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  • Introduction to the Symposium: Causal Inference and Public Health
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Allison E. Aiello, Lawrence W. Green

    Assessing the extent to which public health research findings can be causally interpreted continues to be a critical endeavor. In this symposium, we invited several researchers to review issues related to causal inference in social epidemiology and environmental science and to discuss the importance of external validity in public health. Together, this set of articles provides an integral overview of the strengths and limitations of applying causal inference frameworks and related approaches to a variety of public health problems, for both internal and external validity.

    更新日期:2019-11-18
  • Commentary: Causal Inference for Social Exposures
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Jay S. Kaufman

    Social epidemiology seeks to describe and quantify the causal effects of social institutions, interactions, and structures on human health. To accomplish this task, we define exposures as treatments and posit populations exposed or unexposed to these well-defined regimens. This inferential structure allows us to unambiguously estimate and interpret quantitative causal parameters and to investigate how these may be affected by biases such as confounding. This paradigm has been challenged recently by some critics who favor broadening the exposures that may be studied beyond treatments to also consider states. Defining the exposure protocol of an observational study is a continuum of specificity, and one may choose to loosen this definition, incurring the cost of causal parameters that become commensurately more vague. The advantages and disadvantages of broader versus narrower definitions of exposure are matters of continuing debate in social epidemiology as in other branches of epidemiology.

    更新日期:2019-11-18
  • Causal Modeling in Environmental Health
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Marie-Abèle Bind

    The field of environmental health has been dominated by modeling associations, especially by regressing an observed outcome on a linear or nonlinear function of observed covariates. Readers interested in advances in policies for improving environmental health are, however, expecting to be informed about health effects resulting from, or more explicitly caused by, environmental exposures. The quantification of health impacts resulting from the removal of environmental exposures involves causal statements. Therefore, when possible, causal inference frameworks should be considered for analyzing the effects of environmental exposures on health outcomes.

    更新日期:2019-11-18
  • Making Health Research Matter: A Call to Increase Attention to External Validity
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Amy G. Huebschmann, Ian M. Leavitt, Russell E. Glasgow

    Most of the clinical research conducted with the goal of improving health is not generalizable to nonresearch settings. In addition, scientists often fail to replicate each other's findings due, in part, to lack of attention to contextual factors accounting for their relative effectiveness or failure. To address these problems, we review the literature on assessment of external validity and summarize approaches to designing for generalizability. When investigators conduct systematic reviews, a critical need is often unmet: to evaluate the pragmatism and context of interventions, as well as their effectiveness. Researchers, editors, and grant reviewers can implement key changes in how they consider and report on external validity issues. For example, the recently published expanded CONSORT figure may aid scientists and potential program adopters in summarizing participation in and representativeness of a program across different settings, staff, and patients. Greater attention to external validity is needed to increase reporting transparency, improve program dissemination, and reduce failures to replicate research.

    更新日期:2019-11-18
  • Causes and Patterns of Dementia: An Update in the Era of Redefining Alzheimer's Disease
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Bryan D. James, David A. Bennett

    The burden of dementia continues to increase as the population ages, with no disease-modifying treatments available. However, dementia risk appears to be decreasing, and progress has been made in understanding its multifactorial etiology. The 2018 National Institute on Aging–Alzheimer's Association (NIA-AA) research framework for Alzheimer's disease (AD) defines AD as a biological process measured by brain pathology or biomarkers, spanning the cognitive spectrum from normality to dementia. This framework facilitates interventions in the asymptomatic space and accommodates knowledge that many additional pathologies (e.g., cerebrovascular) contribute to the Alzheimer's dementia syndrome. The framework has implications for how we think about risk factors for “AD”: Many commonly accepted risk factors are not related to AD pathology and would no longer be considered risk factors for AD. They may instead be related to other pathologies or resilience to pathology. This review updates what is known about causes, risk factors, and changing patterns of dementia, addressing whether they are related to AD pathology/biomarkers, other pathologies, or resilience.

    更新日期:2019-11-18
  • Earth Observation: Investigating Noncommunicable Diseases from Space
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Peng Jia, Alfred Stein, Peter James, Ross C. Brownson, Tong Wu, Qian Xiao, Limin Wang, Clive E. Sabel, Youfa Wang

    The United Nations has called on all nations to take immediate actions to fight noncommunicable diseases (NCDs), which have become an increasingly significant burden to public health systems around the world. NCDs tend to be more common in developed countries but are also becoming of growing concern in low- and middle-income countries. Earth observation (EO) technologies have been used in many infectious disease studies but have been less commonly employed in NCD studies. This review discusses the roles that EO data and technologies can play in NCD research, including (a) integrating natural and built environment factors into NCD research, (b) explaining individual–environment interactions, (c) scaling up local studies and interventions, (d) providing repeated measurements for longitudinal studies including cohorts, and (e) advancing methodologies in NCD research. Such extensions hold great potential for overcoming the challenges of inaccurate and infrequent measurements of environmental exposure at the level of both the individual and the population, which is of great importance to NCD research, practice, and policy.

    更新日期:2019-11-18
  • Racism and Health: Evidence and Needed Research
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    David R. Williams, Jourdyn A. Lawrence, Brigette A. Davis

    In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism—structural racism, cultural racism, and individual-level discrimination—to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.

    更新日期:2019-11-18
  • Interventions to Support Behavioral Self-Management of Chronic Diseases
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    John P. Allegrante, Martin T. Wells, Janey C. Peterson

    A majority of the US adult population has one or more chronic conditions that require medical intervention and long-term self-management. Such conditions are among the 10 leading causes of mortality; an estimated 86% of the nation's $2.7 trillion in annual health care expenditures goes toward their treatment and management. Patient self-management of chronic diseases is increasingly essential to improve health behaviors, health outcomes, and quality of life and, in some cases, has demonstrated effectiveness for reducing health care utilization and the societal cost burden of chronic conditions. This review synthesizes the current state of the science of chronic disease self-management interventions and the evidence for their effectiveness, especially when applied with a systematic application of theories or models that account for a wide range of influences on behavior. Our analysis of selected outcomes from randomized controlled trials of chronic disease self-management interventions contained in 10 Cochrane systematic reviews provides additional evidence to demonstrate that self-management can improve quality of life and reduce utilization across several conditions.

