PHS Research Publications

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    Health literacy, health outcomes and equity: A trend analysis based on a population survey
    (SAGE Publications, 2023-01-23) Keene Woods, Nikki; Ali, Umama; Medina, Melissa; Reyes, Jared; Chesser, Amy K.
    Health literacy continues to be an issue among minority groups. Population surveys are one strategy used to help better understand health disparities. The Behavioral Risk Factor Surveillance System (BRFSS) in Kansas added health literacy questions to the survey in 2012. This study examined population health literacy levels and health trends from 2012 to 2018. The health status variables included health care coverage status, general health rating, presence of chronic conditions, and length of time since the last check-up. The percentage of individuals reporting low health literacy decreased from 67% in 2012 to 51% in 2018. The percentage of participants with income levels less than 15,000 dollars was 9% in 2012 and 7% in 2018. Health literacy was lowest among the age group 18 to 24-year-olds, those who identified as multiracial, separated, not graduated from high school, out of work for more than 1 year, income less than 10,000 dollars with other living arrangements, and living in a suburban county of metropolitan statistical area. Additionally, many health conditions improved, and those reporting health insurance increased slightly. The study demonstrates how health literacy continues to be an issue, and how education and primary prevention are necessary to improve limited health literacy and health outcomes. Findings from both state-level and national BRFSS population surveys can help educate the public health and clinical health services workforce to provide better care and address health disparities for high risk populations.
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    Creating a vision for a healthier workforce using a systems-based approach
    (Wolters KLuwer, 2022-03-01) Walkner, Laurie; May, Kathleen; Goldman, Bailey; Shultz, Hannah; Armbruster, Sonja; Grimm, Brandon; Hawley, Suzanne; Menke, Abigail; Orr, Shirley; Wilson, Kristin; Moody, Jeneane; Uden-Holman, Tanya; Ginn, Kaci
    Context: The public health system faces unprecedented challenges due to the pandemic, racism, health inequity, and the politicization of public health. At all levels of the system, the workforce is experiencing distress, burnout, safety issues, and attrition. Public health is being challenged to demonstrate and justify its impact and value, while also leveraging opportunities for learning and system strengthening. Program: To explore the current state and identify opportunities to strengthen the public health system, the Region 7 Midwestern Public Health Training Center (MPHTC), with support from Engaging Inquiry, embarked on a distinctive type of systems analysis, called “dynamic systems mapping.” Implementation: This approach brought together diverse sectors of public health partners in the region to develop a rich contextual narrative and system-level understanding to highlight and align existing and emergent strengths, areas for growth, and tangible goals for the immediate- and long-term sustainability of local and regional health. Evaluation: Focus groups and workshops were conducted with diverse practitioners to identify upstream causes and downstream effects of 11 key forces driving system behavior. These focus groups resulted in the development of a visual map that MPHTC is utilizing to identify opportunities for leverage, develop strategies to maximize the potential impact of these leverage points, as well as facilitate continuous learning. Discussion: Public health utilization of systems mapping is a valuable approach to strengthening local and national system responses to current and future public health needs. Outcomes and lessons learned from the systems mapping process are discussed.
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    Noma: Experiences of survivors, opinion leaders and healthcare professionals in Burkina Faso
    (MDPI, 2022-06-30) Kagoné, Moubassira; Mpinga, Emmanuel Kabengele; Dupuis, Marc; Moussa-Pham, Marie-Solène Adamou; Srour, Margaret Leila; Grema, Maïna S.; Zacharie, Ngoyi-Bukonda; Baratti-Mayer, Denise
    The scientific literature on noma (Cancrum Oris) has clearly increased in recent decades, but there seems to have been limited analysis of issues around the psycho-social impacts of this disease. Even when these issues have been addressed, the focus has tended to be on patient experiences, whereas the community dimension of the disease and the role of healthcare professionals and community leaders in mitigating these impacts remain largely unexplored. A study in the form of semi-directed interviews with 20 noma survivors and 10 healthcare professionals and community leaders was conducted between January and March 2021 in Burkina Faso with the aim of describing the experiences of noma survivors, generating knowledge about living with the burden of the disease and understanding the attitudes of community leaders towards the disease. The results reveal that noma is a disease that affects economically vulnerable populations and leads to extreme household poverty. As far as treatment is concerned, patients tend to turn to practitioners of both traditional and modern medicine. Within communities, noma survivors face discrimination and stigma. The study highlighted a lack of information and knowledge about noma. However, surgical operations lead to patient satisfaction and these remain one of the coping strategies used to tackle the stigma and discrimination. The recommendations set out in this article are aimed firstly at stepping up research into the psycho-social impacts of noma, and secondly at considering these impacts in regional programmes and national plans to combat the disease.
