bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring health expectancy in the European Union
Authors: Santos JV , Viana J , Devleesschauwer B , Haagsma JA , Costa Santos C , Ricciardi W , Freitas A 
Published: October 2022

Abstract

Background
Healthy life expectancy (HLE) is a population health measure that combines mortality and morbidity, which can be calculated using different methods. In this study, we aimed to assess the correlation, reliability and (dis)agreement between two estimates monitored in the European Union (EU), that is, the European Commission's HLE based on self-perceived health (SPH-HLE) and the Institute for Health Metrics and Evaluation's HLE based on disability weight (DW-HLE), by sex, and comparing these results with LE and proportion of life spent in good health (%GH).

Methods
We performed a retrospective study in the EU28 countries, between 2010 and 2017. The HLE methods differ in definition, measurement and valuation of health states. While SPH-HLE relies directly on one question, DW-HLE relies on epidemiological data adjusted for DW. Spearman's r, intraclass correlation coefficient, information-based measure of disagreement and Bland-Altman plots were used to assess reliability, correlation and disagreement in HLE resulting from both methods and in LE or %GH measured by both institutions.

Results
Correlation and reliability between SPH-HLE and DW-HLE were good (better for males), with low disagreement, and were even better for LE between both institutions. The HLE Bland-Altman plots suggest a variability range of approximately 6 years for both sexes, higher for females. There was also an increasing HLE difference between methods with higher average HLE for both sexes.

Conclusions
We showed wide variations between both methods with a clear and different high impact on female and male HLE, showing a tendency for countries with higher health expectancies to yield larger gaps between SPH-HLE and DW-HLE.
Acknowledgements: This presentation was supported by National Funds through FCT - Fundação para a Ciência e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDP/4255/2020)

Key messages
• Different methods for evaluating health expectancy lead to significantly different results.
• There is a systematic tendency with countries with higher health expectancies to yield larger gaps between SPH-HLE and DW-HLE.
Barriers and facilitators to healthcare access for homeless people in four European countries
Authors: Schiffler T , Carmichael C , Lehner L , Gil-Salmeron A , Kouvari M , Karnaki P , Grabovac I 
Published: October 2022

Abstract

Background
People experiencing homelessness (PEH) have higher prevalence of adverse health outcomes and premature mortality compared to the general population, and often experience significant barriers in accessing healthcare services. This study aimed to better understand the health needs of PEH, as well as to identify the barriers and facilitators to their timely and equitable access to health services from the perspective of PEH and relevant health professionals and social care workers.

Methods
During autumn 2021, a cross-national qualitative study was conducted within the framework of the Horizon 2020 funded CANCERLESS project. Semi-structured interviews were conducted across four European settings (Austria, Greece, Spain and the UK). Interviews were audio-recorded, transcribed verbatim and analyzed according to the inductive thematic approach set out by Saldaña (2021).

Results
In total, 69 interviews were completed with a sample comprising 15 professionals working in homelessness support services, 19 health professionals, and 35 PEH. Three overarching themes relating to the research question were identified: (a) Health needs of people experiencing homelessness; (b) Barriers to access healthcare services and (c) Facilitators to access healthcare services. Overall, the general health of PEH was depicted as extremely poor and mainstream health services were portrayed as ill-equipped to respond to the needs of this population, with many organizational and system-level barriers noted. Tailored approaches to care, and in particular involving trusted professionals in the delivery of care, were identified as a key strategy for overcoming existing barriers.

Conclusions
While a number of context-specific findings were identified, results indicated there to be a high degree of overlap and consistency in the health needs of PEH, and in the barriers and facilitators that exist when accessing healthcare across four different healthcare systems.

Key messages
• Homelessness is a determinant of health that is linked to poor health outcomes. Tailored approaches that draw upon trusting relationships have the potential to overcome this problem.
• The array of identified barriers indicates that general healthcare services are not currently structured in a way that facilitates timely and equitable access and appropriate care for PEH.
Barriers to access cancer prevention services for the homeless population in four European countries
Authors: Schiffler T , Carmichael C , Gil-Salmeron A , Kouvari M , Karnaki P , Grabovac I 
Published: October 2022

Abstract

Background
People experiencing homelessness (PEH) are known to have increased burden of cancer and higher cancer-related mortality when compared to the general population. These outcomes are linked to a variety of etiological factors, as well as the existence of significant barriers in accessing cancer prevention services. The aim of this study was to better understand current practices and knowledge relating to cancer prevention among PEH, health professionals and social care workers.

Methods
During autumn 2021, a cross-national qualitative study was conducted within the framework of the Horizon 2020 funded CANCERLESS project. Data were collected in Austria, Greece, Spain and the UK through semi-structured interviews. Interviews were transcribed verbatim and thematically analyzed in accordance with the approach set out by Saldaña (2021).

