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• Published: 26 September 2024

Recognizing and responding to stigma-related barriers in health care

• Carmen H. Logie   ORCID: orcid.org/0000-0002-8035-433X 1 , 2 , 3 , 4 &
• Laura Nyblade 5  

Nature Reviews Disease Primers volume  10 , Article number:  70 ( 2024 ) Cite this article

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• Disease prevention
• Health occupations
• Health services
• HIV infections

Health-care stigma has profound impacts on health outcomes through reducing health-care uptake, disrupting linkage to and retention in care, and lowering treatment initiation and adherence. Appropriate tools and approaches must be utilized to reduce health-care stigma and to improve health-care quality, engagement and health outcomes for communities at large.

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Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada

Carmen H. Logie

United Nations University Institute for Water, Environment, and Health, Hamilton, Ontario, Canada

Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada

Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada

Social, Statistical and Environmental Sciences, Research Triangle Institute, Washington DC, USA

Laura Nyblade

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Corresponding author

Correspondence to Carmen H. Logie .

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Logie, C.H., Nyblade, L. Recognizing and responding to stigma-related barriers in health care. Nat Rev Dis Primers 10 , 70 (2024). https://doi.org/10.1038/s41572-024-00554-6

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Published : 26 September 2024

DOI : https://doi.org/10.1038/s41572-024-00554-6

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What are the trending topics in Public Health and related disciplines?

You can identify some of the most discussed and influential topics with the help of Altmetric attention scores, which take into account several outlets including social media, news articles, and policy documents.

Drawing from a selection of Public Health and Medicine journals, we have compiled a list of the articles that have been mentioned the most over the past few months.

Discover the articles that are trending right now, and catch up on current topics in Public Health and related disciplines. We will update our collection every few weeks; come back to this page to be on top of the latest conversations in Public Health and Medicine. Previously featured articles are listed here .

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Age and Ageing

Alcohol and alcoholism, american journal of epidemiology, annals of work exposures and health, epidemiologic reviews, european journal of public health, family practice, health education research, health policy and planning, health promotion international, international health, international journal of epidemiology, international journal for quality in health care, journal of public health, journal of travel medicine, journal of tropical pediatrics, nicotine & tobacco research, transactions of the royal society of tropical medicine & hygiene.

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The British Occupational Hygiene Society (BOHS) developed a control banding matrix for employers and others to help assess the risks of COVID-19 infection, and calls for further work to validate the reliability of the tool. Browse the Annals' collection on occupational hygiene for virus protection: https://academic.oup.com/annweh/pages/covid-19 

In 1777, George Washington ordered a mandatory inoculation program for his troops, in what would become the first mass immunization mandate in the US. This archival article discussess and contextualizes immunization practices for US Armed Forces.

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While medical practice is often undermined by subsequent investigation, randomized trials relevant to primary care generally hold up over time.

This study shows the potential for using social media influencers to inspire positive engagements on pro-vaccine health messaging. For more content on accurate information's importance for public health, browse the latest article collection from HER: https://academic.oup.com/her/pages/covid-19

Current emergency response planning does not have adequate coverage to maintain health systems functionality for essential health service delivery alongside emergency-specific interventions and healthcare. The findings from this study can help align health emergency planning with broader population health needs.

This case study shows that that ongoing efforts are needed to improve sustainability of nutrition policy and programmes to address all diet-related diseases.

This review article outlines evidence for a range of institutional measures and behaviour-change measures, and highlights research and knowledge gaps.

The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since World War II in Western Europe or the breakup of the Soviet Union in Eastern Europe.

The authors propose an update to the Equator’s Consolidated criteria for reporting qualitative research (COREQ) checklist, with the aim of enhancing inclusivity.

This study confirms previous findings on a low risk of SARS-CoV-2 reinfection. If confirmed, these findings suggest that more targeted restriction policies can be applied to the subjects that recovered after a first infection. Read highly cited papers on COVID-19 from the Journal of Public Health: https://academic.oup.com/jpubhealth/pages/covid-19

Given the Delta variant's high reproductive number associated with higher transmissibility, in a context of globally still low vaccine coverage rates and lower vaccine effectiveness, public health and social measures will need to be substantially strengthened. A high reproductive number also means that much higher vaccine coverage rates need to be achieved compared to the originally assumed.

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151+ Public Health Research Topics [Updated 2024]

The important area of public health research is essential to forming laws, influencing medical procedures, and eventually enhancing community well-being. As we delve into the vast landscape of public health research topics, it’s essential to understand the profound impact they have on society.

This blog aims to provide a comprehensive guide to selecting and understanding the diverse array of public health research topics.

Overview of Public Health Research Topics

Table of Contents

Public health research encompasses a wide range of subjects, reflecting the interdisciplinary nature of the field. From epidemiology and health policy to environmental health and infectious diseases, researchers navigate through various dimensions to address complex health challenges.

Each category holds its own significance, contributing to the overall understanding of public health dynamics.

Key Considerations in Selecting Public Health Research Topics

• Current Relevance: Assess the timeliness of potential topics by considering recent health trends, emerging issues, and societal concerns.
• Impact on Public Health: Evaluate the potential impact of the research on improving health outcomes, addressing disparities, or influencing policy and interventions.
• Feasibility and Resources: Gauge the practicality of conducting research on a particular topic, considering available resources, data accessibility, and research infrastructure.
• Ethical Considerations: Scrutinize the ethical implications of the research, ensuring it aligns with ethical standards and guidelines, especially when dealing with vulnerable populations or sensitive topics.

Top 151+ Public Health Research Topics

Epidemiology.

• The Impact of Social Determinants on Disease Outcomes
• Patterns and Trends in Emerging Infectious Diseases
• Investigating Health Disparities among Different Ethnic Groups
• Childhood Obesity and its Long-Term Health Consequences
• Assessing the Effectiveness of Contact Tracing in Disease Control

Health Policy

• Universal Healthcare: Comparative Analysis of Global Models
• The Role of Telemedicine in Improving Healthcare Access
• Evaluating Mental Health Policies and Their Impact on Communities
• Assessing the Impact of Affordable Care Act on Public Health
• Vaccine Policies and Public Perception: A Comprehensive Study

Environmental Health

• Climate Change and Health: Adapting to the Challenges
• Air Quality and Respiratory Health in Urban Environments
• Waterborne Diseases and Strategies for Safe Water Supply
• Occupational Health Hazards: A Comprehensive Workplace Analysis
• The Impact of Green Spaces on Mental Health in Urban Areas

Infectious Diseases

• Antimicrobial Resistance: Strategies for Mitigation
• Vaccination Strategies and Herd Immunity
• Global Health Security: Preparedness for Pandemics
• The Impact of Vector-Borne Diseases on Public Health
• Emerging Trends in Antibiotic-Resistant Infections

Chronic Diseases

• Lifestyle Interventions for Preventing Cardiovascular Diseases
• Genetic Factors in the Development of Cancer: A Comprehensive Study
• Aging and Health: Addressing the Healthcare Needs of the Elderly
• Diabetes Prevention Programs: Efficacy and Implementation
• Mental Health in Chronic Disease Patients: Bridging the Gap

Maternal and Child Health

• Maternal Mortality: Understanding Causes and Prevention
• The Impact of Breastfeeding on Infant Health and Development
• Childhood Immunization: Barriers and Strategies for Improvement
• Teenage Pregnancy and Its Long-Term Health Consequences
• Mental Health Support for Postpartum Women: Current Gaps and Solutions

Health Behavior and Promotion

• Smoking Cessation Programs: Effectiveness and Challenges
• Physical Activity Promotion in Schools: Strategies for Success
• Nutrition Education and Its Impact on Healthy Eating Habits
• Mental Health Awareness Campaigns: Assessing Public Perceptions
• The Role of Social Media in Health Promotion

Global Health

• Assessing the Impact of International Aid on Global Health
• Water, Sanitation, and Hygiene (WASH) Programs in Developing Countries
• The Role of Non-Governmental Organizations in Global Health
• Communicable Disease Control in Refugee Populations
• Global Access to Essential Medicines: Challenges and Solutions

Community Health

• Community-Based Participatory Research: Best Practices and Challenges
• The Impact of Community Health Workers on Health Outcomes
• Health Literacy and its Relationship to Health Disparities
• Assessing the Effectiveness of Mobile Health (mHealth) Interventions
• Community Resilience in the Face of Public Health Crises

Healthcare Quality and Patient Safety

• Hospital-Acquired Infections: Strategies for Prevention
• Patient Safety Culture in Healthcare Organizations
• Quality Improvement Initiatives in Primary Care Settings
• Healthcare Accreditation: Impact on Patient Outcomes
• Implementing Electronic Health Records: Challenges and Benefits

Mental Health

• Stigma Reduction Programs for Mental Health Disorders
• Integrating Mental Health into Primary Care Settings
• The Impact of COVID-19 on Mental Health: Long-Term Implications
• Mental Health in the Workplace: Strategies for Employee Well-being
• Suicide Prevention Programs: Effectiveness and Outreach

Health Disparities

• Racial Disparities in Healthcare: Addressing Systemic Inequities
• LGBTQ+ Health Disparities and Inclusive Healthcare Practices
• Socioeconomic Status and Access to Healthcare Services
• Geographical Disparities in Health: Rural vs. Urban
• The Impact of Gender on Health Outcomes and Access to Care

Public Health Education

• Evaluation of Public Health Education Programs
• Innovative Approaches to Teaching Public Health Concepts
• Online Health Education Platforms: Opportunities and Challenges
• Interdisciplinary Training in Public Health: Bridging Gaps
• Continuing Education for Public Health Professionals: Current Landscape

Digital Health

• The Role of Wearable Devices in Health Monitoring
• Telehealth Adoption: Barriers and Opportunities
• Health Apps for Chronic Disease Management: User Perspectives
• Blockchain Technology in Healthcare: Privacy and Security Implications
• Artificial Intelligence in Disease Diagnosis and Prediction

Health Economics

• Cost-Effectiveness of Preventive Health Interventions
• The Impact of Healthcare Financing Models on Access to Care
• Pharmaceutical Pricing and Access to Essential Medicines
• Economic Evaluation of Health Promotion Programs
• Health Insurance Coverage and Health Outcomes: A Global Perspective

Innovations in Public Health

• 3D Printing in Healthcare: Applications and Future Prospects
• Gene Editing Technologies and their Ethical Implications
• Smart Cities and Public Health: Integrating Technology for Well-being
• Nanotechnology in Medicine: Potential for Disease Treatment
• The Role of Drones in Public Health: Surveillance and Intervention

Food Safety and Nutrition

• Foodborne Illness Outbreaks: Investigating Causes and Prevention
• Sustainable Food Systems: Implications for Public Health
• Nutritional Interventions for Malnutrition in Developing Countries
• Food Labeling and Consumer Understanding: A Critical Review
• The Impact of Fast Food Consumption on Public Health

Substance Abuse

• Opioid Epidemic: Strategies for Prevention and Treatment
• Harm Reduction Approaches in Substance Abuse Programs
• Alcohol Consumption Patterns and Public Health Outcomes
• Smoking and Mental Health: Exploring the Connection
• Novel Psychoactive Substances: Emerging Threats and Strategies

Occupational Health

• Workplace Stress and Mental Health: Intervention Strategies
• Occupational Hazards in Healthcare Professions: A Comparative Analysis
• Ergonomics in the Workplace: Improving Worker Health and Productivity
• Night Shift Work and Health Consequences: Addressing Challenges
• Occupational Health and Safety Regulations: A Global Overview

Disaster Preparedness and Response

• Pandemic Preparedness and Lessons from COVID-19
• Natural Disasters and Mental Health: Post-Traumatic Stress
• Emergency Response Systems: Improving Timeliness and Efficiency
• Communicating Health Risks During Emergencies: Public Perception
• Collaborative Approaches to Disaster Response in Global Health

Cancer Research

• Precision Medicine in Cancer Treatment: Current Advancements
• Cancer Screening Programs: Efficacy and Challenges
• Environmental Factors and Cancer Risk: Exploring Connections
• Survivorship Care Plans: Enhancing Quality of Life after Cancer
• Integrative Therapies in Cancer Care: Complementary Approaches

Sexual and Reproductive Health

• Access to Contraception in Developing Countries: Challenges and Solutions
• Comprehensive Sex Education Programs: Impact on Teen Pregnancy
• Reproductive Health Rights: Global Perspectives and Challenges
• Infertility Treatment: Ethical Considerations and Societal Impact
• Maternal and Child Health in Conflict Zones: Addressing Challenges

Cardiovascular Health

• Hypertension Prevention Programs: Strategies and Effectiveness
• Cardiovascular Disease in Women: Gender-Specific Risk Factors
• Innovations in Cardiac Rehabilitation Programs
• Artificial Heart Technology: Advancements and Ethical Implications
• Impact of Air Pollution on Cardiovascular Health: A Global Concern

Social Determinants of Health

• Educational Attainment and Health Outcomes: Exploring Links
• Income Inequality and its Impact on Population Health
• Social Support Networks and Mental Health: A Comprehensive Study
• Neighborhood Environments and Health Disparities
• Employment and Health: The Interplay of Work and Well-being

Genomics and Public Health

• Population Genomics and its Implications for Public Health
• Genetic Counseling and Education: Empowering Individuals and Families
• Ethical Issues in Genetic Research: Privacy and Informed Consent
• Pharmacogenomics: Tailoring Drug Therapies to Individual Genotypes
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• Published: 15 February 2023

The impact of food insecurity on health outcomes: empirical evidence from sub-Saharan African countries

• Sisay Demissew Beyene   ORCID: orcid.org/0000-0001-7347-4168 1  

BMC Public Health volume  23 , Article number:  338 ( 2023 ) Cite this article

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Food insecurity adversely affects human health, which means food security and nutrition are crucial to improving people’s health outcomes. Both food insecurity and health outcomes are the policy and agenda of the 2030 Sustainable Development Goals (SDGs). However, there is a lack of macro-level empirical studies (Macro-level study means studies at the broadest level using variables that represent a given country or the whole population of a country or economy as a whole. For example, if the urban population (% of the total population) of XYZ country is 30%, it is used as a proxy variable to represent represent country's urbanization level. Empirical study implies studies that employ the econometrics method, which is the application of math and statistics.) concerning the relationship between food insecurity and health outcomes in sub-Saharan African (SSA) countries though the region is highly affected by food insecurity and its related health problems. Therefore, this study aims to examine the impact of food insecurity on life expectancy and infant mortality in SSA countries.

