bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing and implementing practical ways to address slum health determinants: Learning from India
Authors: Agarwal S , Verma S , Verma N , Kothiwal K 
Published: October 2020

Abstract

Issue
There is a need for adaptable/scalable methods to understand environmental determinants of health and well-being in slums of LMIC cities. Catalysing grassroots actions to reduce health inequalities is needed with strong community leadership in slums.

Methods
Conducted in 2016-2017 in Indore (3 m population), India this practice undertakes qualitative health assessments using simple, actionable indicators with community knowledge and prioritizes solutions. Participatory neighbourhood level assessment of sewerage, toilets, garbage disposal and water supply by slum women was done using three colour scale: red for poor condition, yellow for moderate condition and green for good condition across 24 slums. Since slum women live these challenges daily, they can assess conditions. A qualitative adaptation of WHO's Urban HEART, this practice seeks to learn how slum women assess conditions, implement actions for improvement of slum environment.

Results
Context responsive actions included submitting community petitions and reminders to Municipal authorities by slum women to repair sewerage lines, construct toilets, increase regularity of garbage collection and improve public water supply in slums. Of 24 slums assessed in 2016, 6 were designated as “red”, 14 as “yellow” and 4 as “green” on condition of toilets and sewerage. On garbage disposal and water supply, 8 slums were designated as “red”, 10 as “yellow” and 6 as “green”. With coordination with Municipal authorities in 2017, slums on “red” reduced to 3 in each group, those assessed as “green” increased to 10 with improved conditions.

Lessons
This approach helps slum communities to assess problems and implement solutions. The methodology is simple, low-cost, easily understood by less educated, academics, policy makers and uses community wisdom. It is adaptable for NGOs, relevant policies/guidelines in LMIC cities. This collective community health assessment directly catalyses demand side action.

Key messages
Collective efficacy is a group’s shared belief in its ability to utilize information, pursue actions to overcome obstacles accomplishing a valued goal. This method is key to replicate this practice. People’s efforts to bring public services to the slums through collective action can reduce urban health inequality.
Health promotion in Swiss municipalities: towards proportionate universalism
Authors: Amstutz D , Villa O , Georges A , Lutz A , Zuercher K , Pasche M 
Published: October 2020

Abstract

Background
Health promotion goes beyond the health sector. Municipalities, the local public authorities in Switzerland, have a crucial role to promote population health in all their decisions.
Initially developed by Promotion Santé Valais, the label “Healthy municipality” exists in the canton of Vaud since 2015. The label takes stock of existing measures in health promotion and prevention in all sectors and incentivise new interventions. The labelling process respects different criteria and is validated by an external committee. It is voluntarist, free of charge for the municipality but requires time and intersectoral communication. This abstract explores equity in the uptake of the label.

Results
In Vaud, 17 municipalities have been labelled “healthy”. Two external evaluations by Swiss universities highlighted that small villages are less involved in the label than urban areas. To achieve health equity, we need to identify and approach municipalities with limited human and financial resources, that might be less active in health promotion and/or whose population is socioeconomically disadvantaged. Preliminary results indicate that municipalities below 1000 inhabitants, in rural areas, should be targeted first. We are currently investigating the barriers and facilitators for them to enrol in the label.

Lessons
As labels rewarding healthy cities are expanding worldwide, it is important to document and reflect on who benefits from them, and who does not. Our practice is now focusing more on villages in rural areas, with less resources than urban settings. We investigate their needs regarding the type of support that we, public health professionals, can provide. Proportionate universalism principles should also apply to advocacy for health promotion, at the municipality level.

Key messages
To achieve health in all policies, the role of municipalities is essential. More efforts in health promotion should target specifically small and rural municipalities, with limited resources.
The inflammatory potential of the diet is prospectively associated with subjective hearing impairment
Authors: Andreeva V A , Péneau S , Julia C , Shivappa N , Hébert J R , Wirth M D , Touvier M , Hercberg S , Galan P , Kesse-Guyot E 
Published: October 2020

Abstract

Background
Age-related hearing loss is prevalent yet insufficiently addressed by public health research. Subjective hearing loss has been highlighted as a key determinant of reduced quality of life, while chronic low-grade inflammation is an established determinant of adverse age-related outcomes. To our knowledge, this study was the first to investigate the link between the inflammatory potential of the diet and hearing loss.

