Public Health Specialists Research Articles

Developing A Clinical Evidence Retrieval Service in Response to the COVID-19 Pandemic

In response to the COVID-19 pandemic, policies, and treatment guidelines underwent rapid and frequent change. This threatened to disrupt the measured practice of evidence-based medicine (EBM), which relies on tried-and-tested interventions. The uncertainty was compounded by the overwhelming amount of misinformation disseminated via social media. Thus, arose a need for valid information to guide clinical practice. COVID-19 Evidence Retrieval Service (CERS), an evidence retrieval service piloted at a local and then rolled out at a national level, was conceived and developed to address this issue. This article describes the components and implementation of the (CERS), The service’s objective was to review the available medical literature for the best evidence to answer COVID-19-related questions posed by practicing clinicians. Team members providing the service comprised librarians, clinicians, public health specialists, and medical students. Multiple lessons were learned through the development and provision of CERS. Firstly, the rapid nature of the pandemic necessitated adaptations of the current practice of EBM. Secondly, all work processes were conducted online, which proved efficient and sustainable. Thirdly, Lower Middle-Income Country (LMIC) oriented services such as CERS were valid because they provided more relevant questions to resource-limited healthcare systems. Our experience has reinforced that an integrated, evidence-based retrieval service is feasible and valuable to support healthcare workers and policymakers in making informed decisions by performing a systematic appraisal. Crucially, medical students and young healthcare professionals can play a pivotal role in setting up these services.

Fluoride; An Updated Review

Background: Fluoride can arrest dental caries and prevent its progression. The most important advantage of fluoride is that there is no need for cavity preparation; in this respect, it eliminates the utilization of air motors. Furthermore, it provides a good choice for younger children without cooperation ability and patients requiring special care. This study aimed to review the literature about fluoride and to advise public health specialists about the types of fluoride and that fluoride is still a right and safe choice in the COVID-19 pandemic. Methods: Through a search in electronic databases containing Medline, Scopus, Web of Science, and PubMed, a total of one hundred forty-two systematic reviews and original articles in the period of 2008-2021 were selected. The following keywords were used: pediatric dentistry, coronavirus, oral health, tooth remineralization, COVID-19, fluoride, dental fluorosis, and preventive dentistry. Results: Data from selected papers was extracted and classified to evaluate the importance of fluoride in the prevention of dental caries. Fluoride has been selected as a good choice for the prevention and control of dental caries during the coronavirus pandemic. Conclusion: The research has focused on increasing the awareness of public health specialists, advising them that any type of fluoride use is expedient and safe during the COVID-19 pandemic.

News from the European Journal of Therapeutics: A new issue and a new editorial board

News from the European Journal of Therapeutics: A new issue and a new editorial board

P-336 Presence of stage III/IV endometriosis associated with systemic inflammation poses as individual risk factor for coronary heart disease in Indian women: Inklings for the search