The study was conducted for the whole population of 31 sampled SSA countries selected based on data availability. The study uses secondary data collected online from the databases of the United Nations Development Programme (UNDP), the Food and Agricultural Organization (FAO), and the World Bank (WB). The study uses yearly balanced data from 2001 to 2018. This study employs a multicountry panel data analysis and several estimation techniques; it employs Driscoll-Kraay standard errors (DKSE), a generalized method of momentum (GMM), fixed effects (FE), and the Granger causality test.

A 1% increment in people’s prevalence for undernourishment reduces their life expectancy by 0.00348 percentage points (PPs). However, life expectancy rises by 0.00317 PPs with every 1% increase in average dietary energy supply. A 1% rise in the prevalence of undernourishment increases infant mortality by 0.0119 PPs. However, a 1% increment in average dietary energy supply reduces infant mortality by 0.0139 PPs.

Conclusions

Food insecurity harms the health status of SSA countries, but food security impacts in the reverse direction. This implies that to meet SDG 3.2, SSA should ensure food security.

Peer Review reports

Food security is essential to people’s health and well-being [ 1 ]. Further, the World Health Organization (WHO) argues that health is wealth and poor health is an integral part of poverty; governments should actively seek to preserve their people’s lives and reduce the incidence of unnecessary mortality and avoidable illnesses [ 2 ]. However, lack of food is one of the factors which affect health outcomes. Concerning this, the Food Research and Action Center noted that the social determinants of health, such as poverty and food insecurity, are associated with some of the most severe and costly health problems in a nation [ 3 ].

According to the FAO, the International Fund for Agricultural Development (IFAD), and the World Food Programme (WFP), food insecurity is defined as "A situation that exists when people lack secure access to sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life" ([ 4 ]; p50). It is generally believed that food security and nutrition are crucial to improving human health and development. Studies show that millions of people live in food insecurity, which is one of the main risks to human health. Around one in four people globally (1.9 billion people) were moderately or severely food insecure in 2017 and the greatest numbers were in SSA and South Asia. Around 9.2% of the world's population was severely food insecure in 2018. Food insecurity is highest in SSA countries, where nearly one-third are defined as severely insecure [ 5 ]. Similarly, 11% (820 million) of the world's population was undernourished in 2018, and SSA countries still share a substantial amount [ 5 ]. Even though globally the number of people affected by hunger has been decreasing since 1990, in recent years (especially since 2015) the number of people living in food insecurity has increased. It will be a huge challenge to achieve the SDGs of zero hunger by 2030 [ 6 ]. FAO et al. [ 7 ] projected that one in four individuals in SSA were undernourished in 2017. Moreover, FAO et al. [ 8 ] found that, between 2014 and 2018, the prevalence of undernourishment worsened. Twenty percent of the continent's population, or 256 million people, are undernourished today, of which 239 million are in SSA. Hidden hunger is also one of the most severe types of malnutrition (micronutrient deficiencies). One in three persons suffers from inadequacies related to hidden hunger, which impacts two billion people worldwide [ 9 ]. Similarly, SSA has a high prevalence of hidden hunger [ 10 , 11 ].

An important consequence of food insecurity is that around 9 million people die yearly worldwide due to hunger and hunger-related diseases. This is more than from Acquired Immunodeficiency Syndrome (AIDS), malaria, and tuberculosis combined [ 6 ]. Even though the hunger crisis affects many people of all genders and ages, children are particularly affected in Africa. There are too many malnourished children in Africa, and malnutrition is a major factor in the high infant mortality rates and causes physical and mental development delays and disorders in SSA [ 12 ]. According to UN statistics, chronic malnutrition globally accounts for 165 million stunted or underweight children. Around 75% of these kids are from SSA and South Asia. Forty percent of children in SSA are impacted. In SSA, about 3.2 million children under the age of five dies yearly, which is about half of all deaths in this age group worldwide. Malnutrition is responsible for almost one child under the age of five dying every two minutes worldwide. The child mortality rate in the SSA is among the highest in the world, about one in nine children pass away before the age of five [ 12 ].

In addition to the direct impact of food insecurity on health outcomes, it also indirectly contributes to disordered eating patterns, higher or lower blood cholesterol levels, lower serum albumin, lower hemoglobin, vitamin A levels, and poor physical and mental health [ 13 , 14 , 15 ]. Iodine, iron, and zinc deficiency are the most often identified micronutrient deficiencies across all age groups. A deficiency in vitamin A affects an estimated 190 million pre-schoolers and 19 million pregnant women [ 16 ]. Even though it is frequently noted that hidden hunger mostly affects pregnant women, children, and teenagers, it further affects people’s health at all stages of life [ 17 ].

With the above information, researchers and policymakers should focus on the issue of food insecurity and health status. The SDGs that were developed in 2015 intend to end hunger in 2030 as one of its primary targets. However, a growing number of people live with hunger and food insecurity, leading to millions of deaths. Hence, this study questioned what is the impact of food insecurity on people's health outcomes in SSA countries. In addition, despite the evidence implicating food insecurity and poor health status, there is a lack of macro-level empirical studies concerning the impact of food insecurity on people’s health status in SSA countries, which leads to a knowledge (literature) gap. Therefore, this study aims to examine the impact of food insecurity on life expectancy and infant mortality in SSA countries for the period ranging from 2001–2018 using panel mean regression approaches.

Theoretical and conceptual framework

Structural factors, such as climate, socio-economic, social, and local food availability, affect people’s food security. People’s health condition is impacted by food insecurity through nutritional, mental health, and behavioral channels [ 18 ]. Under the nutritional channel, food insecurity has an impact on total caloric intake, diet quality, and nutritional status [ 19 , 20 , 21 ]. Hunger and undernutrition may develop when food supplies are scarce, and these conditions may potentially lead to wasting, stunting, and immunological deficiencies [ 22 ]. However, food insecurity also negatively influences health due to its effects on obesity, women's disordered eating patterns [ 23 ], and poor diet quality [ 24 ].

Under the mental health channel, Whitaker et al. [ 25 ] noted that food insecurity is related to poor mental health conditions (stress, sadness, and anxiety), which have also been linked to obesity and cardiovascular risk [ 26 ]. The effects of food insecurity on mental health can worsen the health of people who are already sick as well as lead to disease acquisition [ 18 ]. Similarly, the behavioral channel argues that there is a connection between food insecurity and health practices that impact disease management, prevention, and treatment. For example, lack of access to household food might force people to make bad decisions that may raise their risk of sickness, such as relying too heavily on cheap, calorically dense, nutrient-poor meals or participating in risky sexual conduct. In addition, food insecurity and other competing demands for survival are linked to poorer access and adherence to general medical treatment in low-income individuals once they become sick [ 27 , 28 , 29 , 30 ]

Food insecurity increases the likelihood of exposure to HIV and worsens the health of HIV-positive individuals [ 18 ]. Weiser et al. [ 31 ] found that food insecurity increases the likelihood of unsafe sexual activities, aggravating the spread of HIV. It can also raise the possibility of transmission through unsafe newborn feeding practices and worsening maternal health [ 32 ]. In addition, food insecurity has been linked to decreased antiretroviral adherence, declines in physical health status, worse immunologic status [ 33 ], decreased viral suppression [ 34 , 35 ], increased incidence of serious illness [ 36 ], and increased mortality [ 37 ] among people living with HIV.

With the above theoretical relationship between target variables and since this study focuses on the impact of food insecurity on health outcomes, and not on the causes, it adopted the conceptual framework of Weiser et al. [ 18 ] and constructed Fig.  1 .

A conceptual framework of food insecurity and health. Source: Modified and constructed by the author using Weiser et al. [ 18 ] conceptual framework. Permission was granted by Taylor & Francis to use their original Figs. (2.2, 2.3, and 2.4); to develop the above figure. Permission number: 1072954

Several findings associate food insecurity with poorer health, worse disease management, and a higher risk of premature mortality even though they used microdata. For instance, Stuff et al. [ 38 ] found that food insecurity is related to poor self-reported health status, obesity [ 39 ], abnormal blood lipids [ 40 ], a rise in diabetes [ 24 , 40 ], increased gestational diabetes[ 41 ], increased perceived stress, depression and anxiety among women [ 25 , 42 ], Human Immunodeficiency Virus (HIV) acquisition risk [ 43 , 44 , 45 ], childhood stunting [ 46 ], poor health [ 47 ], mental health and behavioral problem [ 25 , 48 , 49 ].

The above highlight micro-level empirical studies, and since the scope of this study is macro-level, Table 1 provides only the existing macro-level empirical findings related to the current study.

Empirical findings in Table 1 are a few, implying a limited number of macro-level level empirical findings. Even the existing macro-level studies have several limitations. For instance, most studies either employed conventional estimation techniques or overlooked basic econometric tests; thus, their results and policy implications may mislead policy implementers. Except for Hameed et al. [ 53 ], most studies’ data are either outdated or unbalanced; hence, their results and policy implications may not be valuable in the dynamic world and may not be accurate like balanced data. Besides, some studies used limited (one) sampled countries; however, few sampled countries and observations do not get the asymptotic properties of an estimator [ 56 ]. Therefore, this study tries to fill the existing gaps by employing robust estimation techniques with initial diagnostic and post-estimation tests, basic panel econometric tests and robustness checks, updated data, a large number of samples.

Study setting and participants

According to Smith and Meade [ 57 ], the highest rates of both food insecurity and severe food insecurity were found in Sub-Saharan Africa in 2017 (55 and 28%, respectively), followed by Latin America and the Caribbean (32 and 12%, respectively) and South Asia (30 and 13%). Similarly, SSA countries have worst health outcomes compared to other regions. For instance, in 2020, the region had the lowest life expectancy [ 58 ] and highest infant mortality [ 59 ]. Having the above information, this study's target population are SSA countries chosen purposively. However, even though SSA comprises 49 of Africa's 55 countries that are entirely or partially south of the Sahara Desert. This study is conducted for a sample of 31 SSA countries (Angola, Benin, Botswana, Burkina Faso, Cameroon, Cabo Verde, Chad, Congo Rep., Côte d'Ivoire, Ethiopia, Gabon, The Gambia, Ghana, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Nigeria, Rwanda, Senegal, Sierra Leone, South Africa, Sudan, Tanzania, and Togo). The sampled countries are selected based on data accessibility for each variable included in the empirical models from 2001 to 2018. Since SSA countries suffer from food insecurity and related health problems, this study believes the sampled countries are appropriate and represent the region. Moreover, since this study included a large sample size, it improves the estimator’s precision.

Data type, sources, and scope

This study uses secondary data collected in December 2020 online from the databases of the Food and Agricultural Organization (FAO), the United Nations Development Programme (UNDP), and the World Bank (WB) (see Table 2 ). In addition, the study uses yearly balanced data from 2001 to 2018, which is appropriate because it captures the Millennium Development Goals, SDGs, and other economic conditions, such as the rise of SSA countries’ economies and the global financial crisis of the 2000s. Therefore, this study considers various global development programs and events. Generally, the scope of this study (sampled countries and time) is sufficient to represent SSA countries. In other words, the study has n*T = 558 observations, which fulfills the large sample size criteria recommended by Kennedy [ 56 ].

The empirical model

Model specification is vital to conduct basic panel data econometric tests and estimate the relationship of target variables. Besides social factors, the study includes economic factors determining people's health status. Moreover, it uses two proxies indicators to measure both food insecurity and health status; hence, it specifies the general model as follows:

The study uses four models to analyze the impact of food insecurity on health outcomes.

where LNLEXP and LNINFMOR (dependent variables) refer to the natural logarithm of life expectancy at birth and infant mortality used as proxy variables for health outcomes. Similarly, PRUND and AVRDES are the prevalence of undernourishment and average dietary energy supply adequacy – proxy and predictor variables for food insecurity.

Moreover, to regulate countries’ socio-economic conditions and to account for time-varying bias that can contribute to changes in the dependent variable, the study included control variables, such as GDPPC, GOVEXP, MNSCHOOL, and URBAN. GDPPC is GDP per capita, GOVEXP refers to domestic general government health expenditure, MNSCHOOL is mean years of schooling and URBAN refers to urbanization. Further, n it , v it , ε it , and μ it are the stochastic error terms at period t. The parameters \({\alpha }_{0}, { \beta }_{0}, { \theta }_{0},{ \delta }_{0}\) refer to intercept terms and \({\alpha }_{1}-{\alpha }_{5}, {\beta }_{1}-{\beta }_{5}, { \theta }_{1}-{\theta }_{5}, and {\delta }_{1}-{\delta }_{5}\) are the long-run estimation coefficients. Since health outcomes and food insecurity have two indicators used as proxy variables, this study estimates different alternative models and robustness checks of the main results. Furthermore, the above models did not address heterogeneity problems; hence, this study considers unobserved heterogeneity by introducing cross-section and time heterogeneity in the models. This is accomplished by assuming a two-way error component for the disturbances with:

From Eq.  2 , the unobservable individual (cross-section) and unobservable time heterogeneities are described by \({\delta }_{i} and {\tau }_{t}\) (within components), respectively. Nonetheless, the remaining random error term is \({\gamma }_{it}\) (panel or between components). Therefore, the error terms in model 1A-1D will be substituted by the right-hand side elements of Eq.  2 .

Depending on the presumptions of whether the error elements are fixed or random, the FE and RE models are the two kinds of models that will be evaluated. Equation ( 2 ) yields a two-way FE error component model, or just a FE model if the assumptions are that \({\delta }_{i} and {\tau }_{t}\) are fixed parameters to be estimated and that the random error component, \({\gamma }_{it}\) , is uniformly and independently distributed with zero mean and constant variance (homoscedasticity).

Equation ( 2 ), on the other hand, provides a two-way RE error component model or a RE model if we suppose \({\delta }_{i} and {\tau }_{t}\) are random, just like the random error term, or \({\delta }_{i},{\tau }_{t}, and {\gamma }_{it}\) are all uniformly and independently distributed with zero mean and constant variance, or they are all independent of each other and independent variables [ 60 ].