Methods
We prospectively studied 3,435 French adults enrolled in the SU.VI.MAX (1994-2002) and SU.VI.MAX 2 (2007-2009) cohorts. The inflammatory potential of the diet was estimated by the Dietary Inflammatory Index (DII) using established methodology and repeated, baseline 24-h dietary records. Subjective hearing impairment was assessed after a median of 12 years by 3 Yes/No items and by a composite score, dichotomized for analyses. We fit multivariable logistic regression models adjusted for pertinent covariates.

Results
Compared to men, women exhibited higher DII (more pro-inflammatory diet) and less hearing impairment (both p &lt; 0.0001). Given significant interaction results, sex-specific models were fit. Among men, a significant positive association between DII (continuous scale) and inability to follow a conversation in a noisy place was found (OR = 1.10; 95% CI: 1.02, 1.18), while the inverse association was seen among women (OR = 0.92; 95% CI: 0.87, 0.98). Regarding the need to turn up the volume on the television/radio, a significant positive association with DII (continuous scale) was found only among men (OR = 1.09; 95% CI: 1.01, 1.18). The only significant association with the composite score of subjective hearing loss was found among women, when modeling DII as quartiles (OR Q3 vs Q1=0.74; 95% CI: 0.57, 0.97).

Conclusions
The findings among men support the hypothesis that a pro-inflammatory diet could increase risk of age-related hearing loss, whereas the findings among women were unexpected and merit further investigation.

Key messages
Given rapid population aging worldwide, there is an urgent need for public health research on modifiable risk factors of hearing impairment. The role of diet in hearing impairment is complex and likely sex-specific; a pro-inflammatory diet might be a risk factor for hearing impairment, especially among men.
What does competent moral expertise look like in public health practice?
Authors: Tahzib F 
Published: October 2020

Abstract

Background
Public health practitioners regularly face moral dilemmas in their daily practice but they are not well prepared to deal with them. Yet, from an ethics perspective, educational programmes are often inadequate. Rather, there is a need to better understand public health ethical competencies and to develop education and training in public health ethics (PHE).

Objectives
This presentation will share findings and learning from an ESRC funded research by the UK Faculty of Public Health in collaboration with the Universities of Southampton and Bristol around the nature of competency in PHE and law. Our leading question is: What are the key ethical and legal knowledge, skills, values and attitudes necessary for PHE and law as a professional competency of the public health workforce (PHW)?

Results
We created a working list of what the competencies should look like based on the material from the competency library, comments from a panel of practitioners, experts which we convened, and own analysis that reflects subject matter knowledge, expressed skill development requirements and personal work experience. These were organized within five areas which: (i) Awareness and Understanding, (ii) Engagement and Research, (iii) Analysis and Reasoning, (iv) Evaluation and Reflection and (v) Action and Advocacy. The five areas and various issues which they cover will be described, as well as reflection and learning from some key activities and initiatives in building competency and capacity.

Conclusions
There is need to appreciate the nature of competency of PHE and build capacity and competency of the PHW through education and training programmes as key element of public health training curricula.

Key messages
There are distinguishing features in teaching, learning and practice of PHE compared to clinical ethics. To implement PHE competencies into practice and in public health curricula requires better understanding of practice and the political mandate of public health.
Stigmatizing policies’ influence on HIV risk through their effect on internalized homonegativity and health behaviors among men who have sex with men in Europe
Authors: Stojanovski K , King E , Amico K R , Eisenberg M , Geronimus A , Schmidt A 
Published: October 2020

Abstract

Background
Men who have sex with men (MSM) in Europe are most affected by HIV disparities. Complex systems theory proposes that many health behaviors and risks arise from numerous cascading and interacting processes. Our aim was to explore how stigmatizing policies at the European country-level create pathways to HIV risk and disparities among MSM in Europe.

Methods
We used data from the 2017 European Men Who Have Sex with Men Internet Survey (EMIS-2017). The anonymous online survey recruited 126,090 European MSM. We assessed condom use with steady & non-steady partners as the outcome. Condom use was categorized from zero to 10 (10 or more partners). Abuse was scored zero to three and internalized homonegativity from zero to six. We used the International Gay and Lesbian Association's Rainbow Index as the main predictor, which ranks European countries' laws and policies regarding LGBTQ+ legal protections from zero (worst) to 100 (best). We used structural equation and multi-level modeling for analyses.

