bluuebunny/crossref_metadata_2025 huggingface dataset:
25.G. Round table: Public health codes of ethical professional conduct for effective practice
Authors:   Organised by: UK Faculty of Public Health, EUPHA Ethics in public health section,   Chair persons: Maggie Rae - UK, Els Maeckelberghe – EUPHA-ETH
Published: October 2020

One of the major outputs of the WHO Regional Office for Europe “Coalition of Partners” initiative has been the development of the “Road map for professionalization of the public health workforce in Europe.” Public health ethics was considered as one of the key pillars for practice for the workforce. The report highlighted the case and urgent need for development of Public Health Codes of ethics and professional conduct (CoC) as an essential part of workforce development strategies. The development of CoCs is considered essential to pursue the mission and moral mandate of public health and to clarify the purpose of professional activities in public health. Scotland has been working as an initial pilot site in Europe to consider developing a CoC for its workforce as part of its public health reform program. The purpose of this roundtable workshop is to share and reflect on the learning from the process, experience and findings from development of the Scottish CoC as the first pilot site in Europe and implications for development of such codes in other public health systems. The workshop will also share the evidence, rationale and background to CoC with research and learning from around the world on the issue. The Roundtable will include brief presentations by an experienced expert panel of senior public health leaders, ethicists and academics who have been working on development of public health Codes of professional conduct. This will be followed by reflection, consultation and debate with participants around the case, nature and options for development of codes of practice and distinguishing features for public health practice. There are issues to whether there is need for country specific, regional or global codes of ethics taking account core public health values and implications for practice. One of the key issues identified is fundamental importance of ensuring such work is linked to a strategy and activities to build competency and capacity around public health ethics and law and to ensure resources, systems and robust education and training activities are put in place for a sustainable development of the issue.

Key messages

The Development of CoCs is important in order to support the workforce, pursue the mission and moral mandate of public health and clarify the purpose of professional activities. There is need to develop activities and strategy for building competency and capacity in public health ethics alongside development of Code of ethics and professional conduct.
The role of vaccines in combating antimicrobial resistance
Authors: Jit M , Cooper B
Published: October 2020

Vaccination is one of the most effective measures to reduce antimicrobial resistance in both human and animal pathogens. This presentation reviews the multiple pathways by which vaccines may act to reduce resistance: they can prevent infections by focal pathogens, reducing the need to use antibiotics; they can selectively protect against resistant subtypes of a pathogen; they can reduce infections by other pathogen species which are routinely treated with antibiotics (not necessarily appropriately) thus reducing bystander selection; and they could selectively reduce transmission in settings such as hospitals which may have higher proportions of resistant strains. Because vaccines are highly specific to their targeted pathogens, they are much less likely to induce resistance compared to antibiotics. Hence, they can be delivered to large populations as a preventive measure to reduce transmission. The impact of vaccination on resistance has been demonstrated for vaccines against Streptococcus pneumoniae, Haemophilus influenzae type b and influenza. Current and pipeline vaccines against pathogens such as Vibrio cholerae, Escherichia coli, Salmonella typhi, RSV, diarrhoeal viruses and nosocomial bacteria may also have potential to reduce resistance. Economic evaluations of vaccines need to be expanded to capture their benefits in reducing resistance, in order to incentivize development and introduction of the right vaccines. Accurately doing so will require health systems, epidemiological and economic research.
A health equity focused National Prevention Plan 2020-2025 and related capacity building (CCM, 201)
Authors: Mattioli B , Bucciardini R , Falzano L , Bena A , Gilardi L , Capra P , Falcone U , Marra M
Published: October 2020

In Italy there are significant differences in life expectancy, morbidity and disability between different social groups: the wealthiest and educated people are better off, get sick less and live longer. The poorer Italian Regions show less favourable health indicators. However, Italy aims to reduce health inequalities (HI) among the priorities of its agenda. The 2014-2018 National Prevention Plan (NPP) had already instructed the Regions to include the fight against HI in the guiding principles of the regional prevention plans (RPP). The new NPP 2020-2025 confirms the need to strengthen the fight against HI and the reduction of the main social and geographical inequalities that are observed in our country represents a priority to all the objectives of the NPP, which requires the disclosure of scientific data, validated methods and tools to guarantee equity in the action. In this scenario, there is a project coordinated by the Istituto Superiore di Sanità with the contribution of DORS, the Documentation Centre for Health Promotion of Piedmont Region. The main objective of this project is to support the Ministry of Health (MoH) and the Regions in order to consolidate the introduction of the equity lenses approach in the new NPP, in particular the project aims at: promoting a health equity-oriented approach in priority and target setting, choice of a strategy, and in the design of the monitoring and evaluation system;investing in a capacity building process for regional officers responsible of the elaboration and implementation of the RPP in each Italian region.