Rather than considering both error components, \({\delta }_{i}, and {\tau }_{t}\) , we can examine only one of them at a time (fixed or random), yielding a one-way error component model, FE or RE. The stochastic error term \({\varpi }_{it}\) in Eq.  2 will then be:

Statistical analysis

This study conducted descriptive statistics, correlation analysis, and initial diagnosis tests (cross-sectional and time-specific fixed effect, outliers and influential observations, multicollinearity, normality, heteroscedasticity, and serial correlation test). Moreover, it provides basic panel econometric tests and panel data estimation techniques. For consistency, statistical software (STATA) version 15 was used for all analyses.

Descriptive statistics and correlation analysis

Descriptive statistics is essential to know the behavior of the variables in the model. Therefore, it captures information, such as the mean, standard deviation, minimum, maximum, skewness, and kurtosis. Similarly, the study conducted Pearson correlation analysis to assess the degree of relationship between the variables.

Initial diagnosis

Cross-sectional and time-specific fixed effect.

One can anticipate differences arising over time or within the cross-sectional units, given that the panel data set comprises repeated observations over the same units gathered over many periods. Therefore, before estimation, this study considered unexplained heterogeneity in the models. One fundamental limitation of cross-section, panel, and time series data regression is that they do not account for country and time heterogeneity [ 60 ]. These unobserved differences across nations and over time are crucial in how the error term is represented and the model is evaluated. These unobserved heterogeneities, however, may be represented by including both country and time dummies in the regression. However, if the parameters exceed the number of observations, the estimate will fail [ 60 ]. However, in this study, the models can be estimated. If we include both country and time dummies, we may assume that the slope coefficients are constant, but the intercept varies across countries and time, yielding the two-way error components model. As a result, this study examines the null hypothesis that intercepts differ across nations and time in general.

Detecting outliers and influential observations

In regression analysis, outliers and influential observations may provide biased findings. Therefore, the Cooks D outlier and influential observation test was used in the study to handle outliers and influencing observations. To evaluate whether these outliers have a stronger impact on the model to be estimated, each observation in this test was reviewed and compared with Cook’s D statistic [ 61 ]. Cook distance evaluates the extent to which observation impacts the entire model or the projected values. Hence, this study tested the existence of outliers.

Normality, heteroscedasticity, multicollinearity, and serial correlation test

Before the final regression result, the data used for the variables were tested for normality, heteroscedasticity, multicollinearity, and serial correlation to examine the characteristics of the sample.

Regression models should be checked for nonnormal error terms because a lack of Gaussianity (normal distribution) can occasionally compromise the accuracy of estimation and testing techniques. Additionally, the validity of inference techniques, specification tests, and forecasting critically depends on the normalcy assumption [ 62 ]. Similarly, multicollinearity in error terms leads to a dataset being highly sensitive to a minor change, instability in the regression model, and skewed and unreliable results. Therefore, this study conducted the normality using Alejo et al. [ 62 ] proposed command and multicollinearity (using VIF) tests.

Most conventional panel data estimation methods rely on homoscedastic individual error variance and constant serial correlation. Since the error component is typically connected to the variance that is not constant during the observation and is serially linked across periods, these theoretical presumptions have lately reduced the applicability of various panel data models. Serial correlation and heteroskedasticity are two estimate issues frequently connected to cross-sectional and time series data, respectively. Similarly, panel data is not free from these issues because it includes cross-sections and time series, making the estimated parameters ineffective, and rendering conclusions drawn from the estimation incorrect [ 63 ]. Therefore, this study used the Wooldridge [ 63 ] test for serial correlation in linear panel models as well as the modified Wald test for heteroskedasticity.

Basic panel econometric tests

The basic panel data econometric tests are prerequisites for estimating the panel data. The three main basic panel data tests are cross-sectional dependence, unit root, and cointegration.

Cross-sectional dependence (CD)

A growing body of the panel data literature concludes that panel data models are likely to exhibit substantial CD in the errors resulting from frequent shocks, unobserved components, spatial dependence, and idiosyncratic pairwise dependence. Even though the impact of CD in estimation depends on several factors, relative to the static model, the effect of CD in dynamic panel estimators is more severe [ 64 ]. Moreover, Pesaran [ 65 ] notes that recessions and economic or financial crises potentially affect all countries, even though they might start from just one or two countries. These occurrences inevitably introduce cross-sectional interdependencies across the cross-sectional unit, their regressors, and the error terms. Hence, overlooking the CD in panel data leads to biased estimates and spurious results [ 64 , 66 ]. Further, the CD test determines the type of panel unit root and cointegration tests we should apply. Therefore, examining the CD is vital in panel data econometrics.

In the literature, there are several tests for CD, such as the Breusch and Pagan [ 67 ] Lagrange multiplier (LM) test, Pesaran [ 68 ] scaled LM test, Pesaran [ 68 ] CD test, and Baltagi et al. [ 69 ] bias-corrected scaled LM test (for more detail, see Tugcu and Tiwari [ 70 ]). Besides, Friedman [ 71 ] and Frees [ 72 , 73 ] also have other types of CD tests (for more detail, see De Hoyos and Sarafidis [ 64 ]). This study employs Frees [ 72 ] and Pesaran [ 68 ] among the existing CD tests. This is because, unlike the Breusch and Pagan [ 67 ] test, these tests do not require infinite T and fixed N, and are rather applicable for both a large N and T. Additionally, Free’s CD test can overcome the irregular signs associated with correlation. However, it also employs Friedman [ 71 ] CD for mixed results of the above tests.

Unit root test

The panel unit root and cointegration tests are common steps following the CD test. Generally, there are two types of panel unit root tests: (1) the first-generation panel unit root tests, such as Im et al. [ 74 ], Maddala and Wu [ 75 ], Choi [ 76 ], Levin et al. [ 77 ], Breitung [ 78 ] and Hadri [ 79 ], and (2) the second-generation panel unit root tests, such as [ 66 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ].

The first-generation panel unit root tests have been criticized because they assume cross-sectional independence [ 90 , 91 , 92 , 93 ]. This hypothesis is somewhat restrictive and unrealistic, as macroeconomic time series exhibit significant cross-sectional correlation among countries in a panel [ 92 ], and co-movements of economies are often observed in the majority of macroeconomic applications of unit root tests [ 91 ]. The cross-sectional correlation of errors in panel data applications in economics is likely to be the rule rather than the exception [ 93 ]. Moreover, applying first-generation unit root tests under CD models can generate substantial size distortions [ 90 ], resulting in the null hypothesis of nonstationary being quickly rejected [ 66 , 94 ]. As a result, second-generation panel unit root tests have been proposed to take CD into account. Therefore, among the existing second-generation tests, this study employs Pesaran’s [ 66 ] cross-sectionally augmented panel unit root test (CIPS) for models 1A–1C . The rationale for this is that, unlike other unit root tests that allow CD, such as Bai and Ng [ 80 ], Moon and Perron [ 87 ], and Phillips and Sul [ 84 ], Pesaran’s [ 66 ] test is simple and clear. Besides, Pesaran [ 66 ] is robust when time-series’ heteroscedasticity is observed in the unobserved common factor [ 95 ]. Even though theoretically, Moon and Perron [ 87 ], Choi [ 96 ] and Pesaran [ 66 ] require large N and T, Pesaran [ 66 ] is uniquely robust in small sample sizes [ 97 ]. Therefore, this study employs the CIPS test to take into account CD, and heteroskedasticity in the unobserved common factor and both large and small sample countries. However, since there is no CD in model 1D , this study employs the first-generation unit root tests called Levin, Lin, and Chu (LLC), Im, Pesaran, Shin (IPS) and Fisher augmented Dickey–Fuller (ADF) for model 1D .

Cointegration test

The most common panel cointegration tests when there is CD are Westerlund [ 98 ], Westerlund and Edgerton [ 99 ], Westerlund and Edgerton [ 100 ], Groen and Kleibergen [ 101 ], Westerlund’s [ 102 ] Durbin-Hausman test, Gengenbach et al. [ 103 ] and Banerjee and Carrion-i-Silvestre [ 104 ]. However, except for a few, most tests are not coded in Statistical Software (STATA) and are affected by insufficient observations. The current study primarily uses Westerlund [ 98 ] and Banerjee and Carrion-i-Silvestre [ 104 ] for models 1A–1C . However, to decide uncertain results, it also uses McCoskey and Kao [ 105 ] cointegration tests for model 1C . The rationale for using Westerlund’s [ 98 ] cointegration test is that most panel cointegration has failed to reject the null hypothesis of no cointegration due to the failure of common-factor restriction [ 106 ]. However, Westerlund [ 98 ] does not require any common factor restriction [ 107 ] and allows for a large degree of heterogeneity (e.g., individual-specific short-run dynamics, intercepts, linear trends, and slope parameters) [ 92 , 107 , 108 ]. Besides, its command is coded and readily available in STATA. However, it suffers from insufficient observations, especially when the number of independent variables increases. The present study employs the Banerjee and Carrion-i-Silvestre [ 104 ] and McCoskey and Kao [ 105 ] cointegration tests to overcome this limitation. The two Engle-Granger-based cointegration tests applicable when there is no CD and are widely used and available in STATA are Pedroni [ 109 , 110 ] and Kao [ 111 ]. However, the Pedroni test has two benefits over Kao: it assumes cross-sectional dependency and considers heterogeneity by employing specific parameters [ 112 ]. Hence, this study uses the Pedroni cointegration test for model 1D .

Panel data estimation techniques

The panel data analysis can be conducted using different estimation techniques and is mainly determined by the results of basic panel econometric tests. Thus, this study mainly employs the Driscoll-Kraay [ 113 ] standard error (DKSE) (for models 1A and 1B ), FE (for model 1C ), and two-step GMM (for model 1D ) estimation techniques to examine the impact of food insecurity on health outcomes. It also employs the Granger causality test. However, for robustness checks, it uses fully modified ordinary least squares (FMOLS), panel-corrected standard error (PCSE), and feasible generalized least squares (FGLS) methods (for models 1A and 1B ). Moreover, it uses a random effect (RE) for model 1C and panel dynamic fixed effect (DFE) techniques for model 1D .

Even though several panel estimation techniques allow CD, most of them – such as cross-section augmented autoregressive distributed lag (CS-ARDL), cross-section augmented distributed lag (CS-DL), common correlated effects pooled (CCEP), and common correlated effects mean group (CCEMG) estimators – require a large number of observations over groups and periods. Similarly, the continuously updated fully modified (CUP-FM) and continuously updated bias-corrected (CUP-BC) estimators are not coded in STATA. Others, like the PCSE, FGLS, and seemingly unrelated regression (SUR), are feasible for T (the number of time series) > N (the number of cross-sectional units) [ 114 , 115 ]. However, a DKSE estimate is feasible for N > T [ 114 ]. Therefore, depending on the CD, cointegration test, availability in STATA, and comparing N against T, this study mainly employs the DKSE regression for models 1A and 1B , FE model for model 1C , and GMM for model 1C .

Finally, to check the robustness of the main result, this study employs FMOLS, FGLS, and PCSE estimation techniques for models 1A and 1B . Furthermore, even though the Hausman test confirms that the FE is more efficient, the study employs the RE for model 1C . This is because Firebaugh et al. [ 116 ] note that the RE and FE models perform best in panel data. Besides, unlike FE, RE assumes that individual differences are random. In addition, this study uses panel DFE for model 1D (selected based on the Hausman test). Finally, the robustness check is also conducted using an alternative model (i.e., when a dependent variable is without a natural log and Granger causality test).

Table 3 shows the overall mean of LNLEXP of the region is 4.063 years which indicates that the region can achieve only 57.43 (using ln(x) = 4.063 = loge (x)  = e 4.063 , where e = 2.718) years of life expectancy. This is very low compared to other regions. Besides, the ranges in the value of LNLEXP are between 3.698 and 4.345 or (40–76 years), implying high variation. Similarly, the mean value of LNINFMOR is 3.969; implying SSA countries recorded 52 infants death per 1000. Moreover, the range of LNINFMOR is between 2.525 and 4.919 or (12 – 135 infant death per 1000), implying high variation within the region. The mean value of people’s prevalence for undernourishment is 21.26; indicating 21% of the population is undernourished. However, the mean value of AVRDES is 107.826, which is greater than 100, implying that the calorie supply is adequate for all consumers if the food is distributed according to the requirements of individuals. When we observe the skewness and kurtosis of the variables of the models, except for LNLEXP and LNINFMOR, all variables are positively skewed. In addition, all variables have positive kurtosis with values between 2.202 and 6.092.

Table 3 also shows the degree of relationship between variables, such that most values are below the threshold or rule of thumb (0.7) for a greater association [ 117 ]. However, the association between LNINFMOR and LNLEXP, as well as between PRUNP and AVRDES, is over the threshold and seems to have a multicollinearity issue. Nevertheless, these variables did not exist together in the models, indicating the absence of a multicollinearity problem.

Table 4 shows whether the cross-sectional specific and time-specific FE in extended models ( model 1A-1D plus Eq.  2 ) are valid. The result reveals that the null hypothesis of the captured unobserved heterogeneity is homogenous across the countries, and time is rejected at 1%, implying the extended models are correctly specified. Besides, to check the robustness of the two-way error component model relative to the pooled OLS estimator, this study conducted an additional poolability test. The result shows the null hypothesis that intercepts homogeneity (pooling) is rejected at a 1% level; thus, the FE model is most applicable, but the pooled OLS is biased.

Cooks D is an indicator of high leverage and residuals. The impact is high when D exceeds 4/N, (N = number of observations). A D > 1 implies a significant outlier problem. The Cooks D result of this study confirms the absence of outliers' problem (see supplementary file 1 ).

Normality, heteroscedasticity, serial correlation, and multicollinearity tests

The results in Table 5 indicate that the probability value of the joint test for normality on e and u are above 0.01, implying that the residuals are normally distributed. The heteroscedasticity results show that the probability value of the chi-square statistic is less than 0.01 in all models. Therefore, the null hypothesis of constant variance can be rejected at a 1% level of significance. In other words, the modified Wald test result for Groupwise heteroskedasticity presented in Table 5 , rejects the null hypothesis of Groupwise homoskedasticity observed by the probability value of 0.0000, which implies the presence of heteroscedasticity in the residuals. Similarly, all models suffer from serial correlation since the probability value of 0.0000 rejects the null hypothesis of no first-order serial correlation, indicating the presence of autocorrelation in all panel models. Finally, the multicollinearity test reveals that the models have no multicollinearity problem since the Variance inflation Factors (VIF) values are below 5.

