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Background: Perceived financial security impacts physical, mental, and social health and overall wellbeing at community and population levels. Public health action on this dynamic is even more critical now that the COVID-19 pandemic has exacerbated financial strain and reduced financial wellbeing. Yet, public health literature on this topic is limited. Initiatives targeting financial strain and financial wellbeing and their deterministic effects on equity in health and living conditions are missing. Our research-practice collaborative project addresses this gap in knowledge and intervention through an action-oriented public health framework for initiatives targeting financial strain and wellbeing., Methods: The Framework was developed using a multi-step methodology that involved review of theoretical and empirical evidence alongside input from a panel of experts from Australia and Canada. In an integrated knowledge translation approach, academics (n = 14) and a diverse group of experts from government and non-profit sectors (n = 22) were engaged throughout the project via workshops, one-on-one dialogues, and questionnaires., Results: The validated Framework provides organizations and governments with guidance for the design, implementation, and assessment of diverse financial wellbeing- and financial strain-related initiatives. It presents 17 priority actionable areas (i.e., entry points for action) likely to have long-lasting, positive effects on people's financial circumstances, contributing to improved financial wellbeing and health. The 17 entry points relate to five domains: Government (All Levels), Organizational & Political Culture, Socioeconomic & Political Context, Social & Cultural Circumstances, and Life Circumstances., Conclusions: The Framework reveals the intersectionality of root causes and consequences of financial strain and poor financial wellbeing, while also reinforcing the need for tailored actions to promote socioeconomic and health equity for all people. The dynamic, systemic interplay of the entry points illustrated in the Framework suggest opportunities for multi-sectoral, collaborative action across government and organizations towards systems change and the prevention of unintended negative impacts of initiatives., (© 2023. The Author(s).)

Introduction: The COVID-19 pandemic has adversely affected the financial well-being of populations globally, escalating concerns about links with health care and overall well-being. Governments and organizations need to act quickly to protect population health relative to exacerbated financial strain. However, limited practice- and policy-relevant resources are available to guide action, particularly from a public health perspective, that is, targeting equity, social determinants of health, and health-in-all policies. Our study aimed to create a public health guidebook of strategies and indicators for multisectoral action on financial well-being and financial strain by decision makers in high-income contexts., Methods: We used a multimethod approach to create the guidebook. We conducted a targeted review of existing theoretical and conceptual work on financial well-being and strain. By using rapid review methodology informed by principles of realist review, we collected data from academic and practice-based sources evaluating financial well-being or financial strain initiatives. We performed a critical review of these sources. We engaged our research-practice team and government and nongovernment partners and participants in Canada and Australia for guidance to strengthen the tool for policy and practice., Results: The guidebook presents 62 targets, 140 evidence-informed strategies, and a sample of process and outcome indicators., Conclusion: The guidebook supports action on the root causes of poor financial well-being and financial strain. It addresses a gap in the academic literature around relevant public health strategies to promote financial well-being and reduce financial strain. Community organizations, nonprofit organizations, and governments in high-income countries can use the guidebook to direct initiative design, implementation, and assessment.

We explored how investments in housing for vulnerable populations (including those experiencing homelessness) are described as leading to cost containment for the health, justice, and social service systems; the nature of any costs and benefits; and variations by housing type and over time. A structured search of peer-reviewed academic research focused on the core concepts of economic benefit, public housing programs, and vulnerable populations. Findings from 42 articles reporting on cost containment specific to health, justice, and social service systems at the municipal, regional, and/or state/provincial level were synthesized. Most of the studies focused on supportive housing interventions, targeted adults (mainly men) experiencing chronic homelessness in the USA, and reported results over 1–5 years. Approximately half of the articles reported on the costs required to house vulnerable populations. About half reported on funding sources, which is critical information for leadership decisions in cost containment for supportive housing. Most of the studies assessing program cost or cost-effectiveness reported a reduction in service costs and/or greater cost-effectiveness. Studies mostly reported impacts on health services, with hospital/inpatient care and emergency service use typically decreasing across the intervention types. All the studies that assessed cost impacts on the justice system reported a decrease in expenditures. Housing vulnerable populations was also found to decrease shelter service use and engagement with the foster care/welfare systems. Housing interventions may offer cost-savings in the short- and medium-term, with a limited evidence base also demonstrating long term benefit. [ABSTRACT FROM AUTHOR]

An editorial is presented in which the authors discuss access to abortion, legislation and potential U.S. Supreme Court hearings concerning abortion in U.S. states, and public and population health.

