Assessment of health equity consideration in masking/PPE policies to contain COVID-19 using PROGRESS-plus framework: a systematic review

Introduction There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE). Methods A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as ‘PROGRESS-Plus’: Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized. Results This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on “occupation” component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on “workers” such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to “worker focused” policy documents, most of the ‘whole population focused’ policy documents didn’t have a PROGRESS-plus equity component rendering them equity limiting for the society. Conclusion Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.

Review of Schemes and Policies for Urban Transport in India with Reference to Socio-Equity Considerations

Public Transport has been seen since ages as the most environmentally sustainable mode of transport. The users of public transport are diverse and have different socio-economic character. Hence the public transport which is not only supposed to be environmentally sustainable but also envisaged to ensure equity amongst various stakeholders of society like the females, elderly and other vulnerable groups through its service. Gender in binary terms of being differentiated based on men and women is a social construct. Public transport systems in developing countries like India witness socio-cultural factors that shape the experience of women in public spaces by social norms extant in society. Along with this, gender-based issues related to public transport are social and behavioural shortcomings as a consequence of a lack of gender sensitivity. On similar lines, elderly have a negative experience involving safety threats, physical and psychological discomfort while accessing public transport systems. The literature published regarding such issues on the gender and elderly question in public transport systems have been studied and has been brought forth under a stand- alone narrative literature review. A literature review is a prerequisite to conducting either stand-alone reviews or as a preliminary study to be supported with quantitative or qualitative analysis. Here, a stand-alone literature review concerning issues in the public transport system in India has been performed. A narrative type of review is conducted to provide an overview of pre- existing published literature. Narrative overviews are useful educational articles as they help present a broad perspective on a topic and often define the development of a problem and/or ways to manage it. The semi-systematic or narrative-review approach is designed for topics that have been theorized differently and studied within diverse disciplines making it unfavourable to study under a full systematic-review process which majorly caters to reviewing quantitative researches. As narrative-styled literature reviews prefer a semi- systematic data collection method, utmost care has been taken to include perspectives from diverse disciplines. The scope of this review is restricted to summarizing the Indian policies, schemes of public transport in light of socio-equity consideration while narrowing the inherent discrepancies within the socio-cultural ethos of the Indian society which influences socio-equity consideration in public spaces in general and the modes of public transport in particular. Research articles from electronic databases were selected based on relevance to understand the issues this viewpoint, their essential findings and possible recommendations are formulated to provide a comprehensive summary of previous researches.

Expanding Implementation Research to Prevent Chronic Diseases in Community Settings

Chronic disease prevention continues to be inadequate, overall and in achieving health equity, in spite of the many evidence-based practices and policies (EBPPs) available to address risk behaviors such as unhealthful eating, lack of physical activity, and tobacco use. Although clinical settings are needed for EBPPs that involve medical procedures such as immunization or early detection, dissemination of EBPPs can be effective in a variety of settings such as schools and childcare centers, worksites, social service organizations, and religious organizations. More implementation research is needed to meet challenges of effective application of EBPPs in such community settings, in which primary missions, capacity, cultures, and values do not focus on health services delivery. To address health equity, consideration of social and economic contexts of people reached in these settings is essential. This review presents lessons learned from past studies to guide future implementation research and practice across diverse settings and geographies. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Multiobjective Optimization for Pavement Network Maintenance and Rehabilitation Programming: A Case Study in Shanghai, China

This study investigates the pavement network maintenance and rehabilitation (M&R) programming problem, over a certain planning horizon and in the context of limited funding. We designed an integer programming model to fulfill three purposes, namely, optimize the road conditions, minimize user disturbance costs, and minimize agency costs. We present a case study in which this model is applied to the pavement network of Shanghai. We investigate the results through the use of five M&R strategies, to identify the Pareto-optimal trade-offs inherent in developing pavement network M&R planning. The results demonstrate that there is a positive relationship between PCI improvement and user disturbance costs and between PCI improvement and agency costs. Additionally, we conduct a comparative analysis between agency and government-oriented strategies to evaluate the effectiveness and equity consideration. The findings suggest that the government-oriented strategy improves the pavement condition effectively with low user disturbance costs, and the agency-oriented strategy accounts for more equity consideration. Finally, we formulate an extension model that considers multiple road types, for application to pavement network M&R programming. The results show that light rehabilitation and preventive maintenance are the most frequently implemented treatments on arterial roads and secondary trunk roads from the case network implementation. This study helps decision-makers identify the trade-offs made when developing a pavement network M&R program.

Generalized route planning approach for hazardous materials transportation with equity consideration

Hazardous materials transportation should consider risk equity and transportation risk and cost. In the hazardous materials transportation process, we consider risk equity as an important condition in optimizing vehicle routing for the long-term transport of hazardous materials between single or multiple origin-destination pairs (O-D) to reduce the distribution difference of hazardous materials transportation risk over populated areas. First, a risk equity evaluation scheme is proposed to reflect the risk difference among the areas. The evaluation scheme uses standard deviation to measure the risk differences among populated areas. Second, a risk distribution equity model is proposed to decrease the risk difference among populated areas by adjusting the path frequency between O-D pairs for hazardous materials transportation. The model is converted into two sub models to facilitate decision-making, and an algorithm is provided for each sub model. Finally, we design a numerical example to verify the accuracy and rationality of the model and algorithm. The numerical example shows that the proposed model is essential and feasible for reducing the complexity and increasing the portability of the transportation process.