Public Health Reports最新文献

{"title":"Area-Level Disparities in Pneumococcal Vaccination Among Publicly Insured US Adults: 2016-2019.","authors":"Salini Mohanty, Saumya Chatrath, Priya Shanmugam, Nicole Cossrow, Peter C Fiduccia, Kelsie Cassell, Esther Smith-Howell, Valina C McGuinn, Jelena Zurovac, Constance Delannoy, Alyssa Evans, Michael Barna, Aparna Keshaviah, Kristen A Feemster","doi":"10.1177/00333549261488379","DOIUrl":"10.1177/00333549261488379","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding pneumococcal vaccine uptake across county-level social vulnerability is important for identifying geographic disparities and informing strategies to increase vaccine uptake and reduce the incidence of pneumococcal disease (PD). Using a retrospective cohort design, we characterized differences in vaccine uptake among publicly insured US adults, comparing vaccination rates among beneficiaries in counties with high versus low social vulnerability.</p><p><strong>Methods: </strong>We assessed uptake and disease risk using claims for Medicare (aged ≥65 y; 2016-2019) and Medicaid (low income or disabled; 2017-2019) beneficiaries. We measured county-level social vulnerability using the 2021 Minority Health Social Vulnerability Index (overall score and 6 theme scores).</p><p><strong>Results: </strong>Of the 56.9 million Medicare beneficiaries analyzed, 36.9% received a pneumococcal vaccine, as did 7.6% of the 8.6 million Medicaid beneficiaries. Vaccine uptake was significantly lower in counties with the highest versus lowest social vulnerability (34.8% vs 38.6% among Medicare beneficiaries, <i>P</i> < .001 and 7.3% vs 7.9% among Medicaid beneficiaries, <i>P</i> < .001). Disparities were most pronounced when vulnerability was based on the socioeconomic status theme in the Medicare cohort and on the health care infrastructure and access theme in the Medicaid cohort. The overall pattern was reversed (with higher uptake in the most vulnerable counties) when vulnerability was based on the minority status and language theme among Medicaid beneficiaries at high risk for PD. Controlling for beneficiary characteristics (age group, sex, disease risk status, race and ethnicity, and urbanicity) strengthened the association between vulnerability and uptake.</p><p><strong>Conclusions: </strong>These findings suggest that county- and individual-level factors are associated with disparities in pneumococcal vaccine uptake and underscore the need for tailored clinical, community, and policy strategies to boost pneumococcal vaccine uptake in socially vulnerable populations.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261488379"},"PeriodicalIF":2.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting Nonreportable Disease Trends Using Electronic Health Records: Human Parvovirus B19 in Minnesota, January 2019 Through September 2024.","authors":"Sophie Wiitala, Lindsey Erickson, Margo Wheatley, Eva Enns, Danielle Kvasager, Elizabeth Dufort, Sarah Lim, Ruth Lynfield, Jennifer Zipprich, Stephen Contag, Paul E Drawz, Kristin Sweet","doi":"10.1177/00333549261460009","DOIUrl":"10.1177/00333549261460009","url":null,"abstract":"<p><strong>Objectives: </strong>In 2024, an increase in human parvovirus B19 (B19) infections among pregnant patients resulting in severe fetal complications highlighted the lack of routine surveillance methods for nonreportable infections. We examined the utility of electronic health record (EHR) data for investigating statewide trends in nonreportable infections, using B19 as a case study.</p><p><strong>Methods: </strong>We used EHR data from 10 health systems aggregated by the Minnesota Electronic Health Record Consortium to analyze statewide B19 trends in Minnesota. We mapped health system data to a common data model using concept identifiers, a standardized medical coding vocabulary. We examined the frequency of B19-associated laboratory testing, diagnoses, and pregnancy complications among Minnesota residents from January 2019 through September 2024, focusing on females of reproductive age (15-44 y) when examining B19-associated pregnancy complications.</p><p><strong>Results: </strong>B19 testing and test positivity increased in 2024 compared with the preceding 60 months. From January 2019 through September 2024, 47 females of reproductive age had B19-associated pregnancy complications within 60 days of a B19 diagnosis or positive laboratory test result. Of these, 19 (40.4%) occurred from January through September 2024 and 28 (59.6%) occurred during the preceding 60 months.