    更新日期:2019-11-18
  • Policies of Exclusion: Implications for the Health of Immigrants and Their Children
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Krista M. Perreira, Juan M. Pedroza

    Public policies play a crucial role in shaping how immigrants adapt to life in the United States. Federal, state, and local laws and administrative practices impact immigrants’ access to education, health insurance and medical care, cash assistance, food assistance, and other vital services. Additionally, immigration enforcement activities have substantial effects on immigrants’ health and participation in public programs, as well as effects on immigrants’ families. This review summarizes the growing literature on the consequences of public policies for immigrants’ health. Some policies are inclusive and promote immigrants’ adaptation to the United States, whereas other policies are exclusionary and restrict immigrants’ access to public programs as well as educational and economic opportunities. We explore the strategies that researchers have employed to tease out these effects, the methodological challenges of undertaking such studies, their varying impacts on immigrant health, and steps that can be undertaken to improve the health of immigrants and their families.

    更新日期:2019-11-18
  • Television News Coverage of Public Health Issues and Implications for Public Health Policy and Practice
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Sarah E. Gollust, Erika Franklin Fowler, Jeff Niederdeppe

    Television (TV) news, and especially local TV news, remains an important vehicle through which Americans obtain information about health-related topics. In this review, we synthesize theory and evidence on four main functions of TV news in shaping public health policy and practice: reporting events and information to the public (surveillance); providing the context for and meaning surrounding health issues (interpretation); cultivating community values, beliefs, and norms (socialization); and attracting and maintaining public attention for advertisers (attention merchant). We also identify challenges for TV news as a vehicle for improving public health, including declining audiences, industry changes such as station consolidation, increasingly politicized content, potential spread of misinformation, and lack of attention to inequity. We offer recommendations for public health practitioners and researchers to leverage TV news to improve public health and advance health equity.

    更新日期:2019-11-18
  • The Use of Excise Taxes to Reduce Tobacco, Alcohol, and Sugary Beverage Consumption
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Frank J. Chaloupka, Lisa M. Powell, Kenneth E. Warner

    In countries around the world, tobacco use, excessive alcohol consumption, and consumption of sugar-sweetened beverages (SSBs) are significant contributors to the global epidemic of noncommunicable diseases. As a consequence, they contribute, as well, to excess health care costs and productivity losses. A large and growing body of research documents that taxes specific to such products, known as excise taxes, reduce consumption of these products and thereby diminish their adverse health consequences. Although such taxation has historically been motivated primarily by revenue generation, governments are increasingly using these taxes to discourage unhealthy consumption. We review the global evidence on the impact of taxes and prices on the consumption of these products and the health and social consequences. We then evaluate arguments commonly raised against these taxes, identify best practices in excise tax policy, and conclude with a summary of the current status of tobacco, alcohol, and SSB excise taxes globally.

    更新日期:2019-11-18
  • Ambient Air Pollution, Noise, and Late-Life Cognitive Decline and Dementia Risk
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Kimberly C. Paul, Mary Haan, Elizabeth Rose Mayeda, Beate R. Ritz

    Exposure to ambient air pollution and noise is ubiquitous globally. A strong body of evidence links air pollution, and recently noise, to cardiovascular conditions that eventually may also affect cognition in the elderly. Data that support a broader influence of these exposures on cognitive function during aging is just starting to emerge. This review summarizes current findings and discusses methodological challenges and opportunities for research. Although current evidence is still limited, especially for chronic noise exposure, high exposure has been associated with faster cognitive decline either mediated through cerebrovascular events or resulting in Alzheimer's disease. Ambient environmental exposures are chronic and affect large populations. While they may yield relatively modest-sized risks, they nevertheless result in large numbers of cases. Reducing environmental pollution is clearly feasible, though lowering levels requires collective action and long-term policies such as standard setting, often at the national level as well as at the local level.

    更新日期:2019-11-18
  • Brain and Salivary Gland Tumors and Mobile Phone Use: Evaluating the Evidence from Various Epidemiological Study Designs
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Martin Röösli, Susanna Lagorio, Minouk J. Schoemaker, Joachim Schüz, Maria Feychting

    Mobile phones (MPs) are the most relevant source of radiofrequency electromagnetic field (RF-EMF) exposure to the brain and the salivary gland. Whether this exposure implies a cancer risk has been addressed in several case-control and few cohort studies. A meta-analysis of these studies does not show increased risks for meningioma, pituitary, and salivary gland tumors. For glioma and acoustic neuroma, the results are heterogeneous, with few case-control studies reporting substantially increased risks. However, these elevated risks are not coherent with observed incidence time trends, which are considered informative for this specific topic owing to the steep increase in MP use, the availability of virtually complete cancer registry data from many countries, and the limited number of known competing environmental risk factors. In conclusion, epidemiological studies do not suggest increased brain or salivary gland tumor risk with MP use, although some uncertainty remains regarding long latency periods (>15 years), rare brain tumor subtypes, and MP usage during childhood.

    更新日期:2019-11-18
  • Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Matilda van den Bosch, Andreas Meyer-Lindenberg

    Mental health and well-being are consistently influenced—directly or indirectly—by multiple environmental exposures. In this review, we have attempted to address some of the most common exposures of the biophysical environment, with a goal of demonstrating how those factors interact with central structures and functions of the brain and thus influence the neurobiology of depression. We emphasize biochemical mechanisms, observational evidence, and areas for future research. Finally, we include aspects of contextual environments—city living, nature, natural disasters, and climate change—and call for improved integration of environmental issues in public health science, policies, and activities. This integration is necessary for reducing the global pandemic of depression.

