Showing papers in "Public Health Reports in 2018"
TL;DR: A novel ecological framework for harmful opioid use is proposed that provides multiple recommendations to improve public health and clinical practice, including improved data collection to guide resource allocation, steps to increase safer prescribing, stigma-reduction campaigns, and increased spending on harm reduction and treatment.
Abstract: Drug overdose is now the leading cause of injury death in the United States. Most overdose fatalities involve opioids, which include prescription medication, heroin, and illicit fentanyl. Current data reveal that the overdose crisis affects all demographic groups and that overdose rates are now rising most rapidly among African Americans. We provide a public health perspective that can be used to mobilize a comprehensive local, state, and national response to the opioid crisis. We argue that framing the crisis from a public health perspective requires considering the interaction of multiple determinants, including structural factors (eg, poverty and racism), the inadequate management of pain, and poor access to addiction treatment and harm-reduction services (eg, syringe services). We propose a novel ecological framework for harmful opioid use that provides multiple recommendations to improve public health and clinical practice, including improved data collection to guide resource allocation, steps to increase safer prescribing, stigma-reduction campaigns, increased spending on harm reduction and treatment, criminal justice policy reform, and regulatory changes related to controlled substances. Focusing on these opportunities provides the greatest chance of making a measured and sustained impact on overdose and related harms.
150 citations
TL;DR: The results highlight the need to explicitly name institutionalized racism in articles in the public health literature and to make it a central concept in inequities research.
Abstract: Objectives:Although a range of factors shapes health and well-being, institutionalized racism (societal allocation of privilege based on race) plays an important role in generating inequities by race. The goal of this analysis was to review the contemporary peer-reviewed public health literature from 2002-2015 to determine whether the concept of institutionalized racism was named (ie, explicitly mentioned) and whether it was a core concept in the article.Methods:We used a systematic literature review methodology to find articles from the top 50 highest-impact journals in each of 6 categories (249 journals in total) that most closely represented the public health field, were published during 2002-2015, were US focused, were indexed in PubMed/MEDLINE and/or Ovid/MEDLINE, and mentioned terms relating to institutionalized racism in their titles or abstracts. We analyzed the content of these articles for the use of related terms and concepts.Results:We found only 25 articles that named institutionalized racism...
137 citations
TL;DR: States may be greatly underestimating the effect of opioid-related overdose deaths because of incomplete cause-of-death reporting, indicating that the current opioid overdose epidemic may be worse than it appears.
Abstract: Objectives:A complete and accurate count of the number of opioid-related overdose deaths is essential to properly allocate resources. We determined the rate of unintentional overdose deaths (non–opioid-related, opioid-related, or unspecified) in the United States and by state from 1999 to 2015 and the possible effects of underreporting on national estimates of opioid abuse.Methods:We abstracted unintentional drug overdose deaths (International Classification of Diseases, 10th Revision, codes X40-X44) with contributory drug-specific T codes (T36.0-T50.9) from the Mortality Multiple Cause Micro-Data Files. We assumed that the proportion of unspecified overdose deaths that might be attributed to opioids would be the same as the proportion of opioid-related overdose deaths among all overdose deaths and calculated the number of deaths that could be reallocated as opioid-related for each state and year. We then added these reallocated deaths to the reported deaths to determine their potential effect on total op...
73 citations
TL;DR: A public health framework for preventing community violence, intimate partner violence and sexual violence, and suicide as key forms of interpersonal and self-directed violence are suggested.
Abstract: Violence is a leading source of morbidity and mortality in the United States. In this article, we suggest a public health framework for preventing community violence, intimate partner violence and sexual violence, and suicide as key forms of interpersonal and self-directed violence. These types of violence often co-occur and share common risk and protective factors. The gender, racial/ethnic, and age-related disparities in violence risk can be understood through an intersectionality framework that considers the multiple simultaneous identities of people at risk. Important opportunities for cross-cutting interventions exist, and intervention strategies should be examined for potential effectiveness on multiple forms of violence through rigorous evaluation. Existing evidence-based approaches should be taken to scale for maximum impact. By seeking to influence the policy and normative context of violence as much as individual behavior, public health can work with the education system, criminal justice system, and other sectors to address the public health burden of interpersonal violence and suicide.