20 Italian Regions participate to this two-year project (2019-2020). Two face-to-face training modules and the sharing of a web community of practice have been planned. The project involves developing support tools that provide equity-oriented practices. The main expected result is the increase of the equity-oriented actions and their dissemination across the country.
Linking health and social data in Brazil: challenges and potentials for public health research
Authors: Barreto M
Published: October 2020

Health research using linked routine population-based data collected for non-research purposes has increased in recent years. In Brazil, the Centre for Data and Knowledge Integration for Health (CIDACS-Fiocruz) was created in 2016 in Salvador with the objective of integrating data to answer research questions related to public health. In CIDACS, efforts are made to obtain high-quality linked data while adhering to security, ethical use and privacy issues. Efforts have been made to conduct operations with respect to implementing the appropriate structures, processes and controls over the original and integrated datasets in order to provide relevant data for research purposes. Two different cohorts have been constructed. The “100 Million Brazilian Cohort” comprises of individuals registered in a National Social Register from 2001 linked to data from different social protection programs ('exposures') and outcomes from various health-related Brazilian National databases (deaths, births, infectious diseases). The main aim is to explore the impact of social protection programs on health using natural experiment approaches. By studying the effect of social policies, they increase our possibilities to explore links between the social and economic determinants and health. The CIDACS Birth Cohort is also a population-based cohort derived from linked data, developed to investigate the relationships between prenatal and early life events on health-related outcomes for infants and children, in the context of social inequalities. The overall objective is to research the effect of obstetric and prenatal conditions on birth, growth, morbidity, and survival in a dynamic cohort. CIDACS is expected to be an important resource for researchers and policymakers interested in enhancing the evidence base pertaining to different aspects of health, as well as investigating the role of social determinants of health and the potential effects of social and environmental policies on health.
Using electronic health records to monitor, augment and evaluate patient care in Singapore
Authors: Tan C S
Published: October 2020

The advent of electronic health records (eHRs) has opened up many opportunities for researchers and practitioners in healthcare to improve human lives. The opportunity to monitor and evaluate events or processes in real time on a large scale is feasible with big data, thereby facilitating timely information and the practice of proactive care. Predictive analytics allows the re-engineering of processes by augmenting them with predictive scores to identify individuals at high risk of adverse events for early intervention. However, to seize these opportunities to improve patient care, alleviating the challenges faced when utilizing eHRs to generate actionable insights is important to unleash the full potential of eHRs. With better access to eHRs and relevant domain experts, it facilitates the appropriate use of eHRs and analytical approaches. To illustrate some of these opportunities and challenges, the following two case studies will be discussed during this presentation: (i) programs developed at an academic health system in Singapore that aim to improve the experience and outcomes of inpatients, and (ii) a nationwide Predictive Model for Admission Prevention in Singapore that identifies suitable discharged inpatients for enrolment into a community-centric program.
The development and evaluation of an evidence-based suicide prevention strategy in Flanders (Belgium)
Authors: Dumon E , Portzky G
Published: October 2020

Background

Suicide rates in Belgium have been consistently high, with a current prevalence of 15.1 suicides per 100.000 inhabitants, which is 1.5 times higher than the European average. In Flanders (northern part of Belgium) more than 10.000 suicide attempts are being registered every year and studies show that 13 % of the population reports a lifetime history of suicidal thoughts. Since 2006 an extensive Suicide Prevention Strategy has been implemented in Flanders, aiming to decrease the Flemish suicide rate by 20% by 2020 (baseline year 2000).

Methods

The Suicide Prevention Strategy has been developed by a team of experts, involving multiple stakeholders and the lay public. The 'Flemish Centre of Expertise in Suicide Prevention' (VLESP) was launched by the government to coordinate and monitor the prevention campaigns, tools and interventions included in the strategy, and to study their effectiveness.

Results

The Suicide Prevention Strategy includes five key strategies namely: 1) mental health promotion, 2) providing helplines and online help, 3) educating health professionals and community facilitators, 4) developing programs targeting high risk groups, 5) developing and implementing targeted suicide prevention guidelines for health professionals and other key gatekeepers. A range of innovative suicide prevention tools and interventions, such as an e-learning course for health professionals, smartphone applications and group therapies for suicidal individuals, have been developed and positively evaluated. In 2017 (in comparison with the year 2000) suicide rates in men decreased with 27% and suicide rates in women with 26%. For suicide attempts, a decrease of 19% was noted.

