Health Policy Research Articles

Health system responsiveness from perspective of people with disabilities in west of Iran: a quantitative study

PurposeResponsiveness is one of the key components of good governance and one of the ultimate goals of health systems. The purpose of this study was to investigate the importance and level of health system responsiveness (HSR) from the perspective of people with disabilities in Iran.Design/methodology/approachThis cross-sectional study was carried out using multi-stage sampling in Kurdistan province in 2020. Of 1,067 participants, 889 and 520 had used outpatient and inpatient services, respectively. HSR questionnaire developed by World Health Organization was completed.FindingsThe dimensions of prompt attention (97%) and social support (81%) were the most and the least important dimensions for the respondents, respectively. In general, 43.6% of the respondents reported a “poor” status for HSR.Research limitations/implicationsDesigning targeted interventions to increase the level of health system responsiveness, especially with a focus on dimensions that are important to respondents but have weak performance, such as communication, confidentiality and autonomy, is suggested based on the findings of this study.Originality/valueThis is the first study performed on HSR from the perspective of people with disabilities in Iran. The findings of this study could be of interest to health policy makers to understand and improve healthcare experiences for marginalized populations globally.

Retention in care among people living with human immunodeficiency virus (HIV) in a low-resource setting.

This study aimed to evaluate the retention in care among a cohort of Egyptian people living with HIV (PLWHIV). The study was conducted on PLWHIV attending Kasr Alainy HIV and Viral Hepatitis Centre, Cairo, Egypt, from January 1, 2019, to March 31, 2023. PLWHIV were considered not retained in care if there was no documented clinical visit or HIV viral load (VL) or CD4 count test for more than 6 months from their last recorded visit or test. Multivariable logistic regression analysis was used to test factors associated with retention in care. After excluding those who died and were referred, 369 PLWHIV were included in the analysis, and retention in care was observed in 325 (88%). The majority were males (81.8%) with a median age of 34 [29-41] years. Undetectable VL (OR: 3.555; 95% CI: 1.49-8.47), hepatitis B vaccination (OR: 2.835; 95% CI: 1.07-7.48), CD4 test availability (OR: 2.604; 95% CI: 1.02-6.64), receiving dolutegravir based antiretroviral therapy (OR: 2.429; 95% CI: 1.06-5.537), and longer duration of know HIV infection (OR: 1.025; 95% CI: 1.01- 1.04) were correlated with retention in care. Surprisingly, higher education levels were negatively correlated with retention in care (OR: 0.195, 95%: CI: 0.071-0.533), suggesting the need for further research to explore this relationship. These results are invaluable for developing targeted interventions and informing health policies to improve retention in HIV care in Egypt. Enhancing access to VL and CD4 testing, promoting VL suppression, and focusing on specific groups at risk of dropping out of care are essential strategies.

The Influence of Political Dynamics on Health Policy in Indonesia

Health policy in Indonesia has experienced various significant changes in line with the political dynamics that occur at the national and local levels. Political dynamics in Indonesia are greatly influenced by various factors, such as the government system, political party ideology, interests of certain groups, and issues that develop in society. This study aims to analyze the influence of political dynamics on health policy in Indonesia, focusing on the post-reform period. The research methodology uses the literature review study method to analyze the influence of political dynamics on health policy in Indonesia. Literature review study is an effective method to collect, analyze, and synthesize information from various sources relevant to the research topic. The summary of the results of the discussion highlights the significant impact of political dynamics on health policy in Indonesia. The discussion emphasized the challenges faced due to changes in political leadership and decentralization of policy coordination. The role of political ideology, collaboration between stakeholders, and global influence in shaping health policies is essential for effective and sustainable health in Indonesia. By understanding the political dynamics that affect health policy, it is hoped that the recommendations produced from this study can make a significant contribution to future health policy improvements in Indonesia.

