progress and clinical applications of high-throughput proteomics in breast cancer, bladder cancer, laryngeal squamous cell carcinoma, gastric cancer, colorectal cancer, and coronavirus disease 2019. The future application of high-throughput proteomics will face challenges such as varying protein properties, limitations of statistical modeling, technical and logistical difficulties in data deposition, integration, and harmonization, as well as regulatory requirements for clinical validation and considerations. However, there are several noteworthy advantages of high-throughput proteomics, including the identification of novel global protein networks, the discovery of new proteins, and the synergistic incorporation with other omic data. We look forward to participating in and embracing future advances in high-throughput proteomics, such as proteomics-based single-cell biology and its clinical applications, individualized proteomics, pathology informatics, digital pathology, and deep learning models for high-throughput proteomics. Several new proteomic technologies are noteworthy, including data-independent acquisition mass spectrometry, nanopore-based proteomics, 4-D proteomics, and secondary ion mass spectrometry. In summary, we believe high-throughput proteomics will drastically shift the paradigm of translational research, clinical practice, and public health in the near future.

Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle-income contexts

BackgroundQualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs).MethodsWe conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted.ResultsOne hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%).ConclusionsA reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.

Vaccine hesitancy under the lens: Nigeria's struggle against the worst diphtheria outbreak in decades.

The resurgence of diphtheria in Nigeria, culminating in an outbreak surpassing previous records, has spotlighted the critical imperative for robust immunization policies amidst a milieu of vaccine hesitancy. This commentary delineates the multifaceted dimensions of the current diphtheria outbreak, which started in May 2022, juxtaposed against historical outbreaks, with a focal examination of the pervasive vaccine hesitancy and its underpinning sociocultural and systemic determinants. The discourse extends to a meticulous evaluation of Nigeria's public health response, underlined by the synergy with international organizations, reflecting a global collaborative ethos in combating the diphtheria menace. A critical appraisal of the prevailing immunization policies unveils a necessity for strategic amendments to invigorate vaccination uptake, essential for curbing the diphtheria outbreak and enhancing public health resilience. The reflections herein advocate for a comprehensive, culturally resonant, and sustainable public health paradigm, encompassing a synergistic approach of policy fortification, community engagement, and international collaboration to navigate the challenges posed by vaccine-preventable diseases epitomized by the ongoing diphtheria outbreak. Through a synthesis of historical lessons, contemporary challenges, and global solidarity, this piece contributes to the broader discourse on enhancing immunization coverage and infectious disease control in Nigeria.

One Health Economics: why and how economics should take on the interdisciplinary challenges of a promising public health paradigm.

In this perspective paper, we argue that Economics could and should contribute to the development and implementation of the One Health approach currently emerging as a relevant interdisciplinary framework to address present and future infectious diseases. We show how proven tools from Health and Environmental Economics, such as burden evaluation, can be extended to fit the One Health multisectoral perspective. This global health framework could also benefit significantly from Economics to design efficient schemes for prevention and disease control. In return, adapting Economics to the challenges of One Health issues could pave the way for exciting developments in the Economics discipline itself, across many subfields.

Advancing the Systems Science Paradigm in Public Health Through Intervention and Evaluation.

Advancing the Systems Science Paradigm in Public Health Through Intervention and Evaluation.

No One-Size-Fits-All: Critical Narrative Intervention and Archeology of Self as Anti-Racist and Anti-Colonial Practices in Body-Focused Repetitive Behaviors.

Health education and research has historically relied on partnerships between institutions that focus on prescribing interventions rather than working with communities to identify and address systemic violence and oppression as root causes of health inequity. This perpetuates harmful colonial paradigms in health education. We present an autoethnographic perspective of our experiences as Black women with Body-Focused Repetitive Behaviors to reexamine harmful assumptions and practices underpinning the field. Through digital storytelling, a qualitative research method, we explore Critical Narrative Intervention (CNI) and the Archeology of Self (AOS) as key methodological frameworks in decolonizing health education. Using our experiences of navigating complex mental health education and care, we highlight CNI and AOS as creative, asset-based, narrative, and participatory approaches to addressing health inequity and promoting an anti-colonist and anti-racist public health paradigm. We call practitioners to explore these methodologies in reimagining how we engage with diverse, historically excluded communities, while critically interrogating our own biases as we move toward equitable partnerships and caring relationships.

