Primary healthcare is one of the most important components of the health system worldwide, facilitating people's access to essential healthcare, especially vulnerable groups. Integrating nutrition services into a primary healthcare (PHC) network is critical for effective health promotion. We investigated nutrition services provided through PHC in high-income and low- and middle-income countries. In this scoping review, we examined 37 studies that involved nutrition care at PHC, indexed by PubMed, MEDLINE, Web of Science, Scopus, Google Scholar, and Sid. Nutritional services provided at the PHC level mainly included nutritional assessment, nutrition counseling and education, child and maternal nutritional care, provided by healthcare workers, nurses, physicians, and dietitians. Nutrition services provided by health systems varied by the degree of diet- and nutrition-related problems, such as diabetes and obesity, as well as maternal and newborn health, and the level of income and development of the countries.

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.

Poor quality obstetric care can harm women's mental health, especially after childbirth. This study examines how the perceived quality of health services during childbirth is related to postpartum depression in Ecuador. Using data from 16,451 women in the 2018 National Health and Nutrition Survey, we applied probit and latent class probit models. We find that higher perceived quality of care during childbirth decreases the likelihood of postpartum depression, with stronger effects in intense and long-lasting cases. The results of the instrumental variables model show that, in the most representative class, comprising 68.15% of the sample, a one-point increase in perceived quality reduces the probability of postpartum depression by 9.1% (CI : -15.2%, -3.0%). This group includes mainly indigenous women, mothers of multiple children, and users of the public health system. These results underscore the urgency of integrating mental health support into maternal care and strengthening policies that improve women's experiences during childbirth in public health facilities.

Title IX regulation changes' impact on sexual misconduct (SM) reporting to the institutions of higher education (IHE) in the United States (US) remain poorly understood. To examine trends in the rates of SM reports submitted to each American institution's Title IX Office, we applied a synthetic control. US IHE members of the American Association of Universities comprised the 'treated' group, and Canadian IHE members of the Major Regional Associations were used to create a counterfactual proxy. Marginally significant increases (P = 0.08) in reports followed the 2017 Title IX guidance change (+ 1.18, + 4.51 and + 2.24 reports per 1000 enrolled students in 2017-2018, 2018-2019 and 2019-2020, respectively), and a marginally significant decrease (- 5.23 reports per 1000 enrolled students in 2020-2021) in SM reports to Title IX offices followed the 2020 Title IX iterations. Reporting and response structures, like those specified in Title IX iterations, may influence rates of SM reporting.

This study evaluates the impact of California's specific per- and polyfluoroalkyl substances (PFAS) legislation on perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) contamination levels in public drinking water. We conducted a comparative statistical analysis using data collected by the United States Environmental Protection Agency (US EPA) Unregulated Contaminant Monitoring Rules (UCMRs), specifically UCMR 3 and UCMR 5. To assess PFOA and PFOS levels in active public water systems during the pre-legislation period (2017) and the post-legislation period (2023) we applied Levene's test to assess differences in variances, followed by unpaired and Welch's t-tests to compare mean PFAS concentrations between the two time periods. We detected a significant decline in both PFOA and PFOS levels post-legislation, suggesting that robust state-level regulatory measures can effectively reduce PFAS contamination. Findings highlight the potential for California's comprehensive approach to serve as a model for national policy to mitigate PFAS exposure and protect public health.

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.

The Israel-Hamas war that began on 7 October 2023 may have spurred anti-Jewish hate crimes, which are associated with measurable health harms including worsened cardiometabolic biomarkers. This study evaluated whether anti-Jewish hate crimes in New York City increased during the Israel-Hamas war using administrative data representing 3255 hate crimes between 2019 and 2024. In 26 of 72 observed months, anti-Jewish hate crimes outnumbered the combined total of all other hate crimes. Compared with other hate crimes, anti-Jewish hate crimes were more likely to be felonies (63% versus 38%, p < 0.001) and less likely to result in arrest (30% versus 57%, p < 0.001). Monthly anti-Jewish hate crimes were on average twice as common during the first year of the Israel-Hamas war than the previous 5 years, adjusting for each borough's Jewish population (PR = 1.97, 95% CI (1.64, 2.35)). The disproportionate frequency of anti-Jewish hate crimes suggests further unmeasured major and minor antisemitic discrimination.

