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Social media use and child cigarette smoking and e-cigarette use: A cohort study 2015-2023.
Get PDFINTRODUCTION: There are growing concerns that advertising and promotion on social media are driving youth use of tobacco and e-cigarettes. The UK provides an instructive example as it has high levels of e-cigarette use, high levels of social media use and a restrictive tobacco control environment. Existing evidence in the UK, however, has not focused on children, and has not been updated to reflect changes in patterns of social media use and in the use of these products. The aim of this study is to assess the associations of social media use with smoking and vaping. METHODS: Using data from the United Kingdom Household Longitudinal Study on adolescents aged 10-17 years between 2015-2023, we employed generalized estimating equation (GEE) models to estimate the relationships between time spent on social media and likelihood of smoking tobacco and using e-cigarettes. Models were controlled for possible confounders including sociodemographics and whether children lived in a home with e-cigarette use or tobacco smoking. We included data from 9359 participants with 25704 observations. RESULTS: Current cigarette smoking was reported by 4.9% of the sample and current e-cigarette use by 3.1%. Our adjusted models found strong relationships between time spent on social media and both smoking and vaping (p for trend <0.001). For example, use of social media for ≥7 hours/day was linked to greater odds of tobacco (adjusted odds ratio, AOR=5.13; 95% CI: 3.32-7.95) and e-cigarette use (AOR=4.26; CI: 2.25-8.08). CONCLUSIONS: This study finds associations between time spent on social media and both smoking and vaping among children. Enforcing regulations on content and restricting the duration of social media use may be warranted to protect children's health
Are local authority green infrastructure strategies in England addressing climate and environmental risks to public health? A policy review
Get PDFEvidence suggests greenspaces can improve mental and physical health and wellbeing, as well as support environmental adaptation and mitigation goals which benefits health. This study aimed to review published local authority (LA) green infrastructure strategies (GISS) in England, to assess to what extent these strategies address climate change and environmental risks to health. A content analysis of 151 publicly available LA GISS in England published between 2012 - 2024 was conducted, sourced from OHID regional teams. Data was extracted on the following categories: health policy, health outcomes, population groups and inequalities, environmental and climate risks to health, monitoring and evaluation and wider determinants of health. Strategies were scored against a thematic framework. Most GISS reviewed recognised the importance of supporting the natural environment to reduce impacts of climate change and environmental hazards, although few acknowledged the benefits to health from managing these risks. Managing flood risks (80 %) and air quality control (66 %) were the most common added benefits identified from local green infrastructure. However, a majority of the LAs did not have a strategy. Strengthening of GISS presents an opportunity for aligning local and national environmental, climate change and health policy. Further collaboration between public health, environment and planning departments in developing comprehensive GISSs will support addressing local climate and health needs
Potential health impact and cost-effectiveness of human papillomavirus vaccination in Tunisia: A comparative modeling study
No full textBackground: Cervical cancer is one of the most prevalent cancers affecting women especially in low- and middle income countries and is caused by persistent infection with human papillomavirus (HPV). HPV vaccination can significantly reduce the cervical cancer burden. However, HPV vaccination is not yet included in the Tunisian immunization program. To inform decision-making on HPV vaccine introduction in Tunisia, we conducted a comparative modeling study to project the health impact and cost-effectiveness of four HPV vaccines (Cecolin, Cervarix, Gardasil, 4, and Gardasil-9) targeted to 12-year-old girls in 2025. Methods: We used two static cohort models (UNIVAC and Papillomavirus Rapid Interface for Modeling and Economics (PRIME)) to estimate the health and economic impact of HPV vaccination from the health system and societal perspectives. Our data inputs to the model include demography and cervical cancer burden as well as unit costs for treatment, vaccines, and vaccine delivery. We estimated health impact in terms of cases, deaths, and disability-adjusted life years (DALYs) averted by HPV vaccination, and economic impact in terms of vaccination costs, treatment costs saved, net cost, and incremental cost-effectiveness ratios (ICERs). Results: We estimated that Cecolin is the most cost-effective HPV vaccine in Tunisia, particularly when cross-protection is considered. Despite Cervarix offering greater health benefits of 70% versus 62% reductions in cervical cancer cases and deaths at 87% coverage, Cecolin has lower net costs and is more favorable across different willingness-to-pay (WTP) thresholds. At a WTP of USD 1169 per DALY averted (30% of Tunisia's GDP per capita), Cecolin and Cervarix demonstrate similar probabilities of being cost-effective. Conclusion: Based on the vaccine impact estimates generated by the UNIVAC and PRIME models, we inferred that the four HPV vaccines (Cecolin, Cervarix Gardasil,4, and Gardasil-9) were cost-effective in the Tunisian context. This evidence is useful to inform HPV vaccine introduction in Tunisia
Policy Drivers of Social Care Workforce Change: United Kingdom Insights, Impacts, and Future Directions
No full textThis report examines how national policy drivers influence social care workforce transformation, highlighting their intended outcomes and unintended repercussions within the ESRC Centre for Care’s Workforce Change Research
Group framework. It is focused on the study ‘Understanding the drivers and implications of care workforce change,’ which investigated national-level policy
drivers of social care workforce change and their intended and unintended effects on the workforce
Independent effects of long and short-term exposures to non-optimal increased temperature on mortality.