Conclusions

Suicide prevention is a public health priority in Flanders. A combination of evidence-based tools and interventions have been developed and assessed in the past years, resulting in a decrease in suicide rates.
2.K. Workshop: Measuring population health literacy. Results of the European health literacy survey 2019
Authors:   Organised by: EUPHA Health promotion section, GOeG (Austria),   Chair persons: Diane Levin-Zamir - Israel, Øystein Guttersrud - Norway
Published: October 2020

As experience in many countries has shown, measuring population health literacy is important for putting health literacy on the agenda of health policy, practice and research and to inform health policy where there is specific need for improving health literacy by interventions.

There is growing evidence that there exists limited comprehensive health literacy for considerable proportions of the general population, that there is a social gradient for health literacy and that limited health literacy has problematic consequences for healthy lifestyles, self-reported health and utilization of professional health services. It was also shown that distributions and associations of health literacy differ considerable between countries. WHÓs Solid Facts - Health Literacy (2013) recommended that health literacy should be monitored regularly by standardized measures in as many countries as possible. Therefore WHO-Europe has initiated the Action Network Measuring Population and Organizational Health Literacy (M-POHL) of national policy experts and researchers. M-POHL has initiated as its first project the European Health Literacy Survey 2019 (HLS19). Based on the European Health Literacy Survey HLS-EU (2011), HLS19 has further developed instruments for measuring general comprehensive health literacy and specific measures for measuring e.g. digital health literacy. This survey is taking place in more than 15 countries of the WHO Europe Region and will have available preliminary first results in October 2020. Therefore the workshop is intended to present first internally comparative results and exemplary national results for health literacy and its correlates and discuss possible consequences of these results for health policy.

The workshop will focus on measuring comprehensive health literacy and digital health literacy in general populations of selected member states of the WHO European Region.

Design of the workshop: Introduction (5′), Presentation 1: Results of measuring comprehensive health literacy in general populations - An international comparison (20′), Statements of Panelists (10′), Discussion with audience (10′), Presentation 2: Results of measuring digital health literacy in general populations - An international comparison (20′), Statements of Panelists (10′), Discussion with audience (10′), Closing (5′).

Key messages

Distributions of comprehensive health literacy of general populations and associations with its social determinants and health consequences differ considerably between countries of WHO-Europe. A new measure for digital health literacy in general populations is related to comprehensive health literacy and varies considerably between countries of the WHO-Europe Region.
Multilateral action to harmonise migrant health data in the WHO European region
Authors: Severoni S , Bartovic J
Published: October 2020

Member states in the WHO European region have made significant progress towards the implementation of the Regional Strategy and Action plan. The presentation includes the regional situation analysis on migration health data collection and results of the second survey on implementation of the Strategy WHO EURO Member States. It will also cover the policy landscape vis a vis migration health data in WHO EURO region and current gaps in migrant health data collection. Challenges and barriers for migrant health data collection and sharing will also be explored. Country examples for possible way forward including strengthening of national systems and coordination; harmonization of markers and definitions; mutual exchange between states & relevant stakeholders; strengthen data linkages in health information systems and provision of technical guidance will be presented.
Mission impossible? Harmonising migration health data across countries
Authors: Zenner D
Published: October 2020

Despite significant efforts, for example within the EU/ EEA, there are currently only few Health information systems (HIS) which are standardized across international borders, and even within countries there can be significant variations. Modalities, technologies and terminologies differ. In the field of migration health, challenges and variations can be more significant. This talk will explore the specific challenges in migration health related HIS, provide an overview of the current HIS landscape pertaining to migration health and sketch out some potential solution to achieve greater harmonization and data sharing across countries.
Physical activity
Authors: Sorić M
Published: October 2020

The focus within this policy area was on the effectiveness of available school-based policies that aim at increasing energy expenditure. A special focus is directed to the type and content of the implemented interventions. In turn, interventions that were designed to increase physical activity were contrasted with the programmes that strived to improve physical fitness as well as with the strategies to reduce sedentary time. The moderation of the effects by gender, with a specific focus on socially vulnerable groups of children (e.g. socially disadvantaged children, ethnic minorities) was also examined.

