Editorial: Public Health and Primary Care, Is 1+1=1?
In: International journal of public health, Band 69
ISSN: 1661-8564
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In: International journal of public health, Band 69
ISSN: 1661-8564
In: The international journal of social psychiatry, Band 64, Heft 4, S. 389-395
ISSN: 1741-2854
Background: Suicide is a tremendous public health issue and worldwide the second leading cause of death among young people. In 2015, Greenland had the highest burden of disease due to self-harm with loss of 2,952.97 disability-adjusted life years per 100,000 inhabitants, more than six times as many as Denmark. Aims: What are possible reasons for Greenland's higher youth suicide rate compared to Denmark, despite being one kingdom of Denmark? Method: Mixed methods in the form of qualitative, semi-structured interviews, the analysis of available data for 2003–2016 and a literature review were conducted with the aim to answer this question. Results: Several exposures cause this difference, most significantly adverse effects of the colonial past, such as social issues and experienced traumas in Greenland compared to its former coloniser Denmark. Conclusion: The ongoing burden of youth suicide in Greenland requires enhanced actions of all stakeholders involved in suicide prevention, intervention and postvention.
In: Safi , M , Bertram , M L & Gulis , G 2020 , ' Assessing delivery of selected public health operations via essential public health operation framework ' , International Journal of Environmental Research and Public Health , vol. 17 , no. 17 , 6435 . https://doi.org/10.3390/ijerph17176435
Background: To assess the conduct of delivery of public health services at the municipal level in Denmark by applying services enlisted in the Essential Public Health Operation framework (EPHO) of WHO. Methods: We conducted individual qualitative interviews with key informants working with public health using a self-assessment survey tool in order to obtain an in-depth understanding of the interrelation or multidisciplinary work in Kolding Municipality. The developed self-assessment survey tool entailed questions about essential public health activities performed in a municipality. Results: The Municipality organizes and contributes to core service delivery EPHOs, namely health protection, health promotion, and disease prevention. It collaborates with the general practitioners and the Region of Southern Denmark, responsible for hospital care, to fulfill the selected EPHOs. Conclusions: To obtain a comprehensive picture of the organizations that deliver public health services within a municipality, it is necessary to conduct interviews with representatives from those organizations as well. Additionally, the results from this study can be used to improve the survey tool further and hereafter conduct a nationwide survey in Denmark, as well as other European countries.
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In the European Union, the Environmental Impact Assessment (EIA) Directive (2014/52/EU) and Strategic Environmental Assessment (SEA) Directive (2011/92/EU) emphasise the assessment of population and human health. The directives require health to be considered within Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA). To date, health is mainly considered in connection with negative environmental factors and in terms of risk assessments. The integration of health in EIA as well as SEA has not been investigated in a Danish context, and this study aims to address the missing knowledge. There is a need for a more comprehensive health assessment within EIA and SEA to comply with the EIA and SEA directives. An integration of health into EIA and SEA will ensure a sound examination of health determinants which can improve decision making and thus comprehensively promote and protect health. To establish the status of the inclusion of the assessment of impacts on health into EIA and SEA, a literature review was performed. In addition, a survey addressed to researchers and practitioners was conducted and analysed through a comparative analysis. The survey examined the needs of practitioners and researchers, focusing on the Danish context, regarding the inclusion of health into EIA and SEA. Enhanced intersectoral cooperation of the health and environmental sectors, more specific guidance documents, and underlying this, stronger political support, were identified among needs for more comprehensive health assessments.
