Public Health Victory Research Articles

Indiana's Public Health Investment Holds Insights For Other States.

Indiana has a business-friendly environment, but historical underinvestment in public health has yielded poor health outcomes. In 2023, when trust in governmental public health was strained nationwide, Indiana increased public health spending by 1,500percent. In this article, we explain how Indiana achieved this unprecedented legislative victory for public health, describing the context, approach, and lessons learned. Specifically, an Indiana University report linking economic vitality and overall health sparked the creation of a governor's commission charged with exploring ways to address Indiana's shortcomings. Working with the Indiana Department of Health, the commission developed multisectoral coalitions and business and government partnerships, and it maintained consistent and coordinated communication with policy makers. Lessons learned included the value of uncoupling public health from partisan narratives, appointing diverse commission membership with strategically selected cochairs, involving local leaders, and ensuring local decision-making control. We believe that Indiana's approach holds insights for other states interested in strengthening public health funding in the current era.

Understanding why collective action resulted in greater advances for tobacco control as compared to alcohol control during the Philippines’ Sin Tax Reform: a qualitative study

Background and aimsIn 2012, the Philippines passed a law popularly known as the ‘Sin Tax Reform’. This law increased excise tax on both tobacco and alcohol. While a victory for...

United States vs Safehouse: The implications of the Philadelphia supervised consumption facility ruling for law and social stigma

In October 2019, a federal judge ruled that a Philadelphia nonprofit (Safehouse) group's plan to open the first site in the U.S. where people can use illegal opioids under medical supervision does not violate federal Controlled Substances Act, delivering a major setback to Justice Department lawyers who launched a legal challenge to block the facility. The Judge wrote that “the ultimate goal of Safehouse's proposed operation is to reduce drug use, not facilitate it,” which represents the first legal decision about whether supervised injection sites can be legally permissible under U.S. law. Although supervised consumption facilities (“SCFs”) remain controversial, they already exist in many countries in Europe as well as Canada, Australia, and Mexico, and evaluations of their public health impact have demonstrated the value of this practice. The decision is hailed as a public health victory and could shape the legal debate in other U.S. cities. Challenges remain as stigmatizing attitudes regarding substance use are widely accepted, culturally endorsed, and enshrined in policy. The Safehouse case shows that SCFs might be able to survive under current federal drug laws, but public understanding and support of these facilities will also be crucial for cities and states to open them.

An Enormous Victory for Public Health in California: Industries Are Responsible for Cleaning Up the Environments They Polluted.

"An Enormous Victory for Public Health in California: Industries Are Responsible for Cleaning Up the Environments They Polluted." , 109(2), pp. 211–212

A Global Public Health Victory for Tobacco Plain-Packaging Laws in Australia

A Global Public Health Victory for Tobacco Plain-Packaging Laws in Australia

Sleep as a Target for Optimized Response to Smoking Cessation Treatment.

This narrative literature review presents a comprehensive discussion of the relationship between habitual sleep and cigarette smoking. The extent to which unhealthy sleep in smokers may be a viable intervention target for promoting response to smoking cessation treatment is considered. Ultimately, this review provides conceptual support for sleep therapy as an adjunctive treatment for smoking cessation.

Addressing Inadequate Federal Legislation Concerning Viral Disasters: A Hard Look at the Emergency Treatment and Active Labor Act

There's no one place a virus goes to die—but that doesn't make its demise any less a public health victory. Throughout human history, viral diseases have had their way with us, and for just as long...

"It's the population, stupid": why changing the policy frame should help Scotland tackle its problem with cheap alcohol.

"It's the population, stupid": why changing the policy frame should help Scotland tackle its problem with cheap alcohol.