59 citations
TL;DR: A retrospective cohort study of HCV-infected Kaiser Permanente Northern California members aged ≥18 during October 2014 to December 2016 found racial/ethnic and socioeconomic disparities exist in DAA initiation.
Abstract: Objectives:The cost of direct-acting antiviral agents (DAAs) for hepatitis C virus (HCV) infection may contribute to treatment disparities. However, few data exist on factors associated with DAA in...
46 citations
TL;DR: As HIV-infected patients live longer, the increasing burden of noncommunicable diseases may complicate their clinical management, requiring primary care providers to be trained in chronic disease management for this population.
Abstract: Objectives:As the life expectancy of people infected with human immunodeficiency virus (HIV) infection has increased, the spectrum of illness has evolved. We evaluated whether people living with HIV accessing primary care in US community health centers had higher morbidity compared with HIV-uninfected patients receiving care at the same sites.Methods:We compared data from electronic health records for 12 837 HIV-infected and 227 012 HIV-uninfected patients to evaluate the relative prevalence of diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, and malignancies by HIV serostatus. We used multivariable logistic regression to evaluate differences. Participants were patients aged ≥18 who were followed for ≥3 years (from January 2006 to December 2016) in 1 of 17 community health centers belonging to the Community Health Applied Research Network.Results:Nearly two-thirds of HIV-infected and HIV-uninfected patients lived in poverty. Compared with HIV-uninfected patients, HIV-infected patient...
42 citations
TL;DR: Trends in the conferral of public health degrees provide a lens into the public health workforce as the needs of workforce development grow and change, and it is imperative to accurately characterize trends in degree conferrals to estimate the future size and composition of thepublic health workforce.
Abstract: Trends in the conferral of public health degrees provide a lens into the public health workforce. As the needs of workforce development grow and change, it is imperative to accurately characterize trends in degree conferrals to estimate the future size and composition of the public health workforce. The challenging task of enumerating public health degree conferrals aligns with the equally challenging task of enumerating the public health workforce, for which the “methodology used needs further improvements in standardization, specificity, data storage, and data availability.” Although a 2015 study characterized the growth of the undergraduate public health major in the United States, our study focused on graduate-level public health education trends in the United States. The impetus for public health education in the United States to have its own identity and academic institutions was established in 1915 with the release of the Welch-Rose Report. The standardization of public health education began in 1919, with a meeting of the Committee of Sixteen. This committee was formed by the American Public Health Association (APHA) to standardize professional public health training. From the beginning, collecting and analyzing institutional data on education in public health presented challenges. A 1950 report by the APHA Committee on Professional Education presented information on the complexities of the definitions used and issues in providing comparable data on public health degree conferrals, showing, for example, that “where both sanitary engineers and public health nurses may receive the degree of MPH [master of public health] through the school of public health, there is sometimes confusion as to the category in which these degrees should be reported.” The report also stated that “this material does not lend itself completely to neat, unequivocal classification.” The Committee of Sixteen first collected information in 1920 from 20 US and Canadian institutions on the education provided to future public health workers. The results showed various degrees, from certificates to doctorates, and differences in requirements for the same degrees. For example, the committee observed that some institutions awarded doctorate degrees in public health for a course of a few weeks’ length, whereas others awarded doctorate degrees after several years of coursework. Informed by this initial effort to catalog public health education, the Committee of Sixteen provided in its final opinions some of the first standardizations of public health education, including that the “first degree in Public Health should be a Certificate in Public Health, a Master of Science in Public Health, or Master of Public Health, to be granted for one or two years postgraduate work” and that “the highest degree in Public Health should be a [Doctor of Public Health], to be granted for not less than two years of work in academic residence.” After the initial work of the Committee of Sixteen, the APHA Governing Council formed a Committee on Public Health Training to make recommendations about public health education. The Committee on Public Health Training released its first report in 1922, which included a list of public health degree offerings, the number of students enrolled, and the number of degrees conferred. The 1922 Committee on Public Health Training report showed more uniformity in the first degrees in public health, as well as doctorate degrees, than the report from the Committee of Sixteen. In 1922, 7 types of public health degrees were granted by 10 US institutions, from certificates to doctoral degrees, that were in either public health or hygiene. After this initial report, various
41 citations
TL;DR: DSME was significantly associated with all 3 self-management behaviors and increasing public health interventions aimed at educating people with diabetes about self- management could improve outcomes.