The current contribution of sedentary behaviours and physical activity to the current obesity epidemic are poorly understood, the STOP project looked at comparing the effectiveness of interventions that aimed to increase energy expenditure by reducing sedentary behaviour with interventions that targeted physical activity or physical fitness, with a special attention directed towards evidence involving disadvantaged groups of children.
Design thinking and public health: importance and applications
Authors: Rachadell J
Published: October 2020

The first presentation will focus on the theoretical basis for DT and how it can be useful when applied to Public Health. It will review how knowledge coming from the entrepreneurial sector can help Public Health professionals and how the increasing pace of technological and social change globally requires Public Health professionals to adapt with new strategies that can tackle complex problems. The presentation will conclude highlighting the importance for PH to learn from other fields of knowledge
How to arrive at good questions and test them
Authors: Do Amparo N
Published: October 2020

The second presentation will focus on the actual process of arriving at the right question. To achieve that, it will highlight the importance of not pursuing one unique idea dogmatically, the balance between an exploitation and exploration mindsets in the workplace, the concept of innovation and the basic principles that should guide it (desirability, viability and feasibility). It will also focus on the DT framework based on inspiration, debate and implementation that allows for a design challenge to be “right sized”, meaning both inspirationable and actionable, people oriented and without jumping into conclusions. The psychological aspect of what clients or people say, think and feel and why those dimensions might differ.
The acceptance of clinical decision support systems among clinicians in the treatment of neck and/or back pain
Authors: Jansen-Kosterink S M , Cabrita M , Flierman I
Published: October 2020

Background

Clinical Decision Support Systems (CDSSs) are computerized systems using case-based reasoning to assist clinicians in making clinical decisions. Despite the proven added value to public health, the implementation of CDSS clinical practice is scarce. Particularly, little is known about the acceptance of CDSS among clinicians. Within the Back-UP project (Project Number: H2020-SC1-2017-CNECT-2-777090) a CDSS is developed with prognostic models to improve the management of Neck and/or Low Back Pain (NLBP). Therefore, the aim of this study is to present the factors involved in the acceptance of CDSSs among clinicians.

Methods

To assess the acceptance of CDSSs among clinicians we conducted a mixed method analysis of questionnaires and focus groups. An online questionnaire with a low-fidelity prototype of a CDSS (TRL3) was sent to Dutch clinicians aimed to identify the factors influencing the acceptance of CDSSs (intention to use, perceived threat to professional autonomy, trusting believes and perceived usefulness). Next to this, two focus groups were conducted with clinicians addressing the general attitudes towards CDSSs, the factors determining the level of acceptance, and the conditions to facilitate use of CDSSs.

Results

A pilot-study of the online questionnaire is completed and the results of the large evaluation are expected spring 2020. Eight clinicians participated in two focus groups. After being introduced to various types of CDSSs, participants were positive about the value of CDSS in the care of NLBP. The clinicians agreed that the human touch in NLBP care must be preserved and that CDSSs must remain a supporting tool, and not a replacement of their role as professionals.

Conclusions

By identifying the factors hindering the acceptance of CDSSs we can draw implications for implementation of CDSSs in the treatment of NLBP.
HESR innovation in analysis that supports decision making and action
Authors: Barr B
Published: October 2020

The European Health Equity Status Report makes innovative use of microdata, at the level of the individual, to decompose the relative contributions of five essential underlying conditions to inequities in health and well-being. These essential conditions comprise: (1) Health services (2) Income security and social protection (3) Living conditions (4) Social and human capital (5) Employment and working conditions. Combining microdata across over twenty sources, the work of HESRi has also produced disaggregated indicators in health, well-being, and each of the five essential conditions. In conjunction with indicators of policy performance and investment, the HESRi Health Equity Dataset of over 100 indicators is the first of its kind, as a resource for monitoring and analysing inequities across the essential conditions and policies to inform decision making and action to reduce gaps in health and well-being.
Health literacy impact on nutrition status and water intake in children
Authors: Saboga-Nunes L , Medeiros M , Bittlingmayer U
Published: October 2020

Background

Health literacy (HL), water intake (WI) and nutrition status (NS) are a growing field of interest in the determinants of health and health promotion. Nevertheless, research focusing HL, WI and NS targeting children is sparse. Therefore, the aim of this study (a component of the CrAdLiSa - developing ChildRen and ADolescents' health Literacy), is to explore the relationship between nutritional status (e.g. BMI), WI and HL levels in Portuguese children towards their HL increment while fighting health disparities.

Methods

A population cross-sectional study included (n = 725) children enrolled in the school year 2018/2019 of four schools in Santarem and Lisbon. Indicators of anthropometric data, WI, HL levels (using the HLS-EU-PT questionnaire) were collected with the CrAdLiSa online self-administered questionnaire.

Results

Preliminary results show that the instrument to measure HL (HLS-EU-PT) show satisfactory internal consistency (Cronbach's alpha coefficient 0,94). The older the age, the lower the amount of WI perception as adequate (p = 0.03); male children (p = 0,02) and children that attend schools in urban area (p = 0,01) drink more water; the older the age, the lower the levels of HL (p = 0.000); children with higher levels of HL have greater WI (p = 0.01) as they have a broader perception of the adequate amount of water needed to be healthy.

