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      La Agencia Estatal de Salud Pública: una oportunidad para el sistema de Salud Pública en España Translated title: Future National Public Health Agency: an opportunity for the public health system in Spain

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          Abstract

          Resumen La creación de un centro estatal de salud pública, con una dotación adecuada de recursos, permitirá afrontar los desafíos de la salud pública del presente y del futuro en España. Para ello, las funciones de esta futura institución, que se propone como Agencia Estatal, deben abordar, además de las necesidades habituales de organización de la salud pública, la conexión de estas con los Objetivos de Desarrollo Sostenible, coordinando una estrategia estatal que integre distintos actores de salud en una red generosa y cooperativa, y desarrollando una estrategia de comunicación en salud pública innovadora, referente y priorizada, entre otros aspectos. La falta de recursos, la relativa desconexión actual de las funciones esenciales de salud pública en el ámbito estatal y la inequidad en el desarrollo autonómico y municipal de estas propician el desarrollo del proyecto de la Agencia como una red de redes, tal como se defiende en este trabajo. Aportamos ideas para un proceso que confiamos en que será decisivo para la salud pública española del siglo XXI.

          Translated abstract

          Abstract The creation of a national centre for public health, with adequate resources, will make it possible to face the public health challenges of the present and the future in our country. To this end, the proposed state agency, should hold functions based on advanced public health organizational schemes, while linking with the sustainable development goals. The coordination of a national public health strategy built on a collaborative network of networks would also be essential, as developing an innovative, benchmarked and prioritised public health communication strategy, among other tasks. The lack of resources, the current relative disconnection of essential public health functions at the state level, and the inequity in their development of these functions at the regional and municipal levels, favour the development of the agency project as a network of networks. In this paper we give ideas for a process that seems decisive for Spanish public health in the 21st century.

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          Addressing Health-Related Misinformation on Social Media

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            Return on investment of public health interventions: a systematic review

            Background Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these proposed disinvestments in public health, we set out to determine the return on investment (ROI) from a range of existing public health interventions. Methods We conducted systematic searches on all relevant databases (including MEDLINE; EMBASE; CINAHL; AMED; PubMed, Cochrane and Scopus) to identify studies that calculated a ROI or cost-benefit ratio (CBR) for public health interventions in high-income countries. Results We identified 2957 titles, and included 52 studies. The median ROI for public health interventions was 14.3 to 1, and median CBR was 8.3. The median ROI for all 29 local public health interventions was 4.1 to 1, and median CBR was 10.3. Even larger benefits were reported in 28 studies analysing nationwide public health interventions; the median ROI was 27.2, and median CBR was 17.5. Conclusions This systematic review suggests that local and national public health interventions are highly cost-saving. Cuts to public health budgets in high income countries therefore represent a false economy, and are likely to generate billions of pounds of additional costs to health services and the wider economy.
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              COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection

              Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk (“Emmentaler cheese model”), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                June 2022
                : 36
                : 3
                : 265-269
                Affiliations
                [4] Pamplona Navarra orgnameUniversidad Pública de Navarra orgdiv1Facultad de Derecho orgdiv2Departamento de Derecho Administrativo Spain
                [3] Cataluña orgnameUniversitat de Lleida orgdiv1Proyecto Salud Pública en Transformación (SPenT), Área de Derecho Administrativo Spain
                [5] Valencia Valencia orgnameUniversitat de Valencia orgdiv1Facultad de Medicina y Odontología orgdiv2Departamento de Medicina Preventiva y Salud Pública Spain
                [10] Elche Alicante orgnameUniversidad Miguel Hernández orgdiv1Departamento de Salud Pública, Historia de la Ciencia y Ginecología España
                [1] Barcelona orgnameInstitut Hospital del Mar d'Investigacions Mèdiques orgdiv1Servicio de Epidemiología y Evaluación Spain
                [2] Barcelona Cataluña orgnameUniversitat Pompeu Fabra orgdiv1Facultad de Ciencias de la Salud y de la Vida orgdiv2Departamento de Salud Comunitaria, Epidemiología y Vigilancia de la Salud Spain
                [11] orgnameCIBER de Epidemiología y Salud Pública (CIBERESP) España
                [9] Baltimore Maryland orgnameJohns Hopkins University United States
                [8] orgnameConsejo Asesor de Salud Pública y Comitè de Bioètica de Catalunya España
                [7] Barakaldo Bizkaia orgnameFundación Vasca de Innovación e Investigación Sanitarias orgdiv1Gestión del Conocimiento y Evaluación de Tecnologías Sanitarias en BIOEF España
                [6] Zaragoza orgnameInstituto Aragonés de Ciencias de la Salud España
                Article
                S0213-91112022000300265 S0213-9111(22)03600300265
                10.1016/j.gaceta.2021.12.001
                35120795
                d3778bdb-25d8-4ae0-9f5d-5cd9a3f7eb24

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 02 December 2021
                : 01 December 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 5
                Product

                SciELO Spain

                Categories
                Artículos Especiales

                Sustainable development goal,Public health,Public health practice,Essential public health functions,Public health administration,Health planning,Planificación en salud,Objetivos de desarrollo sostenible,Salud pública,Práctica de salud pública,Funciones esenciales de salud pública,Administración en salud pública

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