Journal of Public Health Policy最新文献

The Israel-Hamas war that began on 7 October 2023 may have spurred anti-Jewish hate crimes, which are associated with measurable health harms including worsened cardiometabolic biomarkers. This study evaluated whether anti-Jewish hate crimes in New York City increased during the Israel-Hamas war using administrative data representing 3255 hate crimes between 2019 and 2024. In 26 of 72 observed months, anti-Jewish hate crimes outnumbered the combined total of all other hate crimes. Compared with other hate crimes, anti-Jewish hate crimes were more likely to be felonies (63% versus 38%, p < 0.001) and less likely to result in arrest (30% versus 57%, p < 0.001). Monthly anti-Jewish hate crimes were on average twice as common during the first year of the Israel-Hamas war than the previous 5 years, adjusting for each borough's Jewish population (PR = 1.97, 95% CI (1.64, 2.35)). The disproportionate frequency of anti-Jewish hate crimes suggests further unmeasured major and minor antisemitic discrimination.

This study evaluates the impact of California's specific per- and polyfluoroalkyl substances (PFAS) legislation on perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) contamination levels in public drinking water. We conducted a comparative statistical analysis using data collected by the United States Environmental Protection Agency (US EPA) Unregulated Contaminant Monitoring Rules (UCMRs), specifically UCMR 3 and UCMR 5. To assess PFOA and PFOS levels in active public water systems during the pre-legislation period (2017) and the post-legislation period (2023) we applied Levene's test to assess differences in variances, followed by unpaired and Welch's t-tests to compare mean PFAS concentrations between the two time periods. We detected a significant decline in both PFOA and PFOS levels post-legislation, suggesting that robust state-level regulatory measures can effectively reduce PFAS contamination. Findings highlight the potential for California's comprehensive approach to serve as a model for national policy to mitigate PFAS exposure and protect public health.

The COVID-19 pandemic has revealed significant disparities in health research across regions, particularly in Latin America. This viewpoint explores the challenges encountered during a randomized clinical trial in Colombia designed to evaluate the effectiveness of intravenous Alprostadil for treating moderate-to-severe COVID-19. The trial, aimed to address the urgent need for effective treatments, ultimately became undermined by bureaucratic barriers. This experience of regulatory delays and prolonged setbacks highlighted broader systemic issues in health research across Latin America, such as tangled regulatory frameworks, insufficient skilled staff, and limited research infrastructure. These obstacles, combined with financial constraints, prevent timely research, impairing Latin America's ability to address health crises independently. To improve health research policies in the region, lessons from countries like Brazil, Argentina, and Chile, where regulatory processes have been streamlined, suggest that reforms promoting efficient approval systems, policy alignment, and enhanced collaboration are vital for strengthening health research capacity in Latin America.

Upstream income-based policies are widely accepted by researchers as key levers to address health inequalities. However, scarce public resources mean difficult decisions about policy implementation must be clearly justified. A public mandate, through knowledge of public preferences, offers one route to transformative policy change. But we do not know what, if anything, people would be willing to give-up to reduce health inequalities. Nor whether the type of policy through which health inequalities are reduced matters. We make the case for developing a new public health economics research agenda using stated preference techniques to estimate the economic value for upstream income-based policies and health outcomes by considering Universal Basic Income. This new research area has the potential to advance the use of economic valuation methods within public health economics, generating new evidence to inform policy debates around the implementation of upstream income-based policies and how to address health inequalities.

We assessed the association of participation in the Community Eligibility Provision, a universal free school meals policy in the United States, with school and area-level characteristics, and how these associations changed between 2014 and 2020. Using logistic regression models with district-clustered standard errors, in 53,391 eligible schools nationwide, adjusted prevalence of participation was 3.8 percentage points (pp) lower among high schools relative to elementary schools (95% CI: 1.6, 6.0), 8.9 pp lower in small relative to large school districts (95% CI: 4.8, 13.0), 10.9 pp lower in suburban relative to urban schools (95% CI: 6.9, 14.8), and 13.3 pp lower in schools in non-Medicaid expansion relative to expansion states (95% CI: 17.1, 20.7). Over time prevalence of participation in majority Hispanic schools increased to a lesser extent than participation in majority Black schools. Addressing barriers to policy adoption in schools with persistently lower participation will be critical to increase equitable access to universal free school meals.

The issue of maternal morbidity and mortality is a highly urgent American health problem, with more than 50,000 women experiencing pregnancy complications each year. However, Black women are three times more likely to die because of pregnancy-related problems than White women in the United States (U.S.). Black women also experience disproportionately higher rates of maternal mortality than women of every other ethnic and racial group. Compared to other affluent countries, the United States has a strikingly high maternal mortality rate. Between 1990 and 2019, the rate in the U.S. nearly tripled, rising from 8.0 to 20.1 deaths per 100,000 live births. In the last twenty years, maternal mortality rates have declined in countries around the globe, but in the U.S., there has been a 50% increase in maternal mortality. Maternal mortality rates are highest in Mississippi, which had 82.5 deaths per 100,000 births in 2021, and lowest in California, which had 9.7 deaths per 100,000 births in 2021. Expanding Medicaid eligibility, extending postpartum coverage, standardizing care delivery, combating racial bias in medical care through provider training, subsidizing Black physician tuition, and increasing rural health care access will help not only reduce maternal deaths nationwide but also diminish racial disparities in maternal health outcomes.

This study investigates the roles of women empowerment on the prevalence, awareness, and treatment of hypertension among ever-married Nepalese women aged 15-49 years using 2016 Nepal Demographic and Health Survey data. We assessed women empowerment using the Survey-based Women emPowERment (SWPER) index in the domains of 'social independence', 'decision-making', and 'attitudes towards violence'. We assessed associations of domains of women empowerment with hypertension using multiple logistic regression models. Among 4919 women, 568 (12%) had hypertension, 35% were aware of their condition, and 14% were taking anti-hypertensive medication. Majority (72%) of women had high empowerment in ''attitude to violence' domain, 14%-in 'decision-making' domain, and 25%-in the 'social independence' domain; the latter group was also less likely to suffer from hypertension (aOR = 0.68, 95% CI 0.49-0.94). Our findings suggest the need to integrate empowerment initiatives into strategies to prevent hypertension among women in Nepal and similar low- and middle-income settings.

In 2005, a new criminal code -- permitting abortion in specific circumstances -- was enacted to align Ethiopia's legal system with the country's updated Constitution. Despite its significant impact on reproductive health, there have been no studies examining men's attitudes toward Ethiopia's abortion law. We conducted a community-based cross-sectional study among 406 sexually active men from 10 June to 30 October 2023 and found that only 26.6% of men expressed positive attitude toward Ethiopia's abortion law (CI: 21.3%-30.2%). Men who support the law tend to be to be younger, better educated, never married or married at older age, and have an income above 2000ETB. These findings should inform policymakers changes regarding male involvement in decisions about accessing safe abortion services.

Tackling the complex drivers of childhood obesity requires action across sectors and at all levels of government. Elected officials in local government can influence policies targeting communities to prevent childhood obesity, but little is known about their views on local government accountability for tackling the issue. Accountability is the obligation to justify actions on a topic and it could strengthen policy implementation. A qualitative study was conducted involving semi-structured interviews with sixteen Southampton City Council local government councillors. Factors limiting accountability included low citizen engagement, the lack of a national mandate to support local action and unachievable targets. Factors that improved accountability included setting a local mandate, public health officers proactively keeping the issue on the agenda and oversight from other system leaders. The findings from this study inform how public health officers and other stakeholders can work within the local system to progress childhood obesity prevention policies.