DNA microarrays to identify etiological agents, as sensors of environmental wellbeing.

Background: The epidemiologic transition in Mexico has generated a change of paradigm in public health. Morbidity is characterized by infectious diseases and the mortality is due to chronic degenerative diseases. The three most important infectious diseases in the country are: respiratory infections, diarrhea, and urinary tract infections. Method: The objective of this work was to build a tool to monitor the presence of health risks in the environment in a timely manner and to demonstrate its application in different sicknesses, especially those that are water related. In this study, we analyzed water samples from five cenotes with high tourist flow in the State of Yucatan. We developed a DNA microarray for the adequate and prompt detection of viruses, bacteria, fungi, and parasites. This microarray could be used in samples of different origin including air, water (fresh, brackish and saltwater), food, inert surfaces or wounds. Clinically, it would allow prompt and precise detection of etiological agents of infectious diseases to prevent outbreaks. It would also be useful for the identification of those agents that cannot be detected in our laboratories with the traditional methods. It includes 38,000 probes that detect 252 etiological agents of diseases in humans and antimicrobial resistance genes. Results from DNA samples can be obtained in 24h, which would be difficult or impossible using other technologies. Results: The results are readily available within 24h. Samples from five cenotes (sinkholes) with high flow of people, were analyzed with the microarray. The water samples analyzed detected 228 different bacteria, viruses, fungi, and protozoa. They are amongst the most important etiological agents for infectious diseases in Mexico. Conclusions: The microarray provides the opportunity for precise and early detection of various infectious agents in individuals, hospitals and natural environments. This could help reduce the global burden of diseases, the severity of outbreaks, and reduce antibiotic resistance.

Revolutionizing the Public Health Workforce-A Policy Brief in Retrospect of the World Congress on Public Health Rome 2020.

Background: The COVID-19 pandemic dramatically illustrates the consequences of inadequate prioritization of the Public Health Workforce (PHW). This Policy Brief introduces a Call for Action following the plenary session entitled "Revolutionising the Public Health Workforce (PHW) as Agents of Change" as part of the 2020 World Congress on Public Health. Policy Options and Recommendations: In order to revolutionize the PHW, five long-term key approaches are proposed: 1. Transforming public health competencies through transdisciplinary education and inter-professional training; 2. Revolutionizing educational systems by shifting the public health paradigm; 3. Linking public health education and work opportunities; 4. Overcoming the paradoxical shortage and overproduction of graduates and 5. Developing adaptable, multisectoral agents of change. Conclusion: Public health education of the future requires a paradigm shift towards a holistic understanding of public health, characterized by transdisciplinary education, inter-professional training and a closer integration of academia, health services, and communities.

Leadership and Trauma-Informed Care: Working to Support Staff and Teams

The concept of “trauma-informed care” as a paradigm in public health and human services has evolved over the past 30 years. Can trauma-informed practices be used as a leadership tool to help address staff/colleagues as they grapple with the concerns associated with a complex health care landscape? Trauma-informed care shifts the focus from “What’s wrong with you?” to “What happened to you?” This powerful approach to addressing stress might help set the stage for caring and meaningful interactions among staff and colleagues before exchanges become fraught with blame and unproductive or toxic impacts on team-based relationships.