    更新日期:2019-11-18
  • Global Environmental Change and Noncommunicable Disease Risks
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Howard Frumkin, Andy Haines

    Multiple global environmental changes (GECs) now under way, including climate change, biodiversity loss, freshwater depletion, tropical deforestation, overexploitation of fisheries, ocean acidification, and soil degradation, have substantial, but still imperfectly understood, implications for human health. Noncommunicable diseases (NCDs) make a major contribution to the global burden of disease. Many of the driving forces responsible for GEC also influence NCD risk through a range of mechanisms. This article provides an overview of pathways linking GEC and NCDs, focusing on five pathways: (a) energy, air pollution, and climate change; (b) urbanization; (c) food, nutrition, and agriculture; (d) the deposition of persistent chemicals in the environment; and (e) biodiversity loss.

    更新日期:2019-11-18
  • Hazardous Air Pollutants Associated with Upstream Oil and Natural Gas Development: A Critical Synthesis of Current Peer-Reviewed Literature
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Diane A. Garcia-Gonzales, Seth B.C. Shonkoff, Jake Hays, Michael Jerrett

    Increased energy demands and innovations in upstream oil and natural gas (ONG) extraction technologies have enabled the United States to become one of the world's leading producers of petroleum and natural gas hydrocarbons. The US Environmental Protection Agency (EPA) lists 187 hazardous air pollutants (HAPs) that are known or suspected to cause cancer or other serious health effects. Several of these HAPs have been measured at elevated concentrations around ONG sites, but most have not been studied in the context of upstream development. In this review, we analyzed recent global peer-reviewed articles that investigated HAPs near ONG operations to (a) identify HAPs associated with upstream ONG development, (b) identify their specific sources in upstream processes, and (c) examine the potential for adverse health outcomes from HAPs emitted during these phases of hydrocarbon development.

    更新日期:2019-11-18
  • Health Impact Assessment of Transportation Projects and Policies: Living Up to Aims of Advancing Population Health and Health Equity?
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Brian L. Cole, Kara E. MacLeod, Raenita Spriggs

    Health impact assessment (HIA) is a forward-looking, evidence-based tool used to inform stakeholders and policy makers about the potential health effects of proposed projects and policies and to identify options for maximizing potential health benefits and minimizing potential harm. This review examines how health equity, a core principle of health impact assessment (HIA), has been operationalized in HIAs conducted in the United States in one sector, transportation. Two perspectives on promoting health equity appear in the broader public health research literature; one aims at reducing disparities in health determinants and outcomes in affected populations, whereas the other focuses on facilitating community participation and self-determination. Variations in how these perspectives are applied in HIA informed our typology of five ways of addressing health equity in HIA. Transportation HIAs commonly included two of these—selecting vulnerable populations for the focus of the HIA and stakeholder engagement, seen in more than 70% of the 96 HIAs reviewed. Fewer than half of the HIAs assessed current health disparities or changes in their distribution. Only 15% of HIAs addressed equity by focusing on capabilities development or empowerment. Routinely assessing and reporting how an HIA aims to address health equity might better manage expectations and could make HIA practitioners and users more conscious of how an HIA can realistically be used to advance health equity.

    更新日期:2019-11-18
  • Aligning Programs and Policies to Support Food Security and Public Health Goals in the United States
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Hilary K. Seligman, Seth A. Berkowitz

    Food insecurity affects 1 in 8 US households and has clear implications for population health disparities. We present a person-centered, multilevel framework for understanding how individuals living in food-insecure households cope with inadequate access to food themselves and within their households, communities, and broader food system. Many of these coping strategies can have an adverse impact on health, particularly when the coping strategies are sustained over time; others may be salutary for health. There exist multiple opportunities for aligning programs and policies so that they simultaneously support food security and improved diet quality in the interest of supporting improved health outcomes. Improved access to these programs and policies may reduce the need to rely on individual- and household-level strategies that may have negative implications for health across the life course.

    更新日期:2019-11-18
  • Happiness and Health
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Andrew Steptoe

    Research into the relationship between happiness and health is developing rapidly, exploring the possibility that impaired happiness is not only a consequence of ill-health but also a potential contributor to disease risk. Happiness encompasses several constructs, including affective well-being (feelings of joy and pleasure), eudaimonic well-being (sense of meaning and purpose in life), and evaluative well-being (life satisfaction). Happiness is generally associated with reduced mortality in prospective observational studies, albeit with several discrepant results. Confounding and reverse causation are major concerns. Associations with morbidity and disease prognosis have also been identified for a limited range of health conditions. The mechanisms potentially linking happiness with health include lifestyle factors, such as physical activity and dietary choice, and biological processes, involving neuroendocrine, inflammatory, and metabolic pathways. Interventions have yet to demonstrate substantial, sustained improvements in subjective well-being or direct impact on physical health outcomes. Nevertheless, this field shows great potential, with the promise of establishing a favorable effect on population health.

    更新日期:2019-11-18
  • Realist Synthesis for Public Health: Building an Ontologically Deep Understanding of How Programs Work, For Whom, and In Which Contexts
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Justin Jagosh

    Realist synthesis is a literature review methodology for understanding how, for whom, and under what circumstances complex interventions function in complex environments. Using a heuristic called the context-mechanism-outcome (CMO) configuration, realist synthesis produces evidence-informed theories about the interactions between intervention mechanisms and their implementation contexts. Public health interventions and their effects unfold over time and develop differently in different contexts. Much of what causes programs to function remains in a realm beyond empirical measurement. By scrutinizing the theories relevant to the interventions of interest, and by enhancing the conceptualization of complex outcomes, the realist approach deprioritizes evidence hierarchies and harnesses insights from diverse data sources to generate causal understanding. The dynamic learning process that can arise in conducting a realist synthesis may generate new ideas for program development and innovation apart from what can be achieved in reviews providing a summation and aggregation of quantified evidence.

    更新日期:2019-11-18
  • The Economic Case for the Prevention of Mental Illness
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    David McDaid, A-La Park, Kristian Wahlbeck

    Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.