Abstract Study question Can investigating endometriosis—cardiovascular interaction identify women with stage III/IV endometriosis and elucidate pathophysiology of the female heart at a broader level? Summary answer Endothelial dysfunction can occur in absence of structural atherosclerotic changes in young Indian women with endometriosis urging lifelong multidisciplinary care to manage long-term health impact. What is known already Chronic inflammation, enhanced oxidative stress, endothelial dysfunction, and cellular proliferation are hallmarks of both atherosclerosis and endometriosis with unveiled cellular and molecular overlaps between the duos. Further, treatment/s of endometriosis, like, hysterectomy or oophorectomy and/or analgesics confer increased risk of coronary heart disease (CHD) to women with endometriosis. However, CHD in women with endometriosis remains understudied, under-recognized, and underdiagnosed. Incidentally, early atherosclerosis cannot be explained exclusively by traditional cardiovascular risk factors. Aim of the present study was to correlate subclinical atherosclerosis with metabolic parameters and markers of endothelial inflammation in Indian women with stage III/IV endometriosis. Study design, size, duration This observational prospective cohort study constituted 1407 consented women diagnosed with laparoscopically confirmed endometriosis (Group A; n = 718) with age matched control (Group B; n = 689) (counterpart/s of male infertility) from October 2021 to September 2022. Sub-clinical atherosclerosis was investigated before laparoscopy by ultrasound evaluation of carotid intima-media thickness (cIMT) and flow-mediated dilation (FMD). Serum samples were stored at -80 °C for evaluation of biochemical and inflammatory parameters. European Society of Cardiology guidelines were followed for standard definition/s. Participants/materials, setting, methods Traditional (obesity, hypertension) and metabolic (dyslipidaemia, diabetes, hyperhomocysteinemia) cardiovascular risk factor/s were assessed during evaluation and chemiluminescence respectively. Serum levels of interleukin (IL)-6, IL-8, IL-10, TNF-a, VEGF, and VCAM-1 were determined by enzyme-linked-immunosorbent assay/s. Univariate comparisons and bivariate correlations were conducted by Student’s t-test, and Spearman correlation respectively. Adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated by Cox-proportional hazard/s model among Group A vs Group B. Statistical significance was set at p < 0.05. Main results and the role of chance 62.95% and 37.04% women had stage III and stage IV endometriosis respectively as defined according to European Society for Human Reproduction and Embryology 2014 guideline. aRR (adjusted for demographic, obesity, diabetes mellitus, reproductive history, and migraine), documented a higher risk of hypertension (aRR 1.43; 95%CI 1.33–1.54) in women with endometriosis. On stratification of group A in less than and more than 40 years, laboratory parameters were similar except for significantly higher (p < 0.01) serum values of homocysteine, low density lipoprotein and cholesterol, in both age range of group A. FMD, indirect marker of endothelial dysfunction, was found to be lower in group A compared to controls (mean difference: −7.54, 95% CI: -10.32− -4.73; p< 0.001, however, cIMT was similar between both cohort/s. aRR of endometriosis in relation with hypercholesterolemia (1.07; 95%CI 1.01–1.25; p < 0.001), hypertension (1.22; 95%CI 1.14–1.30; p < 0.001), and hyperhomocysteinemia (1.04; 95%CI 0.96–1.12; p < 0.08) decreased with increasing age (>40 years). Systemic inflammation markers, showed an inverse relationship (p < 0.001) between values of FMD and serum levels of IL-6 (r = –0.34), TNF-a (r = –0.85), and VCAM-1 (r = –0.28) in group A. Other correlations were not statistically significant. Limitations, reasons for caution This observational study is not supported by patients with typical cardiovascular risk factors and hence limits generalizability of evidence to other ethnicities. Further, no information on hormonal treatments, such as dianogest (a synthetic progesterone) and/or leuprolide (gonadotropin-releasing hormone analog) are available to assess extent of association between endometriosis and CHD. Wider implications of the findings Higher propensity of subclinical atherosclerosis in younger women with laparoscopically-confirmed endometriosis represent higher systemic inflammation cueing to increased risk for CHD. This suggests the need for risk awareness and subsequent screening for CHD and healthy lifestyle promotion among gynaecologist/s and public health specialists. Trial registration number Not applicable

Knowledge and training of Italian students in Healthcare Settings on COVID-19 vaccines and vaccination strategies, one year after the immunization campaign.

COVID-19 vaccines represent an important opportunity for defeating the disease, as long as high vaccination acceptance rates are achieved. Healthcare workers (HCWs) have a relevant role in the promotion of immunization among the population and since students in healthcare area will be HCWs it is crucial to provide more in-depth knowledge on vaccinations. Therefore, the aim of the study is to assess the knowledge of medical and pharmaceutical area students regarding COVID-19 vaccination and the impact of a specific Elective Teaching Activity (ETA) on the increase of students' knowledge. The ETA was held one year after the immunization campaign in Italy. Students' knowledge was tested with a questionnaire before and after attending the course. Descriptive statistical methods were used to analyse the results obtained. Student's t-tests for paired data were used. Overall, 387 students at the University of Florence attended the course and took the same test before and after the ETA on COVID-19 vaccines. Despite achieving satisfactory average scores in the pre-course test (26/32 ± 4.0), all students were able to significantly enhance their final score (+17.1%; p < 0.001), indicating that the ETA was highly effective in improving their knowledge of COVID-19 vaccination. Medical students demonstrated a better comprehension of the role of the medical specialist in public health in the COVID-19 vaccination campaign, while some uncertainties were revealed regarding the role of pharmacists. The results of this study confirm that specific training activities on vaccination are effective for implementing the knowledge of future health professionals.

Molecular identification of Acanthamoeba spp., Balamuthia mandrillaris and Naegleria fowleri in soil samples using quantitative real-time PCR assay in Turkey; Hidden danger in the soil!

Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri are pathogenic free-living amoeba (FLA) and are commonly found in the environment, particularly soil. This pathogenic FLA causes central nervous system-affecting granulomatous amebic encephalitis (GAE) or primary amebic meningoencephalitis (PAM) and can also cause keratitis and skin infections. In the present study, we aimed to determine the quantitative concentration of Acanthamoeba spp., B. mandrillaris, and N. fowleri in soil samples collected from places where human contact is high by using a qPCR assay in Izmir, Turkey. A total of 45.71% (n = 16) of Acanthamoeba spp., 20% (n = 7) of B. mandrillaris, and 17.4% (n = 6) of N. fowleri were detected in five different soil sources by the qPCR assay. The quantitative concentration of Acanthamoeba spp., B. mandrillaris, and N. fowleri in various soil sources was calculated at 10 × 105 - 6 × 102, 47 × 104 to 39 × 103, and 9 × 103 – 8 × 102 plasmid copies/gr, respectively. While the highest quantitative concentration of Acanthamoeba spp. and B. mandrillaris was determined in garden soil samples, N. fowleri was detected in potting soil samples. Three different genotypes T2 (18.75%), T4 (56.25%), and T5 (25%) were identified from Acanthamoeba-positive soil samples. Acanthamoeba T4 genotype was the most frequently detected genotype from soil samples and is also the most common genotype to cause infection in humans and animals. To the best of our knowledge, the present study is the first study to identify genotype T5 in soil samples from Turkey. In conclusion, people and especially children should be aware of the hidden danger in the garden and potting soil samples that come into contact most frequently. Public health awareness should be raised about human infections that may be encountered due to contact with the soil. Public health specialists should raise awareness about this hidden danger in soil.

Lead's lingering legacy

Lead's ability to cross the placenta and disrupt the neurodevelopment of the fetus is well known. But perhaps equally disturbing is the fact that avoiding the element during pregnancy may not be enough to safeguard the unborn child. Lead lingers, both in the environment and within the body, as do its effects. It accumulates in the bones, where it can remain for decades. Howard Hu is a specialist in preventive medicine and public health at the University of Southern California (Los Angeles, CA, USA). “An expectant mother can do all the right things, live a very clean life, and stay far away from toxins and pollutants, but the lead in her bones can still leach into the blood and damage the foetus”, he pointed out. “If we allow children to be exposed to lead, we are not just putting them at risk of lifelong harm, we are endangering future generations.”

Assessment of knowledge gaps about ionizing radiation among public health specialists in Lithuania

Assessment of knowledge gaps about ionizing radiation among public health specialists in Lithuania

Localizing COVID-19 Misinformation: A Case Study of Tracking Twitter Pandemic Narratives in Pennsylvania Using Computational Network Science

The recent COVID-19 outbreak has highlighted the importance of effective communication strategies to control the spread of the virus and debunk misinformation. By using accurate narratives, both online and offline, we can motivate communities to follow preventive measures and shape attitudes toward them. However, the abundance of misinformation stories can lead to vaccine hesitancy, obstructing the timely implementation of preventive measures, such as vaccination. Therefore, it is crucial to create appropriate and community-centered solutions based on regional data analysis to address mis/disinformation narratives and implement effective countermeasures specific to the particular geographic area. In this case study, we have attempted to create a research pipeline to analyze local narratives on social media, particularly Twitter, to identify misinformation spread locally, using the state of Pennsylvania as an example. Our proposed methodology pipeline identifies main communication trends and misinformation stories for the major cities and counties in southwestern PA, aiming to assist local health officials and public health specialists in instantly addressing pandemic communication issues, including misinformation narratives. Additionally, we investigated anti-vax actors’ strategies in promoting harmful narratives. Our pipeline includes data collection, Twitter influencer analysis, Louvain clustering, BEND maneuver analysis, bot identification, and vaccine stance detection. Public health organizations and community-centered entities can implement this data-driven approach to health communication to inform their pandemic strategies.

