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da Silva RE, Novaes MRCG, de Oliveira C, Guilhem DB. The impact of social cohesion and risk communication on excess mortality due to COVID-19 in 213 countries: a retrospective analysis. BMC Public Health 2024; 24:1598. [PMID: 38877440 PMCID: PMC11179214 DOI: 10.1186/s12889-024-19076-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/06/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Tools for assessing a country's capacity in the face of public health emergencies must be reviewed, as they were not predictive of the COVID-19 pandemic. Social cohesion and risk communication, which are related to trust in government and trust in others, may have influenced adherence to government measures and mortality rates due to COVID-19. OBJECTIVE To analyse the association between indicators of social cohesion and risk communication and COVID-19 outcomes in 213 countries. RESULTS Social cohesion and risk communication, in their dimensions (public trust in politicians, trust in others, social safety nets, and equal distribution of resources index), were associated with lower excess mortality due to COVID-19. The number of COVID-19-related disorder events and government transparency were associated with higher excess mortality due to COVID-19. The lower the percentage of unemployed people, the higher the excess mortality due to COVID-19. Most of the social cohesion and risk communication variables were associated with better vaccination indicators, except for social capital and engaged society, which had no statistically significant association. The greater the gender equality, the better the vaccination indicators, such as the number of people who received all doses. CONCLUSION Public trust in politicians, trust in others, equal distribution of resources and government that cares about the most vulnerable, starting with the implementation of programs, such as cash transfers and combating food insecurity, were factors that reduced the excess mortality due to COVID-19. Countries, especially those with limited resources and marked by social, economic, and health inequalities, must invest in strengthening social cohesion and risk communication, which are robust strategies to better cope with future pandemics.
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Affiliation(s)
- Ricardo Eccard da Silva
- Brazilian Health Regulatory Agency - Anvisa, Setor de Indústrias, Trecho 5, Área Especial 57, Brasília, 71205-050, DF, Brazil
- Faculty of Health Sciences, University of Brasília - UnB, Campos Univ. Darcy Ribeiro, Asa Norte, Brasília, 70910-900, DF, Brazil
| | - Maria Rita Carvalho Garbi Novaes
- Faculty of Health Sciences, University of Brasília - UnB, Campos Univ. Darcy Ribeiro, Asa Norte, Brasília, 70910-900, DF, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London (UCL), 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Dirce Bellezi Guilhem
- Faculty of Health Sciences, University of Brasília - UnB, Campos Univ. Darcy Ribeiro, Asa Norte, Brasília, 70910-900, DF, Brazil
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Lee J, Park S, Jang SN, Reyes KA, Garcia F, Canila C, Oraño J, Ballesteros AJ, Muhartini T, Frans S, Marthias T, Putri LP, Mahendradhata Y, De Foo C. Differential impacts of health systems and sociocultural environment on vulnerable populations during the COVID-19 pandemic: lessons from four Asia-Pacific countries. BMC Public Health 2024; 24:1501. [PMID: 38840230 PMCID: PMC11151645 DOI: 10.1186/s12889-024-18949-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND This study aims to evaluate healthcare systems and pandemic responses in relation to marginalized and vulnerable groups, identify populations requiring urgent care, and assess the differential impacts on their health during the pandemic. METHODS Data were collected by the Asia-Pacific Observatory on Health Systems and Policies (APO)-National University of Singapore and APO-International Health Policy Program consortium members: Korea, Indonesia, Philippines, and Singapore. Data were collected through a combination of semi-structured interviews, policy document reviews, and analysis of secondary data. RESULTS Our findings reveal that the pandemic exacerbated existing health disparities, particularly affecting older adults, women, and children. Additionally, the study identified LGBTI individuals, healthcare workers, slum dwellers, and migrant workers as groups that faced particularly severe challenges during the pandemic. LGBTI individuals encountered heightened discrimination and limited access to health services tailored to their needs. Healthcare workers suffered from immense stress and risk due to prolonged exposure to the virus and critical working conditions. Slum dwellers struggled with healthcare access and social distancing due to high population density and inadequate sanitation. Migrant workers were particularly hard hit by high risks of virus transmission and stringent, often discriminatory, isolation measures that compounded their vulnerability. The study highlights the variation in the extent and nature of vulnerabilities, which were influenced by each country's specific social environment and healthcare infrastructure. It was observed that public health interventions often lacked the specificity required to effectively address the needs of all vulnerable groups, suggesting a gap in policy and implementation. CONCLUSIONS The study underscores that vulnerabilities vary greatly depending on the social environment and context of each country, affecting the degree and types of vulnerable groups. It is critical that measures to ensure universal health coverage and equal accessibility to healthcare are specifically designed to address the needs of the most vulnerable. Despite commonalities among groups across different societies, these interventions must be adapted to reflect the unique characteristics of each group within their specific social contexts to effectively mitigate the impact of health disparities.