Intersecting dimensions: advanced analytical approach to school climate and injury prevention in health policy

BackgroundChild safety in schools is paramount for decision-makers globally, with a focus on ensuring children return home safely. However, the prevalent issue of injuries across educational systems demands a comprehensive investigation into their causes, incorporating interdisciplinary perspectives and social dynamics, to develop effective prevention strategies. The objective of this study is to comprehensively analyze the factors contributing to school-related injuries and examine the impact of school climate on student safety. By employing advanced data analysis techniques, the research aims to develop targeted, effective strategies to enhance child safety in educational settings. This research aims to develop a multidimensional taxonomy to understand child injuries in elementary schools better, enhancing precision in decision-making.MethodsData from 363 Israeli primary schools and 10,855 school injuries attended to by MDA, the principal EMS provider, were analyzed. The study utilized a two-level taxonomy, employing clustering methodology to classify schools into distinct climate "patterns," with each pattern further delineating school injury characteristics into sub-patterns. The chosen method proved effective in revealing nuanced relationships between school injuries and climate characteristics.ResultsAnalysis revealed five school climate clusters, ranging from "good" to "bad," each exhibiting two homogeneous sub-clusters of school injuries. Schools with a "positive" climate witnessed boys predominantly experiencing head injuries during breaks, while girls often sustained limb injuries from playing in corridors. Conversely, within the "negative" climate cluster, subgroups emerged based on injury nature, whether linked to playing or falling from a height.ConclusionThe research delineates a nuanced association between school climate and injury rates, emphasizing the necessity for sophisticated analytical techniques beyond conventional methodologies. Utilizing a diverse dataset from various disciplines, the study highlights the multidimensional aspects of school health. The developed taxonomy reveals the complex dynamics within school environments, advocating for customized health policies to mitigate injuries. Critical findings prompt a reevaluation of established assumptions about the school climate-injury relationship, informing strategic policymaking. For example, it suggests collaboration to enhance school safety through targeted, gender-sensitive interventions and improvements. Integrating different data sources offers a holistic understanding crucial for effective health policy formulation in educational contexts.

Nurses’ Clinical Practice in Nursing Homes: Depressive Symptoms and Fall Risk Assessment

Background: Depression and falls are highly prevalent, interrelated concerns for nursing home (NH) residents. Relationships between depression and falls should guide nurses towards developing evidence-based practices for assessing these conditions together. This study aimed to ascertain NH nurses’ clinical practices and perceptions regarding the assessment of depression and fall risk. Methods: This study was an exploratory descriptive study on the reported practices and perceptions from NH nurses in the canton of Vaud, Western Switzerland. Statistical analyses included descriptive statistics, nonparametric tests and a content analysis of responses to open-ended questions. Results: The mean age of our 116 responding nurses was 44.6 years old (SD = 11.3), 99 were women and their mean work experience in NHs was 13.1 years (SD = 9.2). The reporting showed that 88.8% of nurses relied on mood observation for assessing depression and 88.8% relied on the history of falls to identify fall risk. Only 75.9% and 61.2% of nurses used validated scales to detect depression and fall risk, respectively. Additionally, 56.9% of participants considered depression to be a significant factor in fall risk. Conclusion: Validated tools to assess depression and fall risk in NHs should be used more widely. Health policies must support and enhance NH nurses’ training and skills.

The Construction of British Columbia's Palliative Care Benefits Policy and Implications for Nursing Practice.

Nurses have a critical role to play in creating, implementing, critiquing, and advancing health policy within diverse contexts to ensure people living with life-limiting illness receive equitable and ethical access to palliative care services and programs. This article describes a critical analysis of the British Columbia's Palliative Care Benefits (BCPCB). The BCPCB is a provincial government program in British Columbia (B.C.), Canada, that provides eligible residents with palliative care services at home. Utilizing Fairclough's Dialectical-Relational Critical Discourse Analysis, the study investigates the process by which BCPCB determines B.C. residents' eligibility and access to resources proportionate to their need, function, illness burden, and urgency. This article reviews the construction of palliative care in Canada and how current biomedical perspectives construct palliative care policy and services in B.C. The findings indicate that the BCPCB program produces vague, discriminatory, and ableist prognostication practices through the implementation of its eligibility policy. This article also suggests that palliative care nurses are optimally positioned for policy influence: to critique, disrupt, and transform the BCPCB Program and palliative care practices.

