Regional Public Health Policies Research Articles

Assessing the health and economic burden of obesity-related complications in East-Asian populations: implementation of risk equations in the Core Obesity Model for Japan and model validation

ObjectiveObesity is associated with a significant clinical and economic burden and its prevalence has reached epidemic proportions worldwide. An ethnicity-specific impact of excess weight has been demonstrated, with Asian individuals...

ASSISTÊNCIA MATERNO-INFANTIL DE GESTANTES COM DIAGNÓSTICO DE SÍFILIS EM UMA MATERNIDADE NO INTERIOR DO ESTADO DE SÃO PAULO

The objective of this study is to evaluate the maternal and infant care of pregnant women infected with syphilis. A retrospective cross-sectional study was carried out of syphilis cases in pregnant women treated at a public hospital in the interior of São Paulo who presented a positive rapid test for syphilis at delivery in 2020. The rate of syphilis found during pregnancy was 45.6 per 1000 live births. In total, 82% of the pregnant women who were diagnosed with syphilis during prenatal care received the recommended treatment and 100% of these pregnant women attended at the maternity hospital studied were treated in accordance with the guidelines of the STD/AIDS Reference and Training Center of the Health Department of São Paulo. Regional public health policies should prioritize campaigns to prevent sexually transmitted infections and review prenatal care processes so that all pregnant women infected with syphilis receive the recommended treatment.

Liver cancer in Hidalgo State, Mexico: analysis of the status, risk factors and regional public health policy requirements: a cross-sectional correlational study.

ABSTRACTBACKGROUND: In Latin America, liver cancer is one of the top causes of cancer mortality. It is the fifth most common cause of death among malignant tumors in Mexico and is the leading cause in Hidalgo State (43.8% of the population living in poverty).OBJECTIVE: To conduct a correlational analysis on the main risk factors for liver cancer in Hidalgo State, Mexico, including municipal disaggregation and comparison with the national level.DESIGN AND SETTING: Cross-sectional, correlational, descriptive and comparative epidemiological study using Mexican governmental databases covering 1990-2019.METHODS: A comprehensive review of the databases of the General Directorate of Health Information (DGIS) was performed to analyze official death figures, hospital discharges and national and municipal population projections, using specific search criteria defined in the Global Burden of Disease classification, based on the risk factors for liver cancer.RESULTS: Liver cancer rates showed an evident rise in Hidalgo (183%), moving from 21st place in Mexico in 1990 to 9th place in 2019. This increase was correlated with alcoholism. An increasing trend for liver cancer deaths, of 133.89%, is projected for 2030. Females and the population over 60 years of age are more affected. There are some critical regions with liver cancer death rates twice the national rate or more.CONCLUSION: Targeted effective public health strategies should be structured by identifying, characterizing and regionalizing critical marginalized municipalities that are vulnerable to alcoholism and other risk factors for liver cancer. This approach may be helpful for other states in Mexico or similar countries.

Spatial autocorrelation and stratified heterogeneity in the evaluation of breast cancer risk inequity and socioeconomic factors analysis in China: Evidence from Nanchang, Jiangxi Province.

Study of socioeconomic factors can play an important role in the spatial distribution of breast cancer by leading to a better understanding of its spatial pattern and assist breast cancer screening and early diagnosis. Taking Nanchang, a major city in central China, as an example, spatial autocorrelation and stratified heterogeneity were applied using a 10 10 km grid division to analyse breast cancer risk and socioeconomic factors. The research results showed that the median incidence rate of female breast cancer in Nanchang from 2016 to 2018 was 6.6/100,000 with a standard deviation of 12.3/100,000. Areas with higher incidence rates were mainly located in the central urban area and the major county towns. Spatial regression analysis showed that there was a statistically significant correlation between the spatial patterns of breast cancer incidence on the one hand, and on the other socioeconomic factors, such as total gross domestic product (GDP), per capita GDP and density of places of social and economic activities, i.e. points of interest. In addition, the normalized difference vegetation index also played a part in this respect. This research could serve as a reference for regional public health policy formulation and breast cancer screening.

Correlates of attitudes toward COVID-19-related public health policies and prevention practices in six states

Objectives: The COVID-19 pandemic rapidly impacted communities, however there is limited information about the beliefs, behaviors, and trust in government responses of populations across the country. It may be especially useful to understand state-based and regional differences that people reported early in the pandemic, to inform national and regional public health policies and communication strategies. This paper reports on correlates of perceptions of state and federal policies and prevention practices in six states with varying trajectories of COVID-19 cases and deaths, during the first major wave of the pandemic. Methods: A cross-sectional survey of COVID-19 policies, perceptions, and behaviors in six states (three in the northeast/mid-Atlantic and three in the southeastern United States), was conducted in April 2020 using an online platform of research volunteers. The survey asked about demographics; use of and belief about the effectiveness of preventive behaviors; experience with COVID-19 testing, diagnosis, quarantine, and hospitalization; risk behaviors and perception; opinion of local, state, and federal government guidelines and information; sources of information; and scales measuring time perspective and collectivism/individualism. Results: Responses from 1476 adults in six states showed that the most often-practiced prevention practices involved social distancing, and that reactions to federal government policies differed regionally and by political party affiliation. Conclusions: These findings improve understanding of how Americans view government responses to the pandemic, and their prevention practices, early in the pandemic. These data will help to create more effective public health policies to control the pandemic and achieve public support for control measures.

