Engaging Religious Institutions and Faith-Based Communities in Public Health Initiatives: A Case Study of the Romanian Orthodox Church During the COVID-19 Pandemic

The success of public health interventions is highly dependent on the compliance of the general population. State authorities often implement policies without consulting representatives of faith-based communities, thereby overlooking potential implications of public health measures for these parts of society. Although ubiquitous, these challenges are more readily observable in highly religious states. Romania serves as an illustrative example for this, as recent data identify it as the most religious country in Europe. In this paper, we discuss the contributions of the Romanian Orthodox Church (ROC), the major religious institution in the country, to the national COVID-19 mitigation efforts. We present not only the positive outcomes of productive consultations between public health authorities and religious institutions but also the detrimental impact of unidirectional communication. Our work highlights that an efficient dialogue with faith-based communities can greatly enhance the results of public health interventions. As the outlined principles apply to a variety of contexts, the lessons learned from this case study can be generalized into a set of policy recommendations for the betterment of future public health initiatives worldwide.

Why We Eat the Way We Do: A Call to Consider Food Culture in Public Health Initiatives

The way we eat has changed dramatically in only a few decades. While definitions of food culture have previously existed, a clear description of modern food culture that can be used for health promotion is lacking. In this paper, we propose a concept of food culture for application within public health, what a positive food culture looks like compared to negative elements that have dominated in developed countries and the consequences for physical and mental health and wellbeing. We support calls to action from the international community to reconsider the way we eat. All segments of society have a role to play in building a positive food culture, and it is critical that macro (policy and systems) and meso (community) level environmental factors align and provide supportive environments that promote health-enhancing behaviours. Defining food culture is a necessary step towards articulating the complexities that influence food behaviours and impact health. The ultimate goal is collective action to enable population-wide and sustained improvements to the way we eat, and how we think and feel about food.

Governing industry involvement in the non-communicable disease response in Kenya

Background In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development. Methods We developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents. Results The Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action. Conclusion The application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.

Decrease in new diagnosis of HIV/AIDS in the two years period 2019-2020: impact of COVID-19 pandemic

The emergence SARS-CoV-2 in late 2019 and early 2020 has caused a pandemic of unprecedented proportions. Management of COVID-19 became emergent public health priorities, and the impact on other public health initiatives, such as expanded HIV screening and linkage to care, remain largely unknown. In this Single-Center retrospective observational study, we describe the characteristics and circumstance of the new HIV cases during 2020 compared to 2019. We observed a decrease of HIV diagnosis during this period. Interestingly, median age at HIV diagnosis decreased of one decade and percentage of female patients was higher. In addition, more patients received diagnosis during hospitalization and more AIDS-defining conditions, such as Pneumocystis pneumonia, were detected. We express our concern that HIV new diagnoses will increase as a result of people's inability to get tested or treated in this period. More efforts are needed to improve local screening programs both during and after COVID-19 pandemic.

Using a 24 h Activity Recall (STAR-24) to Describe Activity in Adolescent Boys in New Zealand: Comparisons between a Sample Collected before, and a Sample Collected during the COVID-19 Lockdown

Background: Tools that assess all three components of 24 h movement guidelines (sleep, physical activity, and screen use) are scarce. Our objective was to use a newly developed Screen Time and Activity Recall (STAR-24) to demonstrate how this tool could be used to illustrate differences in time-use across the day between two independent samples of male adolescents collected before and during the COVID-19 lockdown. Methods: Adolescent boys aged 15–18 years (n = 109) each completed the STAR-24 twice, n = 74 before lockdown and n = 35 during lockdown. Results: During lockdown more than 50% of the sample reported gaming between 10 am and 12 noon, transport was not reported as an activity, and activities of daily living spiked at mealtimes. Gaming and screen time were more prevalent in weekends than weekdays, with the highest prevalence of weekday screen use (before lockdown) occurring between 8 and 9 pm. Differences in estimates of moderate-to-vigorous physical activity prior to and during lockdown (mean difference (95% CI); 21 (−9 to 51) min) and sleep (0.5 (−0.2 to 1.2) h) were small. Total and recreational screen time were higher during lockdown (2 h (0.7 to 3.3 h) and 48 min (−36 to 132 min), respectively). Conclusions: The STAR-24 holds promise as a single tool that assesses compliance with 24 h movement guidelines. This tool also allows clear illustration of how adolescent boys are using their time (instead of only providing summary measures), providing richer data to inform public health initiatives.