    更新日期:2019-11-18
  • The Next Generation of Diabetes Translation: A Path to Health Equity
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Debra Haire-Joshu, Felicia Hill-Briggs

    Disparities in diabetes burden exist in large part because of the social determinants of health (SDOH). Translation research and practice addressing health equity in diabetes have generally focused on changing individual behavior or providing supportive approaches to compensate for, rather than directly target, SDOH. The purpose of this article is to propose a pathway for addressing SDOH as root causes of diabetes disparities and as an essential target for the next generation of interventions needed to achieve health equity in diabetes prevention and treatment. This review describes (a) the current burden of diabetes disparities, (b) the influence of SDOH on diabetes disparities, (c) gaps in and implications of current translation research, and (d) approaches to achieving health equity in the next generation of diabetes translation.

    更新日期:2019-11-18
  • High-Deductible Health Plans and Prevention
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Olena Mazurenko, Melinda J.B. Buntin, Nir Menachemi

    High-deductible health plans (HDHPs) are becoming more popular owing to their potential to curb rising health care costs. Relative to traditional health insurance plans, HDHPs involve higher out-of-pocket costs for consumers, which have been associated with lower utilization of health services. We focus specifically on the impact that HDHPs have on the use of preventive services. We critique the current evidence by discussing the benefits and drawbacks of the research designs used to examine this relationship. We also summarize the findings from the most methodologically sophisticated studies. We conclude that the balance of the evidence shows that HDHPs are reducing the use of some preventive service, especially screenings. However, it is not clear if HDHPs affect all preventive services. Additional research is needed to determine why variability in conclusions exists among studies. We describe an agenda for future research that can further inform public health decision makers on the impact of HDHPs on prevention.

    更新日期:2019-11-18
  • Innovations in Mixed Methods Evaluations
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Lawrence A. Palinkas, Sapna J. Mendon, Alison B. Hamilton

    Mixed methods research—i.e., research that draws on both qualitative and quantitative methods in varying configurations—is well suited to address the increasing complexity of public health problems and their solutions. This review focuses specifically on innovations in mixed methods evaluations of intervention, program or policy (i.e., practice) effectiveness, and implementation. The article begins with an overview of the structure, function, and process of different mixed methods designs and then provides illustrations of their use in effectiveness studies, implementation studies, and combined effectiveness–implementation hybrid studies. The article then examines four specific innovations: procedures for transforming (or “quantitizing”) qualitative data, application of rapid assessment and analysis procedures in the context of mixed methods studies, development of measures to assess implementation outcomes, and strategies for conducting both random and purposive sampling, particularly in implementation-focused evaluation research. The article concludes with an assessment of challenges to integrating qualitative and quantitative data in evaluation research.

    更新日期:2019-11-18
  • School Health as a Strategy to Improve Both Public Health and Education
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Lloyd J. Kolbe

    Because schools materially influence both health and education, they substantially determine the future well-being and economic productivity of populations. Recent research suggests that healthier children learn better and that more educated adults are healthier. School health is a cross-disciplinary field of study and a fundamental strategy that can be used to improve both health and education outcomes. Modern school health programs include 10 interactive components: health education; physical education and physical activity; nutrition environment and services; health services; counseling, psychological, and social services; physical environment; social and emotional climate; family engagement; community involvement; and employee wellness. This review is written for both health and education audiences. It integrates recent research and developments in relationships among health, education, and economic outcomes; health and education systems; the school health program, its components, and their effectiveness; cross-disciplinary collaboration; local, state, national, and international infrastructures and strategies; implementation science; and relevant academic research, training, and service.

    更新日期:2019-11-18
  • Solving Homelessness from a Complex Systems Perspective: Insights for Prevention Responses
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Patrick J. Fowler, Peter S. Hovmand, Katherine E. Marcal, Sanmay Das

    Homelessness represents an enduring public health threat facing communities across the developed world. Children, families, and marginalized adults face life course implications of housing insecurity, while communities struggle to address the extensive array of needs within heterogeneous homeless populations. Trends in homelessness remain stubbornly high despite policy initiatives to end homelessness. A complex systems perspective provides insights into the dynamics underlying coordinated responses to homelessness. A constant demand for housing assistance strains service delivery, while prevention efforts remain inconsistently implemented in most countries. Feedback processes challenge efficient service delivery. A system dynamics model tests assumptions of policy interventions for ending homelessness. Simulations suggest that prevention provides a leverage point within the system; small efficiencies in keeping people housed yield disproportionately large reductions in homelessness. A need exists for policies that ensure reliable delivery of coordinated prevention efforts. A complex systems approach identifies capacities and constraints for sustainably solving homelessness.

    更新日期:2019-11-18
  • The Digitization of Patient Care: A Review of the Effects of Electronic Health Records on Health Care Quality and Utilization
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-04-01
    Hilal Atasoy, Brad N. Greenwood, Jeffrey Scott McCullough

    Electronic health records (EHRs) adoption has become nearly universal during the past decade. Academic research into the effects of EHRs has examined factors influencing adoption, clinical care benefits, financial and cost implications, and more. We provide an interdisciplinary overview and synthesis of this literature, drawing on work in public and population health, informatics, medicine, management information systems, and economics. We then chart paths forward for policy, practice, and research.

    更新日期:2019-11-18
  • Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm-an Ecosocial Analysis.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-11-26
    Nancy Krieger

    Racism. Sexism. Heterosexism. Gender binarism. Together, they comprise intimately harmful, distinct, and entangled societal systems of self-serving domination and privilege that structure the embodiment of health inequities. Guided by the ecosocial theory of disease distribution, I synthesize key features of the specified "isms" and provide a measurement schema, informed by research from both the Global North and the Global South. Metrics discussed include (a) structural, including explicit rules and laws, nonexplicit rules and laws, and area-based or institutional nonrule measures; and (b) individual-level (exposures and internalized) measures, including explicit self-report, implicit, and experimental. Recommendations include (a) expanding the use of structural measures to extend beyond the current primary emphasis on psychosocial individual-level measures; (b) analyzing exposure in relation to both life course and historical generation; (c) developing measures of anti-isms; and (d) developing terrestrially grounded measures that can reveal links between the structural drivers of unjust isms and their toll on environmental degradation, climate change, and health inequities. Expected final online publication date for the Annual Review of Cancer Biology, Volume 4 is March 4, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