Get PDFAlthough the short-term heat effects are well-established, longer-term effects, beyond those, have recently received attention, in the context of climate change. Our study aims to investigate the potential effects of long-term exposure to non-optimal warm period temperatures on all-cause mortality in four large regions in the UK, Norway, Italy, and Greece. Daily all-cause mortality counts from 1996 to 2018 for four European NUTS-2 regions including 52-662 small areas were collected and associated with spatiotemporal temperature estimates. A NUTS-2 region-specific mixed quasi-Poisson over-dispersed model, with a random intercept per small area within NUTS-2 regions, was applied to investigate the association between long-term temperature exposure and mortality during the warm period (May to September), adjusting for short-term temperature, seasonality, long-term trends, and small-area population characteristics. As long-term temperature exposure indices per small area, we considered: 1) the warm period annual average temperature, 2) the annual standard deviation (SD) of warm period temperature, and 3) the coefficient of variation of warm period temperature (CV). We found consistent results following short-term temperature exposure on mortality, with higher effects in southern areas. Results on the shape of the long-term association between average temperature and mortality differed by country, while the different temperature metrics produced inconsistent findings. Increased mortality was associated with increased annual warm season temperature, lower SD and increased CV in Greece, with higher SD and decreased CV in Italy and with decreased annual temperature and CV in Norway. Effects in the UK did not reach the nominal level of statistical significance. Although our study implies an impact on mortality resulting from longer-term temperature exposure, its direction varied across areas and on the temperature metric used. Further research is warranted, applying non-ecological study designs and covering various geographical areas to capture the impact of individual and area-specific characteristics
Towards Gender Equity and Social Inclusion (GESI) responsive WASH Systems Strengthening
Get PDFThis Learning Note is meant to inspire thought, action, and investment in strengthening WASH systems, ensuring that the rights of marginalised and excluded individuals are integral to the systems strengthening design, rather than an afterthought.
It is divided into two parts:
1. Why it is important to consider Gender and Social Inclusion initiatives in water, sanitation and hygiene (WASH) systems strengthening?
2. How to implement these initiatives - actionable steps across the different elements of the system.
The Learning Note builds on the WASH systems strengthening approach outlined by A. Huston and P. Moriarty in their 2018 working paper ‘Understanding the WASH system and its building blocks: building strong WASH systems for the SDGs’
Local Humanitarianism and Organisational Complexities: Implementation of Safeguarding Measures among CSOs in Arab Countries
Get PDFOver the last decade, several Arab countries have been experiencing long-term political turmoil, civil wars, and ongoing conflicts. As a result, there has been an unprecedented surge in local humanitarianism, exemplified by the expansion of local humanitarian organisations, increased resource allocation for humanitarian action, and a global focus on humanitarian actors’ accountability for affected people. This chapter analyses the complex accountability relationships that influence local responses to humanitarian crises by focusing on implementing safeguarding measures among civil society organisations (CSOs) in five Arab countries: Jordan, Lebanon, Syria, Yemen, and Palestine. The main research question this chapter addresses is: How have local humanitarian organisations evolved in understanding, adopting, integrating, and implementing safeguarding measures in the five Arab countries? This chapter argues that there is a need to reconsider measures adopted by local humanitarian organisations to navigate the accountability demands of different loci and ensure the enforcement of safeguarding policies on the long run
Health Systems in Action (HSiA) Insights – Kazakhstan
Get PDFKey points:
● The Ministry of Healthcare governs Kazakhstan’s
health system and is responsible for policy,
legislation and regulation. The Oblast Health
Departments play an important role in managing
all publicly owned health facilities within
their territories.
● The country’s recent health reforms aim to
progress towards universal health coverage
(UHC) through strong primary health care (PHC)
and family medicine, particularly in rural and
remote areas. Regional and local governments
lead these changes, with increased autonomy for
PHC facility managers.
● Kazakhstan transitioned to a social health
insurance (SHI) system in 2020, aiming to address
equity, access and service quality by improving
the pooling of public funds and enhancing the
participation of private providers in publicly funded
health care.