Hwa-byung (anger syndrome) as a risk factor for suicidal ideation in MZ generation: a survey study in South Korea

IntroductionSuicide is a critical global public health issue, with South Korea exhibiting the highest suicide rate among OECD countries at 24.1 per 100,000 people in 2020. This study focuses on suicidal ideation (SI) within South Korea’s Millennials and Generation Z (Generation MZ) by examining the impact of anger and hwa-byung (HB), a culture-bound anger syndrome.MethodsThe online survey was conducted between June 7 and 12, 2024. The inclusion criteria for this study were the following: (1) generation MZ (i.e., those born between 1980 and 2005); (2) those without a history of mood disorders (i.e., depressive disorders or bipolar disorder); (3) those of Korean nationality and residing in South Korea. Demographic variables and clinical variables including SI, HB, and depression were investigated. The chi-square test or t-test was used to compare the differences between the SI and non-SI groups. Additionally, binary logistic regression analysis was performed to analyze factors associated with the presence of SI. Finally, Pearson’s correlation coefficients were calculated to explore HB symptoms that were highly associated with SI.ResultsTotal 457 participants were included. The survey revealed an overall prevalence of SI of 38.07%, with 18.82% reporting “much” or more SI and 4.81% reporting “very much” SI. Significant differences were found between the SI and non-SI groups in HB symptoms, depression, anxiety, perceived stress, trait anger, state anger, anger-in, and anger-out (all p < 0.001). Logistic regression analysis identified HB symptoms (odds ratio [OR], 1.05; 95% CI, 1.00–1.11; p = 0.050), depression (OR, 1.41; 95% CI, 1.23–1.62; p < 0.001), and state anger (OR, 1.14; 95% CI, 1.05–1.24; p = 0.002) as significant factors for SI. The mediating factors confirmed the direct and indirect effects of HB symptoms on the presence of SI. Pearson’s correlation coefficients between HB symptoms and SI severity ranged from 0.241 to 0.536, with physical symptoms, such as heat sensation and chest pressure, showing high correlations (0.426 to 0.476).ConclusionThese findings highlight the need for mental health policies that integrate Korean medical approaches into suicide prevention. Future research should confirm these results using larger, nationally representative samples to improve generalizability and further explore HB and suicidality in diverse populations.

The role of interdependent self-construal in mitigating the effect of conspiratorial beliefs on vaccine acceptance.

Infectious diseases pose significant challenges to public health, leading to illness and even death. Vaccinations are vital for protecting society, yet beliefs in conspiracy theories related to infectious diseases increase vaccine hesitancy. This paper delves into vaccination decisions in the context of COVID-19, which continues to strain the health care system. While past research focuses on countering conspiratorial beliefs with cognitive persuasion interventions, we propose a social intervention as an alternative. Our novel intervention seeks to mitigate the effects of conspiratorial beliefs by fostering individuals' interdependent self-construal - viewing oneself in the context of social relationships. Interdependent self-construal was operationalized in multiple ways (measured in Studies 1, 2 and 3; manipulated to test causality in Studies 4 and 5). Conspiratorial beliefs were also manipulated in Study 5. The results show that the association between conspiratorial beliefs and vaccine hesitancy is weakened among individuals whose interdependent self-construal is more accessible. Moreover, this effect was mediated by prosocial motivation. We discuss the implications of our findings for developing and communicating health policies and propose potential contexts where this intervention may be relevant, thereby providing valuable insights into enhancing societal well-being in the face of conspiratorial beliefs.

