Public Health Information Research Articles

An investigation of media reports of digital surveillance within the first year of the COVID-19 pandemic.

The COVID-19 pandemic prompted a surge in digital public health surveillance worldwide, with limited opportunities to consider the effectiveness or impact of digital surveillance. The news media shape public understanding of topics of importance, contributing to our perception of priority issues. This study investigated news media reports published during the first year of the pandemic to understand how the use and consequences of digital surveillance technologies were reported on. A media content analysis of 34 high- to low-income countries was completed. The terms "COVID-19," "surveillance," "technologies," and "public health" were used to retrieve and inductively code media reports. Of the 1,001 reports, most were web-based or newspaper sources on the development and deployment of technologies directed at contact tracing, enforcing quarantine, predicting disease spread, and allocating resources. Technology types included mobile apps, wearable devices, "smart" thermometers, GPS/Bluetooth, facial recognition, and security cameras. Repurposed data from social media, travel cards/passports, and consumer purchases also provided surveillance insight. Media reports focused on factors impacting surveillance success (public participation and data validity) and the emerging consequences of digital surveillance on human rights, function creep, data security, and trust. Diverse digital technologies were developed and used for public health surveillance during the first year of the COVID-19 pandemic. The use of these technologies and witnessed or anticipated consequences were reported by a variety of media sources worldwide. The news media are an important public health information resource, as media outlets contribute to directing public understanding and shaping priority public health surveillance issues. Our findings raise important questions around how journalists decide which aspects of public health crises to report on and how these issues are discussed.

Doing public health differently: How can public health departments engage with local communities through social media interventions?

ObjectivesThis paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic. Study designA qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis? MethodsFourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis. ResultsCollaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community. ConclusionsSocial media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues.

Impacts of Indoor Dust Exposure on Human Colonic Cell Viability, Cytotoxicity and Apoptosis.

Environmental exposure to indoor dust is known to be associated with myriad health conditions, especially among children. Established routes of exposure include inhalation and non-dietary ingestion, which result in the direct exposure of gastrointestinal epithelia to indoor dust. Despite this, little prior research is available on the impacts of indoor dust on the health of human gastrointestinal tissue. Cultured human colonic (CCD841) cells were exposed for 24 h to standard trace metal dust (TMD) and organic contaminant dust (OD) samples at the following concentrations: 0, 10, 25, 50, 75, 100, 250, and 500 µg/mL. Cell viability was assessed using an MTT assay and protease analysis (glycyl-phenylalanyl-aminofluorocoumarin (GF-AFC)); cytotoxicity was assessed with a lactate dehydrogenase release assay, and apoptosis was assessed using a Caspase-Glo 3/7 activation assay. TMD and OD decreased cellular metabolic and protease activity and increased apoptosis and biomarkers of cell membrane damage (LDH) in CCD841 human colonic epithelial cells. Patterns appeared to be, in general, dose-dependent, with the highest TMD and OD exposures associated with the largest increases in apoptosis and LDH, as well as with the largest decrements in metabolic and protease activities. TMD and OD exposure were associated with markers of reduced viability and increased cytotoxicity and apoptosis in human colonic cells. These findings add important information to the understanding of the physiologic effects of indoor dust exposure on human health. The doses used in our study represent a range of potential exposure levels, and the effects observed at the higher doses may not necessarily occur under typical exposure conditions. The effects of long-term, low-dose exposure to indoor dust are still not fully understood and warrant further investigation. Future research should explore these physiological mechanisms to further our understanding and inform public health interventions.

Credibility of vaccine-related content on Twitter during COVID-19 pandemic.