Conclusions

These results of CrAdLiSa study showed the usability of the HLS-EU-PT questionnaire adapted for children to assess their HL levels. Children's perception of WI are the first ever results collected from such a population and are part of a seminal research that is needed to improve quality of life of the Portuguese children.
Gender Responsiveness of NCD and tobacco control policies
Authors: Hawkesv S
Published: October 2020

Sarah Hawkes will discuss recent analyses of the gender-responsiveness of NCD policies in general in 6 European countries and tobacco-control policies in particular in a further 4 LMICs. Tobacco use is the world's leading preventable cause of illness and death and the most important risk factor for NCDs and thus developing effective and transformative tobacco control policies remains a pressing priority. Evidence for the sex-disaggregated burden of disease will be supplemented with gendered and intersectional analysis that explains why differences in health outcomes persist, and discussions will centre on how policies and programmes to address NCDs, including those specifically linked to tobacco, can be made more responsive to gender and its intersections.
Different settings of violence and risk factor for suicide: a case-control study in Campinas, Brazil
Authors: Komoda D , Cordeiro R C , Ruiz A M P , Fernández M R B
Published: October 2020

Background

According to WHO, “800,000 people die due to suicide every year” and “is the third leading cause of death in 15-19-years-old”. And although the main risk factor to suicide is a prior attempt, this study tried to find other risk factors, which can guide a broader discussion amongst global and local communities as well as policy makers and healthcare professionals effort against all forms of violence. The aim of the study is to measure the risk of suicide in different sets of violence.

Methods

This is a case-control study held in Campinas-SP, by epiGeo research group on violence during 2019. Cases are defined as people who commited suicide; information on child abuse were collected through verbal autopsy interviews with kinships. For controls, R randomly selected addresses for interview with someone randomly selected. Odds Ratio was obtained by generalized logistic regression. Confidence Interval was set to 95%.

Results

Final analysis shows that suicides represented 14.2% of death due to external causes in 2019. A relation between male sex and suicide was observed (OR: 4.35; CI 2.55 - 7.41; p < 0.0001). Abuse during childhood also showed positive relation (RR: 2.16; CI 1.09 - 4.27; p = 0.0001). Another relation were observed in people with disabilities and suicide risk (RR: 2.04; CI 1.26 - 3.31; p = 0.004).

Conclusions

People who suffered child abuse and people with disabilities are amongst the ones who suffer higher risks of suicide, and the most probable hypothesis relating both conditions is violence. Action must be taken by the global and local communities, policy makers in a broad sense, against maltreatment, bullying, youth violence, intimate partner violence, sexual violence, emotional and psychological violence, and gender-based violence.

Key messages

Strengthening protective policy to overcome violence and abuse against child and other vulnerable people is of major importance to fight suicide risk. Accessibility and protective policies are of utmost importance to a more inclusive and welcoming society.
Exploring health systems readiness for domestic violence in Brazil and Palestine
Authors: Colombini M , d’Oliveira A F , Alkhayyat A , Shaheen A , Garcia-Moreno C , Feder G , Bacchus L
Published: October 2020

Background

Increasing attention has been paid on health systems readiness around domestic violence (DV), a global health issue leading to adverse health consequences. This article aims to present a comparative synthesis of the health system pre-conditions necessary to enable integration of services for domestic violence in Brazil and Palestine.

Methods

A health systems readiness assessment was conducted to explore health systems gaps. Multiple, data sources were used, ranging from qualitative interviews with various stakeholders (e.g. providers, health managers and key informants); structured facility observations (8 clinics); policy document reviews.

Results

Our findings highlight deficiencies in policy and practice that need to be addressed for an effective response. Common preparedness gaps include unclear governance and unsupportive leadership structure; challenges around service delivery such as limited staff protection and limited coordination; and untrained health workforce. Our results illustrate the importance of having clear guidance on roles and responsibilities for both health managers and clinicians. In Brazil, although there is a legal and regulatory system on domestic violence, its implementation has been patchy as health regulations are not well-defined. In both settings, the limited higher-level commitment and political will to reduce violence has affected implementation. Limited guidance, coupled with limited training and perceived lack of support in the facility environment, also impacted on providers' knowledge and confidence in responding to violence. Fear of family retaliation affected frontline providers' actions in both countries.

Conclusions

Our innovative framework helped identify anticipated readiness gaps. It has shown the importance of nurturing the role and values of managers and engaging the leadership across every system to reframe challenges, and strengthening routine practices to encourage staff engagement in responding to DV.