    更新日期:2019-11-01
  • Resetting Policies to End Family Homelessness.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-11-02
    Ellen L Bassuk,Jacqueline A Hart,Effy Donovan

    Homelessness is a devastating experience for children and their families. Families, the majority of whose members are children, now comprise more than one-third of the overall homeless population. Most of these children are less than six years old. Various assumptions have driven policy and the allocation of resources to programs serving these families. Although decades of research and field experience suggest strategies for preventing and reducing this problem, perspectives differ, hindering the development of effective solutions. In this article, we explore some of these assumptions, including (a) definitions of homelessness used to count the numbers of families and determine resource allocation, (b) the needs of children and responses to the impact of adverse childhood experiences, and (c) whether services matter and should be integrated with affordable housing. We conclude by suggesting various directions to ensure that these children are protected and have the opportunity to grow and thrive. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Introduction.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2016-07-22
    Lawrence W Green,Ross C Brownson,Jonathan E Fielding

    更新日期:2019-11-01
  • Public health. Preface.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2009-08-26
    Jonathan E Fielding

    更新日期:2019-11-01
  • Evidence-based public health: a fundamental concept for public health practice.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2009-03-20
    Ross C Brownson,Jonathan E Fielding,Christopher M Maylahn

    Despite the many accomplishments of public health, a greater attention to evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about a decade ago. Key components of EBPH include making decisions on the basis of the best available scientific evidence, using data and information systems systematically, applying program-planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Three types of evidence have been presented on the causes of diseases and the magnitude of risk factors, the relative impact of specific interventions, and how and under which contextual conditions interventions were implemented. Analytic tools (e.g., systematic reviews, economic evaluation) can be useful in accelerating the uptake of EBPH. Challenges and opportunities (e.g., political issues, training needs) for disseminating EBPH are reviewed. The concepts of EBPH outlined in this article hold promise to better bridge evidence and practice.

    更新日期:2019-11-01
  • Assessing public health emergency preparedness: concepts, tools, and challenges.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2006-11-30
    Christopher Nelson,Nicole Lurie,Jeffrey Wasserman

    Policymakers are increasingly seeking to determine whether the federal government's recent investments in public health preparedness have left the public health system better prepared to respond to large-scale public health emergencies. Yet, there remain questions about how to define "public health emergency preparedness," how much preparedness is enough, and how preparedness can be measured and assessed. This chapter identifies the key challenges associated with measuring public health preparedness and reviews approaches currently in use. We also identify some emerging measurement techniques that might help address some of these challenges.

    更新日期:2019-11-01
  • Developing and using the Guide to Community Preventive Services: lessons learned about evidence-based public health.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Peter A Briss,Ross C Brownson,Jonathan E Fielding,Stephanie Zaza

    The Guide to Community Preventive Services (Community Guide) is being developed under the leadership of the independent, nonfederal Task Force on Community Preventive Services. The Task Force makes recommendations for the use of public health programs and policies based on scientific evidence about what practices have worked to improve health. The Community Guide thoroughly searches scientific literature for topic-relevant studies, evaluates their quality according to established criteria, and makes recommendations based on the overall strength of the body of evidence and the size and variability of reported effects. In addition, the Community Guide identifies promising interventions that have not been adequately researched, thus helping to inform the public health research agenda. The continuously updated and expanded body of recommendations and research agenda formulated by this rigorous process have been published on the Internet and in various publications since 1999 and constitute a highly valued and objective evidence-based resource for guiding current and future public health activities. More remains to be learned, however, on how best to disseminate Community Guide findings to key target audiences and encourage their use to inform practice, policy, and additional research.

    更新日期:2019-11-01
  • Sick Individuals and Sick (Microbial) Populations: Challenges in Epidemiology and the Microbiome.
    Annu. Rev. Public Health (IF 10.776) Pub Date : null
    Audrey Renson,Pamela Herd,Jennifer B Dowd

    The human microbiome represents a new frontier in understanding the biology of human health. While epidemiology in this area is still in its infancy, its scope will likely expand dramatically over the coming years. To rise to the challenge, we argue that epidemiology should capitalize on its population perspective as a critical complement to molecular microbiome research, allowing for the illumination of contextual mechanisms that may vary more across populations rather than among individuals. We first briefly review current research on social context and the gut microbiome, focusing specifically on socioeconomic status (SES) and race/ethnicity. Next, we reflect on the current state of microbiome epidemiology through the lens of one specific area, the association of the gut microbiome and metabolic disorders. We identify key methodological shortcomings of current epidemiological research in this area, including extensive selection bias, the use of noncompositionally robust measures, and a lack of attention to social factors as confounders or effect modifiers. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

    更新日期:2019-11-01
  • From developmental origins of adult disease to life course research on adult disease and aging: insights from birth cohort studies.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2013-03-22
    Chris Power,Diana Kuh,Susan Morton

    Maturation of long-running birth cohort studies has fostered a life course approach to adult health, function, and disease and related to conceptual frameworks. Using broad concepts of human development including physical, cognitive, and emotional function, birth cohorts provide insights into the processes across the life course and between generations that link to adult outcomes. We discuss findings on the determinants and health consequences of lifetime trajectories of body size, cognitive and emotional function, and socioeconomic position. Findings from the studies suggest that, for some adult health outcomes, explanations will be incomplete unless exposures and processes from across the life course are taken into account. New birth cohort studies are poised to delineate further the nature and timing of life course relationships in contemporary generations of children.

    更新日期:2019-11-01
  • Stress and cardiovascular disease: an update on current knowledge.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2013-01-10
    Andrew Steptoe,Mika Kivimäki

    Considerable progress has been made during the past decade in research on cardiovascular effects of stress. Early-life stressors, such as childhood abuse and early socioeconomic adversity, are linked to increased cardiovascular morbidity in adulthood. Our updated meta-analyses of prospective studies published until 2011 show a 1.5-fold (95% confidence interval 1.2-1.9) increased risk of coronary heart disease among adults experiencing social isolation and a 1.3-fold (1.2-1.5) excess risk for workplace stress; adverse metabolic changes are one of the underlying plausible mechanisms. Stress, anger, and depressed mood can act as acute triggers of major cardiac events; the pooled relative risk of acute coronary syndrome onset being preceded by stress is 2.5 (1.8-3.5) in case-crossover studies. Stress is also implicated in the prognosis of cardiovascular disease and in the development of stress (takotsubo) cardiomyopathy. A major challenge over the next decade is to incorporate stress processes into the mainstream of cardiovascular pathophysiological research and understanding.