EXPRESSIONS AND REGULATORY MECHANISM OF AUTOPHAGY-RELATED GENES IN SYNOVIAL TISSUE OF OSTEOARTHRITIS

Purpose: With the acceleration of aging worldwide, osteoarthritis (OA) has gradually become a common orthopedic disease among the middle-aged and elderly. Epidemiological investigation showed that the overall incidence of OA patients over 65 years old in China was 8.1%. The joint pain and disability caused by OA are relatively prominent and coupled with the easy loss of labor ability, which has seriously affected the health and become one important social issue. Therefore, it is of great significance to explore the etiology and pathogenesis of OA and take its prevention and treatment as the focus of regional public health policy.

Towards a Public Health Approach to Homicides in Mexico

Background: Homicide was the fifth cause of death in Mexico in 2019 and has been among the top ten causes of death since 2009. Despite its relevance, homicide has neither been considered a public health problem by health authorities nor has been a point of focus for the development of effective prevention strategies, compared to other leading and preventable causes of death. This study aims to establish homicide as a relevant public health problem in Mexico. Methods: We analyzed publicly available data in Mexico from 1998 to 2019 to calculate homicide rates and compare them to other causes of death stratified by age and sex. We also described the age, period, and cohort trends of homicides. Findings: Homicide has been the leading cause of death for both sexes for several age groups since 2010, surpassing cardiovascular disease, diabetes mellitus, cancer, and accidents. Since 2018, homicides have been the main cause of death for females 15 to 24 years old and the second cause of death for 25 to 34 years old. Males 25 to 34 years old experienced the highest homicide rates across all the study period, exceeding 1 per 1,000 in 2019. Interpretation: Homicides are one of the major causes of death in Mexico and currently represent a national public health threat. This study reveals important patterns of homicide deaths that can inform national and regional public health policy. Funding: This study was supported by grants from Open Society Foundations (OSF) and the Drug Policy Program at CIDE. Declaration of Interests: FAE reports funds from Open Society Foundations (OSF) and the Drug Policy Program at CIDE. All authors declare no competing interests.

Socioeconomic inequalities in overall and COVID-19 mortality during the first outbreak peak in Emilia-Romagna Region (Northern Italy).

to provide a description of inequalities in overall and COVID-19 mortality by ecological socioeconomic measures (ESEMs) during the first outbreak peak (March and April 2020) in Emilia-Romagna Region. cross-sectional study based on the record linkage of the COVID-19 notification system, the regional population health register and the 2011 census data. residents in Emilia-Romagna who were grouped according to three ESEMs calculated at census block level: the index of deprivation, the household crowding, and the percentage of the foreign resident population. counts of all deaths and those directly attributable to COVID-19. The association between mortality and ESEMs was assessed through rate differences and mortality rate ratios, estimated through Poisson models. during the outbreak peak, the nine provinces of the Emilia-Romagna Region were unequally hit by the COVID-19 outbreak, with Piacenza recording the highest COVID-19 absolute death toll and Ferrara the lowest. The overall and COVID-19 mortality burden was unequal also in terms of ecological socioeconomic measures. Percentage differences in the age-standardised mortality rates between the least and the most disadvantaged census blocks were greater for COVID-19 mortality than for overall mortality, suggesting that the Coronavirus outbreak has had a stronger impact on the most socioeconomically deprived areas. Although clear gradients were not always present, people living in the most disadvantaged census blocks experienced the highest absolute and relative risk of dying. Rate differences were larger among men, but mortality rate ratios were not always greater among men than women, especially for the COVID-19 mortality. these descriptive yet informative results are relevant to document inequalities and inform regional public health policies and interventions in case of new COVID-19 surges.

Application of GIS Spatial Analysis and Scanning Statistics in the Gynecological Cancer Clustering Pattern and Risk Screening: A Case Study in Northern Jiangxi Province, China.

ObjectiveThe incidence of gynecological cancer is high in China, and the effects of related treatments and preventive measures need to be improved.MethodsThis study uses GIS spatial analysis methods and a scanning statistical analysis to study the major gynecological cancers in northern Jiangxi Province from 2016 to 2018.ResultsThe incidence and spatial pattern of cervical cancer, ovarian cancer, and uterine cancer had agglomeration characteristics and changes during the study period. The gynecological cancer had a spatial autocorrelation and agglomeration in its spatial pattern. The Moran’s Index of the overall gynecological cancer incidence rate was 0.289 (p = 0.005). Ripley’s L(d) function showed that the agglomeration radius was between 51.40 and 52.82 km. The results of the kernel density estimation showed that the cases of gynecological cancer were concentrated in the central and northeastern areas of the study area. The overall county-level incidence of gynecological cancer varied from 0.26 to 11.14 per 100,000. The results of the gravity center analysis showed that the spatial distribution of the gravity center point of gynecological cancer had moved toward the east during the past three years. The results of a hotspot analysis showed that there were five hotspot areas that had gynecological cancers. The most likely clusters of gynecological cancer at the county level in northern Jiangxi Province were distributed in the adjacent areas of Jiujiang, Yichun, and Nanchang, with a relative risk of 1.85.ConclusionThe research shows that GIS can display the distribution of cancer cases and can use spatial analysis methods and scanning statistical techniques to obtain key areas of cancer incidence. These results can provide data and key areas for the formulation of regional public health policies and provide recommendations for cancer screening and the rational allocation of health resources.