Key messages

Conducting a health systems readiness assessment before integrating a new service can anticipate preparedness gaps and inform adaptation that will enhance service uptake and effectiveness. Critical systems gaps to address before integrating domestic violence services in healthcare include staff and managers’ values, leadership and organisational support to frontline providers.
School connectedness, violence-related behaviours and mental health status among in-school youth
Authors: Akinmoju O , Odigwe B , Olusakin T , Fakayode D , Olaopa F , Adejuwon A , Eze D , Olaleye O , Balogun B , Adebayo A
Published: October 2020

Background

Young people spend significant amount of time in school which has a substantial impact on the development of this group. Mental health problems and violence-related behaviours (VRBs) are common among youth including those in school. Studies on the relationship between school connectedness (SC), VRBs and mental health status (MHS) are currently scarce in the literature. This study was conducted to assess SC, VRBs, MHS of in-school youth in a rural community of southwest Nigeria and the association between SC, VRBs, and MHS.

Methods

A cross-sectional study was conducted among 655 respondents randomly selected students of 4 public and 4 private senior secondary schools in Eruwa, Oyo State. A semi-structured interviewer-assisted questionnaire was used to obtain information on SC, VRBs and MHS. SC comprised of a 42-item scale, VRBs had 20 and MHS had 14-item scale. Data was analysed using descriptive statistics and chi-square with level of significance set at 10%.

Results

Mean age of students was 16.4±1.3 years (public 59.2%; private 40.8%). Above one-half (55.8%) were disconnected from school, 86.4% reported participation in or experience of VRBs and 28.3% had poor mental health. Students who did not experience VRBs were less likely to have poor MHS (OR: 0.438; 95%CI: 0.23-0.82; p = 0.010). Students from monogamous family setting were less likely to have poor MHS than those from polygamous setting (OR: 0.672; 95%CI: 0.46-0.99; p = 0.046). Non-smokers were less likely to have poor MHS than their smoking counterparts (OR: 0.298; 95%CI: 0.12-0.73; p = 0.008). Students who rarely experienced being sent out of school were less likely to have poor MHS than those who had regular experience (OR: 0.315; 95%CI: 0.11-0.89; p = 0.029).

Conclusions

There was high prevalence of VRBs among students with majority of them having good MHS. Predictors of poor MHS were experience of VRBs, family setting, smoking status and experience of being sent out of school.

Key messages

Predictors of poor MHS among youth lacking in literature were found. Pathway to addressing these globally is shown below. International bodies’ support for restriction of cigarette’s use by < 18years. Funding of education in rural areas to reduce financial difficulty, parents modelling their children to correct attitude to violence and more studies unravelling mediating factors of polygamy on MHS.
Production losses attributable to suicide mortality in the European Union in 2015
Authors: Łyszczarz B
Published: October 2020

Background

Suicides are an important public health problem with multidimensional consequences for the whole society. One of the under-researched areas of suicide consequences are production losses associated with these deaths. The aim of this study was to estimate the production losses (indirect costs) of suicide deaths in 28 European Union states (EU-28) in 2015.

Methods

The study applied the top-down approach, societal perspective and human capital method to sex- and age-specific data on suicide mortality at working age. The WHO Mortality Database was used to identify the number of deaths (3-year average) in each country while the Eurostat's labour and economic indicators were used to proxy the value economic output lost.

Results

The production losses attributable to suicide deaths in EU-28 in 2015 were €8.81 billion. The per capita indirect costs of these deaths were €17.28 for the whole EU-28 population; Ireland experienced the highest per capita burden (€50.38), while the average costs were the lowest in Cyprus (€3.84). The losses constituted an economic burden of 0.06% of EU-28's GDP; this share ranged from 0.016% (Cyprus) to 0.149% (Latvia). Most of the losses were due to men's deaths and the proportion of losses associated with male mortality ranged from 70.9% (Sweden) to 91.4% (Poland). The results of sensitivity analysis exhibit large variation of losses; the highest costs were estimated with no adjustment for lower employment rates among those committing suicide (36.9% to 238.9% higher than in base scenario) while the lowest costs resulted from the scenario of adjustment for minimum productivity (-47.6% to -65.7% lower than in base scenario).

Conclusions

The production losses caused by suicide deaths are a substantial burden for European economies. Therefore, the use of cost-effective actions aimed at limiting self-harm mortality might be beneficial not only in terms of health gains but could also contribute to limiting indirect costs.

Key messages

Production losses attributable to suicide deaths are 0.06% of EU’s GDP, ranging from 0.02% of GDP in Cyprus to 0.15% of GDP in Latvia. Indirect costs of men’s deaths dominate in all the countries and this can be explained by both higher suicide rates and longer economic activity than among women in Europe.
How to increase the value of self-reported health service data by using data linkage: a case study
Authors: Peng W , Maguire J , Hayen A , Adams J , Sibbritt D
Published: October 2020

Background

This is a case study for recurrent stroke prevention. Lifestyle factors account for about 80% of the risk of recurrent stroke. Most health services studies examining stroke prevention rely on stroke survivors' self-reported lifestyle behaviour data. How can researchers increase the value of collected self-reported data to provide additional information for more comprehensive assessments?