Results
The mean Rainbow Index score was 50.8 with a range from 6 to 88. The Rainbow Index scores were the highest in Western European (mean=62.5), then Central European (mean=45.9), then Eastern Europe (mean=21.4) (p &lt; 0.000). Unadjusted regression models suggested that for every one-unit improvement in the Rainbow Index the number of condomless sexual acts with steady sexual partners was reduced [β=-0.0012, 95% CI (-0.0016, -0.0009)]. The unadjusted structural equation model showed that the relationship between the Rainbow Index and condom use with steady partners was mediated by 30% because of internalized homonegativity (p &lt; 0.000).

Conclusions
The policy context influences HIV risk, especially through the policies' effects on condom use. HIV research and prevention efforts must recognize that structural determinants can shape people's risk for HIV and that the best individual and local efforts may be undermined by structural factors such as policies.
A sustainable ECHI-shortlist
Authors: Tijhuis M , Ombrellaro K , Petrauskaite I , Vaidelauskaite A , Daňková S , Van der Wilk E , Gissler M , Palmieri L 
Published: October 2020

Abstract

Background
The European Core Health Indicators (ECHI) list provides a 'snapshot' of European public health (including care). It is the result of consecutive EU-wide projects in response to a 1998 European Commission (EC) call to establish an indicator list as the core of the EU public health monitoring system. The current list contains 88 indicators, a large part of which have been implemented and used across the EU. Using ECHI to internationally compare public health aspects adds value to national health information. Currently, EC maintains a tool in which the indicators can be consulted. However, no formal governing entity exists. The aim of this study, under the Joint Action on Health Information (InfAct), is to explore the future of the policy guiding role of the ECHI list, the process of adapting and innovating the list and the role of current member state initiatives in this.

Methods
Relevant technical information, available via 'doc(umentation) sheets' dating from 2012, was subjected to an update process. Potential improvements in content (additions, deletions, and adjustments), overall balance and policy relevance were suggested by health information experts (via survey and expert meetings). This work will be expanded in the near future of InfAct.

Results
Peer-reviewed updates of the doc sheets included aligning with meta information from relevant data collecting bodies and reviving web links. A process to guide content changes to the list is in development, balancing sustainability and updates for public health policy. Online background ECHI information is disseminated via ECHI.eu.

Conclusions
Health information experts still consider the ECHI shortlist important for EU health policy, but it needs to be modernized and promoted. A formal structure is needed to ensure the highest value to EC and MS health policies. The future distributed research Infrastructure on population health (DIPoH) may host the shaping and governing the ECHI, in liaison with EC and MS.
Incorporating intersectionality into quantitative research methods in public health
Authors: Bauer G , Scheim A 
Published: October 2020

Abstract

Introduction
The use of intersectionality as an explicit theoretical framework in quantitative public health research is relatively recent, and has involved a wide array of study design and statistical methods. As best practices have not been identified, guidance for research design and analysis is needed.

Methods
We draw on a review of the literature and our own methods publications to present an overview of key considerations in approaching public health research from an intersectional perspective.

Results
Key considerations differ for descriptive studies of intersectional inequalities and analytic studies of potential causes of those inequalities, as research methodologies and their strengths and limitations differ. For descriptive studies, considerations include specification of intersectional groups, multiplicative vs. additive scale for analysis of effects and interactions, limitations of data sets, whether all intersectional groups are of equal interest, and choosing statistical methods. For analytic studies, considerations include whether potential causal factors are relevant and measurable for all intersections or are specific to some, variable measurement, different options in standardization or control of confounding, and statistical analysis methods.

Discussion
We present considerations in incorporating intersectionality frameworks, and provide tools for conceptualizing intersectionality-informed quantitative public health research.
14.L. Workshop: Determinants of family mental health
Authors:   Organised by: EUPHA Public mental health section,   Chair persons: Jutta Lindert – EUPHA-PMH, Johan Bilsen – EUPHA-PMH
Published: October 2020

Abstract
Over the past decade, the demographic composition of the population is rapidly changing. This has a huge impact on family members, especially on youth (10-25years). Youth is a formative period in which young people might be especially vulnerable. Multiple physical, emotional and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems. Promoting psychological well-being and protecting youth from adverse experiences and risk factors that may impact their potential to thrive in later life are critical for their mental health not only during adolescence but also in adulthood. Supportive environments in the family, in the wider community and at a global level are important. Multiple factors determine mental health outcomes in youth. Violence (including wars and conflicts, child abuse and harsh parenting), and socioeconomic problems are risks to mental health of youth. In order to address the mental health needs of vulnerable youth and families with youth, increasing knowledge about factors influencing mental health in this age group is imperative.
This international workshop will be focused on addressing mental health issues of families and youth. The presentations will focus on 1) self-identified mental problems in a rural area of Germany (Marta Natan); 2) the factors associated with child abuse and the consequences of child abuse in a representative sample from Norway (Gertrud Sofie Hafstad); 3) transit experiences and mental health of unaccompanied refugee children (Ilse Derluyn) and 4) suicidal behaviour and violence among young people (Marija Jakubauskiene).