Abstract: Objective:Research outside the United States shows that certain subgroups of patients (eg, those who are older, male, of low socioeconomic status, and uninsured) are less likely than others to repo
40 citations
TL;DR: The cost of a single foodborne illness outbreak to a restaurant can be substantial and outweigh the typical costs of prevention and control measures, and can help decision makers determine investment and motivate research for infection-control measures in restaurant settings.
Abstract: Objectives:Although outbreaks of restaurant-associated foodborne illness occur periodically and make the news, a restaurant may not be aware of the cost of an outbreak. We estimated this cost under varying circumstances.Methods:We developed a computational simulation model; scenarios varied outbreak size (5 to 250 people affected), pathogen (n = 15), type of dining establishment (fast food, fast casual, casual dining, and fine dining), lost revenue (ie, meals lost per illness), cost of lawsuits and legal fees, fines, and insurance premium increases.Results:We estimated that the cost of a single foodborne illness outbreak ranged from $3968 to $1.9 million for a fast-food restaurant, $6330 to $2.1 million for a fast-casual restaurant, $8030 to $2.2 million for a casual-dining restaurant, and $8273 to $2.6 million for a fine-dining restaurant, varying from a 5-person outbreak, with no lost revenue, lawsuits, legal fees, or fines, to a 250-person outbreak, with high lost revenue (100 meals lost per illness), ...
38 citations
TL;DR: In this article, emotional well-being as a scientific concept and its relevance to public health are discussed and ways in which a national emotionalWell-being initiative would complement current public health efforts are discussed.
Abstract: In 2011, the National Prevention, Health Promotion, and Public Health Council named mental and emotional well-being as 1 of 7 priority areas for the National Prevention Strategy. In this article, we discuss emotional well-being as a scientific concept and its relevance to public health. We review evidence that supports the association between emotional well-being and health. We propose a national emotional well-being initiative and describe its 6 components: systematic measurement of emotional well-being, identification of the drivers of emotional well-being, formation of partnerships with diverse stakeholders, implementation and dissemination of evidence-based interventions to promote emotional well-being and its drivers, development of public health messaging, and identification of and strategies to address disparities in emotional well-being and its drivers. Finally, we discuss ways in which a national emotional well-being initiative would complement current public health efforts and the potential challenges to such an initiative.
34 citations
TL;DR: In this installment of Public Health Chronicles, I describe Simkins, highlight its limitations as a legal document, and acknowledge its historical importance in paving the way for sweeping legislative and regulatory changes.
Abstract: In recent years, a growing number of calls have been made to explicitly name and treat racism as a determinant of health. Mounting evidence supports the notion that racism affects health through complex psychosocial, biobehavioral, and structural pathways. Health disparities are increasingly recognized as byproducts of racism. Acknowledging historical injustices—in particular, how racism operates at the individual, interpersonal, and institutional levels to affect health—and appreciating the historical roots of contemporary disparities is a necessary (although not sufficient) step toward achieving health equity. As part of ongoing efforts to address pervasive racial disparities in health, it is essential that public health researchers, practitioners, and others bear in mind the civil rights story of the health care system. As late as the mid-1960s, open segregation infected all organs of the US health care system. Hospital segregation—widespread nationally—was, in many places, legally sanctioned. John Kenny Jr, president of the National Medical Association (NMA), the nation’s oldest and largest organization of black physicians, from 1962 to 1963, explained, “The colored doctor is . . . denied participation in hospital staff membership [and] . . . the Negro patient is discriminated against both in seeking hospital admission, and once he gets in, in where he is placed in the hospital.” Racial discrimination in medical services and facilities was understood to be “one of the prime reasons why Negro infant mortality is from two to five times greater than white infant mortality; why white women are five times less likely to die in childbirth than Negro women; and why Negro life expectancy is almost seven years less than white life expectancy.” Litigation was a key element of civil rights era efforts to end segregation. The case of Simkins v Moses H. Cone Memorial Hospital, initially understood by lawyers and physicians alike as an important but limited strike against hospital segregation, ultimately proved to be a watershed moment in the quest for integration. In this installment of Public Health Chronicles, I describe Simkins, highlight its limitations as a legal document, and acknowledge its historical importance in paving the way for sweeping legislative and regulatory changes. Although less well known than Brown v Board of Education of Topeka, Simkins should be equally celebrated for its dramatic effect on the health care landscape in the United States.