During national COVID-19 vaccine campaigns, people continuously engaged on Twitter to receive updates on the latest public health information, and to discuss and share their experiences. During this time, the spread of misinformation was widespread, which threatened the uptake of vaccines. It is therefore critical to understand the reasons behind vaccine misinformation and strategies to mitigate it. The current research aimed to understand the content of misleading tweets and the characteristics of their corresponding accounts. We performed a machine learning approach to identify misinformation in vaccine-related tweets, and calculated the demographic, engagement metrics and bot-like activities of corresponding accounts. We found critical periods where high amounts of misinformation coincided with important vaccine announcements, such as emergency approvals of vaccines. Moreover, we found Asian countries had a lower percentage of misinformation shared compared to Europe and North America. Our results showed accounts spreading misinformation had an overall 10% greater likelihood of bot activity and 15% more astroturf bot activity than accounts spreading accurate information. Furthermore, we found that accounts spreading misinformation had five times fewer followers and three times fewer verified badges than fact-sharing accounts. The findings of this study may help authorities to develop strategies to fight COVID-19 vaccine misinformation and improve vaccine uptake.

Modernizing the United States' Public Health Infrastructure: A Position Paper From the American College of Physicians.

The United States' public health sector plays a crucial role in preventing illness and promoting health. Public health drove massive gains in life expectancy during the 20th century by supporting vaccination campaigns, promoting motor vehicle safety, and preventing and treating tobacco use. However, public health is underfunded and underappreciated, forcing the field to do more with fewer resources. In this position paper, the American College of Physicians (ACP) updates its 2012 policy recommendations on strengthening the nation's public health infrastructure. ACP calls for effective coordination of public health activities, robust and stable year-to-year funding of public health services, a renewed and well-supported public health workforce, action to address health-related dis- and misinformation, modernized public health data systems, and greater coordination between public health and medical sectors.

Pediatric Respiratory Illnesses: An Update on Achievable Benchmarks of Care.

Pediatric respiratory illnesses (PRI): asthma, bronchiolitis, pneumonia, croup, and influenza are leading causes of pediatric hospitalizations, and emergency department (ED) visits in the United States. There is a lack of standardized measures to assess the quality of hospital care delivered for these conditions. We aimed to develop a measure set for automated data extraction from administrative data sets and evaluate its performance including updated achievable benchmarks of care (ABC). A multidisciplinary subject-matter experts team selected quality measures from multiple sources. The measure set was applied to the Public Health Information System database (Children's Hospital Association, Lenexa, KS) to cohorts of ED visits and hospitalizations from 2017 to 2019. ABC for pertinent measures and performance gaps of mean values from the ABC were estimated. ABC were compared with previous reports. The measure set: PRI report includes a total of 94 quality measures. The study cohort included 984 337 episodes of care, and 82.3% were discharged from the ED. Measures with low performance included bronchodilators (19.7%) and chest x-rays (14.4%) for bronchiolitis in the ED. These indicators were (34.6%) and (29.5%) in the hospitalized cohort. In pneumonia, there was a 57.3% use of narrow spectrum antibiotics. In general, compared with previous reports, there was improvement toward optimal performance for the ABCs. The PRI report provides performance data including ABC and identifies performance gaps in the quality of care for common respiratory illnesses. Future directions include examining health inequities, and understanding and addressing the effects of the coronavirus disease 2019 pandemic on care quality.

A Scoping Review of the Relationship Between Physical Activity and Mental Health Among Immigrants in Western Countries: An Integrated Bio-Psycho-Socio-Cultural Lens.

Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners.

P10-002-23 Precision Nutrition: Is the Hype is Exceeding the Science and Evidentiary Standards Needed To Inform Public Health Recommendations for Prevention of Chronic Disease?

P10-002-23 Precision Nutrition: Is the Hype is Exceeding the Science and Evidentiary Standards Needed To Inform Public Health Recommendations for Prevention of Chronic Disease?

New developments and expansion of the GP in-hours syndromic surveillance system: collaboration between UKHSA and the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub.