Cross-sectional dependence test

Results in Table 6 strongly reject the null hypothesis of cross-sectional independence for models 1A – 1C . However, for model 1D , the study found mixed results (i.e., Pesaran [ 68 ] fails to reject the null hypothesis of no CD while Frees [ 72 ] strongly rejects it). Thus, to decide, this study employs the Friedman [ 71 ] CD test. The result fails to reject the null hypothesis of cross-sectional independence, implying that two out of three tests fail to reject the null hypothesis of cross-sectional independence in model 1D . Therefore, unlike others, there is no CD in model 1D (see Table 6 ).

Unit root tests

Table 7 shows that all variables are highly (at 1% level) significant either at level (I(0)) or first difference (I(1)), which implies all variables are stationary. In other words, the result fails to reject the null hypothesis of unit root (non-stationary) for all variables at a 1%-significance level, either at levels or the first differences. Thus, we might expect a long-run connection between these variables collectively.

Cointegration tests

The results in Table 8 show that both the Westerlund [ 98 ] and Banerjee and Carrion-i-Silvestre [ 104 ] cointegration tests strongly reject the null hypothesis of no-cointegration in models 1A and 1B . However, model 1C provides a mixed result, i.e. the Banerjee and Carrion-i-Silvestre [ 104 ] test rejects the null hypothesis of no cointegration, yet the reverse is true for the Westerlund [ 98 ] test. Therefore, this study conducted further cointegration tests for model 1C . Even though Westerlund and Edgerton [ 99 ] suffer from insufficient observation, it is based on the McCoskey and Kao [ 105 ] LM test [ 118 ]. Thus, we can use a residual-based cointegration test in the heterogeneous panel framework proposed by McCoskey and Kao [ 105 ]. However, an efficient estimation technique of cointegrated variables is required, and hence the FMOLS and DOLS estimators are recommended. The residuals derived from the FMOLS and DOLS will be tested for stationarity with the null hypothesis of no cointegration amongst the regressors. Since the McCoskey and Kao [ 105 ] test involves averaging the individual LM statistics across the cross-sections, for testing the residuals FMOLS and DOLS stationarity, McCoskey, and Kao [ 105 ] test is in the spirit of IPS (Im et al. [ 74 ]) [ 119 ].

Though FMOLS and DOLS are recommended for the residuals cointegration test, DOLS is better than FMOLS (for more detail, see Kao and Chiang [ 120 ]); therefore, this study uses a residual test derived from DOLS. The result fails to reject the null hypothesis of no cointegration. Two (Banerjee and Carrion-i-Silvestre [ 104 ] and McCoskey and Kao [ 105 ]) out of three tests fail to reject the null hypothesis of no cointegration; hence, we can conclude that there is no long-run relationship among the variables in model 1C .

Unlike other models, since there is CD in model 1D , this study employs the Pedroni [ 109 ] and Kao [ 111 ] cointegration tests for model 1D . The result strongly rejects the null hypothesis of no cointegration, which is similar to models 1A and 1B , that a long-run relationship exists among the variables in model 1D (see Table 5 ).

Panel data estimation results

Table 9 provides long-run regression results of all models employing appropriate estimation techniques such as DKSE, FE, and two-step GMM, along with the Granger causality test. However, the DKSE regression can be estimated in three ways: FE with DKSE, RE with DKSE, and pooled Ordinary Least Squares/Weighted Least Squares (pooled OLS/WLS) regression with DKSE. Hence, we must choose the most efficient model using Hausman and Breusch-Pagan LM for RE tests (see supplementary file 2 ). As a result, this study employed FE with DKSE for models 1A and 1B . Further, due to Hausman's result, absence of cointegration and to deal with heterogeneity and spatial dependence in the dynamic panel, this study employs FE for the model1C (see the supplementary file 2). However, due to the absence of CD, the presence of cointegration, and N > T, this study uses GMM for model 1D . Moreover, according to Roodman [ 121 ], the GMM approach can solve heteroskedasticity and autocorrelation problems. Furthermore, even though two-step GMM produces only short-run results, it is possible to generate long-run coefficients from short-run results [ 122 , 123 ].

The DKSE result of model 1A shows that a 1% increment in people's prevalence for undernourishment reduces their life expectancy by 0.00348 PPs (1 year or 366 days). However, in model 1C, a 1% rise in the prevalence of undernourishment increases infant mortality by 0.0119 PPs (1 year or 369 days). The DKSE estimations in model 1B reveal that people’s life expectancy rises by 0.00317 PPs with every 1% increase in average dietary energy supply. However, the GMM result for model 1D confirms that a 1% incrementin average dietary energy supply reduces infant mortality by 0.0139 PPs. Moreover, this study conducted a panel Granger causality test to confirm whether or not food insecurity has a potential causality to health outcomes. The result demonstrates that the null hypothesis of change in people’s prevalence for undernourishment and average dietary energy supply does not homogeneously cause health outcomes is rejected at 1% significance, implying a change in food insecurity does Granger-cause health outcomes of SSA countries (see Table 9 ).

In addition to the main results, Table 9 also reports some post-estimation statistics to ascertain the consistency of the estimated results. Hence, in the case of DKSE and FE models, the validity of the models is determined by the values of R 2 and the F statistics. For instance, R 2 quantifies the proportion of the variance in the dependent variable explained by the independent variables, representing the model’s quality. The results in Table 9 demonstrate that the explanatory variables explain more than 62% of the variance on the dependent variable. Cohen [ 125 ] classifies the R 2 value of 2% as a moderate influence in social and behavioral sciences, while 13 and 26% are considered medium and large effects, respectively. Therefore, the explanatory variables substantially impact this study's models. Similarly, the F statistics explain all independent variables jointly explain the dependent one. For the two-step system GMM, the result fails to reject the null hypothesis of no first (AR(1)) and second-order (AR(2)) serial correlation, indicating that there is no first and second-order serial correlation. In addition, the Hansen [ 126 ] and Sargan [ 127 ] tests fail to reject the null hypothesis of the overall validity of the instruments used, which implies too many instruments do not weaken the model.

Robustness checks

The author believes the above findings may not be enough for policy recommendations unless robustness checks are undertaken. Hence, the study estimated all models without the natural logarithm of the dependent variables (see Table 10 ). The model 1A result reveals, similar to the above results, individuals’ prevalence for undernourishment significantly reduces their life expectancy in SSA countries. That means a 1% increase in the people's prevalence of undernourishment reduces their life expectancy by 0.1924 PPs. Moreover, in model 1B , life expectancy rises by 0.1763 PPs with every 1% increase in average dietary energy supply. In model 1C , the rise in infants’ prevalence for undernourishment has a positive and significant effect on their mortality rate in SSA countries. The FE result implies that a 1% rise in infants’ prevalence for undernourishment increases their mortality rate by 0.9785 PPs. The GMM result in model 1D indicates that improvement in average dietary energy supply significantly reduces infant mortality. Further, the Granger causality result confirms that the null hypothesis of change in the prevalence of undernourishment and average dietary energy supply does not homogeneously cause health outcomes and is rejected at a 1% level of significance. This implies a change in food insecurity does Granger-cause health outcomes in SSA countries (see Table 10 ).

The study also conducted further robustness checks using the same dependent variables (as Table 9 ) but different estimation techniques. The results confirm that people’s prevalence of undernourishment has a negative and significant effect on their life expectancy, but improvement in average dietary energy supply significantly increases life expectancy in SSA countries. However, the incidence of undernourishment in infants contributes to their mortality; however, progress in average dietary energy supply for infants significantly reduces their mortality (see Table 11 ).

The main objective of this study is to examine the impact of food insecurity on the health outcomes of SSA countries. Accordingly, the DKSE result of model 1A confirms that the rise in people’s prevalence for undernourishment significantly reduces their life expectancy in SSA countries. However, the FE result shows that an increment in the prevalence of undernourishment has a positive and significant impact on infant mortality in model 1C . This indicates that the percentage of the population whose food intake is insufficient to meet dietary energy requirements is high, which leads to reduce life expectancy but increases infant mortality in SSA countries. The reason for this result is linked to the insufficient food supply in SSA due to low production and yields, primitive tools, lack of supporting smallholder farms and investment in infrastructure, and government policies. Besides, even though the food is available, it is not distributed fairly according to the requirements of individuals. Moreover, inadequate access to food, poor nutrition, and chronic illnesses are caused by a lack of well-balanced diets. In addition, many of these countries are impacted by poverty, making it difficult for citizens to afford nutritious food. All these issues combine to create an environment where individuals are more likely to suffer malnutrition-related illnesses, resulting in a lower life expectancy rate. The DKSE estimation result in model 1B reveals that improvement in average dietary energy supply positively impacts people's life expectancy in SSA countries. However, the improvement in average dietary energy supply reduces infant mortality.

Based on the above results, we can conclude that food insecurity harms SSA nations' health outcomes. This is because the prevalence of undernourishment leads to increased infant mortality by reducing the vulnerability, severity, and duration of infectious diseases such as diarrhea, pneumonia, malaria, and measles. Similarly, the prevalence of undernourishment can reduce life expectancy by increasing the vulnerability, severity, and duration of infectious diseases. However, food security improves health outcomes – the rise in average dietary energy supply reduces infant mortality and increases the life expectancy of individuals.

Several facts and theories support the above findings. For instance, similar to the theoretical and conceptual framework section, food insecurity in SSA countries can affect health outcomes in nutritional, mental health, and behavioral channels. According to FAO et al. [ 128 ], the prevalence of undernourishment increased in Africa from 17.6% of the population in 2014 to 19.1% in 2019. This figure is more than twice the global average and the highest of all regions of the world. Similarly, SSA is the world region most at risk of food insecurity [ 129 ]. According to Global Nutrition [ 130 ] report, anemia affects an estimated 39.325% of women of reproductive age. Some 13.825% of infants have a low weight at birth in the SSA region. Excluding middle African countries (due to lack of data), the estimated average prevalence of infants aged 0 to 5 months who are exclusively breastfed is 35.73%, which is lower than the global average of 44.0%. Moreover, SSA Africa still experiences a malnutrition burden among children aged under five years. The average prevalence of overweight is 8.15%, which is higher than the global average of 5.7%. The prevalence of stunting is 30.825%—higher than the worldwide average of 22%. Conversely, the SSA countries’ prevalence of wasting is 5.375%, which is higher than most regions such as Central Asia, Eastern Asia, Western Asia, Latin America and the Caribbean, and North America. The SSA region's adult population also faces a malnutrition burden: an average of 9.375% of adult (aged 18 and over) women live with diabetes, compared to 8.25% of men. Meanwhile, 20.675% of women and 7.85% of men live with obesity.

According to Saltzman et al. [ 17 ], micronutrient deficiencies can affect people’s health throughout their life cycle. For instance, at the baby age, it causes (low birth weight, higher mortality rate, and impaired mental development), child (stunting, reduced mental capacity, frequent infections, reduced learning capacity, higher mortality rate), adolescent (stunting, reduced mental capacity, fatigue, and increased vulnerability to infection), pregnant women (increased mortality and perinatal complications), adult (reduced productivity, poor socio-economic status, malnutrition, and increased risk of chronic disease), elderly (increased morbidity (including osteoporosis and mental impairment), and higher mortality rate).

Though this study attempts to fill the existing gaps, it also has limitations. It examined the impact of food insecurity on infant mortality; however, their association is reflected indirectly through other health outcomes. Hence, future studies can extend this study by examining the indirect effect of food insecurity on infant mortality, which helps to look at in-depth relationships between the variables. Moreover, this study employed infant mortality whose age is below one year; hence, future studies can broaden the scope by decomposing infant mortality into (neonatal and postnatal) and under-five mortality.

Millions of people are dying every year due to hunger and hunger-related diseases worldwide, especially in SSA countries. Currently, the link between food insecurity and health status is on researchers' and policymakers' agendas. However, macro-level findings in this area for most concerned countries like SSA have been given only limited attention. Therefore, this study examined the impact of food insecurity on life expectancy and infant mortality rates. The study mainly employs DKSE, FE, two-step GMM, and Granger causality approaches, along with other estimation techniques for robustness checks for the years between 2001 and 2018. The result confirms that food insecurity harms health outcomes, while food security improves the health status of SSA nations'. That means that a rise in undernourishment increases the infant mortality rate and reduces life expectancy. However, an improvement in the average dietary energy supply reduces infant mortality and increases life expectancy. Therefore, SSA countries need to guarantee their food accessibility both in quality and quantity, which improves health status. Both development experts and political leaders agree that Africa has the potential for agricultural outputs, can feed the continent, and improve socio-economic growth. Besides, more than half of the world's unused arable land is found in Africa. Therefore, effective utilization of natural resources is essential to achieve food security. Moreover, since the majority of the food in SSA is produced by smallholder farmers [ 131 ] while they are the most vulnerable to food insecurity and poverty [ 132 , 133 ]; hence, special focus and support should be given to smallholder farmers that enhance food self-sufficiency. Further, improvement in investment in agricultural research; improvement in markets, infrastructures, and institutions; good macroeconomic policies and political stability; and developing sub-regional strategies based on their agroecological zone are crucial to overcoming food insecurity and improving health status. Finally, filling a stomach is not sufficient; hence, a person's diet needs to be comprehensive and secure, balanced (including all necessary nutrients), and available and accessible. Therefore, SSA countries should ensure availability, accessibility, usability, and sustainability to achieve food and nutrition security.

Availability of data and materials

The datasets used and/or analyzed during the current study are available in supplementary materials.