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.

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.

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.

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.

The COVID-19 pandemic has revealed significant disparities in health research across regions, particularly in Latin America. This viewpoint explores the challenges encountered during a randomized clinical trial in Colombia designed to evaluate the effectiveness of intravenous Alprostadil for treating moderate-to-severe COVID-19. The trial, aimed to address the urgent need for effective treatments, ultimately became undermined by bureaucratic barriers. This experience of regulatory delays and prolonged setbacks highlighted broader systemic issues in health research across Latin America, such as tangled regulatory frameworks, insufficient skilled staff, and limited research infrastructure. These obstacles, combined with financial constraints, prevent timely research, impairing Latin America's ability to address health crises independently. To improve health research policies in the region, lessons from countries like Brazil, Argentina, and Chile, where regulatory processes have been streamlined, suggest that reforms promoting efficient approval systems, policy alignment, and enhanced collaboration are vital for strengthening health research capacity in Latin America.

Upstream income-based policies are widely accepted by researchers as key levers to address health inequalities. However, scarce public resources mean difficult decisions about policy implementation must be clearly justified. A public mandate, through knowledge of public preferences, offers one route to transformative policy change. But we do not know what, if anything, people would be willing to give-up to reduce health inequalities. Nor whether the type of policy through which health inequalities are reduced matters. We make the case for developing a new public health economics research agenda using stated preference techniques to estimate the economic value for upstream income-based policies and health outcomes by considering Universal Basic Income. This new research area has the potential to advance the use of economic valuation methods within public health economics, generating new evidence to inform policy debates around the implementation of upstream income-based policies and how to address health inequalities.

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.

Global climate change has increased the risk of wildfires, which pose serious short and long-term mental health problems. Emotional well-being and access to specialized health services are among the most challenging health concerns of those affected by wildfires. In this overview, I discuss the mental health burdens of wildfires and the need for programmatic solutions and resources for developing mental health support infrastructure, including access to care, Skills for Psychological Recovery training programs, and digital health tools. These specialized programs and tools have the potential to improve community resilience and reduce the negative impacts of wildfires on mental health.

Since the 2022 Dobbs decision, 15 states have criminalized abortion for the first time in 50 years. Experts fear that bans will exacerbate the maternal mortality crisis in the country, especially for women of color. One of the top causes of maternal death in the United States is homicide. The relationship between violence and pregnancy is bi-directional; intimate partner violence is associated with unwanted pregnancies and unwanted pregnancies are associated with more intimate partner violence. Researchers have documented stories from women who report seeking an abortion because their partner is abusive, and they do not want to be "tethered" to that partner. With decreased abortion access, more children will likely be born into violent homes, increasing childhood exposure to household and lifetime violence. Our work explores the impact of the Dobbs decision and emphasizes the need for multidisciplinary and trauma informed strategies for preventing unplanned pregnancies and safeguarding families in this new political environment.

Alcohol companies have expanded their presence in the 'zero-alcohol' market with intensive product development and marketing activities. This has been framed by industry as an effort to reduce or solve alcohol-related harm. Such framing fails to acknowledge the financial benefits 'zero-alcohol' products offer alcohol companies and the ongoing concerns regarding alcohol brand marketing. To help inform an understanding of industry priorities, we looked at comments about 'zero-alcohol' products by major beer companies in online publications. In public-facing channels, 'zero-alcohol' products were discussed as tools for moderation, and their market a reflection of the 'good' that companies are doing. However, this contrasts with how they were discussed in industry-facing channels, as tools to expand markets, target new drinking occasions and compete with non-alcoholic beverages. Alcohol companies citing 'zero-alcohol' products as evidence of their commitment to social responsibility reflects a broader pattern of leveraging corporate social responsibility initiatives for commercial gain over genuine public health improvements.