Results
In total, 69 interviews were conducted with a sample comprising 15 professionals working in homelessness support services, 19 health professionals, and 35 PEH. Two overarching themes relating to the research question were identified, namely (a) experiences and understanding of cancer prevention and treatment, and (b) considerations for program intervention. While cancer was a major source of concern, tailored cancer prevention programs for the homeless population were described as effectively non-existent, and very few homeless participants recalled being invited to a screening appointment. Health professionals also indicated that because of barriers to health care, opportunities for the early diagnosis of cancer among PEH were often being missed.

Conclusions
The results indicate that PEH have limited knowledge around the importance of cancer prevention programs, and that more focused input on the part of health and social care services is required in this area. Culturally sensitive and person-centered approaches should be adopted to facilitate access to cancer prevention for PEH.

Key messages
• Specialized cancer prevention and health care pathways that take account of the living conditions and support needs of PEH should be established to improve health and cancer-related outcomes.
• Cancer prevention programs should focus on improving health literacy by using accessible and tailored approaches, both for PEH and those that work directly with the homeless population.
Introducing walkable cities as a Public Health intervention
Authors: Matkovic V , Jevtic M , Kusturica MP , Bouland C , Jukovic M , Stojanovic D 
Published: October 2022

Abstract
COVID-19 pandemic yet again showed that health crises and epidemics are introducing urban planning as a public health response. Globally, we saw a renewed interest in urban environment and healthy living and the changes in urban environments which can make for a healthier living. Even before the pandemic, various urban concepts and models that take as basis a health-oriented, holistic approach are being implemented in many cities. To name a few: car-free centres or neighbourhoods, the so-called ‘Superblocks’, neighbourhoods with low-speed traffic, walkable and cyclable cities aiming at all amenities being easy reach so-called ‘15 Minutes city’. COVID-19 crisis only accelerated many of these initiatives and brought them to global level need and attention. Such interventions are being introduced to demotivate the use of polluting cars, to ease up and to promote healthy and active transportation such as walking and cycling. As a consequence, those interventions not only are hoped to lead to an increase in physical activity, but also better air quality, reduction of noise. Cities have accelerated urban transformations of the space for active transportation such as the introduction of more cycling lanes in their networks, transforming ‘car’ streets to mix use streets, etc. Particularly during the pandemic, the streets that were previously dominated by car use, parking lots, parking spaces, and car lanes have shifted their focus to the pedestrians, healthy and active mobility. Though, not so optimistic continuation of the speed of the changes in urban planning are seen at the end of the pandemic. It is still clear that spaces for people, spaces promoting mental health such as green spaces, green islands, green pedestrian streets and healthy mobility, are missing. Lockdown measures of reducing the car traffic and increasing the walkable spaces for citizens were primarily imposed to save public health but had one important co-benefit - improved air quality in many areas.
2.H. Workshop: Commercial determinants and global capture of public health- cases spanning the world
Authors:   Organised by: Governance, Ethics and Conflict of Interest in Public Health Network, UK Faculty of Public Health,   Chair persons: Jihad Makhoul (Lebanon)
Published: October 2022

Abstract

Growing research around the globe shows that for-profit corporations incur increasingly adverse impacts on health and well-being of people, the planet and the global economy. Their health damaging products and practices fuel non-communicable disease epidemics, damage the earth's natural environment and interfere in health policy making. Such corporate interference in social and public health policy, research and practice is well documented for the pharmaceutical, tobacco, food and beverage, alcohol and arms industries. A commercial determinant lens allows a better understanding of heath inequalities by drawing attention to corporate actors and their tactics as drivers of ill-health rather than people's behaviors. This framework also makes it possible to present interventions to counter these influences. This workshop panel of 5 scholars and activists from around the world who are members of the Governance, Ethics and Conflict of Interest in Public Health Network serves to confirm the detrimental reach of industry practices and the global responses to this interference in public health. It aims to add to the emerging body of knowledge on commercial determinants of health using innovative research approaches and findings. The format is a series of 5 short sequential presentations, followed by an interactive discussion with the audience, moderated by the panel organizer. The presentations will showcase the research methods used including multi-stakeholder interviews, policy analyses, systems mapping and analyses of policy debates. The presentations will also document examples and cases of corporate capture of food industry in Europe, a global mapping of corporate systems, industry interference in health-protecting laws in Columbia, exploitation of humanitarian emergencies in Lebanon, and suggestions of ways forward to protect adults and children from industry vested interests with a Public Health Playbook.