Epstein-Barr Virus Infection and Opisthorchiasis: A Story of Cholangiocarcinoma in the Highly Endemic Area

Dear Editor, Cholangiocarcinoma is an important hepatobiliary cancer. It is considered a deadly cancer. This cancer is very common in Indochina area and there are several deaths due to this cancer every year. This cancer is usually late detected. The patients usually present with severe obstructive jaundice. The advanced cancer is usually seen at first diagnosis and it is usually a non resectable mass. Hence, only palliative care is usually provided to the patients with cholangiocarcinoma. The main endemic countries of cholangiocarcinoma are Laos People’s Democratic Republic and Thailand (1). Hundreds of new cases of cholangiocarcinoma are registered in the endemic area (1). The prevention of the cholangiocarcinoma becomes the regional public health policy. It is accepted that chronic opisthorchiasis is the main risk factor of cholangiocarcinoma in this region (1). Of interest, opisthorchiasis is a fluke infestation. The infestation is usually a result of intake of contaminated fresh water fish that is not well cooked. Of interest, raw fish dish is a common local dish in the endemic area, Indochina. In the endemic area, there is a campaign to promote cancer prevention by avoidance of raw fish intake (2). However, there are many additional factors that can promote the cholangiocarcinogenesis including exposure to nitrosamine contamination in local food (3, 4) and exposure to contaminated pesticide in local food (3, 4). An important possible risk is the concurrent infection. Indeed, there are many tropical infections in the endemic area and some might be considered as risk for promoting cholangiocarcinogenesis. For example, concurrent hepatitis B infection is proved to be a risk (5, 6). It is noted that there is a very high rate of hepatitis B seropositive among patients with cholangiocarcinoma (5, 6). Indeed, the concurrent viral infection should be specially focused on since many viruses are proved to have the cytopathogenic effect. In fact, the virus infection is proved for induction of carcinogenesis in many cancers such as uterine cervix cancer, nasopharyngeal cancer and hepatocellular cancer. Hence, it is no doubt that the virus infection might have possible role in carcinogenesis of cholangiocarcinoma. Of several viruses, the Epstein-Barr virus should be mentioned. In oncology, Epstein-Barr virus infection is proved for relationship to carcinogenesis of nasopharyngeal cancer. Focusing on cholangiocarcinoma, there are many reports indicating that Epstein-Barr virus infection might cause cellular aberration and this can superimpose the pathology due to chronic opisthorchiasis resulting in increased chance of cholangiocarcinoma development (7). It should be hereby noted that Epstein-Barr virus infection does not directly induce the carcinogenesis of biliary tract but its cytopathogenic effect superimpose the problem (7, 8). Focusing on Epstein-Barr virus infection, the seroprevalence of this infection is also extremely high in the Indochinese endemic area of opisthorchiasis and cholangiocarcinoma (9). However, there has never been a study on the possible interrelationship between Epstein-Barr virus infection, opisthorchiasis and cholangiocarcinoma in the Indochinese endemic area. Since the Epstein-Barr virus infection is also a disease that relating to poor hygiene (10), the promotion of hygienic behavior and avoidance of oral contact to others to prevent the concurrent Epstein-Barr virus infection should also be suggested to the local people in in the Indochinese endemic area of cholangiocarcinoma.

Le développement de l'éducation thérapeutique du patient au sein des régions françaises

Therapeutic patient education (TPE) constitutes a new type of prevention and care being offered in France. This article presents a review of its current organisation and status within the country. The work was carried out based upon a questionnaire targeted towards all of the Regional Social Insurance Registry Unions (URCAM). Nearly all of the regions are supported and served by a regional advisory group which most often times facilitated by a representative from the social health insurance office. The development of TPE is situated and structured, for the most part, within the regional public health policy. Training which is specifically targeted for health professionals remains quite erratic. The hospital continues to play an important role and is a driving force, along with the health care networks, in the development of TPE. The close involvement and participation of the general family practitioner and the organisation of high quality, comprehensive care options (through the dissemination of defined criteria and specifications) are the priority areas for action.

Towards a common public health strategy for the region of South Eastern Europe

Aim A seminar organised in the framework of the Public Health Collaboration in South Eastern Europe programme (PH-SEE), Belgrade, Serbia and Montenegro, 23–28 August 2004, aimed to answer the question: Is there a real need for a regional public health policy framework in South Eastern Europe (SEE)? The answer is probably yes because the specific situation in the SEE region has to be taken into account for the development of relevant and realistic public health goals.