Key messages
Determinants of youth mental health can be identified to address common mental disorders in youth. Youth and family mental health cannot be fully addressed without the dignity that is upheld by human rights.
FoodEx2 enhances the harmonization of food consumption, composition and carbon footprint databases
Authors: Ferreira de Sousa R , Padula de Quadros V , Balcerzak A , Bevere T 
Published: October 2020

Abstract

Introduction
FoodEx2 is a food classification and description system developed and maintained by the European Food Safety Authority (EFSA). It is currently used at global level with the support of the Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO) to harmonize datasets in the FAO/WHO Global Individual Food consumption data Tool - FAO/WHO GIFT. This is an open access online platform hosted by FAO and supported by WHO, for collation and dissemination of individual quantitative food consumption data, especially from low- and middle-income countries.

Objective
To demonstrate FoodEx2's usefulness in global harmonization of food description in food consumption datasets and its potential in facilitating food matching for various types of food data.

Methodology
Information was gathered from data owners of food consumption datasets and others who were trained to use FoodEx2, and on the number of datasets that have initiated or completed their data harmonization process, as a result of the FAO/WHO/EFSA collaboration.

Main Findings
Over 50 data owners of food consumption data and/or food composition tables (FCT) have been trained in data re-categorization with FoodEx2. As a result, 6 FCT and 25 food consumption datasets from 18 countries were or are being coded with FoodEx2, and out of those, 30 datasets are or will soon be disseminated through FAO/WHO GIFT in the form of infographics and microdata. Additionally, at least 3 databases of greenhouse gas emission (GHGE) estimates of foods have been mapped with FoodEx2.

Conclusions
Increased harmonization with FoodEx2 would enhance the consistency and reliability of nutrient intake assessments. Harmonization with FoodEx2 is being used to assess the environmental impact of diets and help identifying sustainable food consumption patterns.
16.F. Workshop: Expanding coverage and improving quality: health reforms and policy learning across North America
Authors:   Organised by: North American Observatory on Health Systems and Policies (NAO),   Chair persons: Suszy Lessof - Belgium, Greg Marchildon - Canada
Published: October 2020

Abstract
Health systems globally share challenges with expanding coverage while increasing quality. This workshop organized by the North American Observatory on Health Systems and Policies (NAO) will draw on the results of major health system studies of Canada, the United States (US) and Mexico. The NAO is a partnership of researchers, governments, and health organizations in the three countries, promoting evidence-informed health system policy decision-making. It works with the European Observatory on Health Systems and Policies and other global affiliates. One of the NAO's activities is co-publishing, with the European Observatory and the University of Toronto Press, full-length books about the health care systems in each of the three countries, modeled after the European Observatory's Health System in Transition (HiT) book series that includes full-length treatments of the systems in 70 countries. In 2020 new books will be jointly released in all three countries (Canada's third edition, the US's second, and Mexico's first). This workshop has two overarching

Objectives
first, to describe the recent health policy developments to provide insights into the successes and challenges of the three North American countries' health systems; second, to explore the potential for policy learning across the three countries with shared challenges but quite different institutional, political and economic contexts. Lead authors of each of these studies will deliver a short presentation describing the major public health and health system challenges faced in their country, and providing an analysis of recent health sector reforms. A panel discussion will follow, facilitated by the chairperson, that will start with a speaker that brings an international perspective to comment on the areas of convergence and divergence in health sector reforms in North America with those taking place across the European region. Each of the lead authors will then respond to the questions and comments raised, and will take questions and comments from the participants. This workshop brings together leading health system and public health scholars from Canada, the US, and Mexico for the first time at this international conference, which will provide participants with an opportunity to learn about these complex and ever-changing health systems and to engage in rich and lively discussion.

Key messages
In-depth health system studies provide the opportunity to identify lessons that may be transferable across national boundaries. Comparing recent health reforms in the three largest North American countries provide insight into policy learning across high- and middle- income contexts.