{"title":"Mitigating the black maternal morbidity and mortality crisis in the United States.","authors":"Sophia Scott","doi":"10.1057/s41271-025-00602-9","DOIUrl":"10.1057/s41271-025-00602-9","url":null,"abstract":"<p><p>The issue of maternal morbidity and mortality is a highly urgent American health problem, with more than 50,000 women experiencing pregnancy complications each year. However, Black women are three times more likely to die because of pregnancy-related problems than White women in the United States (U.S.). Black women also experience disproportionately higher rates of maternal mortality than women of every other ethnic and racial group. Compared to other affluent countries, the United States has a strikingly high maternal mortality rate. Between 1990 and 2019, the rate in the U.S. nearly tripled, rising from 8.0 to 20.1 deaths per 100,000 live births. In the last twenty years, maternal mortality rates have declined in countries around the globe, but in the U.S., there has been a 50% increase in maternal mortality. Maternal mortality rates are highest in Mississippi, which had 82.5 deaths per 100,000 births in 2021, and lowest in California, which had 9.7 deaths per 100,000 births in 2021. Expanding Medicaid eligibility, extending postpartum coverage, standardizing care delivery, combating racial bias in medical care through provider training, subsidizing Black physician tuition, and increasing rural health care access will help not only reduce maternal deaths nationwide but also diminish racial disparities in maternal health outcomes.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"909-915"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Women empowerment and hypertension in Nepal: a nationally representative survey analysis.","authors":"Md Shajedur Rahman Shawon, Mohammad Rifat Rahman, Tanij Fahima, Ferdousy Jannat, Fariha Binte Hossain","doi":"10.1057/s41271-025-00593-7","DOIUrl":"10.1057/s41271-025-00593-7","url":null,"abstract":"<p><p>This study investigates the roles of women empowerment on the prevalence, awareness, and treatment of hypertension among ever-married Nepalese women aged 15-49 years using 2016 Nepal Demographic and Health Survey data. We assessed women empowerment using the Survey-based Women emPowERment (SWPER) index in the domains of 'social independence', 'decision-making', and 'attitudes towards violence'. We assessed associations of domains of women empowerment with hypertension using multiple logistic regression models. Among 4919 women, 568 (12%) had hypertension, 35% were aware of their condition, and 14% were taking anti-hypertensive medication. Majority (72%) of women had high empowerment in ''attitude to violence' domain, 14%-in 'decision-making' domain, and 25%-in the 'social independence' domain; the latter group was also less likely to suffer from hypertension (aOR = 0.68, 95% CI 0.49-0.94). Our findings suggest the need to integrate empowerment initiatives into strategies to prevent hypertension among women in Nepal and similar low- and middle-income settings.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"778-794"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Men's attitude toward abortion legislation in Ethiopia.","authors":"Besfat Berihun Erega, Enyew Dagnew Yehuala, Eyob Shitie Lake, Habtamu Gebrehana Belay, Gedefaye Nibret Mihretie, Wassie Yazie Ferede","doi":"10.1057/s41271-025-00603-8","DOIUrl":"10.1057/s41271-025-00603-8","url":null,"abstract":"<p><p>In 2005, a new criminal code -- permitting abortion in specific circumstances -- was enacted to align Ethiopia's legal system with the country's updated Constitution. Despite its significant impact on reproductive health, there have been no studies examining men's attitudes toward Ethiopia's abortion law. We conducted a community-based cross-sectional study among 406 sexually active men from 10 June to 30 October 2023 and found that only 26.6% of men expressed positive attitude toward Ethiopia's abortion law (CI: 21.3%-30.2%). Men who support the law tend to be to be younger, better educated, never married or married at older age, and have an income above 2000ETB. These findings should inform policymakers changes regarding male involvement in decisions about accessing safe abortion services.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"882-889"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna M Localio, Melissa A Knox, Paul L Hebert, Jennifer Sonney, Tom Lindman, Jessica C Jones-Smith