A Conceptual Framework for Safe-and-Sustainable-by-Design to Support Sustainable Business Model Innovation and New Product Development

In order to reach a sustainable future and meet the UN’s Sustainable Development Goals (UN SDGs), business model innovation (BMI) needs to explore theoretical and practical intersections of the traditional innovation management (IM) and new product development (NPD) processes with sustainability considerations. New environmental and health policy ambitions such as those presented in the European Green Deal and the EU Chemicals Strategy for Sustainability (CSS) challenge traditional IM theories on BMI and NPD processes. The Safe-and-Sustainable-by-Design (SSbD) concept is a central element of the CSS and demands a novel approach that integrates innovation with safety, sustainability and circularity of materials, products and processes without compromising their functionality or their technical and/or commercial viability. Importantly, adopting such a concept can prevent regrettable substitutions, future liability and brand image issues for companies. To achieve this, companies must design products with minimal environmental impact, adopt circular economy principles, and ensure social responsibility throughout the value chain, whilst economic viable. By doing so, companies contribute to economic, environmental, and social sustainability. In this perspective, a conceptual framework is proposed on how to achieve sustainable BMI and NPD by integrating traditional IM tools with SSbD using life cycle thinking principles considering external and internal drivers.

Mental health and attitudes toward suicide amongst individuals with gender dysphoria in Iran

IntroductionGender dysphoria (GD) is associated with profound mental health challenges, including heightened suicide risk. This study aimed to explore the mental health status and attitudes toward suicide among individuals with GD in Iran.MethodsA comprehensive assessment was conducted using three validated tools: the General Health Questionnaire (GHQ-28) to gauge emotional distress and psychological well-being, the Beck Depression Inventory (BDI-II) to evaluate the severity of depressive symptoms, and the Predicament Questionnaire (PQ) to measure attitudes toward suicide in the context of social crises.ResultsAmong the 78 participants, 43 (55.1%) were identified as experiencing significant mental health issues, while 21 (26.9%) were found to suffer from severe depression. The average PQ score was 57.92, which aligns with findings from similar populations in previous studies, highlighting a concerning trend in suicide-related attitudes. Further statistical analysis revealed significant correlations between psychological distress (GHQ-28 scores) and attitudes toward suicide (PQ scores), as well as between depressive symptoms (BDI-II scores) and suicide-related attitudes.ConclusionsThese findings indicate a pervasive prevalence of psychological disorders, particularly depression, within this group, and underscore the strong association between depressive states and suicidal ideation. The study underscores the urgent need for targeted mental health interventions and comprehensive healthcare policies tailored to the specific needs of individuals with GD in Iran. Given the substantial mental health burden observed, particularly the risk of suicide, this research highlights the critical importance of integrating mental health care into broader support systems for this population.

Analysis of Fertility Determinants and Regional Disparities in Nigeria using Geo-Additive Regression

This study applied geo-additive regression modelling on high-dimensional data with metrical and categorical predictors, using data from the latest Nigeria Demographic and Health Survey (NDHS-6). The sampled data comprises ninety-three predictors of total children ever born by eighty women of age group between fifteen and forty-nine years. Three penalty-based variable selection criteria—Elastic Net, Smoothly Clipped Absolute Deviation (SCAD), and Minimax Concave Penalty (MCP) were employed to reduce the dimensionality of the data. Geo-additive regression model were thereafter applied on the selected predictors to determine the impact of metrical, categorical and spatial predictors on the response variable. Findings revealed that predictors such as contraceptive use, age at first birth, and marital status are major determinants of total children ever born by a woman in Nigeria. Furthermore, spatial analysis revealed regional disparities in fertility rates within Nigeria, with notably higher fertility rate in northeastern states. This study’s findings have broad applications across disciplines. By providing robust methodologies for handling complex datasets, this research supports evidence-based decision-making in public health, agriculture, and environmental policy. Ultimately, these findings contribute to efforts aimed at promoting sustainable development and enhancing maternal and child health outcomes in Nigeria and similar contexts globally.

