Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada.
BMC Public Health. 2024 Aug 5;24(1):2106. doi: 10.1186/s12889-024-19493-8.
Economic relief programs are strategies designed to sustain societal welfare and population health during a regional or global scale infectious disease outbreak. While economic relief programmes are considered essential during a regional or global health crisis, there is no clear consensus in the literature about their health and non-health benefits and their impact on promoting equity.
We conducted a scoping review, searching eight electronic databases from January 01, 2001, to April 3, 2023, using text words and subject headings for recent pathogens (coronavirus (COVID-19), Ebola, Influenza, Middle East Respiratory Syndrome (MERS), severe acute respiratory syndrome (SARS), HIV, West Nile, and Zika), and economic relief programs; but restricted eligibility to high-income countries and selected diseases due to volume. Title and abstract screening were conducted by trained reviewers and Distiller AI software. Data were extracted in duplicates by two trained reviewers using a pretested form, and key findings were charted using a narrative approach.
We identified 27,263 de-duplicated records, of which 50 were eligible. Included studies were on COVID-19 and Influenza, published between 2014 and 2023. Zero eligible studies were on MERS, SARS, Zika, Ebola, or West Nile Virus. We identified seven program types of which cash transfer (n = 12) and vaccination or testing incentive (n = 9) were most common. Individual-level economic relief programs were reported to have varying degrees of impact on public health measures, and sometimes affected population health outcomes. Expanding paid sick leave programs had the highest number of studies reporting health-related outcomes and positively impacted public health measures (isolation, vaccination uptake) and health outcomes (case counts and the utilization of healthcare services). Equity impact was most often reported for cash transfer programs and incentive for vaccination programs. Positive effects on general well-being and non-health outcomes included improved mental well-being and quality of life, food security, financial resilience, and job security.
Our findings suggest that individual-level economic relief programs can have significant impacts on public health measures, population health outcomes and equity. As countries prepare for future pandemics, our findings provide evidence to stakeholders to recognize health equity as a fundamental public health goal when designing pandemic preparedness policies.
经济救助计划是旨在维持社会福利和人口健康的策略，适用于地区或全球范围内的传染病爆发。虽然在地区或全球卫生危机期间，经济救助计划被认为是必不可少的，但文献中并没有关于其健康和非健康益处以及对促进公平影响的明确共识。
我们进行了范围界定审查，从 2001 年 1 月 1 日至 2023 年 4 月 3 日，使用文本词和主题词搜索了八个电子数据库，用于最近的病原体（冠状病毒（COVID-19）、埃博拉病毒、流感、中东呼吸综合征（MERS）、严重急性呼吸综合征（SARS）、艾滋病毒、西尼罗河病毒和寨卡病毒）和经济救助计划；但由于数量限制，仅将高收入国家和选定疾病纳入资格范围。标题和摘要筛选由经过培训的审查员和 Distiller AI 软件进行。两名经过培训的审查员使用预测试表格进行数据重复提取，并使用叙述方法对关键发现进行图表绘制。
我们从 27263 个去重记录中筛选出 50 篇符合条件的文章。纳入的研究对象是 COVID-19 和流感，发表于 2014 年至 2023 年之间。零项符合条件的研究涉及 MERS、SARS、寨卡病毒、埃博拉病毒或西尼罗河病毒。我们确定了七种计划类型，其中现金转移（n=12）和疫苗接种或检测激励（n=9）最为常见。个体层面的经济救助计划对公共卫生措施有不同程度的影响，有时会影响人口健康结果。扩大带薪病假计划的报告数量最多，报告了与健康相关的结果，并积极影响公共卫生措施（隔离、疫苗接种率）和健康结果（病例数和医疗服务利用）。现金转移计划和疫苗接种激励计划的公平性影响最常被报道。对一般福祉和非健康结果的积极影响包括改善心理健康和生活质量、粮食安全、财务弹性和工作保障。
我们的研究结果表明，个体层面的经济救助计划可以对公共卫生措施、人口健康结果和公平性产生重大影响。随着各国为未来的大流行做准备，我们的研究结果为利益相关者提供了证据，使其认识到在制定大流行防范政策时，将健康公平视为基本公共卫生目标的重要性。