    更新日期:2019-11-01
  • Ecogenomics of respiratory diseases of public health significance.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2010-01-15
    Stavros Garantziotis,David A Schwartz

    Gene-environment interactions are the indisputable cause of most respiratory diseases. However, we still have very limited understanding of the mechanisms that guide these interactions. Although the conceptual approaches to environmental genomics were established several decades ago, the tools are only now available to better define the mechanisms that underlie the interactions among these important etiological features of lung disease. In this article, we summarize recent insights in the environmental genomics (ecogenomics) of common nonmalignant respiratory diseases (asthma, COPD, pulmonary fibrosis, and respiratory infections), describe the framework of gene-environment interactions that inform the pathogenesis of respiratory diseases, and propose future research directions that will help translate scientific advances into public health gains.

    更新日期:2019-11-01
  • Machine Learning in Epidemiology and Health Outcomes Research.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2019-10-03
    Timothy L Wiemken,Robert R Kelley

    Machine learning approaches to modeling of epidemiologic data are becoming increasingly more prevalent in the literature. These methods have the potential to improve our understanding of health and opportunities for intervention, far beyond our past capabilities. This article provides a walkthrough for creating supervised machine learning models with current examples from the literature. From identifying an appropriate sample and selecting features through training, testing, and assessing performance, the end-to-end approach to machine learning can be a daunting task. We take the reader through each step in the process and discuss novel concepts in the area of machine learning, including identifying treatment effects and explaining the output from machine learning models. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

    更新日期:2019-11-01
  • Using Electronic Health Records for Population Health Research: A Review of Methods and Applications.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2015-12-17
    Joan A Casey,Brian S Schwartz,Walter F Stewart,Nancy E Adler

    The use and functionality of electronic health records (EHRs) have increased rapidly in the past decade. Although the primary purpose of EHRs is clinical, researchers have used them to conduct epidemiologic investigations, ranging from cross-sectional studies within a given hospital to longitudinal studies on geographically distributed patients. Herein, we describe EHRs, examine their use in population health research, and compare them with traditional epidemiologic methods. We describe diverse research applications that benefit from the large sample sizes and generalizable patient populations afforded by EHRs. These have included reevaluation of prior findings, a range of diseases and subgroups, environmental and social epidemiology, stigmatized conditions, predictive modeling, and evaluation of natural experiments. Although studies using primary data collection methods may have more reliable data and better population retention, EHR-based studies are less expensive and require less time to complete. Future EHR epidemiology with enhanced collection of social/behavior measures, linkage with vital records, and integration of emerging technologies such as personal sensing could improve clinical care and population health.

    更新日期:2019-11-01
  • Visible and Invisible Trends in Black Men's Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2016-03-19
    Keon L Gilbert,Rashawn Ray,Arjumand Siddiqi,Shivan Shetty,Elizabeth A Baker,Keith Elder,Derek M Griffith

    Over the past two decades, there has been growing interest in improving black men's health and the health disparities affecting them. Yet, the health of black men consistently ranks lowest across nearly all groups in the United States. Evidence on the health and social causes of morbidity and mortality among black men has been narrowly concentrated on public health problems (e.g., violence, prostate cancer, and HIV/AIDS) and determinants of health (e.g., education and male gender socialization). This limited focus omits age-specific leading causes of death and other social determinants of health, such as discrimination, segregation, access to health care, employment, and income. This review discusses the leading causes of death for black men and the associated risk factors, as well as identifies gaps in the literature and presents a racialized and gendered framework to guide efforts to address the persistent inequities in health affecting black men.

    更新日期:2019-11-01
  • Introduction: ARPH Approach to Controversial Issues.
    Annu. Rev. Public Health (IF 10.776) Pub Date : null
    Jonathan E Fielding,Ross C Brownson,Lawrence W Green

    更新日期:2019-11-01
  • Metrics for assessing improvements in primary health care.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2014-03-20
    Kurt C Stange,Rebecca S Etz,Heidi Gullett,Sarah A Sweeney,William L Miller,Carlos Roberto Jaén,Benjamin F Crabtree,Paul A Nutting,Russell E Glasgow

    Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts. It is informed by metrics that include long-term, meaning- and relationship-focused perspectives. Aspirational uses of metrics inspire evolving insights and iterative improvement, using a collaborative, developmental perspective. Performance metrics assess the complex interactions among primary care tenets of accessibility, a whole-person focus, integration and coordination of care, and ongoing relationships with individuals, families, and communities; primary health care principles of inclusion and equity, a focus on people's needs, multilevel integration of health, collaborative policy dialogue, and stakeholder participation; basic and goal-directed health care, prioritization, development, and multilevel health outcomes. Environments that support reflection, development, and collaborative action are necessary for metrics to advance health and minimize unintended consequences.

    更新日期:2019-11-01
  • Toward a systems approach to enteric pathogen transmission: from individual independence to community interdependence.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2012-01-10
    Joseph N S Eisenberg,James Trostle,Reed J D Sorensen,Katherine F Shields

    Diarrheal disease is still a major cause of mortality and morbidity worldwide; thus a large body of research has been produced describing its risks. We review more than four decades of literature on diarrheal disease epidemiology. These studies detail a progression in the conceptual understanding of transmission of enteric pathogens and demonstrate that diarrheal disease is caused by many interdependent pathways. However, arguments by diarrheal disease researchers in favor of attending to interaction and interdependencies have only recently yielded more formal systems-level approaches. Therefore, interdependence has not yet been highlighted in significant new research initiatives or policy decisions. We argue for a systems-level framework that will contextualize transmission and inform prevention and control efforts so that they can integrate transmission pathways. These systems approaches should be employed to account for community effects (i.e., interactions among individuals and/or households).