Current and Emerging Techniques for Diagnosis of Toxoplasmosis in Pregnancy: A Narrative Review

Toxoplasma gondii is an intracellular parasite capable of crossing the placenta in pregnancy and infecting the developing fetus, leading to various congenital anomalies and even abortion. Acute Toxoplasma infection is responsible for almost all cases of congenital toxoplasmosis in immunocompetent pregnant women. Prenatal screening for acute toxoplasmosis primarily involves maternal serology and fetal ultrasound imaging. When serological or ultrasound findings suggest acute infection, further diagnostic tests are necessary to confirm fetal infection. Currently, molecular methods to detect the parasite’s DNA, including polymerase chain reaction-based methods, on amniotic fluid are the gold standard tests for the diagnosis of congenital toxoplasmosis. In this review, we aim to discuss various aspects of screening and diagnostic methods for toxoplasmosis in pregnancy, including (i) current serological assays, screening approaches, and future perspectives; (ii) the role of imaging techniques, with an emphasis on ultrasound; (iii) principles and recent advances in diagnostic molecular methods; (iv) emerging techniques, such as point-of-care-based tests and biosensors, and microRNAs as novel biomarkers of acute infection; and (v) an overview of screening programs in different countries, important epidemiological determinants, and recommendations for Toxoplasma screening health policies.

Systemic failures and human rights violations: lessons from the Life Esidimeni Tragedy

The Life Esidimeni tragedy represents one of the most egregious human rights violations in South Africa's contemporary history. This article examines the series of events that led to the deaths of 141 mental healthcare patients and the severe maltreatment of over 1,400 others following their forced relocation from the Life Esidimeni facility to various unlicensed NGOs. The Gauteng Department of Health's decision to end its contract with Life Esidimeni without adequate planning or consultation led to a humanitarian disaster characterized by neglect, abuse, and gross violations of human rights. This paper reviews the timeline of events, the systemic failures, and the outcomes of various inquiries and legal proceedings, drawing lessons from the incident to inform future healthcare policies and practices. The findings emphasize the need for stringent oversight, transparent decision-making processes, and the protection of vulnerable populations in healthcare settings. The discussion reflects on the broader implications for mental healthcare reform and the importance of accountability and justice in preventing such tragedies. It also underlines the necessity of comprehensive policy frameworks and robust enforcement mechanisms to safeguard the rights and well-being of mental healthcare users.

The Impact of Seasonal Influenza in Reducing the Spread of Diseases in the Kingdom of Saudi Arabia

Seasonal influenza remains a significant public health concern globally, with its impact extending beyond the direct effects of the virus. In the Kingdom of Saudi Arabia, where unique climatic conditions and high-density population events, such as the Hajj and Umrah pilgrimages, create an elevated risk for disease transmission, influenza management has become a critical focus. This study examines the indirect benefits of seasonal influenza control measures in reducing the spread of other infectious diseases within the Kingdom. Drawing on epidemiological data, vaccination coverage reports, and public health policies, the study highlights the role of widespread influenza vaccination campaigns, particularly among high-risk populations such as healthcare workers, the elderly, and pilgrims. The findings reveal a significant correlation between high influenza vaccine uptake and the reduced incidence of respiratory infections, such as pneumonia and bronchitis, and a decline in healthcare utilization during peak seasons. Furthermore, the seasonal influenza vaccination program has enhanced public health awareness, improved disease surveillance infrastructure, and strengthened healthcare preparedness, contributing to the mitigation of other communicable diseases. This study also explores the broader implications of integrating influenza management strategies into Saudi Arabia’s public health framework, including the development of herd immunity and reduced economic burdens on healthcare systems. By showcasing the Kingdom’s efforts in combating influenza and its indirect benefits, the study underscores the importance of sustained investment in vaccination campaigns and the adoption of a comprehensive approach to disease prevention.

