Drink-driving is a major cause of global road traffic fatalities, yet few countries have laws that meet international best practices. One possible reason is the alcohol industry’s opposition to meaningful policies that are perceived to directly threaten sales. Our primary objectives are to document alcohol industry involvement in global road safety policies and programmes and to critically evaluate the responses of public health and road safety communities to this involvement. Under the guidance of the Policy Dystopia Model, we used a mixed methods approach in which data were gathered from expert interviews and a mapping review of 11 databases, 5 watchdog websites and 7 alcohol industry-sponsored initiatives. Triangulation was used to identify points of convergence among data sources. A total of 20 expert interviews and 94 documents were analysed. Our study showed that the alcohol industry acknowledges that drink-driving is an issue but argues for solutions that would limit impact on sales, akin to the message ‘drink—but do not drive’. Industry actors have been involved in road safety through: (1) coalition coupling and decoupling, (2) information production and management, (3) direct involvement in policymaking and (4) implementation of interventions. Our study also shed light on the lack of cohesion within and among the public health and road safety communities, particularly with regard to the topics of receiving funding from and partnering with the alcohol industry. These results were subsequently used to adapt the Policy Dystopia Model as a conceptual framework that illustrates the ways in which the alcohol industry has been involved in global road safety. Several implications can be drawn from this study, including the urgent need to increase awareness about the involvement of the alcohol industry in road safety and to build a cohesive transnational alcohol control advocacy alliance to curb injuries and deaths related to drink-driving.

Background There is a large and growing unmet need for rehabilitation – a diverse category of services that aim to improve functioning across the life course – particularly in low- and middle-income countries. Yet despite urgent calls to increase political commitment, many low- and middle-income country governments have dedicated little attention to expanding rehabilitation services. Existing policy scholarship explains how and why health issues reach the policy agenda and offers applicable evidence to advance access to physical, medical, psychosocial, and other types of rehabilitation services. Drawing from this scholarship and empirical data on rehabilitation, this paper proposes a policy framework to understand national-level prioritization of rehabilitation in low- and middle-income countries. Methods We conducted key informant interviews with rehabilitation stakeholders in 47 countries, complemented by a purposeful review of peer-reviewed and gray literature to achieve thematic saturation. We analyzed the data abductively using a thematic synthesis methodology. Rehabilitation-specific findings were triangulated with policy theory and empirical case studies on the prioritization of other health issues to develop the framework. Results The novel policy framework includes three components which shape the prioritization of rehabilitation on low- and middle-income countries’ national government’s health agendas. First, rehabilitation lacks a consistent problem definition, undermining the development of consensus-driven solutions which could advance the issue on policy agendas. Second, governance arrangements are fragmented within and across government ministries, between the government and its citizens, and across national and transnational actors engaged in rehabilitation service provision. Third, national legacies – particularly from civil conflict – and weaknesses in the existing health system influences both rehabilitation needs and implementation feasibility. Conclusions This framework can support stakeholders in identifying the key components impeding prioritization for rehabilitation across different national contexts. This is a crucial step for ultimately better advancing the issue on national policy agendas and improving equity in access to rehabilitation services.

Background Researchers have highlighted a large-scale global unmet need for rehabilitation. While sex and gender have been shown to interact with each other and with other social and structural factors to influence health and wellbeing, less is known about how sex and gender shape rehabilitation participation and outcomes within health systems. Methods Using an intersectional approach, we examine literature that explores the relationship between sex and/or gender and rehabilitation access, use, adherence, outcomes, and caregiving. Following a comprehensive search, 65 documents met the inclusion criteria for this scoping review of published literature. Articles were coded for rehabilitation-related themes and categorized by type of rehabilitation, setting, and age of participants, to explore how existing literature aligned with documented global rehabilitation needs. Responding to a common conflation of sex and gender in the existing literature and a frequent misrepresentation of sex and gender as binary, the researchers also developed a schema to determine whether existing literature accurately represented sex and gender. Results The literature generally described worse rehabilitation access, use, adherence, and outcomes and a higher caregiving burden for conditions with rehabilitation needs among women than men. It also highlighted the interacting effects of social and structural factors like socioeconomic status, racial or ethnic identity, lack of referral, and inadequate insurance on rehabilitation participation and outcomes. However, existing literature on gender and rehabilitation has focused disproportionately on a few types of rehabilitation among adults in high-income country contexts and does not correspond with global geographic or condition-based rehabilitation needs. Furthermore, no articles were determined to have provided an apt depiction of sex and gender. Conclusion This review highlights a gap in global knowledge about the relationship between sex and/or gender and rehabilitation participation and outcomes within health systems. Future research should rely on social science and intersectional approaches to elucidate how gender and other social norms, roles, and structures influence a gender disparity in rehabilitation participation and outcomes. Health systems should prioritize person-centered, gender-responsive care, which involves delivering services that are responsive to the complex social norms, roles, and structures that intersect to shape gender inequitable rehabilitation participation and outcomes in diverse contexts.

Background The burden of energy and fuel poverty (EFP) in Europe is increasing in the face of the cost-of-living crisis, the Russian invasion of Ukraine, the coronavirus disease 2019 (COVID-19) pandemic and the climate emergency. While the health impacts of EFP are often the driving reason for addressing it, EFP’s association with health is poorly delineated. This review aims to scope the evidence of EFP’s association with health in Europe. Methods A scoping review based on Arksey and O’Malley’s framework was conducted using search terms relevant to EFP, health and Europe. Five databases were searched, in addition to hand searching. Review selection was performed by two independent reviewers, and articles were thematically analyzed. Results Thirty-five articles published between January 2000 and March 2022 were included. The literature varied in definitions and measurements of EFP and in the health indicators examined. The review revealed a negative association between EFP and health, specifically, general unspecified poor health (9 articles), excess winter mortality (3 articles), communicable diseases (3 articles), non-communicable diseases (11 articles), mental health (15 articles) and well-being (12 articles). While women were reported to be at a higher risk of EFP than men, children and older adults were identified as particularly vulnerable to EFP’s adverse health repercussions. Conclusions This scoping review illustrates a significant and complex association between EFP and various domains of health. Though heterogeneity across research makes it difficult to compare findings, our review supports the use of health as a justification to address EFP and urges public health to be more involved in EFP mitigation.

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