TL;DR: Investing in programs that improve neighborhood environments affected by high rates of physical disorder and vacancy may be a way to decrease violence, but routine remediation may be needed to increase the public health impact of blight abatement programs in warmer climates, where weeds and vegetation grow rapidly.
Abstract: Objectives:In 2005, Hurricane Katrina caused damage in New Orleans, Louisiana, and much of the land in low-resource neighborhoods became vacant and blighted. In 2014, New Orleans launched a program...
TL;DR: The case for the central role of policy in mitigating America’s public health challenges is made and principles that are essential for policy change are proposed based on the authors’ collective experiences and with implications for local health departments, academics, and the next generation of public health leaders.
Abstract: Some of the nation’s greatest public health successes would not have been possible without policy change. The Centers for Disease Control and Prevention’s list of “Ten Great Public Health Achievements”—including motor vehicle safety, tobacco control, and maternal and infant health—all involved policy change. Because of these public health achievements, the average life expectancy at birth for people living in the United States increased by more than 30 years, from 47.3 years in 1900 to 76.8 years in 2000. The age-adjusted death rate in the United States continued to increase to 78.8 years in 2014. However, it decreased to 78.7 years in 2015 and then to 78.6 years in 2016. This emerging trend is the result of numerous public health challenges, especially the opioid and obesity epidemics, which continue to burden society. In this Commentary, we make the case for the central role of policy in mitigating America’s public health challenges. We first define policy, then propose principles that are essential for policy change and are based on the authors’ collective experiences, and conclude with implications for local health departments, academics, and the next generation of public health leaders.
TL;DR: Retail pharmacies may be an effective venue for those who have never been tested for HIV to access HIV testing, particularly if the pharmacies are located in priority areas or where community-based organizations are unable to operate.
Abstract: Objective:As part of the Care and Prevention in the United States Demonstration Project (2012-2016), which aimed to reduce HIV-related morbidity and mortality among racial/ethnic minority groups in...
TL;DR: The authors set out to develop a curriculum competency that would require all UWSPH students to acknowledge racism and its effects, and Seattle’s long history of anti-racist organizing provided a strong foundation for community collaboration and dynamic partnerships to achieve this goal.