The UK Health Security Agency have established a partnership with the Oxford-Royal College of General Practitioners (RCGP) Clinical Informatics Digital Hub (ORCHID) to provide a new source of primary care data to enhance an existing GP in-hours syndromic surveillance system. To provide better coverage of the English population and more comprehensive information to inform public health action. We produced indicators using SNOMED CT codes grouped into syndromes and validated the outputs against the existing GP in-hours data. A daily data feed from the ORCHID system at Oxford to the GP in-hours syndromic surveillance system was established for routine surveillance. Population coverage increased from 6.8 to 18.8 million patients, representative of the English population. More granular data are available at postcode district and lower layer super output level (LSOA), providing better geographical and sociodemographic coverage, and enabling the investigation of social inequalities on conditions diagnosed in primary care. New indicators can be implemented rapidly in response to new public health threats. For decades the RCGP has run sentinel surveillance with integrated virology and now RCGP data are being used for syndromic surveillance. The addition of ORCHID data to the GP in-hours syndromic surveillance system has improved the utility of the system. There is better population coverage, additional syndromic indicators, and greater ability to interrogate the data. The new system will provide enhanced information to support public health in England and highlights the value of GP records for use in protecting the health security of the nation.

IS BREASTFEEDING SUPERIOR TO FORMULA FEEDING IN IMPACTING CHILD COGNITIVE DEVELOPMENT? A SYSTEMATIC REVIEW

Background: Past research evidence has shown that breastfeeding has significant benefits with regard to cognitive development. However, emerging evidence has shown how breastfeeding may lead to equally beneficial outcomes with regard to cognitive development. Therefore, the present study was undertaken to assess the relevant evidence. Aims: The aim of this systematic review was to compare the impact of breastfeeding and formula feeding on cognitive development by analyzing prospective cohort studies. Methods: This research conducted a thorough search of several databases such as AMED, PUBMED in addition to British Nursing Index and CINAHL. The goal was to utilize all sources of information with regard to identification of prospective studies. The search was limited to articles published between 2000 and 2016, resulting in a total of 15 studies, including 10 quantitative and 5 qualitative studies, that were deemed relevant for review. To ensure that the studies selected for review were of high quality and free from biases, two critical appraisal tools were used. The first tool, the Critical Appraisal Skills Program (CASP), is a widely recognized tool for evaluating the quality and rigor of qualitative and quantitative research studies. The second tool, the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Project (EPHPP), is specifically designed to assess the quality of quantitative studies. Results: The review findings revealed that breastfeeding may provide cognitive advantages to children when compared to formula feeding. However, it is pertinent to note how these results are often confounding by factors such as socioeconomic status, parental education etc. Consequently, when evaluating the effects of breastfeeding and formula feeding on cognitive development, it is necessary to consider the role of environmental, biological, social, and cultural factors. Conclusion: Overall, this review underscores the need for further research to better understand the complex relationships between breastfeeding, formula feeding, and cognitive development and to help inform public health policies and interventions aimed at promoting optimal cognitive development in children. Keywords: breast feeding, formula feeding, cognitive development, CASP, Medline, EMBASE

Festivals following the easing of COVID-19 restrictions: Prevalence of new psychoactive substances and illicit drugs

The market for illicit drugs and new psychoactive substances (NPS) has grown significantly and people attending festivals have been identified as being at high risk (high extent and frequency of substance use). Traditional public health surveillance data sources have limitations (high costs, long implementation times, and ethical issues) and wastewater-based epidemiology (WBE) can cost-effectively support surveillance efforts. Influent wastewater samples were analyzed for NPS and illicit drug consumption collected during New Year period (from 29-Dec-2021 to 4-Jan-2022) and a summer Festival (from 29-June-2022 to 12-July-2022) in a large city in Spain. Samples were analyzed for phenethylamines, cathinones, opioids, benzodiazepines, plant-based NPS, dissociatives, and the illicit drugs methamphetamine, MDA, MDMA, ketamine, heroin, cocaine, and pseudoephedrine by liquid chromatography mass spectrometry. High consumption rates of specific NPS and established illicit drugs were identified at the peak of each event. Furthermore, a dynamic change in NPS use (presence and absence of substances) was detected over a period of six months. Eleven NPS, including synthetic cathinones, benzodiazepines, plant-based NPS and dissociatives, and seven illicit drugs were found across both the New Year and summer Festival. Statistically significant differences (p < 0.05) were seen for 3-MMC (New Year vs summer Festival), eutylone (New Year vs summer Festival), cocaine (summer Festival vs normal week and summer Festival vs New Year), MDMA (New Year vs normal week and summer Festival vs normal week), heroin (summer Festival vs New Year) and pseudoephedrine (summer Festival vs New Year). This WBE study assessed the prevalence of NPS and illicit drugs at festivals following the reduction of the COVID-19 pandemic restrictions highlighting the high use of specific substances at the peak of each event. This approach identified in a cost-effective and timely manner without any ethical issues the most used drugs and changes in use patterns and, thus, can complement public health information.