Vitamin D supplementation: bones of contention

The discovery of vitamin D as an essential nutrient for skeletal development a century ago was a major public health victory. Supplementation, whether solar or dietary, prevented the devastating effects of rickets in children. Five decades later, the molecular mechanisms of the vitamin's active form (1,25-dihydroxyvitamin D) and its receptor (vitamin D receptor [VDR]), were elucidated, and subsequently clinical investigators linked vitamin D deficiency or insufficiency with osteoporosis. This finding seemed logical because osteomalacia (ie, the softening of bone in adults due to impaired mineralisation) can cause fractures and often coexists histologically with osteoporosis. Slowly, vitamin D supplementation became established for prevention of osteoporosis. But, as shown in a meta-analysis in The Lancet,1 Reid IR Bolland MJ Grey A Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis. Lancet. 2013; (published online Oct 11.)http://dx.doi.org/10.1016/S0140-6736(13)61647-5 Google Scholar the story is more complex, both from an epidemiological and mechanistic perspective. Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysisContinuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate. Full-Text PDF

Seat Belt Misuse by a Child Transported in Belt-Positioning Booster Seat With Deadly Consequences

Child passenger safety has been a major public health victory, but there is still work to be done. This case presentation is about a 5-year-old boy who placed the shoulder portion of the lap-shoulder seat belt behind his back who was recently killed in a motor vehicle crash. This article reviews what trauma nurses need to know about the latest improvements in child passenger safety practices. Also presented are important resources for trauma nurses to share with families to improve travel safety.

Global eradication of poliomyelitis: Is the end of the campaign in sight?

"The world may be on the brink of achieving a great public health victory. Progress towards eradication of poliomyelitis is outlined highlighting remaining problems."

Brazil and tobacco use: a hard nut to crack

Taxes on tobacco products generated income of around US$ 2.2 billion for the Brazilian government in 2008, but that doesn't mean the Brazilian government is going easy on the tobacco industry. For the past two decades, Brazil has been at the forefront of global tobacco control initiatives. Vera da Costa e Silva, public health specialist who advises the government on tobacco control, is proud to note that Brazil was the first country to ban the use of misleading adjectives such as light and mild from cigarette packages back in 2001. That move was in line with law passed year earlier requiring cigarette manufacturers to include pictorial health warnings covering at least 100% of one of the two main sides of pack. These warnings often depict people in advanced stages of tobacco-related illness. As result of such initiatives, smoking prevalence has come down in the past two decades from 34% of the adult population in 1989 to 15% last year, according to the Brazilian Ministry of Health. But the declining trend has tailed off over the past few years as tobacco companies target new consumers, notably women. Meanwhile, 200 000 Brazilians die every year from tobacco-related diseases, according to the National Cancer Institute (INCA). One area in which Brazilian tobacco control has faltered is in the enforcement of other key tobacco control measures, such as smoking bans in enclosed public places. Although Brazil ratified the WHO Framework Convention on Tobacco Control in 2005, requiring the country to pass laws to restrict tobacco, it has not done this. For that reason, many states and municipalities have taken matters into their own hands by passing their own laws banning smoking from public places with no separate places designated for smokers. However, these by-laws have been challenged as unconstitutional by the hospitality industry and could be overturned by the supreme court. So far four states and eight municipalities have introduced smoking bans in process that Costa e Silva characterizes as a effect. August, big domino went down when the state of Sao Paulo passed its own law banning smoking in enclosed public places. Previous attempts to ban smoking in Sao Paulo have failed as result of weak enforcement and public apathy, but this time things may be different. Sao Paulo state health secretary, Luiz Roberto Barradas Barata, says that 99.5% of the state's pubs, restaurants and hotels are committed to upholding the law. In the last month, we monitored 37 000 places and applied only 198 fines, he says. Establishments in breach of the ban are fined up to US$ 750 for first offence, with the fine doubling for repeat offence. A third breach entails closure of the business for 48 hours and fourth shuts it down for 30 days. Not everyone is happy about the bans. Alexandre Sampaio, president of the Pubs, Restaurants and Hotels Syndicate in the state of Rio de Janeiro claims that such initiatives are unconstitutional. He says that Riffs hospitality industry has suffered 20% decline in visits to restaurants and bars as result of the ban, which the state legislature passed into law but that has yet to come into force. He also argues that the government should be committing resources to informing the public, teenagers in particular, about the dangers of smoking, rather than restricting the spaces in which people can smoke. In few years we would have fewer smokers, he says. [ILLUSTRATION OMITTED] Of course, while banning smoking in public places protects the health of non-smokers, many smokers need more than bans to help them quit. On the cessation front, Brazil is throwing its weight behind nicotine replacement therapies--a move strongly endorsed by the World Health Organization (WHO), which in May of this year put nicotine replacement therapy on the Essential Medicines List (EML). This is public health victory, according to Costa e Silva, who believes that this recent decision by WHO will encourage Brazil and other countries to see nicotine replacement therapy as equally important as any other drug used for prevention purposes and promote cheaper commercial forms of nicotine replacement therapies. …

Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955 – 1975

Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955 – 1975

The Conquest of Lead Poisoning: A Pyrrhic Victory

The Conquest of Lead Poisoning: A Pyrrhic Victory

Health and security in foreign policy.

Introduction Historically, health has occupied the lower echelons of national priorities. Over the past decade, however, national policy-makers have increasingly recognized the deleterious impacts that health crises may have on national interests. As a result, particular health issues occasionally have been elevated within national agendas, especially if they have implications for foreign policy and/or they are perceived as threats to national security. Identifying a health issue as a foreign policy or security issue, or both, may lead to higher prioritization and more attention from top policy-makers, in turn, bringing greater political support and more funding. (1) While health professionals may welcome the higher profile and greater resources given to their issues, characterizing a health issue as a national priority (and particularly as a security issue) may change the understanding of a health threat, put relatively greater emphasis on the views of those outside the health community and potentially alter the approach to solving the problem. Consequently, care should be taken in deciding which health issues should be given priority on par with national security issues and included explicitly in national foreign policy. We support the assertion that [w]hile it is clear that health issues often intersect with security issues, not all health challenges represent security concerns. (2) Health issues that do not pose security threats should not be contextualized as such, since doing so may detract from overarching public health and foreign policy objectives. At the same time, however, we believe that efforts to address all types of health issues through foreign policy contribute to overall improvements in diplomatic relations, which may enhance the security of countries. Health in foreign policy Many health challenges, particularly infectious diseases, are widely recognized as global concerns that do not respect borders. As a result, countries often include in their foreign policies strategies on diseases that have the potential to threaten domestic interests. Public health challenges that are not concomitant security threats should be given consideration as foreign policy priorities on their own merits, without forcing them to be viewed through the prism of national security. One example of a health issue that is addressed through foreign policy but is not a security issue is poliomyelitis. The eradication of polio requires sustained financial commitments and coordinated international efforts. Such coordination has resulted from countries negotiating high-level political commitments under the auspices of the Group of Eight (G8) and other organizations that are not typically seen as health institutions. Despite polio's role as a major cause of disability (and consequent loss of productivity), donor commitment to the Polio Eradication Initiative is not rooted in a concern for its economic or security impact, but in the belief that eradication would be a major victory for public health and would achieve a global good. The impetus for the international effort against polio is not national security concerns but an altruistic desire to ameliorate human morbidity and mortality. Thus, it can be argued that polio eradication is a foreign policy issue for countries, but not a national security issue. Although characterizing a health issue as a foreign policy issue may provide greater visibility and greater funding, there is also a likelihood that programmes associated with such health priorities may be subject to enhanced political scrutiny. Additionally, identifying a particular health issue as a national (or international) priority inherently alters its importance relative to other public health issues. Since resources are generally limited and new funding is difficult to obtain, there is a great risk that the prioritized disease will draw resources away from other health programmes. …

Improvements in prenatal insurance coverage and utilization of care in California: an unsung public health victory.