Modeling and Forecasting the Prevalence of Human Immuno-Deficiency Virus (HIV) in Birnin Gwari Local Government Area of Kaduna State

Human immunodeficiency virus (HIV) has been prevalent in millions of people worldwide for more than 50 years. Therefore, its prevalence must be monitored to make well-informed decisions and create efficient health plans. This paper dwelt on the modeling and prediction of the prevalence of HIV among inpatients and outpatients visiting Jibril Mai-Gwari I Memorial Hospital in Birnin Gwari Local Government Area of Kaduna State. An expo-facto research methodology was adopted for this study through the collection of twelve (12) years of monthly data spanning the period 2010-2021 as extracted from the hospital’s inpatient and outpatient department records. Box and Jenkins analytical approach was used to model the data due to its presence of unit root, as a non-stationarity data cannot be modeled using the conventional time series models. Iterative methods were applied in the identification of several ARIMA models as ARIMA (2, 1, 5) model was found to be the best fit among the 25 iterated models based on its higher loglikelihood (-435.57), lower variance (24.95) and lower AIC (887.13). More so, the model was found to scale through the portmanteau tests of residual independence (Ljung-Box Chi-square 5.9261, p-value > 0.05) and normality (Wilk 0.9830, p-value > 0.05), a confirmatory test of model reliability and accuracy. Although the prognosis suggests that HIV prevalence may not change significantly in the upcoming years, the expanding uncertainty band suggests that it will be challenging to estimate HIV prevalence in the future with high confidence. To manage prevalence and lower the chance of an unanticipated increase, public health measures must be consistent and effective.

Program UE dla zdrowia w europejskiej debacie parlamentarnej

EU HEALTH PROGRAMME IN THE EUROPEAN PARLIAMENTARY DEBATEThe weakness of the response to the pandemic that was visible in many EU Member States, especially in the first period of the crisis, resulted in increased expectations for action at the European level. This was reflected in the EU4Health programme prepared in the same period. The analysis carried out in this article concerns parliamentary debates on the new EU health program and, indirectly, discussions on the further direction of changes in European health policy. The author put forward two hypotheses: 1. In the parliamentary debate on the EU health programme, positive opinions (regardless of party differences) towards the proposed actions, resulting from the experience of the pandemic crisis, will prevail. 2. The analysed debate will highlight differences regarding the further deepening of the integration process in the area of health – supporters of deepening integration (‘towards a real health union’) versus supporters of cooperation based on the current state-centric approach to health in the EU. As the analysis of the strategy and speeches during the plenary debates shows, the pandemic context has become an important point of reference for these activities. It allows us to confirm the hypothesis indicating the dominance of MEPs’ positive assessment of the solutions proposed by the strategies. The second hypothesis was also confirmed. The analysed speeches presented varied assessments of further integration leading to the creation of the European Health Union. Right-wing parties emphasised the need to maintain the status quo in the field of health (health policy in the hands of the state). MEPs from the EPP, S&D and Renew Europe presented a position more open to change. Taking into account that member states are responsible for health policy and for any changes in this area (specific treaty changes), the results of the debate should be treated as a presentation of political possibilities rather than a forecast of actions for the near future.

Implications of Modifiable and Non-Modifiable Determinants of Dementia for Public Health Policies and Prevention Strategies

Dementia, characterized by cognitive decline and memory deterioration, poses a significant and growing global health challenge. Alzheimer's disease (AD) is the most common form, with others including Lewy body dementia (LBD), frontotemporal dementia (FTD), and vascular dementia (VaD). The World Health Organization estimates that 55 million people worldwide are affected, a number projected to triple by 2050. This essay explores both non-modifiable and modifiable determinants of dementia and their implications for public health policies and prevention efforts. Non-modifiable determinants include age, genetics, and sex, all of which significantly influence dementia risk. Ageing is the primary risk factor, with genetic factors such as mutations in APP, PSEN1, and PSEN2, and the APOE 4 allele increasing susceptibility. Women, due to their longer lifespan and hormonal differences, are at a higher risk compared to men. Modifiable determinants encompass lifestyle factors and medical conditions, notably diet, physical activity, alcohol and tobacco use, hypertension, and diabetes. Effective public health policies, like the WHO's Global Action Plan, emphasize early intervention and lifestyle modifications. Integrating these determinants into policy making requires a balanced approach, considering the dynamic nature of modifiable factors and the specific needs of an aging population. The essay underscores the need for comprehensive public health education, destigmatization of dementia, and an inclusive healthcare infrastructure to enhance dementia prevention and care, ultimately reducing the societal burden of this condition.