Zoonotic urbanisation: multispecies urbanism and the rescaling of urban epidemiology

A focus on zoonotic urbanisation challenges existing conceptions of global urbanism. In this article I consider how a modified urban political ecology framework might help to illuminate emerging landscapes of epidemiological risk. I show how a multi-scalar perspective on urban epidemiology, including the impact of colonialism, global capitalism, and changing relations with non-human others, unsettles existing analytical approaches. I contrast resilience-oriented public health paradigms, focused on the malleability of nature, with a historically grounded set of insights into global environmental change. I suggest that the conceptual field of zoonotic urbanisation provides an analytical entry point for understanding an emergent ‘triple crisis’ spanning climate change, biodiversity loss, and global health threats.

Application of artificial intelligence to the public health education.

With the global outbreak of coronavirus disease 2019 (COVID-19), public health has received unprecedented attention. The cultivation of emergency and compound professionals is the general trend through public health education. However, current public health education is limited to traditional teaching models that struggle to balance theory and practice. Fortunately, the development of artificial intelligence (AI) has entered the stage of intelligent cognition. The introduction of AI in education has opened a new era of computer-assisted education, which brought new possibilities for teaching and learning in public health education. AI-based on big data not only provides abundant resources for public health research and management but also brings convenience for students to obtain public health data and information, which is conducive to the construction of introductory professional courses for students. In this review, we elaborated on the current status and limitations of public health education, summarized the application of AI in public health practice, and further proposed a framework for how to integrate AI into public health education curriculum. With the rapid technological advancements, we believe that AI will revolutionize the education paradigm of public health and help respond to public health emergencies.

Lost Lessons of the 1918 Influenza: The 1920s Working Hypothesis, the Public Health Paradigm, and the Prevention of Deadly Pandemics.

In standard historical accounts, the hyperlethal 1918 flu pandemic was inevitable once a novel influenza virus appeared. However, in the years following the pandemic, it was obvious to distinguished flu experts from around the world that social and environmental conditions interacted with infectious agents and could enhance the virulence of flu germs. On the basis of the timing and geographic pattern of the pandemic, they hypothesized that an "essential cause" of the pandemic's extraordinary lethality was the extreme, prolonged, and industrial-scale overcrowding of US soldiers in World War I, particularly on troopships. This literature synthesis considers research from history, public health, military medicine, veterinary science, molecular genetics, virology, immunology, and epidemiology. Arguments against the hypothesis do not provide disconfirming evidence. Overall, the findings are consistent with an immunologically similar virus varying in virulence in response to war-related conditions. The enhancement-of-virulence hypothesis deserves to be included in the history of the pandemic and the war. These lost lessons of 1918 point to possibilities for blocking the transformation of innocuous infections into deadly disasters and are relevant beyond influenza for diseases like COVID-19. (Am J Public Health. 2022;112(10):1454-1464. https://doi.org/10.2105/AJPH.2022.306976).

Health promotion strategies toward improved healthcare access for migrants and refugees in Europe: MyHealth recommendations.

MyHealth European project (2017-2020) was committed to elaborate on models to engage vulnerable migrants and refugees (VMR) in their health through community involvement. Low healthcare access and poor quality of healthcare services for VMR is a common reality in many European countries. The purpose of the present study, as part of MyHealth project, was the development of an agenda for actions and consequent recommendations to tackle the issue. A qualitative research design was applied at four study sites in Barcelona, Spain; Berlin, Germany; Brno, Czech Republic and Athens, Greece. The Metaplan® group discussions allowed the collection, organization and process of ideas and opinions elaborated in the collaborative groups. In total, 14 sessions took place: 4 with health and social professionals (n = 41) and 10 with VMR (n = 77). A participatory thematic analysis was performed at every session and overall for all sessions a thematic analysis synthesized the findings. The suggested actions were divided into two levels of recommendations: (i) local authorities at destination country-related, such as the investment in health professionals' cultural competences, and (ii) VMR-related, such as adaptation of help-seeking behavior patterns. Special attention was proposed to women survivors of violence and homeless minors. The study concluded to an agenda for action in Europe. We advocate for a public health paradigm shift where, while holding a bottom-up approach, VMR as well as professionals working with them are actively and meaningfully engaged in the decision-making process of access-enhancing and health promotion strategies in a given socio-cultural context.