Abstract: Seventeen-year-old unarmed Trayvon Martin was shot and killed by a Florida Stand Your Ground patrol volunteer in 2012 while walking home from a convenience store. His death launched a nationwide conversation on America’s long-sore subject of race, igniting the Black Lives Matter movement. These conversations were also held in schools and programs of public health because the field has long recognized racism as a determinant of health. But although we academics have chronicled the role of racism in shaping health outcomes, we have rarely turned our gaze inward to examine how our own schools and programs of public health perpetuate racism. Furthermore, we have largely failed to prepare our graduates with an understanding of the roots of racism and how it affects public health work. The University of Washington, a top-ranked school of public health in a politically liberal US city (Seattle, Washington), has had a long history of campus social activism. In 2011, the nationwide Occupy movement was a clear presence on the University of Washington campus, and although the movement served to limber up resistance to income inequality, national movement leaders were regularly challenged on their own racial illiteracy. Many students and faculty at the University of Washington watched with increasing awareness as difficult racially charged events unfolded both nationally and locally. University of Washington students and faculty members recognized how our own institution perpetuated patterns of racism even within progressive spaces and began organizing to make structural changes. Students, motivated in part by the larger Black Lives Matter movement and local organizing to prevent the construction of a new $210 million county youth detention center, began to speak up to compel the University of Washington School of Public Health (UWSPH) to address our own racism. Seattle’s long history of anti-racist organizing provided a strong foundation for community collaboration and dynamic partnerships to achieve this goal. Historically, training programs for health professionals have identified cultural competence as a curriculum objective. Cultural competence education in academic settings has evolved to acknowledge the power and privilege associated with whiteness. Similarly, some training programs have moved away from the gentler term, multicultural education, and toward the more challenging frame, antiracist education. Indeed, in recent years, racism has been conceptualized as a quintessential “wicked problem,” with profound intergenerational effects, and tackling it requires systems change theory and structural power analysis. A curriculum competency is a description of an observable knowledge or skill for students to attain. Measuring a student’s competency in anti-racist thinking and practice can be challenging. Successful completion of a required course is an obvious, although not foolproof, approach. Tools for self-assessing one’s cultural competency or racial literacy have been validated, as have classroom exercises to reduce prejudice. Still, the resistance of some faculty and students to acknowledge race as a legitimate topic (eg, by diluting it with sex, gender, and/or social class concerns) is well documented, for example, by Sue in “Race Talk: The Psychology of Racial Dialogues,” who described the “sincere belief of whites that they are fair, moral and decent human beings who are not responsible for inequities in the lives of people of color, that racism is no longer a detrimental force in society and that our nation should be color-blind.” The authors (along with others at the UWSPH) set out to develop a curriculum competency that would require all UWSPH students to acknowledge racism and its effects, to
TL;DR: To be effective, health departments had to enhance coordination among surveillance, care programs, and providers; develop mechanisms to share data; and address limitations in data systems and data quality.
Abstract: Objectives:The Care and Prevention in the United States Demonstration Project included implementation of a Data to Care strategy using surveillance and other data to (1) identify people with HIV in...
TL;DR: Targeted interventions are needed to improve adolescent influenza vaccination rates and reduce racial/ethnic disparities in adolescent vaccination coverage.
Abstract: Objective:Although research suggests racial/ethnic disparities in influenza vaccination and mortality rates, few studies have examined racial/ethnic trends among US adolescents. We used national cr...
TL;DR: This work recommends strengthening innovative local policies and programs, particularly those that involve community members in identifying problems and potential solutions and that embrace a broad set of goals beyond making eating patterns healthier.
Abstract: Despite 2 decades of effort by the public health community to combat obesity, obesity rates in the United States continue to rise. This lack of progress raises fundamental questions about the adequacy of our current approaches. Although the causes of population-wide obesity are multifactorial, attention to food systems as potential drivers of obesity has been prominent. However, the relationships between broader food systems and obesity are not always well understood. Our efforts to address obesity can be advanced and improved by the use of systems approaches that consider outcomes of the interconnected global food system, including undernutrition, climate change, the environmental sustainability of agriculture, and other social and economic concerns. By implementing innovative local and state programs, taking new approaches to overcome political obstacles to effect policy, and reconceptualizing research needs, we can improve obesity prevention efforts that target the food systems, maximize positive outcomes, and minimize adverse consequences. We recommend strengthening innovative local policies and programs, particularly those that involve community members in identifying problems and potential solutions and that embrace a broad set of goals beyond making eating patterns healthier. We also recommend undertaking interdisciplinary research projects that go beyond testing targeted interventions in specific populations and aim to build an understanding of the broader social, political, and economic context.
TL;DR: A public health perspective on opportunity youth is offered by describing their distribution in the population and consequences of their disconnection, proposing a conceptual model of the issue based on epidemiological principles, life course development concepts, and ecological theory, and recommending multisector strategies for preventing disconnection of young people and reengaging opportunity youth.