Public Health Information Standard Data Quality and Governance

Many public health organizations face data quality challenges due to the complexity of the structure of clinical data systems, the massive growth in the volume of clinical data, and the need for more standardization between clinical systems in terms of naming and modelling. Data quality is an integral part of data governance, ensuring that data management is fit for purpose. It refers to the overall utility of a data set and its ability to be processed and analyzed quickly for other uses. This study uses a qualitative research method which is a principled research method that focuses on the description and understanding of the observed social phenomena. Moreover, the results of the study were obtained in the form of Standards for Data Quality according to the American Health Information Management Association (AHIMA) and the European Health Data Space (EHDS). In addition, there is also a discussion on privacy, security, and compliance. As well as obtaining a data governance framework for the health industry and good health industry governance. The conclusions from this study indicate that the quality of data and governance data in governance in the health industry is essential to ensure the achievement of effective and efficient health services and can be relied upon in decision-making.

Designing an infographic webtool for public health.

To create and evaluate a public health informatics tool, Florence, for communicating information to the public. This user-centered design study included 3 phases: (1) an interview and survey study with public health practitioners to assess needs for creating infographics; (2) the application of assessment findings and public health-motivated design guidelines to the design and development of a public health-specific infographic design tool; and (3) a feasibility and usability study to evaluate the feasibility and usability of the tool. In phase 1, participants noted the importance of tailoring infographics to an audience and wanted flexible tools along with design guidance to help make fewer design decisions. In phase 2, we developed a prototype tool with: (1) layout and functionality familiar to PH users, (2) quick and intuitive ways to add and modify data in visualizations, and (3) health-focused visual elements. In phase 3, participants found Florence to be usable, providing an intuitive and straightforward experience, and that the focus on public health was useful. Based on needs assessments and existing literature, we created Florence along with public health practitioners to address their domain specific needs, ultimately leading to a tool that participants in our study deemed useful. Future research can build on our work to develop user-centered tools to meet their needs. Infographics are important for public health communication. Creating user-centered solutions to address the unique needs of public health can support communication efforts.

Risk factors of tooth wear in permanent dentition: A scoping review.

Tooth wear (TW) prevalence is high and increasing and has important consequences on the patient's quality of life. Knowledge of risk factors is crucial to promote diagnosis, prevention strategies and timely interceptive treatment. Many studies have identified TW risk factors. This scoping review aims to map and describe suspected available factors associated with TW in permanent dentition based on quantitative measurement. The scoping review was conducted using the PRISMA extension of the Scoping Reviews checklist. The search was conducted in October 2022 from the Medline® (PubMed® interface) and Scopus® databases. Two independent reviewers selected and characterised the studies. 2702 articles were identified for assessment of titles and abstracts, and 273 articles were included in the review. The results show a need to standardise TW measurement indices and the study design. The included studies highlighted various factors, classified into nine domains: sociodemographic factors, medical history, drinking habits, eating habits, oral hygiene habits, dental factors, bruxism and temporomandibular disorders, behavioural factors, and stress. Results related to chemical TW (erosion) risk factors underline the importance of eating disorders, gastroesophageal reflux and lifestyle, particularly drinking and eating behaviours, which supports developing public health information campaigns and interventions. Besides chemical, this review identifies evidence of several mechanical TW risk factors, such as toothbrushing and bruxism; the influence of this last factor needs to be further explored. TW management and prevention require a multidisciplinary approach. Dentists are in the first line to detect associated diseases such as reflux or eating disorders. Consequently, practitioners' information and guideline diffusion should be promoted, and a TW risk factors checklist (the ToWeR checklist) is proposed to help diagnostic approaches.