To examine trends in prenatal insurance coverage and utilization of care in California over two decades in the context of expansions in Medi-Cal (California's Medicaid) and other public efforts to increase prenatal care utilization. Retrospective univariate and bivariate analysis of prenatal care coverage and utilization data from 10,192,165 California birth certificates, 1980-99; descriptive analysis of California poverty and unemployment data from the U.S. Census Bureau Current Population Survey; review of public health and social policy literature. The proportion of mothers with Medi-Cal coverage for prenatal care increased from 28.2 to 47.5% between 1989 and 1994, and the proportion uninsured throughout pregnancy decreased from 13.2 to 3.2%. Since the mid-1990s, fewer than 3% of women have had no insurance coverage for prenatal care. Between 1989 and 1999, the proportion of women with first trimester initiation of prenatal care increased from 72.6 to 83.6%, reversing the previous decade's trend, and the proportion of women with adequate numbers of visits rose from 70.7 to 83.1%. Improvements in utilization measures were greater among disadvantaged social groups. Improvements in California during the 1990s coincided with a multifaceted public health effort to increase both prenatal care coverage and utilization, and do not appear to be explained by changes in the economy, maternal characteristics, the overall organization/delivery of health care, or other social policies. While this ecologic study cannot produce definitive conclusions regarding causality, these results suggest an important victory for public health in California.

A Book To Make You Think

While the US tobacco industry settled the mammoth tobacco suits lodged by the 50 US states, elsewhere in the world the tobacco giants continue their denials and questionable marketing practices seemingly oblivious. From this perspective, the events described in Michael Orey's book seem more like a minor skirmish on the edge of the tobacco control movement than a victory for the combined forces of governments and the public health community. Keeping in mind this minor quibble, Assuming the Risk is a tremendously readable and interesting book. Like the fictional novels of John Grisham, it is the characters who drive much of the book's plot. As with most events that change the course of a movement, the US Master Settlement Agreement truly began years earlier in a small and poor county of the poorest state in the United States. Thus, starting with the Willie Horton case, which would serve as the linchpin and common reference point for the proceedings that followed, readers are led through the many cases and events that would culminate, years later, with Mississippi's decision to file suit against the US tobacco industry, a move subsequently followed, probably most notably by Minnesota, by the remaining 49 states. As Orey proceeds with his discussion, readers are introduced to a growing cast of characters, their every personality quirk and foible apparently disclosed by the author. Thus we are told of Merrill Williams' quasi-neurotic tantrums, Jeffery Wigand's difficult temperament, and Mike Moore's career-long determination to do good, as well as many other thumbnail portraits. Where Orey leaves readers wanting is in not discussing the merits of the US states' litigation-driven strategy. Is the $246 billion Master Settlement Agreement really a victory for public health? People are now questioning whether any deal made with the tobacco industry can ever be consistent with the interests of public health. While discussing the role of Congress in legislating the first multi-state agreement, Orey never addresses the apparent lack of coherence exhibited by US politicians on the issue of tobacco control. After reading this book, you get the feeling that the US public and politicians feel that no further legislative or regulatory action is necessary now that the tobacco industry has been forced to pay. Perhaps one cannot fault Orey for sticking to what he does best, which is describing the situations, the people, and the maneuvering that lead to US tobacco's first major setback. Written in a journalistic style that eschews legal jargon in favor of plain language, this book will be of most interest to those outside the legal profession. If not a must read, at least a good read.

The challenge of North Queensland fevers.

SUMMARYThe distribution of fevers in North Queensland may largely be correlated with latitude, altitude and rainfall.In the Gulf country and on mining fields in the early days, typhcid and malaria were major causes of fever. Other cases were commonly designated “typho‐malaria”.On the Pacific coast, the incidence of fevers has been high since the eighties. At first obscure in nature, they have been shown to consist mainly of leptospirosis and scrub typhus.Many minds contributed to the elucidation of the northern fevers ; the staff of the Australian Institute of Tropical Medicine at Townsville played a notable part from 1910 to 193o. Repeatedly, an advance had to await the coming of the right man.The disappearance of typhoid and malaria from the mainland of North Queensland is a public health victory. The means to prevent dengue and to lessen scrub typhus are to hand, but the prevention of leptospirosis is an unsolved problem.