● Residents have access to two packages: a
government-guaranteed package for all and a SHI
package with a wider package of benefits for those
who pay contributions or for whom the government
pays on their behalf.
● Per capita spending on health has increased in
recent years to US$ 1114 in 2021 (adjusted for
purchasing power). The share of public spending
in overall health spending has also increased
(65.3% in 2021) and is now much higher than in
the Central Asian countries overall (39.6%).
Out-of-pocket (OOP) spending has subsequently
declined, from 33.9% of health spending in 2019
to 25.0% in 2021.
● Kazakhstan has an extensive hospital network,
with most hospitals being focused on a single
specialty. The Ministry of Healthcare aims to
optimize efficiency going forward by promoting
multidisciplinary hospitals.
● Despite a high physician density of
407 professionally active staff per
100 000 population, rural areas face shortages,
with 82.8% of physicians working in urban areas.
Nurse numbers have fluctuated but are generally
below the average in the WHO European Region.
● Life expectancy at birth in Kazakhstan steadily
increased in the last two decades, from 65.7 years
in 2000 to 73.3 years in 2019. However,
the country experienced a notable decline during
the COVID-19 pandemic, to 70.3 years in 2021.
Life expectancy for females is 7.6 years higher than
that of males.
● The pandemic resulted in a disruption of essential
health services and increased mortality rates,
including substantial excess mortality. Mental
health problems and maternal mortality increased
markedly.
● Cardiovascular diseases are the leading causes
of mortality, including premature mortality,
underscoring the need for continued prevention
efforts and improved access to care.
● High blood pressure, poor nutrition and smoking are
major causes of deaths and ill-health. Kazakhstan
has initiated policies targeting these factors,
including initiatives to reduce salt consumption and
tobacco use and a ban on vaping products
Prevalence of Adverse Events Reported Following the First Dose of COVID-19 Vaccines in Bahia State, Brazil, from 2021 to 2022.
Get PDFBackground: Despite adverse events following immunization (AEFI) being well described in vaccine trials, there is a need to produce more real-world data on events supposedly attributed to vaccination against COVID-19. This study aims to estimate the prevalence of AEFI in the first dose of COVID-19 vaccines in the state of Brazil and to verify whether such events differ among the types of vaccines offered in this country. Methods: A population-based study using linked administrative data on vaccine registry and adverse events following immunization in 2021 and 2022. The study included 10,169,378 individuals aged 18 or over who lived in Bahia and received the first dose of COVID-19 vaccines. We calculated AEFI prevalence and verified differences among vaccines by logistic regression to estimate crude and adjusted by sex and age group prevalence ratio (PR). Results: The prevalence of AEFI was 74.3 per 100,000 doses applied, with a higher rate of nonserious events, mainly following the ChAdOx1-S. More than two-thirds of these adverse effects occurred in women, and almost half were between 30 and 49 years old. The individuals who received ChAdOx1-S had a 125% higher prevalence than those who received CoronaVac. Those who received BNT162b2 and Ad26.COV2.S had a 71% and 58%, respectively, lower prevalence of AEFI than those who received CoronaVac. Conclusions: The use of vaccines against COVID-19 has proven to be positive and effective in combating SARS-CoV-2, significantly reducing morbidity and mortality from the disease. We cannot deny the presence of adverse events in the context of vaccination. However, the vaccines have proven to be safe and reliable. The results of this study offer relevant data that can contribute to the qualification of AEFI pharmacovigilance in Brazil and worldwide
Water Insecurity in the Jordan Valley: Community Perspectives on Its Impacts on Maternal and Child Health.
Get PDFThe Jordan Valley in the West Bank in Palestine provides a unique social, environmental, and geopolitical context in regard to the global challenge of water insecurity, where its impacts on child and maternal health are only partly understood. Existing research has been largely limited to investigations of water quantity/quality and direct health outcomes, such as infectious disease. This qualitative study aimed to provide a holistic perspective of the challenge of water insecurity and child health, by investigating household water insecurity in Palestine. Focus group discussions explored the lived experiences of women from marginalized communities. These were then thematically analyzed, in reference to social theory. The study identified context-specific aspects of water insecurity, shaped by the background in Palestine involving the occupation and ongoing violent conflict in the area. These challenges disproportionately affect women, who are primarily responsible for water management within their communities, leading to embodied experiences, heightened negative emotions, and increased conflict, both within households and the broader community. Consequently, these stressors heavily impact children: limited caretaking time, due to economic pressures, children's involvement in water-related tasks, and the disruption of social cohesion at both the community and household level, ultimately affect their physical and mental health and their ability to learn and play. Our findings could guide research and policy efforts in developing context-sensitive tools, such as a child water stress index for Palestine