Overview of Antimicrobial Resistance: An Emerging Silent Pandemic

Before the outbreak of Coronavirus disease-19, one of the top 10 most risks identified by the World Health Organization (WHO) is antimicrobial resistance (AMR) that is also known as “silent pandemic.” According to Lord Jim O’Neill’s report, if no action is taken, then AMR will result in 10 million deaths annually by 2050. In the agricultural and medical sectors, the indiscriminate utilization of antimicrobial agents is getting worse. For the treatment of carbapenem-resistant Gram-negative infections, new antibiotics are urgently required. Microbes, through genetic mutations, acquire resistance to combat with antimicrobial drugs and thus maintain their survival. The WHO on October 25, 2022, released the “Fungal Priority Pathogens List” which includes 19 fungi that pose the highest threat to public health. The implementation of strategies that avoid any possible exposure of pathogens to antibiotics in non-clinical environments involves cooperation between clinicians, researchers, and policymakers. To combat the emerging threat posed by AMR, a multifaceted and holistic approach known as “One health for all” is also required. The curriculum of medical schools needs to be revitalized using a one-health concept. By spreading vital public health information, these initiatives will be successful in promoting awareness among students and the general public.

Assessing the impact of serostatus-dependent immunization on mitigating the spread of dengue virus.

Dengue is the most rapidly spreading mosquito-borne disease that poses great threats to public health. We propose a compartmental model with primary and secondary infection and targeted vaccination to assess the impact of serostatus-dependent immunization on mitigating the spread of dengue virus. We derive the basic reproduction number and investigate the stability and bifurcations of the disease-free equilibrium and endemic equilibria. The existence of a backward bifurcation is proved and is used to explain the threshold dynamics of the transmission. We also carry out numerical simulations and present bifurcation diagrams to reveal rich dynamics of the model such as bi-stability of the equilibria, limit cycles, and chaos. We prove the uniform persistence and global stability of the model. Sensitivity analysis suggests that mosquito control and protection from mosquito bites are still the key measures of controlling the spread of dengue virus, though serostatus-dependent immunization is implemented. Our findings provide insightful information for public health in mitigating dengue epidemics through vaccination.

Can delay discounting predict vaccine hesitancy 4-years later? A study among US young adults

Despite being a major threat to health, vaccine hesitancy (i.e., refusal or reluctance to vaccinate despite vaccine availability) is on the rise. Using a longitudinal cohort of young adults (N = 1260) from Los Angeles County, California we investigated the neurobehavioral mechanisms underlying COVID-19 vaccine hesitancy. Data were collected at two time points: during adolescence (12th grade; fall 2016; average age = 16.96 (±0.42)) and during young adulthood (spring 2021; average age = 21.33 (±0.49)). Main outcomes and measures were delay discounting (DD; fall 2016) and tendency to act rashly when experiencing positive and negative emotions (UPPS-P; fall 2016); self-reported vaccine hesitancy and vaccine beliefs/knowledge (spring 2021). A principal components analysis determined four COVID-19 vaccine beliefs/knowledge themes: Collective Responsibility, Confidence and Risk Calculation, Complacency, and Convenience. Significant relationships were found between themes, COVID-19 vaccine hesitancy, and DD. Collective Responsibility (β = -1.158[-1.213,-1.102]) and Convenience (β = -0.132[-0.185,-0.078]) scores were negatively associated, while Confidence and Risk Calculation (β = 0.283[0.230,0.337]) and Complacency (β = 0.412[0.358,0.466]) scores were positively associated with COVID-19 vaccine hesitancy. Additionally, Collective Responsibility (β = -0.060[-0.101,-0.018]) was negatively associated, and Complacency (β = -0.063[0.021,0.105]) was positively associated with DD from fall 2016. Mediation analysis revealed immediacy bias during adolescence, measured by DD, predicted vaccine hesitancy 4 years later while being mediated by two types of vaccine beliefs/knowledge: Collective Responsibility (β = 0.069[0.022,0.116]) and Complacency (β = 0.026[0.008,0.044]). These findings provide a further understanding of individual vaccine-related decision-making among young adults and inform public health messaging to increase vaccination acceptance.