Cognitive Functioning, Dependency, and Quality of Life Among Older Adults

ABSTRACT The determinants of QoL need serious deliberation in national as well as international healthcare guidelines as few studies have assessed the QoL of older individuals across cultures and countries. The current cross-sectional study aimed to examine the relationships between cognitive functioning and level of dependency with quality of life (QoL) and the moderating effects of gender and housing type on these relationships among older adults in Pakistan. A total of 274 respondents (own homes = 153; care homes = 121; Mage = 68.75 years, SD = 5.78 years) participated in this study. Cognitive functioning was assessed through Montreal Cognitive Assessment (MoCA), while level of dependency was assessed through Incapacity Status Scale (ISS). As for the measurement of QoL, World Health Organization Quality of Life (WHOQOL-BREF) instrument (Urdu version) was adopted. The results of Pearson product-moment correlation revealed the significant relationships of the constructs of interest. Cognitive functioning significantly predicted social QoL for males only but did not significantly predict the overall QoL and its four domains (i.e. physical, psychological, social relationship, and environmental health domains), regardless of housing type (i.e. own homes versus care homes). Meanwhile, the results of regression analysis demonstrated the significance of level of dependency in predicting the overall QoL and its four domains for both male and female respondents. As for those living in their own homes, the level of dependency significantly predicted their overall QoL, as well as physical and environmental QoL. For the older adults living in care homes, cognitive functioning predicted only the social QoL for males, but did not predict the overall QoL or its domains for older individuals in care homes or own homes. Based on these findings, this study demonstrated the significance of cognitive functioning, level of dependency, gender, and housing-type care homes as determinants of QoL among older adults. The study findings have implications for policymakers, practitioners, and public health specialists to cautiously create content that will enhance the older individuals’ QoL. Findings can contribute to designing interventions to motivate and preserve functional mobility in older individuals, and the generate community-based programs to enhance or uphold physical activity in the older individuals.

Dutch Healthcare Professionals' Opinion on the Allocation of Responsibilities concerning Prescribing and Administering Medically Indicated Vaccines to Immunocompromised Patients.

Specific vaccines are indicated for immunocompromised patients (ICPs) due to their vulnerability to infections. Recommendation of these vaccines by healthcare professionals (HCPs) is a crucial facilitator for vaccine uptake. Unfortunately, the responsibilities to recommend and administer these vaccines are not clearly allocated among HCPs involved in the care of adult ICPs. We aimed to evaluate HCPs' opinions on directorship and their role in facilitating the uptake of medically indicated vaccines as a basis to improve vaccination practices. A cross-sectional survey was performed among in-hospital medical specialists (MSs), general practitioners (GPs), and public health specialists (PHSs) in the Netherlands to assess their opinion on directorship and the implementation of vaccination care. Additionally, perceived barriers, facilitators, and possible solutions to improve vaccine uptake were investigated. In total, 306 HCPs completed the survey. HCPs almost unanimously (98%) reported that according to them, the primary treating physician is responsible for recommending medically indicated vaccines. Administering these vaccines was seen as a more shared responsibility. The most important barriers experienced by HCPs in recommending and administering were reimbursement problems, a lack of a national vaccination registration system, insufficient collaboration among HCPs, and logistical problems. MSs, GPs and PHSs all mentioned the same three solutions as important strategies to improve vaccination practices, i.e., reimbursement of vaccines, reliable and easily accessible registration of received vaccines, and arrangements for collaboration among the different HCPs that are involved in care. The improvement in vaccination practices in ICPs should focus on better collaboration among MSs, GPs, and PHSs, who should know each other's expertise; clear agreement on responsibility; reimbursement for vaccines; and the availability of clear registration of vaccination history.

Promoting the Cyber Wellness of Internet Users in Papua New Guinea

In Papua New Guinea, there are concerns that the increase in internet accessibility has led to a rise in criminal activities in cyberspace. This paper identifies activities that constitute crimes in the cyberspace of Papua New Guinea. The main prongs of facilitating cyber wellness of Internet users are discussed to inform policy-making in Papua New Guinea. This paper provides guidance to policymakers, public health specialists, education and counselling psychologists, school teachers, educational researchers, and non-governmental organisations on cosmopolitan strategies for promoting cyber wellness in Papua New Guinea and the Pacific Islands in general. Keywords: Cyber wellness, Cyber health, Mental health, Papua New Guinea, Cybersecurity, Cybercrimes, Cyberspace.

Quality Indicators during Delivery and the Immediate Postpartum Period: A Modified Delphi Study.

Our research hypothesis was that most French indicators of quality of care have been validated by experts who are not clinicians and might not always be meaningful for clinicians. Our objective was to define a core set of measurable indicators of care quality during delivery and the immediate postpartum period relevant to clinical practice. A steering committee comprising nine specialists in obstetrics and/or public health conducted a literature review to develop potential indicators. A panel of obstetrician-gynecologists and midwives working in a delivery unit rated each indicator for appropriateness in a two-round Rand-modified Delphi procedure and a physical meeting. The consensus among the panelists was assessed. In the first round, 145 panelists (110 obstetrician-gynecologists and 35 midwives) assessed 77 indicators and 3 definitions: 6 related to labor onset, 20 to delivery, 3 to pain management, 23 to neonatal morbidity/mortality, and 28 to maternal morbidity. In the second round, 132 panelists (98 obstetrician-gynecologists and 34 midwives) assessed 42 indicators and 1 definition. The final set comprised 50 indicators and 2 definitions. This Delphi procedure selected 50 indicators that reflect the quality of perinatal care. These indicators should be recorded in each French maternity ward's birth register for each delivery.