The infant mortality rate (IMR) is the rate of death of children younger than one year of age. In the United States, the IMR has been declining over time. However, it has been declining much more slowly than in other nations. As a result, the US global ranking in IMRs is also declining. This analytic essay explores some of the reasons why it might be undergoing this relative decline by critically dissecting secondary sources of data. We found that slow progress in reducing IMR over the past decade is partly due to lower birth rates among immigrants, who tend to have healthier babies than native-born mothers. However, this does not explain longer-term trends, which reveal a relative decline in the well-being of women of reproductive age. We speculate that longer-term declines are partially due to a deemphasis on government health and antipoverty programs. This deemphasis results not only in weaker socioeconomic support but also in rising medical costs, which are consuming an increasingly larger share of Americans' declining disposable income. [ABSTRACT FROM AUTHOR]

Background Sufficient sleep is needed for the healthy development of youth. However, only a small minority of adolescents obtain adequate amounts of sleep. Although individual-level correlates of sleep have been identified, studies investigating the influence of the environment on sleep are warranted. Methods By using cross-sectional data collected from 1878 urban adolescents living in 38 neighborhoods participating in the 2008 Boston Youth Survey (BYS), we determined the association between neighborhood social fragmentation and sleep. Social fragmentation of each participant's residential neighborhood was composed using 2010 US Census data. Multilevel regression models were used to determine the association between social fragmentation and meeting the recommended hours of sleep (>8.5 h) and sleep duration while controlling for individual-level sex, race, age and nativity. Results Moderate (OR = 0.51, 95% CI = 0.27, 0.97) and high (OR = 0.33, 95% CI = 0.18, 0.61) social fragmentation within the residential neighborhood was associated with a decreased likelihood of obtaining adequate sleep. Those in moderate (β = −23.9, 95% CI = −43.1, −4.8) and high (β = −22.1, 95% CI = −43.3, −0.9) socially fragmented neighborhoods obtained fewer minutes of sleep per night. Conclusions Social fragmentation may be an important determinant of sleep among youth living in urban settings. [ABSTRACT FROM AUTHOR]

Objectives: To examine the independent influence of school economic deprivation, social fragmentation, and social cohesion on the likelihood of participating in no physical activity among students. Methods: Data are from a large-scale longitudinal study of schools based in disadvantaged communities in Quebec, Canada. Questionnaires were administered every year between 2002 and 2008 among n = 14,924 students aged 12 to 18 from a sample of 70 schools. Cross-sectional and longitudinal analyses were conducted. Multilevel modeling was utilized to account for the clustering of students within schools. Schools were categorized as being low, moderate or high economic deprivation, social fragmentation and social cohesion. Those who indicated that they do no participate in any physical activity during the week were identified as being physically inactive. Results: In baseline multilevel cross-sectional analyses, adolescents attending schools in the highest (compared to the lowest) levels of socioeconomic deprivation and social fragmentation were more likely to be physically inactive (OR = 1.33, 95% CI = 1.03, 1.72; and OR = 1.24, 95% CI = 0.98, 1.56, respectively). Conversely, students attending schools with the highest cohesion were less likely to be physically inactive (OR = 0.78, 95% CI = 0.61, 0.99). In longitudinal analysis, physically active students who attended schools with the highest social fragmentation were more likely to become physically inactive over two years (OR = 1.65, 95% CI = 1.09, 2.51). Conclusion: The school socioeconomic environment appears to be an important contextual influence on participation in no physical activity among adolescents. Following adolescents beyond two years is necessary to determine if these environments have a lasting effect on physical activity behavior. [ABSTRACT FROM AUTHOR]

Abstract: Objective. : The purposes of this study were to describe the prevalence of modes of transportation to school and to identify socioeconomic correlates. Methods. : Proportions of students using different modes of transportation were estimated among a population-based sample of 3613 youth aged 9, 13, and 16 years who participated in the 1999 Quebec Child and Adolescent Health and Social Survey. Results. : Weighted analyses showed significant differences in the use of different modes of transportation to and from school across socioeconomic groups. For example, 40.3%, 15.2%, and 13.0% of 9, 13, and 16 year olds walked to school. In addition, 1.2%, 11.3%, and 13.8% of 9, 13, and 16 year olds used public transportation whereas 33.1%, 51.2%, and 55.6% of 9, 13, and 16 year olds took the school bus to school; 14.3%, 7.3%, and 5.0% of 9, 13, and 16 year olds were transported by car; finally, 10.7%, 14.1%, and 11.7% of 9, 13, and 16 year olds indicated they used multiple modes of transportation. Girls, higher income of children, children of immigrants, and rural-dwelling children were less likely to walk to school. Conclusion. : Findings indicate that there are differing modes of transportation to and from school across socioeconomic groups. [Copyright &y& Elsevier]