Abstract: Approximately 1 in 9 teenagers and young adults aged 16-24 in the United States is currently disconnected from school and employment. These disconnected young people (ie, opportunity youth) are not only at high risk for long-term emotional, behavioral, and health problems, but they also represent a loss of human capital, with high social and economic costs. In this article, we offer a public health perspective on opportunity youth by describing their distribution in the population and consequences of their disconnection; proposing a conceptual model of the issue based on epidemiological principles, life course development concepts, and ecological theory; and recommending multisector strategies for preventing disconnection of young people and reengaging opportunity youth. A public health approach to the problem of opportunity youth would involve developing and investing in youth monitoring data systems that can be coordinated across multiple sectors, consolidating both the delivery and funding of services for opportunity youth, developing policies and programs that encourage engagement of young people, and fostering systematic approaches to the testing and scaling up of preventive and reengagement interventions.
TL;DR: SLE was greatly underreported as a cause of mortality on death records of SLE patients, particularly in older decedents and those with cancer, thereby underestimating the true burden of this disease.
Abstract: Objectives:Mortality due to rare diseases, which are substantial sources of premature mortality, is underreported in mortality studies. The objective of this study was to determine the completeness...
TL;DR: The current annual number of women with HIV infection delivering infants in the United States is about 5000, which is substantially lower than the 2006 estimate, and more accurate estimates would require comprehensive reporting of perinatal HIV exposure.
Abstract: Objectives:The annual number of women with HIV infection who delivered infants in the United States was estimated to be 8700 in 2006. An accurate, current estimate is important for guiding perinata...
TL;DR: Evidence supports CDC’s current recommendation that sexually active MSM be screened at least annually for HIV, but some MSM might benefit from more frequent screening, and future research should evaluate which MSM subpopulations would benefit most from morerequent HIV screening.
Abstract: The Centers for Disease Control and Prevention (CDC) recommended in 2006 that sexually active gay, bisexual, and other men who have sex with men (MSM) be screened for human immunodeficiency virus (HIV) at least annually. A workgroup comprising CDC and external experts conducted a systematic review of the literature, including benefits, harms, acceptability, and feasibility of annual versus more frequent screening among MSM, to determine whether evidence was sufficient to change the current recommendation. Four consultations with managers of public and nonprofit HIV testing programs, clinics, and mathematical modeling experts were conducted to provide input on the programmatic and scientific evidence. Mathematical models predicted that more frequent than annual screening of MSM could prevent some new HIV infections and would be more cost-effective than annual screening, but this evidence was considered insufficient due to study design. Evidence supports CDC’s current recommendation that sexually active MSM...
TL;DR: A conceptual framework is presented that represents a shift from compartmentalized solutions toward an inclusive systems approach that encourages partnership across disciplines and sectors and identifies priorities in research, practice, and education to advance the role of public health in decision making to improve health.
Abstract: Environmental quality has a profound effect on health and the burden of disease. In the United States, the environment-related burden of disease is increasingly dominated by chronic diseases. At the local level, public health practitioners realize that many policy decisions affecting environmental quality and health transcend the authorities of traditional health department programs. Healthy decisions about the built environment, including housing, transportation, and energy, require broad collaborative efforts. Environmental health professionals have an opportunity to address the shift in public health burden toward chronic diseases and play an important role in the design of healthy communities by bringing data and tools to decision makers. This article provides a guide for community leaders to consider the public health effects of decisions about the built environment. We present a conceptual framework that represents a shift from compartmentalized solutions toward an inclusive systems approach that encourages partnership across disciplines and sectors. We discuss practical tools to assist with environmental decision making, such as Health Impact Assessments, environmental public health tracking, and cumulative risk assessment. We also identify priorities in research, practice, and education to advance the role of public health in decision making to improve health, such as the Health Impact Assessment, as a core competency for environmental health practitioners. We encourage cross-disciplinary communication, research, and education that bring the fields of planning, transportation, and energy in closer collaboration with public health to jointly advance the systems approach to today's environmental challenges.
TL;DR: The disproportionate incidence of microcephaly in newborns in poor areas of Recife reinforces the need for government and public health authorities to formulate policies that promote social equity and support for families and their children with microcePHaly.
Abstract: Objectives:We assessed sociodemographic and health care factors of mothers and newborns during a 2015-2016 outbreak of microcephaly in Recife, Brazil, and we analyzed the spatial distribution and i...