First and Later Dating Experiences and Dating Violence among High School Students

This study investigated early dating experiences by exploring the complex aspects of first-time and later romantic involvement as well as the surrounding circumstances. In total, 377 young people (with the median age being 17 years) were investigated in six high schools in two cities in Lithuania using a questionnaire designed for research purposes by the authors. The results from this study in Lithuania contribute to the field by showing current data on the cultural and psychosocial aspects of dating experiences in high schools. This investigation into first-time and later dating creates an appropriate window to explore and investigate the attitudes, dating habits, and experiences of late adolescents, comprising negative experiences and sexual harassment, which could be used to build preventative programmes. The obtained results provide various data that are useful for trying to better understand the current habits and experiences of young people, for public health specialists, educators, and doctors and also provide an opportunity for monitoring trends, dynamic changes over time, and cross-cultural comparisons.

Public health in Asia during the COVID-19 pandemic: global health governance, migrant labour, and international health crises

Any book on the topic of ‘public health in Asia during the COVID–19 pandemic’ must tick three boxes. It must be ambitious in scope; discuss the political, sociological and economic aspects of public health (not just the science of public health) at the national level; and examine Asia's role in global health governance. This book does indeed tick all three. In addition, it has some strong highlights. The edited volume brings together 15 chapters, which are arranged into four themes: health policies in Asia; Asia's role in global health governance; national-level responses of Asian countries; and the impact of the COVID–19 pandemic on migrants’ health in Asia. The contributors include scholars of Asia area studies, International Relations (IR), economics, political science and public policy. The three editors are specialists in IR, global health and the politics of modern China. For context, the reviewers are specialists in health systems, public health and global health. We welcome other disciplines analysing health questions, especially as they shed light on social determinants and political economy dimensions, using IR theory to resolve global health commons problems, such as pandemics. These perspectives from other disciplines are especially welcome given the paucity of literature on the impact of the COVID–19 pandemic in Asia, from regional and interdisciplinary approaches. Therefore, we commend the book's three main strengths. First, there is a strong initial focus on the political and international relations in the context of past pandemics, such as the SARS outbreak in 2003 and the development of the International Health Regulations legal instrument in 2005. This focus is helpful because public health teaching tends to focus more on questions of epidemiology, science and the clinical impact of pandemics. Consequently, public health knowledge often downplays the international political, social and economic drivers and impacts. Second, the book demonstrates in-depth knowledge about the current governance structures, especially when applying the lenses of political science, IR and political economy to the study of pandemics. This is testament to the skills of the contributors and editors. Third and last, this book has an entire section on migrant health, which remains under-researched and under-discussed despite its importance to equity, justice and general public health common sense.

Antimicrobial resistance: a Biochemical Society position statement

Antimicrobial resistance: a Biochemical Society position statement

The 2022 monkeypox outbreak: A UK military perspective.

With the emergence of SARS-CoV-2 and now monkeypox, the UK Defence Medical Services have been required to provide rapid advice in the management of patients with airborne high consequence infectious diseases (A-HCID). The Defence Public Health Network (DPHN) cadre, consisting of closely aligned uniformed and civilian public health specialists have worked at pace to provide evidence-based recommendations on the clinical management, public health response and policy for monkeypox, with military medicine and pathology clinicians (primarily infectious disease physicians and medical microbiologists). Military environments can be complicated and nuanced requiring specialist input and advice to non-specialists as well as unit commanders both in the UK and overseas. DPHN and military infection clinicians have close links with the UK National Health Service (NHS) and the UK Health Security Agency (UKHSA), allowing for a dynamic two-way relationship that encompasses patient management, public health response, research and development of both UK military and national guidelines. This is further demonstrated with the Royal Air Force (RAF) Air Transport Isolator (ATI) capability, provided by Defence to support the UK Government and UKHSA. Military infectious disease clinicians are also embedded within NHS A-HCID units. In this manuscript we provide examples of the close interdisciplinary working of the DPHN and Defence clinicians in managing military monkeypox patients, co-ordinating the public health response, advising the Command and developing monkeypox policy for Defence through cross-government partnership. We also highlight the co-operation between civilian and military medical authorities in managing the current outbreak.

