To date, COVID-19 has claimed more than 100 000 American lives. Early inquiry suggests preexisting conditions are key risk factors contributing to COVID-19 mortality and air pollution exposure could exacerbate this relationship. Building on prior research linking deaths from respiratory viruses to air pollution exposures, we investigate how 2014 National Air Toxics Assessment hazardous air pollutants (HAPs) respiratory hazard quotient and respiratory hazard index are related to COVID-19 mortality. Our focus on HAPs builds upon the knowledge base linking poor air quality to COVID-19 mortality, since most (if not all) earlier studies only include criteria pollutants. Herein, we examine the relationship between HAP exposure and US-based COVID-19 mortality, while controlling for socioeconomic status, population health indicators, and exposure to PM2.5 and ozone. We fit county-level negative binomial mixed models, predicting COVID-19 mortality as a function of HAP respiratory toxicity levels and relevant covariates. We include models for combined exposure to HAPs, as well as for specific pollutants. We find that an increase in the respiratory hazard index is associated with a 9% increase in COVID-19 mortality. Although differing in magnitude, this association holds for individual HAPs acetaldehyde, and diesel PM. These findings help us to understand variation in US-based COVID-19 mortality rates, reinforce existing research linking air pollution to mortality, and emphasize the importance of regulatory efforts to limit air pollution exposure risk.

In determining whether new health technologies should be funded, health technology assessment (HTA) committees prefer explicit to implicit methods of analysis in enhancing transparency and consistency of decision making. The aim of this study was to develop and pilot a multicriteria decision analysis (MCDA) framework for the Queensland Department of Health HTA program committee, which weighted decision making criteria according to their perceived importance as determined by group consensus. The criteria used in the MCDA framework were identified by reviewing the five unweighted criteria used in the existing process, consultation with committee members and literature review. Criteria were clearly defined and ordinal categories of lowest to highest preferred were assigned against which technology submissions would be rated. Criteria weights were determined through a discrete choice experiment (DCE) survey of committee members using validated software. Mean weighted technology scores were then used to guide deliberative discussions in determining final funding decisions. The MCDA framework created one additional criterion to the previous five. The criteria and their mean weights identified through the DCE survey were clinical benefit and safety (27.2%), quality of evidence (19.2%), implementation capacity (16.9%), innovation (15.4%), burden of disease and clinical need (13.3%) and societal and ethical values (8.0%). Criterion weights varied considerably between individual committee members, with one criterion having a difference of 36.9% between the highest and lowest preference weights. Following deliberative discussions, all but one of 10 submissions were awarded funding. The submission not supported received the third lowest score through the MCDA model. This pilot application of an MCDA framework, as a complement to committee deliberation, conferred greater transparency and objectivity on HTA assessment of technologies. The framework converted an implicit, unweighted review process to one that is more explicit, flexible in weighting importance and pragmatic. HTA programs involve complex decision-making processes requiring the consideration of multiple criteria. Explicit methods of analysis that use weighted criteria according to their relative importance enhance transparency and consistency of decision making by HTA committees, and are preferred to implicit reviews using unweighted criteria. This article describes the development and piloting of an MCDA framework that aims to improve transparency, objectivity and consistency of funding decisions of the Queensland HTA committee. Criteria were identified through a review of current processes, committee discussions and a literature review, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence system. Criteria were weighted using a discrete choice experiment involving committee members. Using weighted criteria, mean technology scores were calculated and incorporated into deliberative discussions to determine funding de...

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This article reassesses interwar French advertising through the case study of alcohol, one of the period's most widely advertised and popular products. Examining the ways in which alcoholic beverages were branded, marketed, and advertised, the article revises the historiography of French advertising in several ways. Histories of interwar French advertising have described an industry that was retarded and underdeveloped, or else slowly progressing through the application and adaptation of American practices. By contrast, this article suggests that during the period French advertising was a remarkably successful enterprise which should be analysed on its own terms rather than through the dominant paradigm of Americanization. French interwar publicity innovations, like the alcoholic beverages that utilized them, were very much ‘home grown’ phenomena. Both were firmly rooted in Belle Époque advertising traditions and contemporary French consumer patterns. Advertising did not create a new consumer culture; instead it reflected and was, in turn, shaped by the society in which it operated and the products being advertised.

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