    更新日期:2019-11-01
  • Identifying the effects of environmental and policy change interventions on healthy eating.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2015-03-19
    Deborah J Bowen,Wendy E Barrington,Shirley A A Beresford

    Obesity has been characterized as a disease. Strategies to change the incidence and prevalence of this disease include a focus on changing physical and social environments, over and above individual-level strategies, using a multilevel or systems approach. We focus our attention on evidence published between 2008 and 2013 on the effectiveness of interventions in nutrition environments, i.e., environmental interventions designed to influence the intake of healthful foods and amount of energy consumed. An overarching socioecological framework that has guided much of this research was used to characterize different types of environmental strategies. Intervention examples in each area of the framework are provided with a discussion of key findings and related conceptual and methodological issues. The emphasis in this review is on adults, but clearly this literature is only one part of the picture. Much research has been focused on child-specific interventions, including environmental interventions. Some evidence suggests effectiveness of policy-based or other types of interventions that aim to regulate or restructure environments to promote healthy dietary choices, and these strategies would apply to both children and adults. Opportunities to evaluate these policy changes in adults' social and physical environments are rare. Much of the existing research has been with children. As conceptual and methodological issues continue to be identified and resolved, we hope that future research in this domain will identify environmental strategies that can be included in intervention toolboxes to build healthy nutrition environments for both adults and children.

    更新日期:2019-11-01
  • Systems science methods in public health: dynamics, networks, and agents.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2012-01-10
    Douglas A Luke,Katherine A Stamatakis

    Complex systems abound in public health. Complex systems are made up of heterogeneous elements that interact with one another, have emergent properties that are not explained by understanding the individual elements of the system, persist over time, and adapt to changing circumstances. Public health is starting to use results from systems science studies to shape practice and policy, for example in preparing for global pandemics. However, systems science study designs and analytic methods remain underutilized and are not widely featured in public health curricula or training. In this review we present an argument for the utility of systems science methods in public health, introduce three important systems science methods (system dynamics, network analysis, and agent-based modeling), and provide three case studies in which these methods have been used to answer important public health science questions in the areas of infectious disease, tobacco control, and obesity.

    更新日期:2019-11-01
  • Perspectives: the third revolution in health.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-05-18
    Lester Breslow

    更新日期:2019-11-01
  • The direct care worker: the third rail of home care policy.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Robyn I Stone

    Home health aides, home care workers, and personal care attendants form the core of the paid home care system, providing assistance with activities of daily living and the personal interaction that is essential to quality of life and quality of care for their clients. High turnover and long vacancy periods are costly for providers, consumers, their families, and workers themselves. In 2002, 37 states identified worker recruitment and retention as major priority issues. Demographic and economic trends do not augur well for the future availability of quality home care workers. Policymakers in the areas of health, long-term care, labor, welfare, and immigration must partner with providers, worker organizations, and researchers to identify and implement the most successful interventions for developing and sustaining this workforce at both policy and practice levels. The future of home care will depend, in large part, on this "third rail" of long-term care policy.

    更新日期:2019-11-01
  • Physician gender and patient-centered communication: a critical review of empirical research.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Debra L Roter,Judith A Hall

    Physician gender has stimulated a good deal of interest as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians are more patient-centered in their communication with patients. Our objective is to synthesize the results of two meta-analytic reviews the effects of physician gender on communication in medical visits within a communication framework that reflects patient-centeredness and the functions of the medical visit. We performed online database searches of English-language abstracts for the years 1967 to 2001 (MEDLINE, AIDSLINE, PsycINFO, and BIOETHICS), and a hand search was conducted of reprint files and the reference sections of review articles and other publications. Studies using a communication data source such as audiotape, videotape, or direct observation were identified through bibliographic and computerized searches. Medical visits with female physicians were, on average, two minutes (10%) longer than those of male physicians. During this time, female physicians engaged in significantly more communication that can be considered patient-centered. They engaged in more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk. Moreover, the patients of female physicians spoke more overall, disclosed more biomedical and psychosocial information, and made more positive statements to their physicians than did the patients of male physicians. Obstetrics and gynecology may present a pattern different from that of primary care: Male physicians demonstrated higher levels of emotionally focused talk than their female colleagues. Female primary care physicians and their patients engaged in more communication that can be considered patient-centered and had longer visits than did their male colleagues. Limited studies exist outside of primary care, and gender-related practice patterns might differ in some subspecialties from those evident in primary care.

    更新日期:2019-11-01
  • International differences in drug prices.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Judith L Wagner,Elizabeth McCarthy

    This paper addresses how and why drug prices differ across countries. Studies of international variation in drug prices reach varied conclusions owing to methodological and data disparities. Price differences do exist across countries, with the United States footing the highest bill, but the differences are not nearly as large as they appear at first glance. The higher prices in the United States are concentrated among a subset of brand-name drugs and among those without insurance covering drugs. Some U.S. health plans obtain price concessions from manufacturers similar to those obtained by national governments. Price concessions occur whenever purchasers are willing to let price be a consideration in decisions about access and utilization. In low-income countries the vast majority are unwilling to pay for effective drugs simply because they are unable to pay. Low-income nations need more price discrimination--and vastly lower prices--if they are ever to afford the world's most effective medicines.

    更新日期:2019-11-01
  • Economic implications of increased longevity in the United States.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Dorothy P Rice,Norman Fineman

    The elderly population in America is growing in size owing to declining death rates, increasing life expectancy, and the aging of the baby boomers. Although the prevalence of chronic illness and disability increases with age, successful aging in the elderly population is widespread, and the elderly are generally healthy. Indeed, the prevalence of disability among the elderly is declining, and expenditures for their care are increasingly concentrated at the end of life rather than during extra years of relatively healthy life. Nevertheless, health care costs will undoubtedly increase during the next 30 years as a result of the baby boomers entering late life. The economic and social impact of future growing health care expenditures for the elderly will be significant. Important policy issues will include the continued viability of the Medicare and Social Security programs, future needs for long-term care, improvement of the health status of the elderly, technological advances, the need for a geriatric work force, and development of viable strategies to pay for escalating medical care costs.