Nutritional and General Awareness of Vitamin D Status among Adult Population in Sulaymaniyah Governorate, Kurdistan Region, Iraq: A Cross-Sectional Study

The health benefits of vitamin D are widely acknowledged by scientific and public health specialists. In Iraq, vitamin D deficiency and inadequacy are highly prevalent. However, public knowledge on this problem is scarce. This research aimed to evaluate the participants' knowledge about vitamin D, particularly their nutrition-related understanding and behavior, along with their overall attitude toward sun exposure. A descriptive cross-sectional survey of Iraqi adults over 18 was performed with a collection of serum 25(OH)D result between June and September 2022. The observed serum vitamin D indicated that only 25% of the participant had healthy (&gt;30 ng/ml) vitamin D levels. The majority of participants, 90.9%, were aware of vitamin D. Media and primary health care centers were major vitamin D information sources (57.3 and 32%, respectively). Despite believing sunshine is the principal source of vitamin D (90.2%), respondents lacked understanding about the duration (26.3%) and frequency (30%) of sun exposure. In addition, less than 10% of individuals attributed vitamin D shortage to kidney and liver problems, fat malabsorption, obesity, and bariatric surgery. Nevertheless, more than two-thirds (83.3%) of participants defined the positive role of vitamin D in preventing osteoporosis and immune system strengthening (61%). Furthermore, nutritional awareness among the participants was variable. Approximately, 75% misrepresented the percentage of vitamin D supplied by food, over 50% believed that fruit and vegetables are vitamin D sources, 43% of vegetarians are not at risk for vitamin D deficiency, and rather plants considered (70.3%) as an approach to lessen vitamin D deficiency. Additionally, optimal daily intake was recognized by only 10%. Similarly, only 18.3% was aware of the optimal level of serum vitamin D. Notably, 54% was entirely ignorant of the benefits of dietary fortification. Although 55% of the surveyed population used vitamin D supplements, and 76% acknowledged it through their doctor's recommendation, exceeding two-thirds incorrectly anticipated that drinking tea would impair vitamin D absorption. Therefore, 90% would buy supplements without a prescription if needed. Implementing nutrition education initiatives, encouraging healthy lifestyles, and supporting vitamin D examination should be included in Iraq's health care system.

Scopes of utilization of public health specialist nurses in government health care service of Bangladesh

Scopes of utilization of public health specialist nurses in government health care service of Bangladesh

The role of health protection teams in reducing health inequities: findings from a qualitative study

IntroductionThe UK Health Security Agency’s (UKHSA) Health Protection Teams (HPTs) provide specialist public health advice and operational support to NHS, local authorities and other agencies in England. The development of a three-year UKHSA Health Equity strategy creates a unique opportunity for HPTs to reduce health inequities within their work.AimsThis study aimed to understand current health equity activities and structures within HPTs, and to propose future HPT-led health equity activities.MethodsBetween November 2021 - March 2022, HPT staff from the nine UKHSA regions were invited to participate in a semi-structured interview or focus group.ResultsTwenty-seven participants covering all nine UKHSA regions took part in a total of 18 interviews and two focus groups. There was enthusiasm to address health inequity, and many reported this as their motivation for working in public health. All HPTs routinely engaged in health equity work including, variously: liaising with other organisations; advocacy in case and outbreak management meetings; developing regional HPT health equity action plans; and targeting under-served populations in day-to-day work. HPT staff discussed the challenge of splitting their time between reacting to health protection incidents (e.g., COVID as the main priority at the time) and pro-active work (e.g., programmes to reduce risk from external hazards for vulnerable populations). Although COVID had raised awareness of health inequities, knowledge of health equity among the professionally diverse workforce appeared variable. Limited evidence about effective interventions, and lack of clarity about future ways of working with other organisations were also shared as barriers to tackling health inequities.ConclusionHPTs welcomed the development of UKHSA’s health equity strategy, and through this study identified opportunities where HPTs can influence, support and lead on tackling health inequities. This includes embedding health equity into HPTs’ acute response activities, stakeholder working, and staff management. This study also identified a need for health equity training for HPTs to improve knowledge and skills, utilising evidence-based approaches to health equity. Finally, we have identified areas where HPTs can lead, for example using brief advice interventions and through developing resources, such as standard operating procedures that focus on vulnerable populations. These findings will support a more integrated approach to addressing health equity through health protection work.