Abbreviations

Augmented Dickey–Fuller

Acquired Immunodeficiency Syndrome

Average Dietary Energy Supply

Common Correlated Effects Mean Group

Common Correlated Effects Pooled

Cross-Sectional Dependence

Cross-Sectionally Augmented Panel Unit Root Test

Cross-Section Augmented Autoregressive Distributed Lag

Cross-Section Augmented Distributed Lag

Continuously Updated Bias-Corrected

Continuously Updated Full Modified

Dynamic Fixed Effect

Driscoll-Kraay Standard Errors

Dynamic Ordinary Least Square

Error Correction Model

Food and Agricultural Organization

Fixed Effect

Feasible Generalised Least Squares

Fully Modified Ordinary Least Square

Gross Domestic Product (GDP) per capita

Generalised Method of Momentum

Domestic General Government Health Expenditure

Human Immunodeficiency Virus

Integration at First Difference

International Fund for Agricultural Development

Infant Mortality Rate

Im, Pesaran, Shin

Lag of Infant Mortality Rate

Lag of Natural Logarithm of Infant Mortality Rate

Life Expectancy at Birth

Levin, Lin, and Chu

Lagrange Multiplier

Natural Logarithm of Infant Mortality Rate

Natural Logarithm of Life Expectancy at Birth

Mean Years of Schooling

Ordinary Least Squares

Panel-Corrected Standard Error

Pooled Mean Group

Prevalence of Undernourishment

Random Effect

Sustainable Development Goals

Sub-Saharan African

Statistical Software

Seemingly Unrelated Regression

Urbanisation

World Food Programme

World Health Organization

Weighted Least Squares

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11 global health issues to watch in 2023, according to IHME experts

Published December 20, 2022

As the year 2022 winds down, what is next on the horizon for global health? We turned to our IHME experts for their takes on the most critical health issues to watch in 2023. Entering our fourth year grappling with COVID-19, most of our experts pointed to issues that were impacted in some way by the pandemic, like long COVID and mental health. They also offered potential interventions to address the threats. 

The faculty members and research scientists who shared their insights are professor Mohsen Naghavi , assistant professor Hwme Kyu , assistant professor Angela Micah , affiliate professor Michael Brauer , affiliate assistant professor Alize Ferrari , lead research scientist Liane Ong , lead research scientist Sarah Wulf Hanson, postdoctoral scholar Christian Razo, postdoctoral scholar Ewerton Cousin, and researcher Emma Nichols. Their comments have been lightly edited for clarity.

1. Long COVID

“Long COVID is absolutely a health issue to watch in 2023. The health impact of long COVID often disrupts a person’s ability to engage with school, work, or relationships for months at a time.   “People with long COVID need diagnostic and proper rehabilitation support from primary care physicians. We desperately need more research to find effective treatments as well as preventive measures to reduce the risk of developing long COVID.” — Sarah Wulf Hanson, lead research scientist of the non-fatal and risk quality enhancement team and lead author of the JAMA paper on long COVID     

2. Mental health

“Mental disorders are a leading cause of disability worldwide, with no evidence of a decrease in this burden since 1990. The impact of the COVID-19 pandemic, war, and violence on mental health remains a priority, specifically understanding how these have impacted the prevalence and burden of mental disorders in 2022 onward and how countries should be adapting their mental health response accordingly. 

“Currently in the GBD study, we investigate childhood sexual abuse, intimate partner violence, and bullying victimization as risk factors for mental disorders. Going forward, we need a better understanding of the other risk factors for mental disorders, how these vary across different populations, and how to offer the best opportunities for prevention at the population level.” — Alize Ferrari, affiliate assistant professor and team lead for estimating the burden of mental disorders     

3. Impact of climate change

“Climate change is already affecting the health of millions of people all over the world, and more importantly, climate change will worsen throughout this century. People are experiencing both the direct effects of extreme heat that we measure in the GBD and a myriad of indirect effects. Flooding can force people from their homes and affect their mental health, droughts and storms can impact food security and water availability, and wildfire smoke episodes can increase air pollution. As we know from the pandemic, preparedness is key, and we are far from prepared for the health impacts of a warmer climate.

“Most of the emphasis to date on climate change – and rightly so – has been on what we call mitigation: reducing the emissions that lead to global warming. Yet to date these efforts have been far too modest. We are now at a point where climate change is clearly with us, and much more attention needs to be put on minimizing the impacts on global health through adaptation or enhancing resilience. 

“One aspect of this is improving overall health and enhancing socioeconomic development because we know that those who are more vulnerable will suffer the most. In addition, there are technological solutions that can support adaptation , such as the use of drought-resistant crops, increasing vegetation in cities to reduce the urban heat island effect, or repurposing land use to adapt to rising sea levels. 

“Air pollution is one of the leading global risk factors that we evaluate in the GBD – currently responsible for about 8% of all global mortality – yet it is a problem with known solutions. Increasing the speed at which we address air pollution will save lives today. Those solutions will move the world closer to the net-zero carbon emissions goals that we need to ultimately address the causes of climate change.” — Michael Brauer, affiliate professor and team lead for estimating the burden of environmental, occupational, and dietary risk factors     

4. Cardiovascular disease

“Cardiovascular diseases such as ischemic heart disease and stroke are the leading causes of death globally, accounting for 28% of total deaths in 2021. Additionally, cardiovascular diseases substantially contribute to health loss and the economic burden on health care systems. Most cardiovascular diseases can be prevented by addressing modifiable cardiovascular risk factors such as high blood pressure, high cholesterol, obesity, dietary risks, smoking, and air pollution.” — Christian Razo, postdoctoral scholar on the team estimating cardiovascular disease burden and lead author of a Burden of Proof study on the effects of elevated systolic blood pressure on ischemic heart disease     

5. Lower respiratory infections

“Lower respiratory infections (LRI), especially respiratory syncytial virus (RSV) and influenza, are health issues to watch in 2023.   “ We saw a general decline in influenza and RSV infections in 2020 due to COVID-19 mitigation measures such as mask use and social distancing. With the relaxation of these measures, many young children who haven’t been exposed to RSV in the past couple of years are being infected, resulting in RSV outbreaks . Countries have also experienced a surge in influenza across all ages.    “ Annual influenza vaccination provides an opportunity to reduce the LRI burden attributable to flu. There is no vaccine yet to prevent RSV, but promising vaccine trials are underway . ” — Hmwe Kyu, assistant professor and team lead for estimating the burden of HIV, TB, and select infectious diseases    “ After experiencing significant disruptions to health care systems worldwide due to the COVID-19 pandemic, the increases in respiratory infections and other communicable diseases have been added to the existing burden of chronic non-communicable diseases, creating a dual burden of disease exacerbated by social inequalities observed globally.” — Christian Razo     

6. Poverty’s role in health

“It seems that poverty is the mother of inequality in health. The unequal distribution of resources has expanded due to climate change and increasing violence. Low- and middle-income countries experience worse health outcomes than high-income countries: the life expectancy is 34 years lower, the under-5 mortality around 100 times higher, deaths due to interpersonal violence and suicide are 30 times higher, and deaths attributable to antimicrobial resistance (AMR) are 12 times higher. We must urgently address the impact of poverty on health, life, and death.” — Mohsen Naghavi, professor and team lead for causes of death, shocks, intermediate causes and estimating the burden of AMR     

7. Health systems strengthening

“Strengthening health systems globally remains a critical aspect of what is needed for resilient health systems. This will be particularly relevant as countries refocus their resources and attention after the acute phase of the COVID-19 pandemic.

“I think what is needed is a longer-term commitment from donors and governments – financial and human resources, governance structures, management, information systems – to ensure that interventions are set up for long-term sustainability and can deliver the outcomes that are aspired to across health systems.” — Angela Micah, assistant professor and co-lead of the development assistance for health resource tracking team

“Given the immense strain of COVID-19 on primary care and hospital systems the past two-and-a-half years, attention should be paid to building back up the health care system and enabling frontline workers to do their jobs effectively. Public health leaders and policymakers need to reflect on lessons learned from the pandemic to prevent health care system collapse in the next crisis and to ensure that people who need care can access quality health care.” — Sarah Wulf Hanson     

8. Diabetes

“Diabetes is the fourth main cause of DALYs in Latin America and the Caribbean, and among the top five causes, it is the only one that shows an increase in the age-standardized rate compared to 1990. The burden of diabetes in the Americas is large, increasing, heterogeneous, and expanding, especially in countries in Central Latin America and the Caribbean. 

“Population-based interventions such as taxes and incentives, more informative food labeling, improving the built environment to facilitate exercise, and greater advocacy to inform people of the risk diabetes poses, combined with expanded health education to combat diabetes risk factors, seem the best options. Policies aimed to help avoid weight gain and improve dietary quality are also paramount. 

“Another important aspect is improving the response of health systems in terms of access and quality care. These should include universal access to low-cost insulin and oral anti-diabetic medication to decrease avoidable deaths from acute complications. Health systems should also strive to furnish feedback from their administrative data systems to providers to help orient diabetes care.” — Ewerton Cousin, postdoctoral scholar on the neglected tropical diseases team and lead author of The Lancet Diabetes & Endocrinology paper on diabetes burden in the Americas     

9. Road injuries

“Road injuries are still an important and preventable injury. For people 15-49 years old, road injuries are the leading cause of death .

“Interventions such as helmets, seatbelts, airbags, speed limits, and laws discouraging alcohol-impaired driving do work. But implementation is not the only thing that determines their success – human behavior must adhere to those policies to make them effective." — Liane Ong, lead research scientist and team lead for estimating the burden of injuries, chronic respiratory diseases, neurological disorders, substance use disorders, diabetes and kidney diseases, sensory organ diseases, musculoskeletal disorders, and impairments (BIRDS)     

10. Dementia

“Anticipated trends in population growth and population aging are expected to lead to large increases in the number of people affected by dementia globally, underscoring the public health importance of dementia. To adequately care for those with dementia, appropriate planning for the necessary supports and services required is needed.

“Interventions targeting modifiable risk factors, such as low education, smoking, and high blood sugar, have the potential to reduce the overall societal burden and should be prioritized.” — Emma Nichols, researcher on the BIRDS team and lead author of The Lancet Public Health paper on dementia forecasting     

11. Population aging

“Adapting health systems to support older populations’ needs should be front of mind in 2023. Globally, the proportion of the population that is above 65 is expected to increase in the coming years. While a lot of attention (and rightfully so) has historically focused on diseases that affect children, it will be prudent to begin thinking through and systematically planning for some of these upcoming changes in demography as well, especially in low- and middle-income countries.” — Angela Micah

Superbugs could jeopardise food security for over two billion people and increase annual health care costs by US$ 159 billion annually by 2050, finds most extensive modelling to date 

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Research Topics & Ideas: Healthcare

F inding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Topics & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

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Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

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19 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

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Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

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can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

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I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

I have been racking my brain for a while on what topic will be suitable for my PhD in health informatics. I want a qualitative topic as this is my strong area.

Hi, may I please be assisted with research topics in the medical laboratory sciences

How do i frame a qualitative topic that will be suitable for the use of calibrated drape among midwifes. this is a thesis for my master programme in midwifery education.

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Student mental health is in crisis. Campuses are rethinking their approach

Amid massive increases in demand for care, psychologists are helping colleges and universities embrace a broader culture of well-being and better equipping faculty to support students in need

Vol. 53 No. 7 Print version: page 60

• Mental Health

By nearly every metric, student mental health is worsening. During the 2020–2021 school year, more than 60% of college students met the criteria for at least one mental health problem, according to the Healthy Minds Study, which collects data from 373 campuses nationwide ( Lipson, S. K., et al., Journal of Affective Disorders , Vol. 306, 2022 ). In another national survey, almost three quarters of students reported moderate or severe psychological distress ( National College Health Assessment , American College Health Association, 2021).

Even before the pandemic, schools were facing a surge in demand for care that far outpaced capacity, and it has become increasingly clear that the traditional counseling center model is ill-equipped to solve the problem.

“Counseling centers have seen extraordinary increases in demand over the past decade,” said Michael Gerard Mason, PhD, associate dean of African American Affairs at the University of Virginia (UVA) and a longtime college counselor. “[At UVA], our counseling staff has almost tripled in size, but even if we continue hiring, I don’t think we could ever staff our way out of this challenge.”

Some of the reasons for that increase are positive. Compared with past generations, more students on campus today have accessed mental health treatment before college, suggesting that higher education is now an option for a larger segment of society, said Micky Sharma, PsyD, who directs student life’s counseling and consultation service at The Ohio State University (OSU). Stigma around mental health issues also continues to drop, leading more people to seek help instead of suffering in silence.

But college students today are also juggling a dizzying array of challenges, from coursework, relationships, and adjustment to campus life to economic strain, social injustice, mass violence, and various forms of loss related to Covid -19.

As a result, school leaders are starting to think outside the box about how to help. Institutions across the country are embracing approaches such as group therapy, peer counseling, and telehealth. They’re also better equipping faculty and staff to spot—and support—students in distress, and rethinking how to respond when a crisis occurs. And many schools are finding ways to incorporate a broader culture of wellness into their policies, systems, and day-to-day campus life.

“This increase in demand has challenged institutions to think holistically and take a multifaceted approach to supporting students,” said Kevin Shollenberger, the vice provost for student health and well-being at Johns Hopkins University. “It really has to be everyone’s responsibility at the university to create a culture of well-being.”

Higher caseloads, creative solutions

The number of students seeking help at campus counseling centers increased almost 40% between 2009 and 2015 and continued to rise until the pandemic began, according to data from Penn State University’s Center for Collegiate Mental Health (CCMH), a research-practice network of more than 700 college and university counseling centers ( CCMH Annual Report , 2015 ).

That rising demand hasn’t been matched by a corresponding rise in funding, which has led to higher caseloads. Nationwide, the average annual caseload for a typical full-time college counselor is about 120 students, with some centers averaging more than 300 students per counselor ( CCMH Annual Report , 2021 ).

“We find that high-caseload centers tend to provide less care to students experiencing a wide range of problems, including those with safety concerns and critical issues—such as suicidality and trauma—that are often prioritized by institutions,” said psychologist Brett Scofield, PhD, executive director of CCMH.

To minimize students slipping through the cracks, schools are dedicating more resources to rapid access and assessment, where students can walk in for a same-day intake or single counseling session, rather than languishing on a waitlist for weeks or months. Following an evaluation, many schools employ a stepped-care model, where the students who are most in need receive the most intensive care.