{"title":"Participation in the community eligibility provision - a universal free school meals policy in the United States in 2014-2020.","authors":"Anna M Localio, Melissa A Knox, Paul L Hebert, Jennifer Sonney, Tom Lindman, Jessica C Jones-Smith","doi":"10.1057/s41271-025-00590-w","DOIUrl":"10.1057/s41271-025-00590-w","url":null,"abstract":"<p><p>We assessed the association of participation in the Community Eligibility Provision, a universal free school meals policy in the United States, with school and area-level characteristics, and how these associations changed between 2014 and 2020. Using logistic regression models with district-clustered standard errors, in 53,391 eligible schools nationwide, adjusted prevalence of participation was 3.8 percentage points (pp) lower among high schools relative to elementary schools (95% CI: 1.6, 6.0), 8.9 pp lower in small relative to large school districts (95% CI: 4.8, 13.0), 10.9 pp lower in suburban relative to urban schools (95% CI: 6.9, 14.8), and 13.3 pp lower in schools in non-Medicaid expansion relative to expansion states (95% CI: 17.1, 20.7). Over time prevalence of participation in majority Hispanic schools increased to a lesser extent than participation in majority Black schools. Addressing barriers to policy adoption in schools with persistently lower participation will be critical to increase equitable access to universal free school meals.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"795-815"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13694218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ravita Taheem, Kathryn Woods-Townsend, Wendy Lawrence, Janis Baird, Keith M Godfrey, Mark A Hanson
{"title":"Accountability for tackling childhood obesity: insights from local councillors in England.","authors":"Ravita Taheem, Kathryn Woods-Townsend, Wendy Lawrence, Janis Baird, Keith M Godfrey, Mark A Hanson","doi":"10.1057/s41271-025-00573-x","DOIUrl":"10.1057/s41271-025-00573-x","url":null,"abstract":"<p><p>Tackling the complex drivers of childhood obesity requires action across sectors and at all levels of government. Elected officials in local government can influence policies targeting communities to prevent childhood obesity, but little is known about their views on local government accountability for tackling the issue. Accountability is the obligation to justify actions on a topic and it could strengthen policy implementation. A qualitative study was conducted involving semi-structured interviews with sixteen Southampton City Council local government councillors. Factors limiting accountability included low citizen engagement, the lack of a national mandate to support local action and unachievable targets. Factors that improved accountability included setting a local mandate, public health officers proactively keeping the issue on the agenda and oversight from other system leaders. The findings from this study inform how public health officers and other stakeholders can work within the local system to progress childhood obesity prevention policies.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"749-761"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Singapore's health reforms in response to an aging society.","authors":"Divyansh Panesar","doi":"10.1057/s41271-025-00592-8","DOIUrl":"10.1057/s41271-025-00592-8","url":null,"abstract":"<p><p>Singapore's shift toward a more collectivist model of healthcare marks a significant departure from its traditionally neoliberal approach, particularly in addressing the needs of its rapidly ageing population. The CareShield Life and Long-Term Care reforms aim to enhance financial protection, expand community-based services, and align health policy with evolving societal expectations. Nevertheless, questions remain about the adequacy of coverage, particularly in the context of rising chronic disease and long-term care costs. The move toward community care introduces important logistical and quality challenges. Singapore's approach is unique in its extensive stakeholder engagement and values-based design. It reflects a pragmatic effort to reconcile long-standing principles of personal responsibility with growing demand for collective security in later life. Though outcomes will take time to manifest, the reform represents a notable case of policy realignment and offers transferable lessons for health systems navigating ageing and sustainability challenges.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"847-857"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonio Ramón Gómez-García, Andrea Liseth Cevallos Paz, Raúl Gutiérrez-Alvarez
