RESUMEN
BACKGROUND: Smoke-free policies (SFPs) in public places are increasing globally, but developing countries are lagging behind. Understanding youth attitudes towards SFPs can inform SFP initiatives. METHODS: A multilevel logistic regression analysis of data collected from youth aged 13-15 years (2000-2006) who completed the Global Youth Tobacco Survey (GYTS) in 115 countries, primarily in the developing world, was conducted. The analysis examined relationships between support for SFPs and individual-level measures related to smoking status, and exposure to secondhand smoke (SHS), controlling for demographic and environmental factors of interest and country-level policy factors. RESULTS: In all, 77.3% of 356,395 youth in 115 countries favoured SFPs, including majorities of non-smokers (78.7%) and smokers (63.6%). In the multivariable analysis knowledge of smoke harm was the strongest predictor of favouring SFPs (OR 2.42, 95% CI 2.27 to 2.67). Exposure to countermarketing (OR 1.40, 95% CI 1.25 to 1.57) and school anti-smoking education (OR 1.22, 95% CI 1.13 to 1.31) were also positively associated. Current smoking (OR 0.48, 95% CI 0.41 to 0.53), susceptibility to smoking (OR 0.46, 95% CI 0.40 to 0.52) and exposure to tobacco promotion were negatively associated. Significant country-level variation was observed. The presence of any national smoke-free legislation in a country was positively associated with youth favouring such policies. CONCLUSIONS: The majority of youth worldwide support, yet lack, smoke-free policies in public places, while being regularly exposed to SHS. Youth support of SFPs is most positively associated with knowledge of the harmful effects of tobacco smoke. Redoubling education efforts represents an opportunity to establish smoke-free environments and improve health of children in developing countries.
Asunto(s)
Actitud Frente a la Salud , Países en Desarrollo , Promoción de la Salud/legislación & jurisprudencia , Política Pública , Cese del Hábito de Fumar/legislación & jurisprudencia , Fumar/legislación & jurisprudencia , Contaminación por Humo de Tabaco/legislación & jurisprudencia , Adolescente , Salud Global , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Mercadotecnía , Análisis Multivariante , Instalaciones PúblicasRESUMEN
The federally funded Cities Readiness Initiative (CRI) requires seamless federal, state, and local public health coordination to provide antibiotics to an entire city population within 48 hours of an aerosolized release of anthrax. We document practical lessons learned from the development and implementation of the Boston CRI plan. Key themes center on heightened emphasis on security, a new mass protection model of dispensing, neighborhood-centric clinic site selection, online training of Medical Reserve Corps volunteers, and the testing of operations through drills and exercises. Sharing such lessons can build national preparedness.
Asunto(s)
Carbunco/tratamiento farmacológico , Antibacterianos/provisión & distribución , Bioterrorismo , Planificación en Desastres/organización & administración , Antibacterianos/uso terapéutico , Boston , Comunicación , Planificación en Desastres/métodos , Servicios Médicos de Urgencia/organización & administración , Humanos , Modelos Organizacionales , Estudios de Casos Organizacionales , Desarrollo de Programa , Instalaciones Públicas , Salud Pública , Administración de la Seguridad , Medidas de Seguridad/organización & administraciónRESUMEN
Post-9/11, preparedness planning has catalyzed intrastate regionalization of local public health resources throughout the United States. Investigating this trend unveils several regionalization themes, relevant in other sectors of government, which are applicable to local public health. In this review article, we begin by briefly examining the lessons learned from regionalization for police and fire services, drawing comparisons to public health. Then we provide a brief history of the accelerating regionalization of local public health services sparked by the current attention to emergency preparedness. In particular, we offer case studies from Massachusetts and the National Capital Region to highlight examples of regionalization outcomes related to networking, coordination, standardization, and centralization of public health services. The impact of social capital on preparedness is also explored. Finally, we summarize research needs for the future.