Given the wide range of concerns students are facing, experts say this approach makes more sense than offering traditional therapy to everyone.

“Early on, it was just about more, more, more clinicians,” said counseling psychologist Carla McCowan, PhD, director of the counseling center at the University of Illinois at Urbana-Champaign. “In the past few years, more centers are thinking creatively about how to meet the demand. Not every student needs individual therapy, but many need opportunities to increase their resilience, build new skills, and connect with one another.”

Students who are struggling with academic demands, for instance, may benefit from workshops on stress, sleep, time management, and goal-setting. Those who are mourning the loss of a typical college experience because of the pandemic—or facing adjustment issues such as loneliness, low self-esteem, or interpersonal conflict—are good candidates for peer counseling. Meanwhile, students with more acute concerns, including disordered eating, trauma following a sexual assault, or depression, can still access one-on-one sessions with professional counselors.

As they move away from a sole reliance on individual therapy, schools are also working to shift the narrative about what mental health care on campus looks like. Scofield said it’s crucial to manage expectations among students and their families, ideally shortly after (or even before) enrollment. For example, most counseling centers won’t be able to offer unlimited weekly sessions throughout a student’s college career—and those who require that level of support will likely be better served with a referral to a community provider.

“We really want to encourage institutions to be transparent about the services they can realistically provide based on the current staffing levels at a counseling center,” Scofield said.

The first line of defense

Faculty may be hired to teach, but schools are also starting to rely on them as “first responders” who can help identify students in distress, said psychologist Hideko Sera, PsyD, director of the Office of Equity, Inclusion, and Belonging at Morehouse College, a historically Black men’s college in Atlanta. During the pandemic, that trend accelerated.

“Throughout the remote learning phase of the pandemic, faculty really became students’ main points of contact with the university,” said Bridgette Hard, PhD, an associate professor and director of undergraduate studies in psychology and neuroscience at Duke University. “It became more important than ever for faculty to be able to detect when a student might be struggling.”

Many felt ill-equipped to do so, though, with some wondering if it was even in their scope of practice to approach students about their mental health without specialized training, Mason said.

Schools are using several approaches to clarify expectations of faculty and give them tools to help. About 900 faculty and staff at the University of North Carolina have received training in Mental Health First Aid , which provides basic skills for supporting people with mental health and substance use issues. Other institutions are offering workshops and materials that teach faculty to “recognize, respond, and refer,” including Penn State’s Red Folder campaign .

Faculty are taught that a sudden change in behavior—including a drop in attendance, failure to submit assignments, or a disheveled appearance—may indicate that a student is struggling. Staff across campus, including athletic coaches and academic advisers, can also monitor students for signs of distress. (At Penn State, eating disorder referrals can even come from staff working in food service, said counseling psychologist Natalie Hernandez DePalma, PhD, senior director of the school’s counseling and psychological services.) Responding can be as simple as reaching out and asking if everything is going OK.

Referral options vary but may include directing a student to a wellness seminar or calling the counseling center to make an appointment, which can help students access services that they may be less likely to seek on their own, Hernandez DePalma said. Many schools also offer reporting systems, such as DukeReach at Duke University , that allow anyone on campus to express concern about a student if they are unsure how to respond. Trained care providers can then follow up with a welfare check or offer other forms of support.

“Faculty aren’t expected to be counselors, just to show a sense of care that they notice something might be going on, and to know where to refer students,” Shollenberger said.

At Johns Hopkins, he and his team have also worked with faculty on ways to discuss difficult world events during class after hearing from students that it felt jarring when major incidents such as George Floyd’s murder or the war in Ukraine went unacknowledged during class.

Many schools also support faculty by embedding counselors within academic units, where they are more visible to students and can develop cultural expertise (the needs of students studying engineering may differ somewhat from those in fine arts, for instance).

When it comes to course policy, even small changes can make a big difference for students, said Diana Brecher, PhD, a clinical psychologist and scholar-in-residence for positive psychology at Toronto Metropolitan University (TMU), formerly Ryerson University. For example, instructors might allow students a 7-day window to submit assignments, giving them agency to coordinate with other coursework and obligations. Setting deadlines in the late afternoon or early evening, as opposed to at midnight, can also help promote student wellness.

At Moraine Valley Community College (MVCC) near Chicago, Shelita Shaw, an assistant professor of communications, devised new class policies and assignments when she noticed students struggling with mental health and motivation. Those included mental health days, mindful journaling, and a trip with family and friends to a Chicago landmark, such as Millennium Park or Navy Pier—where many MVCC students had never been.

Faculty in the psychology department may have a unique opportunity to leverage insights from their own discipline to improve student well-being. Hard, who teaches introductory psychology at Duke, weaves in messages about how students can apply research insights on emotion regulation, learning and memory, and a positive “stress mindset” to their lives ( Crum, A. J., et al., Anxiety, Stress, & Coping , Vol. 30, No. 4, 2017 ).

Along with her colleague Deena Kara Shaffer, PhD, Brecher cocreated TMU’s Thriving in Action curriculum, which is delivered through a 10-week in-person workshop series and via a for-credit elective course. The material is also freely available for students to explore online . The for-credit course includes lectures on gratitude, attention, healthy habits, and other topics informed by psychological research that are intended to set students up for success in studying, relationships, and campus life.

“We try to embed a healthy approach to studying in the way we teach the class,” Brecher said. “For example, we shift activities every 20 minutes or so to help students sustain attention and stamina throughout the lesson.”

Creative approaches to support

Given the crucial role of social connection in maintaining and restoring mental health, many schools have invested in group therapy. Groups can help students work through challenges such as social anxiety, eating disorders, sexual assault, racial trauma, grief and loss, chronic illness, and more—with the support of professional counselors and peers. Some cater to specific populations, including those who tend to engage less with traditional counseling services. At Florida Gulf Coast University (FGCU), for example, the “Bold Eagles” support group welcomes men who are exploring their emotions and gender roles.

The widespread popularity of group therapy highlights the decrease in stigma around mental health services on college campuses, said Jon Brunner, PhD, the senior director of counseling and wellness services at FGCU. At smaller schools, creating peer support groups that feel anonymous may be more challenging, but providing clear guidelines about group participation, including confidentiality, can help put students at ease, Brunner said.

Less formal groups, sometimes called “counselor chats,” meet in public spaces around campus and can be especially helpful for reaching underserved groups—such as international students, first-generation college students, and students of color—who may be less likely to seek services at a counseling center. At Johns Hopkins, a thriving international student support group holds weekly meetings in a café next to the library. Counselors typically facilitate such meetings, often through partnerships with campus centers or groups that support specific populations, such as LGBTQ students or student athletes.

“It’s important for students to see counselors out and about, engaging with the campus community,” McCowan said. “Otherwise, you’re only seeing the students who are comfortable coming in the door.”

Peer counseling is another means of leveraging social connectedness to help students stay well. At UVA, Mason and his colleagues found that about 75% of students reached out to a peer first when they were in distress, while only about 11% contacted faculty, staff, or administrators.

“What we started to understand was that in many ways, the people who had the least capacity to provide a professional level of help were the ones most likely to provide it,” he said.

Project Rise , a peer counseling service created by and for Black students at UVA, was one antidote to this. Mason also helped launch a two-part course, “Hoos Helping Hoos,” (a nod to UVA’s unofficial nickname, the Wahoos) to train students across the university on empathy, mentoring, and active listening skills.

At Washington University in St. Louis, Uncle Joe’s Peer Counseling and Resource Center offers confidential one-on-one sessions, in person and over the phone, to help fellow students manage anxiety, depression, academic stress, and other campus-life issues. Their peer counselors each receive more than 100 hours of training, including everything from basic counseling skills to handling suicidality.

Uncle Joe’s codirectors, Colleen Avila and Ruchika Kamojjala, say the service is popular because it’s run by students and doesn’t require a long-term investment the way traditional psychotherapy does.

“We can form a connection, but it doesn’t have to feel like a commitment,” said Avila, a senior studying studio art and philosophy-neuroscience-psychology. “It’s completely anonymous, one time per issue, and it’s there whenever you feel like you need it.”

As part of the shift toward rapid access, many schools also offer “Let’s Talk” programs , which allow students to drop in for an informal one-on-one session with a counselor. Some also contract with telehealth platforms, such as WellTrack and SilverCloud, to ensure that services are available whenever students need them. A range of additional resources—including sleep seminars, stress management workshops, wellness coaching, and free subscriptions to Calm, Headspace, and other apps—are also becoming increasingly available to students.

Those approaches can address many student concerns, but institutions also need to be prepared to aid students during a mental health crisis, and some are rethinking how best to do so. Penn State offers a crisis line, available anytime, staffed with counselors ready to talk or deploy on an active rescue. Johns Hopkins is piloting a behavioral health crisis support program, similar to one used by the New York City Police Department, that dispatches trained crisis clinicians alongside public safety officers to conduct wellness checks.

A culture of wellness

With mental health resources no longer confined to the counseling center, schools need a way to connect students to a range of available services. At OSU, Sharma was part of a group of students, staff, and administrators who visited Apple Park in Cupertino, California, to develop the Ohio State: Wellness App .

Students can use the app to create their own “wellness plan” and access timely content, such as advice for managing stress during final exams. They can also connect with friends to share articles and set goals—for instance, challenging a friend to attend two yoga classes every week for a month. OSU’s apps had more than 240,000 users last year.

At Johns Hopkins, administrators are exploring how to adapt school policies and procedures to better support student wellness, Shollenberger said. For example, they adapted their leave policy—including how refunds, grades, and health insurance are handled—so that students can take time off with fewer barriers. The university also launched an educational campaign this fall to help international students navigate student health insurance plans after noticing below average use by that group.

Students are a key part of the effort to improve mental health care, including at the systemic level. At Morehouse College, Sera serves as the adviser for Chill , a student-led advocacy and allyship organization that includes members from Spelman College and Clark Atlanta University, two other HBCUs in the area. The group, which received training on federal advocacy from APA’s Advocacy Office earlier this year, aims to lobby public officials—including U.S. Senator Raphael Warnock, a Morehouse College alumnus—to increase mental health resources for students of color.

“This work is very aligned with the spirit of HBCUs, which are often the ones raising voices at the national level to advocate for the betterment of Black and Brown communities,” Sera said.

Despite the creative approaches that students, faculty, staff, and administrators are employing, students continue to struggle, and most of those doing this work agree that more support is still urgently needed.

“The work we do is important, but it can also be exhausting,” said Kamojjala, of Uncle Joe’s peer counseling, which operates on a volunteer basis. “Students just need more support, and this work won’t be sustainable in the long run if that doesn’t arrive.”

Further reading

Overwhelmed: The real campus mental-health crisis and new models for well-being The Chronicle of Higher Education, 2022

Mental health in college populations: A multidisciplinary review of what works, evidence gaps, and paths forward Abelson, S., et al., Higher Education: Handbook of Theory and Research, 2022

Student mental health status report: Struggles, stressors, supports Ezarik, M., Inside Higher Ed, 2022

Before heading to college, make a mental health checklist Caron, C., The New York Times, 2022

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Identifying health problems and health research priorities in developing countries

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• 1 London School of Hygiene and Tropical Medicine, UK.
• PMID: 2661849

When we were invited to prepare this background paper on the health problems of the developing countries for the Commission on Health Research for Development, our first thought was to compile and organize available data on the causes of morbidity and mortality affecting different age groups in various populations. It soon became clear that this would not be especially useful. There are major gaps in the available data, particularly from the poorer countries and for people above 5 years of age. The data that are available are often of poor or uncertain quality, collected from unrepresentative or undefined subpopulations, and not strictly comparable due to different definitions and data-collection methods. Additionally, in the absence of agreed definitions and analytical frameworks, it is not clear what could or should be done with the data on health problems so amassed. More fundamentally, we have come to doubt whether the current array of epidemiological concepts and tools is sufficient for the task. We therefore decided that, while giving an overview of current knowledge on levels and trends of morbidity and mortality, the emphasis of this paper should be more towards concepts, methods, and data deficiencies. In Section 1, we set out definitions and frameworks for considering health problems and health research; we review recent conceptual models for the analysis of the determinants of child survival; and we outline a framework, focusing on modifiable determinants of health and life-cycle health effects, which is used in subsequent sections. In Section 2, relationships between national and societal level determinants and health are reviewed and then set aside. In Section 3, we review available data on world patterns and trends of morbidity and mortality, highlighting the data deficiencies and lacunae. In Section 4, we follow the life of a woman in a developing country and examine the health problems, and their determinants, which she and her children face. In Section 5, we draw these strands together and, having reviewed current approaches to prioritizing health problems and suggested some ways in which they could be improved, in Section 6 identify several research priorities, emphasizing the need for methodological research. This paper was commissioned in March 1987; prepared in draft and presented to a meeting at Chateau de Bossey, Geneva, Switzerland during 15-17 July; and revised and completed in September 1987. It is in no sense definitive or final.(ABSTRACT TRUNCATED AT 400 WORDS)

PIP: The fact that economic progress has a bearing on health can be seen in most developing countries where widespread poverty causes poor health and high mortality. Childhood mortality is highest in Africa and in Southern Asia. The rate of decline in mortality has decreased in these areas since the 1950s. In Sri Lanka, approximately 5% of the children 5 years old die, yet yearly 1/3 of the children 5 Afghanistan and a few West African countries die. In less developed countries, adult mortality is high: in places where the life expectancy of a 15-year-old is under 50 years, 30-40% will die before age 60. 80-90% of the deaths from water and food borne diseases are accounted for by diarrhea and dysentery, and 60-70% of the deaths from airborne diseases by pneumonia and bronchitis. Present estimates from 4 localities indicate that measles, malaria, tetanus, and acute respiratory infection account for more than 90% of all child mortality. Various estimates suggest that there are 100-300 million cases of malaria and 1-2 million malaria-related deaths annually. Estimates indicate a ratio of abortions varying between 9/1000 live births in East Africa to 325/1000 live births in Latin America. 1986 WHO data indicate that induced abortion is responsible for 7-50% of all maternal deaths in developing countries. More than 90 countries now that operational diarrheal disease control programs, 47 countries are producing oral rehydration solutions, 8450 health personnel have been trained in diarrhea program supervisory skills, and oral rehydration use rates are slowly rising.