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    Economic and social costs of Noma: Design and application of an estimation model to Niger and Burkina Faso
    (MDPI, 2022-06-28) Mpinga, Emmanuel Kabengele; Srour, Margaret Leila; Moussa, Marie-Solène A.; Dupuis, Marc; Kagoné, Moubassira; Grema, Maïna S.; Zacharie, Ngoyi-Bukonda; Baratti-Mayer, Denise
    Background: While noma affects hundreds of thousands of children every year, taking their lives, disfiguring them and leaving them permanently disabled, the economic and social costs of the disease have not been previously estimated. An understanding of the nature and levels of these costs is much needed to formulate and implement strategies for the prevention and control of this disease, or to mitigate its burden. The objectives of our study were to develop a model for estimating the economic and social costs of noma and to provide estimates by applying this model to the specific contexts of two countries in the “noma belt”, namely Burkina Faso and Niger. Methods: Three main approaches were used. The estimation of prevalence levels of potential noma cases and of cases that should receive and actually do receive medical care was carried out using a literature review. The documentary approach made it possible to estimate the direct costs of noma by analyzing the database of a non-governmental organization operating in this field and present in both countries. Indirect costs were estimated using the human capital method and the cost component analysis technique. Results: The direct costs of care and management of noma survivors amount to approximately USD 30 million per year in Burkina Faso, compared to approximately USD 31 million in Niger. They mainly include costs for medical treatment, surgery, hospital stays, physiological care, psychological care, social assistance, schooling, vocational training and care abroad. Indirect costs are estimated at around 20 million in lost production costs in Burkina and around 16 million in Niger. Costs related to premature deaths are estimated at more than USD 3.5 billion in Burkina Faso and USD 3 billion in Niger. Finally, the costs to survivors who are unable to marry are around USD 13.4 million in Burkina and around USD 15 million in Niger. Intangible costs were not calculated. Conclusions: The neglect of noma and inaction in terms of prevention and control of the disease have enormous economic and social costs for households, communities and states. Future studies of this kind are necessary and useful to raise awareness and eradicate this disease, which impacts the health and well-being of children and results in lifelong suffering and severe economic and social costs to survivors and their families.
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    Artificial intelligence and human rights: Are there signs of an emerging discipline? A systematic review
    (Dove Medical Press, 2022-02-02) Mpinga, Emmanuel Kabengele; Bukonda, Ngoyi K. Z.; Qailouli, Said; Chastonay, Philippe
    Aim: Our systematic review seeks to understand the linkages and reciprocal relationships between the artificial intelligence (AI) and human rights (HRs) and to unveil the signs of emergence of a new discipline at the crossroads of these two disciplines. Background: AI and HRs have evolved in parallel as two fields, with AI technology engineers eventually interested in the consequences of their products on HRs, while more recently HRs experts have been exploring the benefits and threats of AI technologies on the protection and promotion of HRs. Methods: A broad range of databases within the fields of legal sciences, social sciences, health-care sciences and the more general sciences practitioner base “Web of Science” were explored. Articles were selected according to strict inclusion/exclusion criteria and systematically analyzed regarding their content and authorship. Results: The crossroad between AI and HRs is a dynamic field where researchers from different disciplines have been exploring issues such as autonomous lethal weapons, privacy protection, discriminatory decision-making in the insurance and finance systems, intellectual property, and legal personality of the robots. Signs of the emergence of a new discipline were identified. Conclusion: Identifying appropriate strategies to consolidate this emerging discipline seems necessary: one could be the development of academic programs at the crossroad of these two fields