Communicating science in the COVID-19 news in the UK during Omicron waves: exploring representations of nature of science with epistemic network analysis

News media plays a vital role in communicating scientific evidence to the public during the COVID-19 pandemic. Such communication is important for convincing the public to follow social distancing guidelines and to respond to health campaigns such as vaccination programmes. However, newspapers were criticised that they focus on the socio-political perspective of science, without explaining the nature of scientific works behind the government’s decisions. This paper examines the connections of the nature of science categories in the COVID-19 era by four local newspapers in the United Kingdom between November 2021 to February 2022. Nature of science refers to different aspects of how science works such as aims, values, methods and social institutions of science. Considering the news media may mediate public information and perception of scientific stories, it is relevant to ask how the various British newspapers covered aspects of science during the pandemic. In the period explored, Omicron variant was initially a variant of concern, and an increasing number of scientific evidence showed that the less severity of this variant might move the country from pandemic to endemic. We explored how news articles communicate public health information by addressing how science works during the period when Omicron variants surge. A novel discourse analysis approach, epistemic network analysis is used to characterise the frequency of connections of categories of the nature of science. The connection between political factors and the professional activities of scientists, as well as that with scientific practices are more apparent in left-populated and centralist outlets than in right-populated news outlets. Among four news outlets across the political spectrum, a left-populated newspaper, the Guardian, is not consistent in representing relations of different aspects of the nature of scientific works across different stages of the public health crisis. Inconsistency of addressing aspects of scientific works and a downplay of the cognitive-epistemic nature of scientific works likely lead to failure in trust and consumption of scientific knowledge by the public in the healthcare crisis.

Mitigating the impacts of the COVID-19 pandemic on vulnerable populations: Lessons for improving health and social equity

The COVID-19 pandemic had an inequitable and disproportionate impact on vulnerable populations, reversing decades of progress toward healthy populations and poverty alleviation. This study examines various programmatic tools and policy measures used by governments to support vulnerable populations during the pandemic. A comparative case study of 15 countries representing all World Health Organization's regions offers a comprehensive picture of countries with varying income statuses, health system arrangements and COVID-19 public health measures. Through a systematic desk review and key informant interviews, we report a spectrum of mitigation strategies deployed in these countries to address five major types of vulnerabilities (health, economic, social, institutional and communicative). We found a multitude of strategies that supported vulnerable populations such as migrant workers, sex workers, prisoners, older persons and school-going children. Prioritising vulnerable populations during the early phase of COVID-19 vaccination campaigns, direct financial subsidies and food assistance programmes were the most common measures reported. Additionally, framing public health information and implementing culturally sensitive health promotion interventions helped bridge the communication barriers in certain instances. However, these measures remain insufficient to protect vulnerable populations comprehensively. Our findings point to the need to expand fiscal space for health, enlarge healthcare coverage, incorporate equity principles in all policies, leverage technology, multi-stakeholder co-production of policies and tailored community engagement mechanisms.

HealthE: Recognizing Health Advice &amp; Entities in Online Health Communities

The task of extracting and classifying entities is at the core of important Health-NLP systems such as misinformation detection, medical dialogue modeling, and patient-centric information tools. Granular knowledge of textual entities allows these systems to utilize knowledge bases, retrieve relevant information, and build graphical representations of texts. Unfortunately, most existing works on health entity recognition are trained on clinical notes, which are both lexically and semantically different from public health information found in online health resources or social media. In other words, existing health entity recognizers vastly under-represent the entities relevant to public health data, such as those provided by sites like WebMD. It is crucial that future Health-NLP systems be able to model such information, as people rely on online health advice for personal health management and clinically relevant decision making. In this work, we release a new annotated dataset, HealthE, which facilitates the large-scale analysis of online textual health advice. HealthE consists of 3,400 health advice statements with token-level entity annotations. Additionally, we release 2,256 health statements which are not health advice to facilitate health advice mining. HealthE is the first dataset with an entity-recognition label space designed for the modeling of online health advice. We motivate the need for HealthE by demonstrating the limitations of five widely-used health entity recognizers on HealthE, such as those offered by Google and Amazon. We additionally benchmark three pre-trained language models on our dataset as reference for future research. All data is made publicly available.