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A Comprehensive Analysis of Mental Health Problems in India and the Role of Mental Asylums

Vanee r meghrajani.

1 Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Manvi Marathe

2 Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Ritika Sharma

3 Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Ashwini Potdukhe

4 Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Mayur B Wanjari

5 Research Scientist, Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

Avinash B Taksande

6 Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND

This review article provides a comprehensive overview of the current state of mental health in India, highlighting the challenges faced, the existing initiatives, and the future directions for improving mental healthcare delivery. India is grappling with a high prevalence of mental health disorders, including depression, anxiety disorders, bipolar disorder, schizophrenia, and substance use disorders. The burden of mental health issues on individuals, families, and society is immense, leading to reduced quality of life, impaired functioning, and significant economic and social consequences. Various social and cultural factors, such as stigma, discrimination, gender inequalities, poverty, rapid urbanization, and cultural beliefs surrounding mental illness, further exacerbate the challenges of addressing mental health problems. Access to mental healthcare remains a significant concern, with considerable gaps in access to and quality of treatment and limited availability of mental health professionals, especially in rural areas. Inadequate infrastructure, a lack of awareness, and insufficient integration into primary healthcare systems hinder access to appropriate care. The historical development of mental asylums in India is examined, highlighting their establishment, purpose, and evolution over time. Critiques and challenges associated with mental asylums are discussed, including stigmatization, human rights concerns, the absence of human center approaches, quality of care, and the need for alternative approaches to mental healthcare.

Introduction and background

With its vast population and diverse demographics, India confronts a substantial mental health burden that warrants urgent attention [ 1 ]. Mental disorders cut across various age groups, socioeconomic backgrounds, and geographical regions, impacting individuals from all walks of life [ 1 ]. The repercussions of these conditions encompass personal suffering, impaired daily functioning, and extensive societal costs [ 1 ]. The prevalence of mental health disorders in India has risen steadily in recent years, contributing to the escalating public health concern. Estimates suggest that nearly 15% of the Indian population grapples with some form of mental health issue. This figure encompasses many disorders, including anxiety disorders, depression, bipolar disorder, schizophrenia, substance use disorders, and neurodevelopmental disorders [ 2 ].

The consequences of these mental health challenges reverberate throughout society. Firstly, individuals struggling with mental health problems face immense personal anguish and distress, as these conditions often impede their ability to lead fulfilling lives. They may encounter difficulties maintaining relationships, pursuing education or employment opportunities, and participating in social activities [ 3 ]. Moreover, mental health problems substantially affect the overall functioning of communities and the nation. Decreased productivity, both in the workplace and within households, is a significant economic consequence. Mental health issues often lead to absenteeism, reduced work efficiency, and long-term disability, negatively impacting workforce productivity and economic growth [ 4 , 5 ].

The financial burden associated with mental health problems cannot be overlooked. Increased healthcare expenditure is incurred due to the need for mental healthcare services, including diagnosis, treatment, medication, and therapy [ 6 ]. The indirect costs, such as lost productivity and an increased burden on caregivers, further exacerbate the economic impact [ 6 ]. Beyond the economic aspect, mental health problems in India also have far-reaching social implications. Stigma and discrimination surrounding mental disorders persist in many communities, hindering individuals from seeking help and support. This leads to delays in diagnosis and treatment, perpetuating the cycle of suffering and exacerbating the long-term consequences [ 7 ].

The rising prevalence of mental health disorders in India and their multifaceted impacts necessitate a comprehensive understanding of the challenges. Addressing mental health issues becomes crucial not only for the well-being of affected individuals but also for the overall progress and development of the nation. By investigating the role of mental asylums in this context, this review article aims to shed light on potential strategies to tackle mental health problems and improve the lives of individuals grappling with these conditions in India [ 1 , 2 , 6 ]. This review article aims to comprehensively analyze mental health problems in India and explore the role of mental asylums in addressing these challenges. By examining the historical and current context, this review aims to shed light on the strengths, limitations, and potential future directions of mental asylums in the Indian mental health landscape.

Methodology

The literature search strategy involved a comprehensive approach to identifying relevant studies on mental health problems in India. Multiple databases, including PubMed, PsycINFO, and Google Scholar, were searched using a combination of keywords such as "mental health," "India," "prevalence," "burden," "access to care," and "mental health disorders." The search was conducted without any language or date restrictions to ensure the inclusion of a wide range of studies. In addition to academic literature, reports from government agencies, international organizations, and non-governmental organizations were reviewed to capture a holistic understanding of the topic. To ensure the selection of appropriate studies, specific inclusion and exclusion criteria were applied. Inclusion criteria included studies on mental health problems in India, prevalence rates, types of mental health disorders, access to mental healthcare, social and cultural factors influencing mental health, and mental health policies and initiatives in India. Both quantitative and qualitative studies were considered. Studies that provided insights into the challenges, current practices, and future directions for mental healthcare in India were prioritized. Exclusion criteria involved studies that were not specific to mental health or did not pertain to the Indian context. Studies with insufficient data, case reports, editorials, and opinion pieces were also excluded. The focus was primarily on peer-reviewed articles, systematic reviews, meta-analyses, and research reports that provided substantial evidence and analysis of mental health problems in India. The selection of studies involved a two-step process. Initially, titles and abstracts were screened to assess their relevance to the research topic. Subsequently, full-text articles were reviewed based on the inclusion and exclusion criteria. Any discrepancies or uncertainties during the study selection process were resolved through discussion and consensus among the research team members.

Mental health problems in India

Prevalence and Types of Mental Health Disorders

In India, mental health disorders have a high prevalence, impacting a considerable proportion of the population. Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370 per 1000 people in India [ 8 ]. This prevalence encompasses a broad spectrum of mental health disorders, reflecting the diverse challenges individuals face in the country [ 8 ]. The prevalence rates of mental health disorders in India highlight the need for effective interventions and support systems to address the mental well-being of the population. Conditions such as depression, anxiety disorders, bipolar disorder, schizophrenia, and substance use disorders are commonly observed mental health disorders in India [ 8 ].

Depression: Depression is a common mental health disorder characterized by persistent sadness, hopelessness, and a loss of interest or pleasure in activities. At the population level, 3.5% of deaths were attributable to anxiety or depression [ 9 ]. It can negatively impact an individual's mood, thoughts, behavior, and physical well-being. Symptoms of depression may include fatigue, changes in appetite, sleep disturbances, difficulty concentrating, and thoughts of self-harm or suicide. Depression can significantly impair a person's daily functioning, interpersonal relationships, and overall quality of life [ 9 ].

Anxiety disorders: Anxiety disorders are characterized by excessive and persistent worry, fear, or anxiety that significantly interfere with daily functioning. Generalized anxiety disorder involves chronic and excessive worry about various aspects of life. Panic disorder is characterized by recurrent panic attacks, which are intense periods of overwhelming fear and physical symptoms such as heart palpitations and shortness of breath. Phobias involve an intense fear of specific objects, situations, or activities. Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to alleviate anxiety. Anxiety disorders can cause significant distress, avoidance behaviors, and impaired functioning [ 10 ].

Bipolar disorder: Bipolar disorder is characterized by alternating periods of elevated mood (mania or hypomania) and episodes of depression. During manic episodes, individuals may experience heightened energy levels, decreased sleep, racing thoughts, inflated self-esteem, impulsive behavior, and an exaggerated sense of self-importance. Depressive episodes are marked by sadness, loss of interest, fatigue, and changes in appetite and sleep patterns. Bipolar disorder can profoundly impact an individual's emotions, behavior, relationships, and overall functioning [ 11 ].

Schizophrenia: Schizophrenia is a chronic and severe mental disorder that affects a person's perception of reality, thinking processes, emotions, and behavior. Common symptoms include hallucinations (perceiving things that are not there), delusions (false beliefs), disorganized speech and behavior, reduced emotional expression, and social withdrawal. Individuals with schizophrenia may experience difficulties in cognitive functioning, such as problems with memory, attention, and executive functioning. Schizophrenia can significantly impair an individual's ability to think, interact with others, and function in society [ 12 ].

Substance use disorders: Substance use disorders involve the excessive and compulsive use of substances, such as alcohol or drugs, despite negative consequences. These disorders can have significant impacts on mental health. Substance abuse can lead to addiction, dependence, and withdrawal symptoms when the substance is unavailable. Substance use disorders can cause various mental health issues, including mood disorders, anxiety disorders, psychosis, cognitive impairments, and social and occupational problems. The associated problems may include financial difficulties, legal issues, relationship conflicts, and physical health complications [ 13 ].

Social and cultural factors influencing mental health in India

Societal Stigma and Discrimination

Mental illness carries a significant social stigma in Indian society, leading to discrimination and social exclusion for individuals with mental health problems. The stigma surrounding mental illness often stems from misconceptions, fear, and a lack of awareness. This stigma creates barriers to seeking help and support, as individuals may fear judgment, rejection, or negative consequences. Consequently, individuals may delay or avoid seeking treatment, resulting in inadequate or delayed care and further exacerbating their condition [ 14 ].

Gender Inequalities

Gender inequalities in India have a profound impact on mental health. Women, in particular, face unique challenges and are more vulnerable to mental health problems. Factors such as domestic violence, sexual abuse, unequal power dynamics, limited access to education and employment opportunities, and societal expectations can contribute to increased stress, anxiety, and depression among women. The intersectionality of gender with other factors, such as socioeconomic status and caste, further compounds mental health disparities [ 15 ].

Poverty and Socioeconomic Factors

Poverty and socioeconomic disparities play a crucial role in developing and exacerbating mental health disorders in India. Limited resources, including access to quality healthcare, mental health services, and essential social support systems, significantly impact mental well-being. Stressful living conditions, financial instability, and a lack of opportunities for upward mobility contribute to heightened psychological distress and the risk of mental health problems [ 16 ].

Rapid Urbanization and Migration

India's rapid urbanization and migration patterns have significant implications for mental health. Urban areas often present challenges such as social dislocation, loss of social support networks, increased competition, and higher stress levels. The migration process, whether from rural to urban areas or within urban areas, can disrupt social cohesion, traditional support systems, and stability, leading to an increased risk of mental health problems [ 17 ].

Family Dynamics and Societal Pressure

Family dynamics and societal expectations pressure individuals, impacting their mental well-being. Expectations related to education, career success, marriage, and gender roles can create significant stress and anxiety. Interpersonal conflicts, strained relationships, and dysfunctional family dynamics can also contribute to developing mental health issues. In some cases, the stigma associated with mental illness within families can lead to a lack of understanding and support, further hindering the individual's ability to seek help [ 18 ].

Cultural Beliefs Surrounding Mental Illness

Cultural beliefs and traditional practices related to mental illness vary across different regions and communities in India. These beliefs can influence help-seeking behaviors, treatment approaches, and perceptions of mental health. Sometimes, cultural beliefs may stigmatize mental illness, discourage open discussions, and promote harmful practices or ineffective remedies. This can hinder access to evidence-based care and perpetuate the cycle of mental health-related challenges [ 19 ].

The Burden of Mental Health Issues on Individuals and Society

Mental health problems substantially burden individuals and society as a whole in India. Individuals with mental health disorders often experience a reduced quality of life, impaired functioning in various domains (such as work, relationships, and education), and an increased risk of suicide [ 20 ]. Societally, mental health problems lead to significant productivity losses due to absenteeism, decreased work performance, and disability. The economic impact includes increased healthcare costs and decreased productivity, impeding social and economic development [ 21 ]. Additionally, mental health problems contribute to the overall burden on the healthcare system, straining resources and diverting attention from other areas of healthcare.

Access to mental healthcare in India

Shortage of Mental Health Professionals

The availability of mental health professionals, including psychiatrists, psychologists, and psychiatric nurses, is insufficient to meet the growing demand for mental healthcare in India. The shortage is particularly prominent in rural areas, where access to mental health professionals is limited. This uneven distribution of services creates a significant barrier for individuals seeking timely and appropriate mental healthcare [ 22 - 23 ].

Inadequate Infrastructure and Resources

Mental healthcare facilities, especially in rural areas, often lack the necessary infrastructure, equipment, and resources to provide comprehensive care. There is a shortage of psychiatric hospitals, outpatient clinics, and community-based services. The lack of appropriate infrastructure hinders the delivery of mental healthcare services and limits the capacity to meet the diverse needs of individuals with mental health disorders [ 24 ].

Lack of Awareness and Stigma

Limited awareness and pervasive stigma surrounding mental health issues in India contribute to the underutilization of mental healthcare services. The stigma associated with mental illness leads to discrimination, social isolation, and prejudice against individuals seeking help. This stigma discourages individuals from openly discussing their mental health concerns and seeking timely treatment [ 25 ].

Insufficient Integration into Primary Healthcare

Mental health services are not adequately integrated into primary healthcare systems in India. This lack of integration results in a fragmented approach to mental healthcare, hindering early detection, timely intervention, and continuity of care for individuals with mental health problems. The separation of mental health from primary healthcare reinforces the notion that mental health is separate from physical health, perpetuating the treatment gap [ 26 ].

Historical development of mental asylums in India

Establishment and Purpose of Mental Asylums

Mental asylums were established in India during the colonial era, primarily under British rule. The first mental asylum in India, the Indian Lunatic Asylum, was established in 1745 in Calcutta (now Kolkata). These institutions were initially established to confine and segregate individuals with mental illness from the rest of society. The focus was primarily on custodial care, with little emphasis on therapeutic interventions [ 27 ].

The main objectives of mental asylums were to provide a secure and controlled environment for those deemed "insane" and to manage and control perceived threats posed by individuals with mental illness. Asylums were often located in remote areas away from urban centers and were designed to isolate individuals with mental illness from the general population [ 28 ].

Changes and Evolution of Mental Asylums Over Time

Over time, mental asylums in India have undergone significant changes and evolution. With advancements in medical understanding and changes in societal attitudes towards mental illness, the approach to care within mental asylums shifted from custodial confinement to a more humane and therapeutic approach [ 29 ].

In the mid-19th century, mental asylums began adopting moral treatment principles influenced by European reform movements. Moral treatment aims to provide a more humane and respectful environment for individuals with mental illness. It focused on promoting moral and spiritual development, engaging patients in meaningful activities, and creating a supportive therapeutic milieu [ 30 ].