Methods

45 and Up Study is the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. This case study linked self-reported longitudinal lifestyle data in the 45 and Up Study, with corresponding mortality data (i.e. NSW Registry of Births, Deaths and Marriages & NSW Cause of Death Unit Record File) and hospital data (i.e. NSW Admitted Patient Data Collection) via the Centre for Health Record Linkage (CHeReL). The main outcome measures are health services, clinical outcomes, and mortality rates for stroke care. The analyses will include descriptive analysis, multivariate regression analysis, and survival analysis.

Results

A total of 8410 stroke survivors who participated in the 45 and Up Study were included in this data linkage study. From January 2006 to December 2015, 99249 hospital claims (mean: 13 times admission to hospital per person) and 2656 death registration records have been linked to these participants. The mean age of the stroke survivors was 72 (SD = 11) years, with 56% being males. These results are preliminary and more analyses will be conducted by using quality of life status, clinical diagnosis, comorbidities, and procedures.

Conclusions

Data linkage enables researchers to generate comprehensive findings on health services studies and gain a more holistic understanding of the determinants and outcomes of stroke prevention with lower data collection costs and less burden on participants.

Key messages

Data linkage brings about a new opportunity for self-reported data on health services utilisation. It is a cost-effective way to enhance existing self-reported data via the data linkage approach to increase its usefulness for informing health service planning.
28.G. Workshop: Foresight studies at the global, European and national level: what can we learn from them?
Authors:   Organised by: RIVM (Netherlands),   Chair persons: Henk Hilderink - Netherlands, Robert Vonk - Netherlands
Published: October 2020

Foresight studies provide valuable information for (strategic) policy-making. They provide insights into the most important future trends and challenges, which is essential for well-informed policy-making. The number of foresight studies in the field of Public Health was limited but the number of studies is growing rapidly over last years. With these studies becoming available, their findings might become a more a regular component of population health monitoring activities. Given the relatively early stage of development of foresight studies in the field of Public health, a proper understanding and interpretation of the future studies might need some further guidance. How to deal with an (uncertain) future in the policy making process is one of the issues that needs to be addressed. This workshop starts with an interactive session to get a better understanding of the level of knowledge and needs regarding foresight studies, followed by the presentations of four different applications of foresight studies. The first one is at the global level from the institute for health metrics and evaluation (IHME) who has a long track record regarding public health data gathering and applying these, for example, to calculate the Global Burden of Disease. Next, EURO-HEALTHY project will present the Scenarios for population health inequalities in 2030 in Europe, partly based on a Web-Delphi process with a multidisciplinary panel. The third presentation will be from Public Health Wales on Futures for Wales which puts future health in the broader perspective of wellbeing. The last presentation will also be a national one, the Public Health foresight study, which has been conducted for more than 2025 years with an update published in 2020. After these presentations, ample time will be reserved for discussion on how these studies could best contribute to better public health policy making. Workshop participants will be informed about the main results of recent foresight studies, allowing them to reflect on these from their own perspective. They will get insight into the approaches and methods used in these recent studies, which may be helpful or inspiring for their own practice.

Key messages

Public health foresight studies are done more frequently and their findings can influence public health policy making. In this workshop, the methodology and findings of foresight studies at the global, European, and national level will be discussed.
Scenarios for population health inequalities in 2030 in Europe
Authors: Vieira A C L
Published: October 2020

Health inequalities have been consistently reported across and within European countries and continue to pose major challenges to policy-making. In the EURO-HEALTHY project, funded by Horizon 2020, three 2030 time-horizon scenarios were developed, depicting the key factors that may affect the evolution of PH inequalities across European regions. A three-stage socio-technical approach was applied: i) identification of drivers (key factors expected to affect the evolution of PH inequalities across European regions until 2030) - this stage engaged in a Web-Delphi process a multidisciplinary panel of 51 experts and other stakeholders representing the different perspectives regarding PH inequalities; ii) generation of scenario structures - different drivers' configurations (i.e. their hypotheses for evolution) were organised into coherent scenarios using the Extreme-World Method; and iii) validation of scenario structures and generation of scenario narratives. Stages ii) and iii) were conducted in two workshops with a strategic group of 13 experts with a comprehensive view about PH inequalities. Three scenarios were developed for the evolution of PH inequalities in Europe until 2030: 'Failing Europe' (worst-case but plausible scenario), 'Sustainable Prosperity' (best-case), and an interim scenario 'Being Stuck' depicting a 'to the best of our knowledge' evolution. These scenarios show the extent to which a combination of Political, Economic, Social, Technological, Legal and Environmental drivers shape future health inequalities, providing information for European policy-makers to reflect upon whether and how to design robust policy solutions to tackle PH inequalities. The work presented owes its innovation to the use of a technological platform to interact with participants for idea-generation, together with the use of future-oriented evidence within a face-to-face environment to trigger discussion among a small strategic group to enrich the scenario narratives.
Dutch Public health Foresight study 2018/20
Authors: Hilderink H
Published: October 2020

