Frank Pega

Politics, policies and population health: A commentary on Mackenbach, Hu and Looman (2013).

Politics, policies and population health : A commentary on Mackenbach, Hu and Looman (2013)

The Case for the World Health Organization’s Commission on Social Determinants of Health to Address Gender Identity

We analyzed the case of the World Health Organizations Commission on Social Determinants of Health, which did not address gender identity in their final report. We argue that gender identity is increasingly being recognized as an important social determinant of health (SDH) that results in health inequities. We identify right to health mechanisms, such as established human rights instruments, as suitable policy tools for addressing gender identity as an SDH to improve health equity. We urge the World Health Organization to add gender identity as an SDH in its conceptual framework for action on the SDHs and to develop and implement specific recommendations for addressing gender identity as an SDH.

The explanation of a paradox? A commentary on Mackenbach with perspectives from research on financial credits and risk factor trends.

The explanation of a paradox? : A commentary on Mackenbach with perspectives from research on financial credits and risk factor trends

Health status and epidemiological capacity and prospects: WHO Western Pacific Region

BACKGROUND This article on the state of epidemiology in the WHO Western Pacific Region (WPR) is the first in a series of eight articles commissioned by the International Epidemiological Association (IEA) to identify global opportunities to promote the development of epidemiology. METHODS Global mortality and disease data were used to summarize the burden of mortality, disease, risk factor and patterns of inequalities in the region. Medline bibliometrics were used to estimate epidemiological publication output by country. Key informant surveys, Internet and literature searches and author knowledge and networks were used to elicit perspectives on epidemiological training, research, funding and workforce. Findings The WPR has the lowest age-standardized disability-adjusted life-years (DALY) rate per 1000 of the six WHO regions, with non-communicable disease making the largest percentage contributions in both low- and middle-income countries (LMICs, 68%) and high-income countries (HICs, 84%) in the WPR. The number of Medline-indexed epidemiological research publications per year was greatest for Japan, Australia and China. However, the rate per head of population was greatest for Micronesia and New Zealand. The substantive focus of research roughly equated with burden of disease patterns. Research capacity (staff, funding, infrastructure) varies hugely between countries. Epidemiology training embedded within academic Masters of Public Health programmes is the dominant vehicle for training in most countries. Field epidemiology and in-service training are also common. The Pacific Island countries and territories, because of sparse populations over large distances and chronic workforce and funding capacity problems, rely on outside agencies (e.g. WHO, universities) for provision of training. Cross-national networks and collaborations are increasing. CONCLUSION Communicable disease surveillance and research need consolidation (especially in eastern Asian WPR countries), and non-communicable disease epidemiological capacity requires strengthening to match disease trends. Capacity and sustainability of both training and research within LMICs in WPR are ongoing priorities. China in particular is advancing quickly. One role for the IEA in building capacity is facilitating collaborative networks within WPR.

Toward Global Comparability of Sexual Orientation Data in Official Statistics: A Conceptual Framework of Sexual Orientation for Health Data Collection in New Zealand’s Official Statistics System

Objective. Effectively addressing health disparities experienced by sexual minority populations requires high-quality official data on sexual orientation. We developed a conceptual framework of sexual orientation to improve the quality of sexual orientation data in New Zealands Official Statistics System. Methods. We reviewed conceptual and methodological literature, culminating in a draft framework. To improve the framework, we held focus groups and key-informant interviews with sexual minority stakeholders and producers and consumers of official statistics. An advisory board of experts provided additional guidance. Results. The framework proposes working definitions of the sexual orientation topic and measurement concepts, describes dimensions of the measurement concepts, discusses variables framing the measurement concepts, and outlines conceptual grey areas. Conclusion. The framework proposes standard definitions and concepts for the collection of official sexual orientation data in New Zealand. It presents a model for producers of official statistics in other countries, who wish to improve the quality of health data on their citizens.

Home safety assessment and modification to reduce injurious falls in community-dwelling older adults: cost-utility and equity analysis

Background This study aimed to improve on previous modelling work to determine the health gain, cost-utility and health equity impacts from home safety assessment and modification (HSAM) for reducing injurious falls in older people. Methods The model was a Markov macrosimulation one that estimated quality-adjusted life-years (QALYs) gained. The setting was a country with detailed epidemiological and cost data (New Zealand (NZ)) for 2011. A health system perspective was taken and a discount rate of 3% was used (for both health gain and costs). Intervention effectiveness estimates came from a Cochrane systematic review and NZ-specific intervention costs were from a randomised controlled trial. Results In the 65 years and above age group, the HSAM programme cost a total of US

The impact of in-work tax credit for families on self-rated health in adults: a cohort study of 6900 New Zealanders

98 million (95% uncertainty interval (UI) US

Climate change, cash transfers and health

65 to US

A Systematic Review of Health Economic Analyses of Housing Improvement Interventions and Insecticide-Treated Bednets in the Home.

139 million) to implement nationally and the accrued net health system costs were US

Taxation of sugar‐sweetened beverages for reducing their consumption and preventing obesity or other adverse health outcomes

74 million (95% UI: cost saving to US