The algerian state’s health policy, the Corona pandemic as an example

After the transmission of the Corona virus from the Chinese city of Wuhan, the first case in Algeria, the country's higher authorities took responsibility for managing the Corona 19 pandemic; A special budget was allocated to manage this crisis and confront this virus, and a set of measures were taken and a number of decisions were issued coinciding with the changes in the epidemiological situation. Efforts were focused on getting out of this pandemic with the least damage and the fewest deaths, as it was decided to impose compulsory quarantine on travelers coming from abroad. Suspension of studies, a complete closure of the country, and quarantine and social distancing measures were imposed to control the spread of the virus. The Ministry of Health has played a key role in supervising the implementation and control of health policies in coordination with various other sectors, and a green number has been launched around the clock and an application for smart phones to enable people to access information and resources related to the Corona virus, and all material and human capabilities have been exploited to prevent the virus. or treat the injured. And with the increasing number of infections, the matter prompted more measures to be taken, represented in imposing partial and total quarantine in the states and cities that witness a daily increase in the number of infections, and commercial activities were suspended, the suspension of studies extended, and other decisions aimed at limiting the spread of the Corona virus and taking care of the injured.

Gender differences in self-rated health among older adults in the Chinese workforce

IntroductionThis study investigates gender-based disparities in self-rated health among older individuals in the Chinese workforce, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS). Understanding these health gaps is crucial for crafting effective health policies and interventions in light of the rapidly aging population.Materials and methodsData from the 2020 CHARLS survey, comprising Chinese individuals aged 45 and above, were analyzed, focusing on older adults actively employed. Descriptive statistics and regression analyses examined gender discrepancies in self-rated health, considering diverse sociodemographic, economic, and health-related factors.ResultsGender disparities in demographics, work environments, and self-rated health were observable among male and female participants. Older males tended to have higher rates of smoking and alcohol consumption, coupled with lower incomes. In contrast, females exhibited healthier behaviors influenced by access to healthcare and lifestyle modifications. For males, economic stability and moderate alcohol use positively influenced self-rated health, while females benefited from healthcare coverage and healthy lifestyle choices. Tailored gender-specific health interventions should prioritize these unique factors to enhance overall well-being.DiscussionDiscussions highlighted the impact of demographic variables, including age, marital status, social security, and employment conditions, on self-rated health. The study emphasized the crucial role of marital relationships in the health outcomes of older adult workers.ConclusionThis study underscores the pivotal role of gender in self-rated health variations and provides essential insights for targeted interventions. By considering both quantitative and qualitative determinants of well-being, focused health policies can effectively address the health and well-being of aging populations, especially older adult workers.

Exploring Sentiment, Values, and Misinformation Surrounding Vaccination Legislation on Twitter: A Case Study of California’s Passage of SB277

ABSTRACT California remains among a handful of U.S. states with no clause for a personal belief exemption for required vaccines due to passage of SB277. As vaccines represent an important tool in the public health arsenal against SARS-CoV-2 and may yet be required by schools and employers, other states may consider enacting laws similar to SB277 to address COVID-19 and future outbreaks of infectious diseases. In this case study of California’s SB277 bill, we examine the sentiment, values, and misinformation shared on Twitter regarding this bill in the days leading up to, during, and after its successful enactment into law in 2015 using a sample of geocoded tweets (N = 1,000). Results of our content analysis of tweet sentiments before and after the law was signed offer evidence for significant differences in vaccine misinformation [χ 2 (1, N = 1,000) = 4.01, p = .045, Φ = .06], and individual values related to power [χ 2 (1, N = 1,000) = 71.57, p < .001, Φ = -.27] and achievement [χ 2 (1, N = 1,000) = 4.39, p = .036, Φ = .07]. Findings suggest that although most tweets did not contain misinformation, few provided scientific evidence to back claims. Implication for theory, research, and health policy and practice are discussed.