    更新日期:2019-11-01
  • The role of culture in health communication.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Matthew W Kreuter,Stephanie M McClure

    This paper examines the role of culture as a factor in enhancing the effectiveness of health communication. We describe culture and how it may be applied in audience segmentation and introduce a model of health communication planning--McGuire's communication/persuasion model--as a framework for considering the ways in which culture may influence health communication effectiveness. For three components of the model (source, message, and channel factors), the paper reviews how each affects communication and persuasion, and how each may be affected by culture. We conclude with recommendations for future research on culture and health communication.

    更新日期:2019-11-01
  • Lessons learned from public health mass media campaigns: marketing health in a crowded media world.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Whitney Randolph,K Viswanath

    Every year, new public health mass media campaigns are launched attempting to change health behavior and improve health outcomes. These campaigns enter a crowded media environment filled with messages from competing sources. Public health practitioners have to capture not only the attention of the public amid such competition, but also motivate them to change health behaviors that are often entrenched or to initiate habits that may be new or difficult. In what ways are public health mass media campaigns now attempting to succeed in a world crowded with media messages from a myriad of sources? What are the conditions that are necessary for a media campaign to successfully alter health behaviors and alter outcomes in the long term? To what extent can the successes and failures of previous campaigns be useful in teaching important lessons to those planning campaigns in the future? In this chapter we attempt to answer these questions, drawing from recent literature on public health mass media campaigns.

    更新日期:2019-11-01
  • Housing and public health.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Mary Shaw

    This review considers the broad area of housing and public health, one of the traditional and core areas of public health research and intervention. The review takes into account the range of factors, acting at different levels, directly and indirectly, through which housing affects health. In public health terms, housing affects health in a myriad of relatively minor ways, in total forming one of the key social determinants of health. The paper closes by considering how the improvement of housing and neighborhoods has been a core activity of public health and a central component in tackling poverty. Investment in housing can be more than an investment in bricks and mortar: It can also form a foundation for the future health and well-being of the population. Addressing poor-quality housing and detrimental neighborhoods, in the broadest sense, is thus a task that should be grasped with vigor and determination by all those involved in public health.

    更新日期:2019-11-01
  • Harm reduction approaches to reducing tobacco-related mortality.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Dorothy K Hatsukami,Jack E Henningfield,Michael Kotlyar

    Tobacco harm reduction approaches are gaining increased attention. Much of this attention is due to a growing concern that significant populations of smokers either do not want to quit or believe they are unable to quit smoking, and to a concern over tobacco-industry attempts to produce tobacco products that claim to result in less toxin exposure. Decreasing tobacco toxin exposure as a method for reducing mortality and morbidity may be a reasonable tobacco control strategy. However, the impact of this strategy must be explored both on individual and population levels. A significant amount of independent research is needed to inform policy decisions. Regulatory authority over potential reduced exposure products is also essential.

    更新日期:2019-11-01
  • Assuring the health of immigrants: what the leading health indicators tell us.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Namratha R Kandula,Margaret Kersey,Nicole Lurie

    Over the past 20 years, the United States has experienced one of the largest waves of immigration in its history. Understanding the health status and needs of immigrants is important because of their growing numbers and their contribution to the health of the nation, but it is challenging because of gaps in national databases, the heterogeneity of immigrant populations, and uncertainty about how migration affects health. Healthy People 2010 outlines the nation's public health objectives for the current decade. It includes ten leading health indicators (LHIs) chosen because of their importance as public health issues, their ability to motivate action, and the availability of data to measure their progress. In this paper, we discuss the health of immigrants from the perspective of these LHIs, as they provide a framework for anticipating some of the future health needs of immigrants and help define priority areas for research and action.

    更新日期:2019-11-01
  • The public health workforce.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Hugh Tilson,Kristine M Gebbie

    The development of a fully-competent public health workforce as a key component of the nation's public health infrastructure has become the focus of increasing attention. The subject is included in one, and is the major topic of a second, report from the Institute of Medicine published late in 2002. Workforce issues have stimulated the convening of the majority of public health-related associations in a range of collaborations on the subjects of defining, enumerating, credentialing, educating, and studying the workforce. The authors review the major questions confronting the field and introduce key components of current thinking about approaches to improvement.

    更新日期:2019-11-01
  • The current state of public health in China.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Liming Lee

    In the past 50 years, China has made great achievements in controlling infectious diseases and improving the public's health and hygiene. However, in the twenty-first century, owing to the negative effects brought on by aging of the population and the burdens of diseases, urbanization, industrialization, and globalization, Chinese public health officials are encountering greater difficulties than ever. Old operating models of public health cannot meet present requirements. The main problems are poor capacity to respond to public health emergencies, severe inequality of health care services, and lagging development of public health information systems. Public health in China can gradually meet the requirements of social development and the increasing public demand for health care services only when the public health is directed by informatization, globalization, technification, and humanization.

    更新日期:2019-11-01
  • Modeling infection transmission.
    Annu. Rev. Public Health (IF 10.776) Pub Date : 2004-03-16
    Jim Koopman

    Understanding what determines patterns of infection spread in populations is important for controlling infection transmission. The science that advances this understanding uses mathematical and computer models that vary from deterministic models of continuous populations to models of dynamically evolving contact networks between individuals. These provide insight, serve as scientific theories, help design studies, and help analyze data. The key to their use lies in assessing the robustness of inferences made using them to violation of their simplifying assumptions. This involves changing model forms from deterministic to stochastic and from compartmental to network, as well as adding realistic detail and changing parameter values. Currently inferences about infection transmission are often made using stratified rate or risk comparisons, logistic regression models, or proportionate hazards models that assume an absence of transmission. Robustness assessment will show many of these inferences to be wrong. A community of epidemiologist modelers is needed for effective robustness assessment.

    更新日期:2019-11-01
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