Key messages
• Corporate interference in public health is a growing concern globally for its health harming influence on health systems and future generations.
• Continued concerted research revealing overt and covert health harming industry practices is needed to counter their impact on PH in a world fraught with global challenges and uncertainty.
Employer support for employees returning to work from sick leave – evidence for Europe
Authors: Leoni T 
Published: October 2022

Abstract

Background
Employers play an important role in facilitating the return-to-work (RTW) of employees after a prolonged sick leave. The involvement of employers in RTW efforts is however largely unexplored in an international comparative context. This paper provides evidence on the diffusion of procedures to support RTW after sick leave in European workplaces and discusses different policy approaches to involve employers in RTW.

Methods
Employer activities are examined using microdata from the three waves of the European Survey on New and Emerging Risks (ESENER), collected in 2009, 2014 and 2019 (N = 47,425). ESENER is a representative company survey, conducted on behalf of the European Agency for Safety and Health at Work (EU-OSHA). The outcome of interest is information on the existence of a procedure to support employees’ RTW after a long sickness absence. The analysis is carried out using logistic models, comparing countries and welfare state regimes.

Results
Overall, 71.8% percent of workplaces with more than 50 employees have procedures to support RTW. Employer support is most common in Nordic and Anglo-Saxon countries (OR = 3.2, 95% CI 2.58-4.05 and OR = 8.9, 95% CI 5.41-14.68 respectively, compared to Continental countries and accounting for firm size and sector of activity). In Southern and Eastern Europe, the diffusion of RTW support is lowest (OR = 0.3, 95% CI 0.26-0.37 and OR = 0.2, 95% CI 0.17-0.24). With the exception of Nordic and Anglo-Saxon countries, smaller establishments are significantly less likely to have procedures in place than larger ones. The observed patterns are stable over time.

Conclusions
Employer support for RTW varies greatly across countries and welfare state regimes, indicating that institutional settings and policies matter for employer involvement in RTW, particularly in smaller workplaces. Countries with high levels of RTW support display different combinations of legal obligations and/or incentives for employers to support RTW.

Key messages
• There are large differences in employer support for RTW after sick leave across Europe.
• High support levels are associated with policies combining obligations and/or incentives for employers.
Labour market strategies addressing precarious employment and its impacts: A systematic review
Authors: Gunn V , Vignola EF , Wegman DH , Hogstedt C , Bodin T , Orellana C , O'Campo P , Albin M , Håkansta C ,   PWR Consortium
Published: October 2022

Abstract

Background
Precarious employment (PE), characterized by reduced worker rights, and employment and income insecurity, has complex public health implications including negative impacts on workers’ mental and physical health, occupational health and safety, wellbeing, and inequities in access to health and social protections. There is, however, a knowledge gap regarding effectiveness of interventions. We describe findings from a review of evaluated interventions with potential to address PE.

Methods
Our systematic review followed the 2020 PRISMA framework and covered PubMed, Scopus, Web of Science, and sources of grey literature. We included qualitative, quantitative, or mixed-methods studies evaluating initiatives to reduce workers’ PE published from 2000 to 2021 and focused on adult workers.

Results
The 23 eligible studies from across the world evaluated diverse strategies addressing PE including tax and trade reforms, industrial disputes legislation, business registration, and use of incentives to stimulate permanent contracts. Also included were union strategies to reach precarious workers, the provision of social benefits, and youth apprenticeships. Generally, while most initiatives had the potential to tackle certain PE aspects, they usually acted only on one or two PE dimensions. Additionally, the evaluation components were missing key details, thus, limiting the generalizability of findings, as did the heterogeneity of study designs, initiative purposes, economic and political context, and diverse populations targeted.

Conclusions
The increase in PE prevalence and its complex health implications requires sustainable upstream public health solutions. Multidisciplinary collaborations among public health and occupational health practitioners along with researchers, evaluation specialists, economists, and politicians could facilitate the implementation and evaluation of policies and standards regulating and monitoring PE and its health impacts.

Key messages
• Precarious employment has complex public health implications.
• Sustainable solutions to address precarious employment must be upstream and multidisciplinary.
2.L. Workshop: Public Health Institution and Academia’s role in building capacity for Health Impact Assessment
Authors:   Organised by: EUPHA-HIA, EUPHA-HWR, ASPHER,   Chair persons: Piedad Martin-Olmedo (EUPHA-HIA), Ellen Kuhlmann (EUPHA-HWR)
Published: October 2022