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Affiliation(s)
- Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Hyo-tree nursing home, Incheon, Republic of Korea
| | - Susan Park
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Seoul National University, Seoul, Republic of Korea
| | - Soong-Nang Jang
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea.
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
| | | | - Fernando Garcia
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Carmelita Canila
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Joseph Oraño
- Alliance for Improving Health Outcomes, Quezon City, Philippines
| | | | - Tri Muhartini
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Sandra Frans
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Tiara Marthias
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Likke Prawidya Putri
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Yodi Mahendradhata
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Depok, Indonesia
| | - Chuan De Foo
- NUS Saw Swee Hock School of Public Health and National University Health System, Singapore, Singapore
- Duke NUS Graduate Medical School, Singapore, Singapore
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Excess suicide attributable to the COVID-19 pandemic and social disparities in South Korea. Sci Rep 2022; 12:18390. [PMID: 36319683 PMCID: PMC9626586 DOI: 10.1038/s41598-022-22751-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/19/2022] [Indexed: 01/01/2023] Open
Abstract
The impact of COVID-19 pandemic on suicide remains unclear and might differ according to individuals' socioeconomic characteristics. We aimed to investigate excess suicide attributable to COVID-19 in South Korea, stratified by the outbreak period and individual characteristics. We obtained daily time-series suicide mortality data for January 2017-December 2020 from the Korea National Statistics Office and performed a two-stage interrupted time-series analysis. We estimated excess suicide in 16 regions of Korea using a quasi-Poisson time-series regression model and pooled the region-specific estimates using a mixed-effects multivariate meta-analysis model in the first and second stages, respectively. From February 18 to December 31, 2020, suicide decreased by 9.5% [95% empirical confidence interval (eCI): 3.8%, 15.6%] compared to the number expected from the pre-pandemic period. The decrease in excess suicide risk from the initial pandemic was pronounced during the pandemic's first and third waves. Further, we found that the decrease in suicide was more evident in individuals who were male [11.7% (95% eCI: 5.5%, 18.0%)], middle-aged [13.7% (95% eCI: 7.8%, 19.6%)], highly educated [12.6% (95% eCI: 6.4%, 19.4%)], and married [13.6% (95% eCI: 8.0%, 20.3%)] than in the general population, based on the point estimates. Our results provide timely evidence to establish public health policies for suicide prevention and suggest the prioritization of resource allocation for mental health of individuals based on individual characteristics.
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Felemban EM, Youssef HAM, Al Thobaity A. Factors Affecting the Decontamination Process in Hospitals in Saudi Arabia. Risk Manag Healthc Policy 2021; 14:357-363. [PMID: 33542666 PMCID: PMC7850977 DOI: 10.2147/rmhp.s295262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/18/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Hospitals face various types of disasters that require either decontamination or disinfection interventions. These contaminants can be chemical, biological, radioactive, or infectious, such as COVID-19. Further, there are few studies in the literature on factors affecting decontamination in hospitals in Saudi Arabia. Methods Approximately 157 healthcare providers (doctors, nurses, and other specialists) participated in this study. Principle component analysis was used to explore three factors in Saudi Arabia that affect the ability of healthcare providers to decontaminate appropriately. Results Three factors were extracted: (1) having adequate skills to perform decontamination, (2) being adequately prepared for decontamination before a disaster occurs, and (3) organizational barriers to decontamination. There was a positive correlation between the skills and preparedness and a negative correlation between barriers and both skills and preparedness. Discussion It is essential to prepare for decontamination during disasters more effectively and to ensure that all healthcare providers have the requisite skills. Moreover, barriers to decontamination must be investigated thoroughly to improve implementation.
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Affiliation(s)
- Ebaa M Felemban
- Nursing Department, Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hanan A M Youssef
- Nursing Department, Applied Medical Sciences, Taif University, Taif, Saudi Arabia
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