“A Personal Decision”: A Mixed-Methods Study of Parents’ Opposition to School-Based Public Health Initiatives in the Wake of COVID-19

Schools play a key role in promoting public health. Yet, these initiatives also face opposition from parents, and such opposition may be increasing in the wake of misinformation campaigns and efforts to politicize public health. During the COVID-19 pandemic, for example, parent opposition helped derail schools’ efforts to require masks and vaccines. Thus, it is important for educators and policymakers to understand the extent, source, and nature of parents’ opposition to new school-based public health initiatives. Combining data from a national survey of US parents (N=1,945) with a content analysis of a Facebook group for parents in one politically divided school community, we found that, at the peak of the pandemic (December 2020), nearly one third of parents opposed each of our two focal initiatives. We also found that parents based their opposition to (or support for) school-based public health initiatives on individualistic calculations about the costs and benefits those initiatives would impose on their individual child. Those calculations, however, did not always follow the same logic. In light of those varied logics, vaccine opposition was most common among Republicans, mothers (especially white mothers), parents without college degrees, and Black parents. Meanwhile, opposition to mask mandates was disproportionately common among Republicans, fathers, and college-educated parents (especially among white parents), as well as among those who had COVID-19. We conclude that individualistic approaches to parental decision-making are preventing communities from enacting and maintaining school-based public health initiatives and undermining health and education as public goods.

Advancing precision public health using human genomics: examples from the field and future research opportunities

Precision public health is a relatively new field that integrates components of precision medicine, such as human genomics research, with public health concepts to help improve population health. Despite interest in advancing precision public health initiatives using human genomics research, current and future opportunities in this emerging field remain largely undescribed. To that end, we provide examples of promising opportunities and current applications of genomics research within precision public health and outline future directions within five major domains of public health: biostatistics, environmental health, epidemiology, health policy and health services, and social and behavioral science. To further extend applications of genomics within precision public health research, three key cross-cutting challenges will need to be addressed: developing policies that implement precision public health initiatives at multiple levels, improving data integration and developing more rigorous methodologies, and incorporating initiatives that address health equity. Realizing the potential to better integrate human genomics within precision public health will require transdisciplinary efforts that leverage the strengths of both precision medicine and public health.

Need and Importance of Nutrition Informatics in India: A Perspective

Nutrition informatics (NI) is the effective retrieval, organization, storage, and optimum use of information, data and knowledge for food-and-nutrition-related problem-solving and decision-making. There is a growing opportunity to facilitate technology-enabled behavioral change interventions to support NI research and practice. This paper highlights the changing landscape of food and nutrition practices in India to prepare a NI workforce that could provide some valuable tools to address the double burden of nutrition. Management and interpretation of data could help clarify the relationships and interrelationships of diet and disease in India on both national and regional levels. Individuals with expertise in food and nutrition may receive training in informatics to develop national informatics systems. NI professionals develop tools and techniques, manage various projects and conduct informatics research. These professionals should be well prepared to work in technological settings and communicate data and information effectively. Opportunities for training in NI are very limited in developing countries. Given the current progress in developing platforms and informatics infrastructure, India could serve as an example to other countries to promote NI to support achieving SDGs and other public health initiatives.

Racial/Ethnic Health Disparity in the U.S.: A Decomposition Analysis

Following recent econometric developments, we use self-assessed general health on a Likert scale conditioned by several objective determinants to measure health disparity between non-Hispanic Whites and minority groups in the United States. A statistical decomposition analysis is conducted to determine the contributions of socio-demographic and neighborhood characteristics in generating disparities. Whereas, 72% of health disparity between Whites and Blacks is attributable to Blacks’ relatively worse socio-economic and demographic characteristics, it is only 50% for Hispanics and 65% for American Indian Alaska Natives. The role of a number of factors including per capita income and income inequality vary across the groups. Interestingly, “blackness” of a county is associated with better health for all minority groups, but it affects Whites negatively. Our findings suggest that public health initiatives to eliminate health disparity should be targeted differently for different racial/ethnic groups by focusing on the most vulnerable within each group.

Governing Industry Involvement in the Non-Communicable Disease Response in Kenya

BackgroundIn low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development.MethodsWe developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents.ResultsThe Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action.ConclusionThe application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs capacities to govern multinational corporations’ contributions to NCDs in particular and development in general.