In the 20th century, developing psychiatric research institutes and training centers in India further contributed to the evolution of mental healthcare practices. These institutions played a crucial role in advancing the understanding, diagnosis, and treatment of mental health disorders. They also provided opportunities to train mental health professionals and conduct research to improve care [ 31 ].

Role of Mental Asylums in Addressing Mental Health Problems

Mental asylums significantly addressed mental health problems in India, particularly when alternative options were limited. They provided a place of refuge for individuals with mental illness, offering shelter, basic care, and some level of treatment. The asylums acted as custodial institutions, ensuring the containment and management of individuals considered "insane" by societal standards [ 32 ].

Although mental asylums' quality of care and conditions varied widely, some asylums did strive to provide treatment and rehabilitation to their residents. Occupational therapy, recreation, and vocational training were introduced to promote functional improvement and reintegration into society. Some mental asylums also contributed to the understanding and treatment of mental health disorders through research and training initiatives [ 33 ].

However, it is important to acknowledge that mental asylums face significant criticism and challenges. Stigmatization, abuse, overcrowding, a lack of resources, and inadequate staff training were pervasive issues. These concerns led to an evaluation of the asylum model and the recognition of the need for broader reforms in mental healthcare delivery [ 34 ]. The role of mental asylums has evolved, and today, the focus is shifting towards community-based care, deinstitutionalization, and integrating mental health services into mainstream healthcare systems.

Critiques and challenges of mental asylums in India

Stigmatization and Social Attitudes Towards Mental Asylums

Mental asylums in India have historically faced stigmatization and negative societal attitudes. They have been associated with neglect, abuse, and human rights violations. The perception of mental asylums as places of confinement and isolation perpetuates the stigma surrounding mental health and hampers efforts to promote community-based care. This stigma often prevents individuals from seeking help and reinforces the idea that mental health conditions should be dealt with in isolation rather than as part of a broader community [ 35 ].

Human Rights Concerns and Ethical Considerations

Human rights concerns have been raised regarding mental asylums in India. Reports have documented overcrowding, a lack of privacy, and inadequate living conditions in some institutions. Patients' rights, including dignity, autonomy, and privacy, can be compromised in these settings. Additionally, the ethical considerations of involuntary admissions, the use of restraints, and the need for informed consent in psychiatric treatment are critical issues that must be addressed to protect individuals' rights and well-being [ 36 ].

Quality of Care and Treatment Modalities

The quality of care provided in mental asylums varies widely across India. While some institutions adhere to evidence-based treatments, rehabilitation programs, and a multidisciplinary approach, others struggle with resource constraints, inadequate staffing, and outdated practices. Using outdated treatments and over-reliance on medications without adequate psychosocial support services remain challenges within the mental asylum system. Improving the quality of care requires a focus on the training and capacity-building of mental health professionals, ensuring access to evidence-based treatments, and promoting holistic approaches that address the individual's social, psychological, and emotional needs [ 37 ].

Alternative Approaches to Mental Healthcare

The criticisms and challenges surrounding mental asylums have spurred the exploration of alternative approaches to mental healthcare in India. Community-based care has gained recognition as a more humane and effective approach that emphasizes the involvement of families, communities, and social support networks. Integrating mental health into primary healthcare settings allows for early detection, timely intervention, and holistic management of mental health problems. Other alternative approaches include mobile mental health units to reach underserved populations, telemedicine for remote consultations, and the implementation of psychosocial interventions that prioritize individual empowerment, resilience, and well-being. These alternative approaches promote a shift towards person-centered care and community support, reducing reliance on institutionalized care and enhancing India's overall mental health ecosystem [ 38 ].

Current mental health initiatives in India

Government Programs and Policies

The Government of India has implemented several programs and policies to address mental health issues. The National Mental Health Program (NMHP) is a flagship initiative to improve mental healthcare services. The program aims to provide accessible and affordable mental healthcare, promote community participation, train mental health professionals, and raise awareness about mental health. It also emphasizes integrating mental health into primary healthcare systems [ 39 ].

In addition, the Mental Healthcare Act of 2017 is significant legislation that prioritizes the rights and dignity of individuals with mental illness. It provides a legal framework for delivering mental healthcare, protects the rights of individuals with mental illness, decriminalizes suicide, and promotes community-based care [ 40 ].

Community-Based Mental Health Services

Community-based mental health services have gained prominence in India as a strategy to bridge the treatment gap and improve access to mental healthcare. These services adopt a decentralized approach, delivering mental healthcare at the community level through trained professionals. Community mental health programs involve outreach activities, awareness campaigns, counseling services, and support for individuals with mental health disorders and their families. The aim is to reduce stigma, enhance accessibility, and provide holistic care sensitive to communities' cultural context [ 38 ].

Integration of Mental Health into Primary Healthcare

Integrating mental health into primary healthcare is a key strategy to improve access to mental healthcare services. The District Mental Health Program (DMHP) is a notable initiative. The DMHP focuses on strengthening mental health services at the primary care level by training primary healthcare workers to identify and manage common mental health conditions. It involves capacity building, the provision of essential psychotropic medications, referral systems, and community-based rehabilitation services. This integration ensures that mental health is given equal importance to physical health, leading to early detection, timely intervention, and continuity of care [ 41 ].

Awareness Campaigns and Advocacy Efforts

Awareness campaigns and advocacy efforts are critical to promoting mental health literacy, reducing stigma, and raising public awareness about mental health issues. Non-governmental organizations (NGOs), mental health professionals, and community groups actively engage in advocacy, education, and destigmatization initiatives. These efforts aim to challenge stereotypes, provide accurate information about mental health, promote help-seeking behaviors, and create supportive environments for individuals with mental health disorders. Awareness campaigns often utilize various media platforms, community events, and workshops to reach a wide audience and promote positive attitudes toward mental health [ 42 ]. These current mental health initiatives in India demonstrate a multifaceted approach that combines government policies, community-based services, integration into primary healthcare, and awareness campaigns. Such comprehensive efforts are crucial in addressing the complex challenges of mental health and improving the overall mental well-being of individuals in the country.

Future directions for mental health in India

Increasing the Number of Mental Health Professionals

Addressing the shortage of mental health professionals requires a multi-pronged approach. One strategy is to increase the number of psychiatrists, psychologists, psychiatric nurses, and other mental health specialists. This can be achieved through expanded training programs that attract more individuals to the field and provide them with the necessary skills and knowledge to practice effectively. Scholarships and incentives can also be offered to encourage professionals to work in underserved areas where the shortage is more pronounced. By increasing the workforce in mental health, access to care can be improved [ 43 ].

Enhancing Training and Capacity-Building

To ensure the delivery of high-quality mental healthcare, it is crucial to provide comprehensive and specialized training to mental health professionals. This includes continuous professional development programs that keep professionals updated with the latest evidence-based practices. Professionals can provide more effective and targeted interventions by enhancing their knowledge and skills in diagnosing and treating mental health disorders. Training programs should focus on culturally sensitive approaches and address the specific needs of diverse populations [ 44 ].

Decentralizing Mental Health Services

To bridge the gap in mental healthcare between urban and rural areas, it is essential to strengthen mental healthcare infrastructure and services at the district and community levels. This involves establishing mental health facilities, outpatient clinics, and community-based services in rural and remote areas. By bringing mental health services closer to where people live, access to care can be improved, and individuals can receive timely interventions. This also helps reduce the burden on tertiary care centers and psychiatric hospitals [ 45 ].

Integrating Mental Health into Primary Healthcare

Recognizing the importance of early detection and intervention, integrating mental health services into primary healthcare settings is crucial. This integration involves training primary healthcare providers to identify and manage common mental health conditions. It also includes establishing referral systems between primary care and specialized mental health services. Individuals can receive timely support and treatment by integrating mental health into primary healthcare, and the stigma associated with seeking mental healthcare can be reduced [ 46 ].

Strengthening Referral Systems

To ensure seamless transitions between different levels of care, robust referral systems must be developed. Effective communication and coordination between primary healthcare providers, specialized mental health services, and other relevant sectors (such as education and employment) are essential. Referral systems should ensure that individuals with mental health problems receive continuous support and follow-up care as they move through different stages of their treatment journey. This helps maintain continuity of care and address individuals' holistic needs [ 47 ].

Public-Private Partnerships and Leveraging Technology

To improve mental healthcare delivery, collaborations between the public and private sectors can be fostered through public-private partnerships. Such partnerships can enhance resource allocation, capacity-building, and the development of innovative approaches to mental health. Private sector involvement can bring additional expertise and resources to complement public sector efforts. Furthermore, leveraging technology can significantly improve access to mental healthcare, particularly in remote and underserved areas. Telemedicine, mobile health applications, and online platforms can facilitate virtual consultations, remote monitoring, and self-help interventions, expanding the reach of mental health services [ 48 ].

By implementing these recommendations, India can make significant strides in improving mental healthcare delivery, addressing workforce shortages, enhancing training and capacity-building, decentralizing services, integrating mental health into primary care, strengthening referral systems, and harnessing the potential of public-private partnerships and technology. These strategies contribute to a more comprehensive and accessible mental health system that meets the diverse needs of individuals nationwide.

Policy reforms and resource allocation

Allocating Adequate Resources

Increasing budgetary allocations specifically for mental health is essential. Sufficient funds should be allocated to support infrastructure development, including the establishment of mental health facilities, outpatient clinics, and community-based services. Adequate resources are also necessary to recruit and train mental health professionals, implement training programs for primary healthcare providers, conduct research, and address mental health disparities across regions [ 49 ].

Prioritizing Mental Health in the Healthcare Agenda

Recognizing mental health as a priority area within the broader healthcare system is essential for effective reform. This involves integrating mental health into national health policies, strategic plans, and programs. Setting measurable targets and indicators for improving mental healthcare outcomes helps ensure that progress is monitored and interventions are evidence-based [ 50 ].

Developing a Robust Regulatory Framework

Establishing and implementing a comprehensive regulatory framework is crucial for ensuring quality standards, ethics, and guidelines for mental health services. This includes developing licensing and accreditation processes for mental healthcare providers, monitoring compliance with professional standards, and enforcing ethical guidelines. Additionally, monitoring and evaluation mechanisms should be in place to assess the quality and effectiveness of mental healthcare delivery, identify areas for improvement, and ensure accountability [ 51 ].

Ensuring Policy Implementation

Strengthening coordination and collaboration among government departments responsible for mental health, social welfare, education, and employment is necessary for effective policy implementation. Intersectoral collaboration facilitates a holistic approach to addressing mental health issues and ensures that policies and initiatives are coordinated. This coordination can include sharing resources, data, and expertise, as well as joint planning and monitoring of mental health programs [ 52 ].

Holistic and multidisciplinary approaches to mental health

Integrating Psychological, Social, and Biological Perspectives

Recognizing that mental health disorders have complex causes and manifestations, it is essential to adopt an integrated approach that addresses mental health's biological, psychological, and social determinants. This means acknowledging the interplay between genetic factors, brain chemistry, individual experiences, and social contexts in developing and managing mental health disorders [ 53 ].

Collaborative Care Models

Collaborative care models involve a coordinated and team-based approach to mental healthcare delivery. These models bring together multiple stakeholders, including mental health professionals, primary healthcare providers, social workers, and community organizations, to work collaboratively to address the needs of individuals with mental health disorders [ 54 ].

Promoting community participation and support systems

Engaging Community Leaders and Organizations

Collaborating with community leaders, religious and cultural organizations, and community-based groups is crucial for promoting mental health awareness, reducing stigma, and improving access to care. Community leaders and organizations have significant influence and reach within their communities. By partnering with them, it is possible to conduct awareness campaigns, organize educational events, and disseminate accurate information about mental health. This collaboration can help create supportive environments where individuals feel comfortable seeking help and accessing mental healthcare services. Community-based organizations can also play a role in identifying individuals in need of support and connecting them with appropriate resources [ 55 ].

Involving Individuals with Lived Experience

It is essential to involve individuals with personal experience with mental health problems in decision-making, service planning, and advocacy efforts. Their unique insights and perspectives can contribute to more person-centered and recovery-oriented mental healthcare services. These individuals can provide valuable input on the challenges they faced, the types of support that were helpful to them, and the gaps in existing services. Their involvement can help shape policies, programs, and interventions more responsive to the needs and preferences of individuals with mental health disorders. It also empowers them to become advocates for mental health and reduce stigma through sharing their stories and experiences [ 56 ].

Peer Support Networks and Community-Based Rehabilitation

Establishing peer support networks, self-help groups, and community-based rehabilitation programs is essential for fostering a sense of belonging and support among individuals with mental health disorders. Peer support networks provide a platform for individuals to connect, share experiences, and offer mutual support. These networks can help reduce feelings of isolation and provide a sense of community, which is particularly beneficial during recovery. Self-help groups allow individuals to share coping strategies, provide emotional support, and learn from each other's experiences. Community-based rehabilitation programs empower individuals with mental health disorders to develop skills, reintegrate into society, and participate in meaningful activities. These initiatives promote social inclusion, recovery, and well-being [ 57 ]. By implementing these recommendations, India can significantly improve its mental healthcare delivery, ensure better access and quality of care, reduce stigma, and promote holistic well-being for individuals with mental health disorders.

Conclusions

Addressing mental health problems in India holds immense significance, considering the scale of human value impact involved. The country's population size gives added weight to the importance of tackling these barriers. It is crucial to recognize that mental health issues affect a significant portion of the population and can lead to severe consequences if left unaddressed. Therefore, concerted efforts are essential to combating these challenges effectively. Reducing the stigma surrounding mental illness is critical to addressing mental health problems in India. Stigma creates barriers that hinder individuals from seeking the necessary help and support they require. To overcome this, public awareness campaigns and educational initiatives are vital in combating stigma and promoting understanding and empathy toward those with mental health conditions. A comprehensive and compassionate approach is necessary to tackle India's complex mental health challenges. By reducing stigma, improving accessibility, enhancing the quality of services, shifting towards community-based care, protecting human rights, and integrating mental health into mainstream healthcare systems, India can make significant progress in addressing mental health issues. The benefits will extend beyond individuals, contributing to society's overall development and well-being.

The authors have declared that no competing interests exist.