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In: Humboldt-Dachroeden , S , Fischer-Bonde , B & Gulis , G 2019 , ' Analysis of Health in Environmental Assessments : A Literature Review and Survey with a Focus on Denmark ' , International Journal of Environmental Research and Public Health , vol. 16 , no. 22 , 4570 . https://doi.org/10.3390/ijerph16224570
In the European Union, the Environmental Impact Assessment (EIA) Directive (2014/52/EU) and Strategic Environmental Assessment (SEA) Directive (2011/92/EU) emphasise the assessment of population and human health. The directives require health to be considered within Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA). To date, health is mainly considered in connection with negative environmental factors and in terms of risk assessments. The integration of health in EIA as well as SEA has not been investigated in a Danish context, and this study aims to address the missing knowledge. There is a need for a more comprehensive health assessment within EIA and SEA to comply with the EIA and SEA directives. An integration of health into EIA and SEA will ensure a sound examination of health determinants which can improve decision making and thus comprehensively promote and protect health. To establish the status of the inclusion of the assessment of impacts on health into EIA and SEA, a literature review was performed. In addition, a survey addressed to researchers and practitioners was conducted and analysed through a comparative analysis. The survey examined the needs of practitioners and researchers, focusing on the Danish context, regarding the inclusion of health into EIA and SEA. Enhanced intersectoral cooperation of the health and environmental sectors, more specific guidance documents, and underlying this, stronger political support, were identified among needs for more comprehensive health assessments.
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In: Humboldt-Dachroeden , S , Fischer-Bonde , B & Gulis , G 2019 , ' Analysis of Health in Environmental Assessments-A Literature Review and Survey with a Focus on Denmark ' , International Journal of Environmental Research and Public Health , vol. 16 , no. 22 , 4570 . https://doi.org/10.3390/ijerph16224570
In the European Union, the Environmental Impact Assessment (EIA) Directive (2014/52/EU) and Strategic Environmental Assessment (SEA) Directive (2011/92/EU) emphasise the assessment of population and human health. The directives require health to be considered within Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA). To date, health is mainly considered in connection with negative environmental factors and in terms of risk assessments. The integration of health in EIA as well as SEA has not been investigated in a Danish context, and this study aims to address the missing knowledge. There is a need for a more comprehensive health assessment within EIA and SEA to comply with the EIA and SEA directives. An integration of health into EIA and SEA will ensure a sound examination of health determinants which can improve decision making and thus comprehensively promote and protect health. To establish the status of the inclusion of the assessment of impacts on health into EIA and SEA, a literature review was performed. In addition, a survey addressed to researchers and practitioners was conducted and analysed through a comparative analysis. The survey examined the needs of practitioners and researchers, focusing on the Danish context, regarding the inclusion of health into EIA and SEA. Enhanced intersectoral cooperation of the health and environmental sectors, more specific guidance documents, and underlying this, stronger political support, were identified among needs for more comprehensive health assessments.
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In: The international journal of social psychiatry, Band 63, Heft 2, S. 161-168
ISSN: 1741-2854
Background: Suicide is a significant public health issue worldwide, resulting in loss of lives, and burdening societies. Aims: To describe and analyze the time trends of suicide rates (SRs) in the Slovak Republic in 1993–2015 for targeted suicide prevention strategies. Methods: Data for this study were obtained from the mortality database of the Statistical Office of the Slovak Republic. Crude and standardized annual SRs were calculated. Trends and relative risks of suicide according to age and sex were analyzed by joinpoint regression and negative binomial regression. Results: In total, there were 14,575 suicides in the Slovak Republic in the period 1993–2015 (85.3% were men). The overall average age-standardized SR for the study period was 11.45 per 100,000 person years. The rate increases with age, the highest is in men aged 75+ (42.74 per 100,000 person years). Risk of suicide is six times higher in men than in women and nine times higher in men than in women in the age group 25–34. The time trend of SRs is stable or decreasing from 1993 to 2007, but increasing after 2007, corresponding with increased unemployment rate in the country. Conclusion: The SR in the Slovak Republic is slightly below the average of Organisation for Economic Co-operation and Development (OECD) nations. Highest SR is observed in men of working age and in retirement. Society might benefit from a strategy of education for improving the recognition of suicide risks.