Abstract

Health impact assessment (HIA) is a process, which systematically judges the potential, and sometimes unintended effects of any new proposal (policy, project, program or strategy) on the population health, and the distribution of those effects within the population. It was conceived in 1999 as the supporting tool for the implementation of Health in All Policies (HiAP), but its practical use remains quite partial worldwide, with exceptional regions and countries (e.g. Wales (UK), Australia). Several surveys conducted nationally, but also across Europe by the World Health Organization-Regional Office for Europe identified several barriers that hinder a broader and more extensive practical application of HIA. One of these limitations lies in the lack of understanding and knowledge of professionals from non-health sectors about the benefits that addressing health considerations in the planning process of their projects, strategies or programs may have. In this sense, the HIA is frequently seen as an additional bureaucratic burden. Other common constraints reported refer to inadequate resources (guidelines, tools, evidence) and lack of qualified staff experienced in conducting HIA. Respondents from those surveys also deplored a history of unsatisfactory experiences involving intersectoral collaboration with health professionals, decision makers and other public sector stakeholders. Health agencies, such as national and regional Public Health Institutes (PHIs) can play a critical role in overcoming these limitations. They can act by providing independent advice and support based on the best available evidence to governments and proposal developers (projects, programs, strategies). However, they need to have knowledge, resources and capacity to do so. On the other hand, these basic concepts and procedures related to HiAP or HIA are rarely addressed in depth in the university curricular training of health sectors or other sectors such as environmental science or urbanism. Present workshop intends to analyse different experiences in Europe regarding the role of PHIs and also the academia in overcoming those reported exiting barriers, and reach a more sustainable and healthy societies. The fundamentals of what could be a training program on HIA principles across Europe will be also discussed.

Key messages
• PHIs can demonstrate leadership for HIA and HiAP by providing support to decision makers in better understand the wider health impacts and how they will manifest themselves across the population.
• HIA practice requires of the design of proper training programs and of certain validation process, which avoids conflicts regarding consultants’ impartiality and independence in conducting a HIA.
Old and new challenges of HIA Capacity building in Portugal
Authors: Costa L , Costa A , Dias Ferreira AC , Martín-Olmedo P , Green L 
Published: October 2022

Abstract
Within the European framework on health, adopted in 2012 by the Member States in the World Health Organization European Region, Health Impact Assessment (HIA) plays a crucial role in achieving the Sustainable Development Goals by supporting decision-makers to address health impacts and inequalities and ensure health gains. In Portugal, the integration of HIA in the Public Health Services (PHS) is still lacking despite of several attempts to implement HIA. In the pandemic and post-pandemic context, Public Health Authorities are busy with a lot of mandatory tasks, and the absence of a national policy framework for HIA that puts into practice the legal obligations arising from the Environment Impact Assessment Directive 2014/52/EU inhibits its sustainable implementation. The National Institute of Health Doutor Ricardo Jorge (INSA) has been involved in capacity building initiatives designed to further support the institutionalization of HIA in Portugal. This presentation outlines the lessons learned from this experience and will identify key facilitators and barriers elements for HIA implementation in specific contexts. The role of PHS in HIA development and execution will be discussed taking into consideration policy dialogue conclusions, and data collected from a survey aim to address the use and perception of this methodology in Public Health Units at the local level. The more recent Portuguese Fundamental Law on Health (Law nº95/2019) provides an important policy support ensuring Health in All Policies (HiAP) and it also opens a new pathway to enable HIA implementation at the national, regional, and local levels. In this respect, the PHS could play a crucial role taking leadership for HIA in Portugal. Novel and old approaches are still withstanding challenges.
The Empowering Example of High Vaccine Uptake among the Arab Minority in Israel
Authors: Essa-Hadad J 
Published: October 2022

Abstract

Introduction
Over 1.9 million Arabs live in Israel and constitute 21% of the total population. Despite being a disadvantaged minority population with wide gaps in health indicators, Arabs have higher Human Papillomavirus (HPV) and Measles, Mumps, and Rubella (MMR) vaccination rates compared with the general Jewish population.

Methods
In-depth interviews with 20 health care providers and 30-40 Arab mothers and teens will be conducted to collect information about health system enablers to HPV and MMR vaccination. All interviews are conducted in Arabic by an Arab researcher, audio-recorded, transcribed, and analysed using thematic analysis of the transcripts. Themes will be mapped on the theoretical Social-Ecological Model.

Results and discussion
Preliminary results indicate several health system enablers, such as accessible vaccination services through the school system and mother child clinics, vaccination provided at no cost, and high levels of trust towards healthcare professionals, who are Arab and understand the social and cultural norms of the community. Despite high vaccine uptakes, parents and teens had limited knowledge regarding vaccination, particularly HPV.

Conclusions
This research provides important insights into health system enablers regarding HPV and MMR vaccination among the Arab minority in Israel. Such evidence can serve as a basis for interventions and guidance to improve vaccine uptake among other underserved minority communities in Europe.