{"title":"Social inequities, climate change, and informal employment in Ecuador: a forthcoming challenge for occupational safety and health policies.","authors":"Antonio Ramón Gómez-García, Andrea Liseth Cevallos Paz, Raúl Gutiérrez-Alvarez","doi":"10.1057/s41271-025-00597-3","DOIUrl":"10.1057/s41271-025-00597-3","url":null,"abstract":"<p><p>This viewpoint examines the inadequate protection of informal workers against climate change hazards under new legislation in Ecuador. The recent Executive Decree No. 255 (Regulation on Occupational Safety and Health), enacted in May 2024, explicitly excludes informal sector workers, who are at elevated risk due to climate change impacts such as rising extreme temperatures. Based on national survey data, it is estimated that 52.5% of the Ecuadorian workforce is informally employed, with figures exceeding 80% in sectors like agriculture and construction. This analysis highlights the most vulnerable workers and emphasizes the need to review and extend social security coverage to include informal workers. Integrating these considerations into the forthcoming National Occupational Safety and Health Policy is crucial.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"870-881"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Plastic pollution in India: assessing the impact of environmental criminal law enforcement.","authors":"Bhupal Bhattacharya, Rishi Dev, Abdesselam Salmi","doi":"10.1057/s41271-025-00591-9","DOIUrl":"10.1057/s41271-025-00591-9","url":null,"abstract":"<p><p>Plastic pollution has become a significant environmental challenge in India, causing adverse effects on human health, wildlife, and ecosystems. Although there are policies and regulations in place to address the issue, the problem persists, indicating a gap in their implementation. We examined the existing policies, the role of law enforcement agencies, the potential impact of environmental criminal law enforcement on plastic pollution in India, and the challenges of policy implementation. This paper contributes to the ongoing dialogue on addressing plastic pollution in India and provides recommendations for policymakers and stakeholders to implement measures for a cleaner, healthier environment.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"762-777"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"\"If you can't measure it, you can't improve it\": why do we need a new tool to assess hospital resilience?","authors":"Merette Khalil, Hamid Reza Khankeh, Elham Ghanaatpisheh, Arvin Barzanji, Hamid Ravaghi","doi":"10.1057/s41271-025-00605-6","DOIUrl":"10.1057/s41271-025-00605-6","url":null,"abstract":"<p><p>Hospital resilience is a critical determinant of health system function during emergencies and disasters, as hospitals are often the last line of healthcare. Strengthening hospital resilience is a way to ensure uninterrupted, safe, and effective care when crises strike. However, the varied interpretations of resilience hinder its operationalization and evaluation. The lack of standardized, measurable indicators highlights the complexity of hospital resilience and the inadequacy of current assessment tools. This viewpoint explores existing gaps and challenges in effectively assessment of hospital resilience, including failures to measure dynamic capacities, community engagement, and external risk factors. We suggest the urgent development of a participatory, evidence-based tool to guide hospital administrators, policymakers, and researchers. Such a tool would aid in informing focused interventions, enhancing system-wide readiness, and enhancing global response capacity to respond to future disasters.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"899-908"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Estimating the impact of non-pharmaceutical interventions on COVID mortality using reductions in influenza mortality as an effect indicator.","authors":"Robert D Morris","doi":"10.1057/s41271-025-00570-0","DOIUrl":"10.1057/s41271-025-00570-0","url":null,"abstract":"<p><p>This study uses influenza mortality reduction (IMR) as an indicator of the aggregate effect of non-pharmaceutical interventions (NPI's) on the spread of respiratory infections to assess their impact on COVID mortality. Age-adjusted COVID mortality for US states were modeled using four variables: COVID mortality prior to introduction of NPI's, vaccination rates, IMR relative to 2016-2019, and population density. A simple linear model of the entire pandemic with only these variables explained 66% of the variability in COVID mortality with IMRs affecting the first two years and vaccination having an impact in the second and third year. A counterfactual model of no NPI's suggests they prevented 850,000 COVID related deaths in the United States. These results support the use of IMR's as an indicator of the aggregate impact of NPIs for controlling transmission of respiratory infections, including COVID and suggest that COVID mortality would have been almost 75% higher without them.</p>","PeriodicalId":50070,"journal":{"name":"Journal of Public Health Policy","volume":" ","pages":"533-548"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}