In: Appiah-Brempong , E , Harris , M J , Newton , S & Gulis , G 2018 , ' Examining school-based hygiene facilities: a quantitative assessment in a Ghanaian municipality ' , B M C Public Health , vol. 18 , 581 . https://doi.org/10.1186/s12889-018-5491-9
Background: The crucial role of adequate water, sanitation and hygiene (WASH) facilities in influencing children's handwashing behaviour is widely reported. Report from UNICEF indicates a dearth of adequate data on WASH facilities in schools, especially in the developing world. This study sought to contribute to building the evidence-base on school hygiene facilities in Ghana. The study further explored for possible associations and differences between key variables within the context of school water, sanitation and hygiene. Methods: Data was collected from 37 junior high schools using an observational checklist. Methods of data analysis included a Scalogram model, Fisher's exact test, and a Student's t-test. Results: Results of the study showed a facility deficiency in many schools: 33% of schools had students washing their hands in a shared receptacle (bowl), 24% had students using a single cotton towel to dry hands after handwashing, and only 16% of schools had a functional water facility. Furthermore, results of a proportion test indicated that 83% of schools which had functional water facilities also had functional handwashing stations. On the other hand, only 3% of schools which had functional water facilities also had a functional handwashing stations. A test of difference in the proportions of the two sets of schools showed a statistically significant difference (p < 0.001). In addition, 40% of schools which had financial provisions for water supply also had functional handwashing stations. On the other hand, only 7% of schools which had financial provisions for water supply also had functional handwashing stations. There was a statistically significant difference in the proportions of the two sets of schools (p = 0.02). Conclusion: We conclude that it is essential to have a financial provision for water supply in schools as this can potentially influence the existence of a handwashing station in a school. An intervention by government, educational authorities and civil society organisations towards enabling schools in low resource areas to have a sustainable budgetary allocation for WASH facilities would be timely.
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In: Gulis , G , Aringazina , A , Sangilbayeva , Z , Zhan , K , de Leeuw , E & Allegrante , J P 2021 , ' Population health status of the republic of kazakhstan : Trends and implications for public health policy ' , International Journal of Environmental Research and Public Health , vol. 18 , no. 22 , 12235 . https://doi.org/10.3390/ijerph182212235
The Republic of Kazakhstan began undergoing a political, economic, and social transition after 1991. Population health was declared an important element and was backed with a substantial commitment by the central government to health policy. We examine key trends in the population health status of the Republic of Kazakhstan and seek to understand them in relation to the ongoing political, economic, and social changes in society and its aspirations in health policy. We used the Global Burden of Disease database and toolkit to extract and analyze country-specific descriptive data for the Republic of Kazakhstan to assess life expectancy, child mortality, leading causes of mortality, disability-adjusted life years, and causes and number of years lived with disability. Life expectancy declined from 1990 to 1996 but has subsequently recovered. Ischemic heart disease, stroke, and chronic obstructive pulmonary disease remain among the leading causes of death; child mortality for children under 5 years has declined; and cardiovascular risk factors account for the greatest cause of disability. Considering its socioeconomic development over the last two decades, Kazakhstan continues to lag behind OECD countries on leading health indictors despite substantial investments in public health policy. We identify seven strategic priorities to improve the efficiency and effectiveness of the health care system.
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In: Loncarevic , N , Radl-Karimi , C M , Bertram , M , Gulis , G , Thøgersen , M , Skovgaard , T & Aro , A R 2015 , ' Politicians learned to request more research knowledge - intervention results from Denmark ' , European Journal of Public Health , vol. 25 , no. 3 , pp. 226-227 . https://doi.org/10.1093/eurpub/ckv173.034
The interventions were on physical activity policies at initiation phase; Kolding eight-month workshop and guidance intervention (n = 21 team members) aimed to promote inter-sector collaboration; Varde 10-month working group and guidance intervention (n = 11) aimed to facilitate systematic strategy development in research knowledge use and inter-sector collaboration.
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The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessmentwith special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals.
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