TL;DR: The issues involved in information blocking are described, including the federal actions taken to identify the problem, prohibit it, and impose civil penalties for engaging in it, as well as the implications for interoperability.
Abstract: Interoperability, or the easy, secure exchange of electronic health information (EHI), is now vital to health care and public health functions, including disease and laboratory reporting. Conversely, “information blocking,” or activities that interfere with collecting, using, and exchanging EHI, can seriously harm public health. The 21st Century Cures Act (the Act), signed into law on December 13, 2016, establishes a legal framework to: address the use and exchange of health data through health information technology (HIT), strengthen interoperability, and prevent information blocking, among other health-related initiatives. Before the Act, information blocking was not defined or well understood and could not be effectively prevented, leaving interoperability unprotected. The Act defined these concepts and incorporated them into Title IV of the Public Health Service Act (PHSA) under “Delivery.” This article describes the issues involved in information blocking, including the federal actions taken to identify the problem, prohibit it, and impose civil penalties for engaging in it, as well as the implications for interoperability.
TL;DR: Heterogeneity in rates of adverse birth outcomes by country of birth for foreign-born Hispanic women is demonstrated, and states should stratify data by maternal country of Birth to understand possible changes in data on birth outcomes.
Abstract: Objectives:Despite knowledge that the Hispanic population is growing in the United States and that birth outcomes may vary by maternal country of birth, data on birth outcomes by maternal country o...
TL;DR: During the implementation of Health Models, enrolled patients had increases in rates of viral suppression and achieved rates of engagement in care and viral suppression that were higher than national levels; however, additional supportive services may be needed to further reduce socioeconomic disparities in the rates of Viral suppression.
Abstract: Objectives:The Care and Prevention in the United States Demonstration Project aimed to reduce HIV/AIDS-related morbidity and mortality among racial/ethnic minority groups in 8 states. We evaluated ...
TL;DR: It is concluded that, to enhance the success in reducing morbidity and mortality from HIV/AIDS, it must understand the SDHs of HIV/ AIDS, invest in efforts to dismantle the social conditions that lead to HIV-related disparities, and strengthen the scientific evaluation of these efforts.
Abstract: The federal Care and Prevention in the United States (CAPUS) Demonstration Project (hereinafter, CAPUS), which is featured in this supplemental issue of Public Health Reports, highlighted how addressing social determinants of health (SDHs) could reduce morbidity and mortality from HIV infection and AIDS. In this commentary, we explore the rationale behind CAPUS and discuss how sustained efforts such as CAPUS could help reduce and ultimately eliminate racial/ethnic disparities in HIV/AIDS. We review growing scientific evidence documenting that interventions that address social and living conditions can be effective in reducing risks of HIV infection. We conclude that, to enhance our success in reducing morbidity and mortality from HIV/AIDS, we must understand the SDHs of HIV/ AIDS, invest in efforts to dismantle the social conditions that lead to HIV/AIDS–related disparities, and strengthen the scientific evaluation of these efforts.
TL;DR: More complete and accurate data on race, ethnicity, primary language, and nativity can improve the quality, representativeness, and usefulness of public health surveillance and monitoring systems to plan and evaluate targeted public health interventions to eliminate health disparities.
Abstract: Objective:Despite increasing diversity in the US population, substantial gaps in collecting data on race, ethnicity, primary language, and nativity indicators persist in public health surveillance and monitoring systems. In addition, few systems provide questionnaires in foreign languages for inclusion of non-English speakers. We assessed (1) the extent of data collected on race, ethnicity, primary language, and nativity indicators (ie, place of birth, immigration status, and years in the United States) and (2) the use of data-collection instruments in non-English languages among Centers for Disease Control and Prevention (CDC)–supported public health surveillance and monitoring systems in the United States.Methods:We identified CDC-supported surveillance and health monitoring systems in place from 2010 through 2013 by searching CDC websites and other federal websites. For each system, we assessed its website, documentation, and publications for evidence of the variables of interest and use of data-collec...