The four-year Public Health Foresight Study (VTV) provides insight into the most important societal challenges for public health and health care in the Netherlands. The seventh edition of the Dutch Public Health Foresight study was published in 2018, with an update in 2020. In this update a business-as-usual or Trend Scenario was developed using 2018 as a base year. In the trend scenario demographic and epidemiological projections have been used to depict the future trends regarding ageing, health, disease, health behaviors, health expenditures and health inequalities. Next, these trends are used to identify the most important future challenges and opportunities for public health. In the 2020 update, special attentions is given to climate change and the local living environment and their impacts and interaction with public health outcomes. Trends in lifestyle-related lifestyle show both positive (smoking prevalence) and negative (overweight prevalence) future developments. Dementia will be the leading cause of mortality and disease burden in 2040 by far. Health care expenditures will double by 2040, with cancers showing the most rapid growth of all disease groups. The insights of this study are directly used as input for the National Health Policy Memorandum and for the National Prevention Accord.
Engaging patients: how to speak so patients want to listen
Authors: Rubinelli S
Published: October 2020

The paternalistic approach to health professional-patient communication is often no longer successful. The main reasons for this include the fact that trust in medicine and health professionals is no longer taken for granted. In many domains, the concepts of 'expert' and 'science' are in shadow. Moreover, patients can access all sorts of health information, including information that is or seems inconsistent with the advice given by their health professionals. This talk aims to illustrate some basic approaches to communication that can enhance health professional-patient interaction. First, health professionals should consider their communication with patients as a form of persuasion. Persuasion, that does not equal manipulation, is a way to communicate that takes into consideration the knowledge, beliefs, and attitudes of interlocutors. By adopting a person-centered style, health professionals should present their advice by contextualizing it into the emotional and cognitive setting of the patients. Second, communication should consider the lived experience of patients, that is the impact that a health condition or a preventive behavior has on their quality of life and their experience of pleasure. Indeed, managing health conditions is not just applying health advice: it often demands a change in lifestyles that can negatively impact how patients live their lives. Third, health professionals should develop clear strategies to engage with information that patients find from other sources. Health professionals must ask patients if they disagree with them, and to clarify any eventual difference of opinion. The information age has positively favored a democratization of health information. Yet, it imposes that health systems care for their communication. This talk concludes by presenting main evidence from on how to reinforce hospitals, public health institutions, and health services in communication so that patients want to listen.
Engaging policy makers: how to make the message pass?
Authors: Greco D
Published: October 2020

Vaccination remains a serious matter of concern from a relevant part of the population, therefore a quite delicate issue for policy-makers. The paradox between vaccination success and vaccination hesitancy is a current issue: the more vaccination has been successful in eliminating or reducing the incidence of diseases the lower the perception of risk among younger parents' cohorts that never saw diseases for which their children are requested to be vaccinated.

This hesitancy is reflected in the politicians' space, as they are quite reluctant to impose measures that will target the mass of healthy young children potentially raising negative reaction from the parent's population.

Financial issues are not a concern in the rich world: vaccination global budget is a small fraction of the running health expenditures; money is still a problem in developing countries, but there population and politicians do accept happily donation for new vaccination campaigns.

But the situation is quickly changing: in the northern hemisphere, despite the growth of vaccination hesitancy seven new vaccines have been successfully introduced in the last decade (e.g. Chickenpox, HPV, Rotavirus) and new ones are close to introduction (e.g. Herpes Zoster, Gonorrhea, Norovirus, RSV).

Are policy-maker changing the traditional reluctant attitude against new vaccines? Few factors have been underlined in the last decade: Vaccination cost-benefit analysis offer politicians a good argument to show they are working for the population health.Mathematical models are becoming frequently used tools to show the economic gain of vaccination.The consequences of fake news and antivaccine narrative are warning politicians for more respect for science.Newly emerging epidemic diseases are increasing population confidence for public health interventions.

Those factors are influencing health communication and could become useful tools to complement policy-makers' strategies.