</p><p><strong>Conclusions: </strong>These findings support the use of EHR data for disease trend analyses, particularly for rare conditions, care processes, and nonreportable diseases.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261460009"},"PeriodicalIF":2.3,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Anthrax Attacks to Threats Posed by Generative Artificial Intelligence: The Changing Nature of Biosecurity in the 21st Century.","authors":"David B Resnik, Grantham H Buchanan, Mohammad Hosseini, Stanley Maloy, Dan Eisenman","doi":"10.1177/00333549261486268","DOIUrl":"10.1177/00333549261486268","url":null,"abstract":"","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261486268"},"PeriodicalIF":2.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of SARS-CoV-2 Positivity in Travelers and Community Prevalence: Serial Cross-Sectional Data From the Traveler-based Genomic Surveillance Program.","authors":"Teresa C Smith, Stephen M Bart, Samantha M Loh, Jessica E Rothman, Nathan D Grubaugh, Lauren Gardner, Robert C Morfino, Benjamin H Rome, Andrew P Rothstein, Siyao Lisa Li, Ezra Ernst, Scott W Olesen, Allison Taylor Walker, Cindy R Friedman, Sarah Anne J Guagliardo","doi":"10.1177/00333549261477721","DOIUrl":"10.1177/00333549261477721","url":null,"abstract":"<p><strong>Objectives: </strong>As SARS-CoV-2 testing has declined, estimating disease prevalence has become challenging. The Centers for Disease Control and Prevention's Traveler-based Genomic Surveillance (TGS) program collects voluntary samples from arriving international travelers to detect SARS-CoV-2 variants. We assessed the correlation between SARS-CoV-2 positivity in travelers and community case data for their corresponding countries of origin.</p><p><strong>Methods: </strong>From December 6, 2021, through January 22, 2023, travelers (aged ≥18 y) arriving at selected US airports provided self-collected nasal swabs, which were pooled by country of origin and tested for SARS-CoV-2 using reverse transcription polymerase chain reaction. We compared weekly SARS-CoV-2 positivity rates from travelers who arrived from 6 countries (Brazil, France, Germany, India, South Africa, United Kingdom) with weekly community case rates for that same country. For the United Kingdom, we also compared traveler data with data from the UK Coronavirus (COVID-19) Infection Survey. We conducted correlation analyses by country and divided data into intervals to control for time-varying confounders. Using Spearman rank correlation, we assessed the correlations between traveler data and community or household data.</p><p><strong>Results: </strong>SARS-CoV-2 positivity in travelers and community case data frequently demonstrated concordance (66.7% of time intervals were significantly correlated, defined as <i>P</i> < .05). After June 12, 2022, when predeparture SARS-CoV-2 testing was no longer required of US-bound travelers, sample positivity among travelers arriving from the United Kingdom was significantly correlated with positivity estimates from the UK COVID-19 Infection Survey (<i>r</i>_s = 0.76; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Data from travelers may reflect trends similar to country-level SARS-CoV-2 transmission. When community testing is limited, public health authorities could consider using TGS or similar systems to monitor transmission activity.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261477721"},"PeriodicalIF":2.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future Leaders in Infections and Global Health Threats: Lessons Learned From a Federal Government Public Health Leadership Training Program, 2019-2026.","authors":"Gary Brunette, Amanda West, Natara Bierria, Alyssa Azhari, Michael P Cherry, Robert D Kirkcaldy","doi":"10.1177/00333549261480983","DOIUrl":"10.1177/00333549261480983","url":null,"abstract":"<p><p>Federal public health agencies face complex challenges that require leaders capable of making strategic decisions, directing emergency response, and advancing crucial health services. Public health leadership skills can be cultivated through leadership development programs. However, limited data are available to guide the development and implementation of such programs. We describe the Centers for Disease Control and Prevention's (CDC's) Future Leaders in Infections and Global Health Threats (FLIGHT) fellowship. In 2019, CDC established FLIGHT to develop emerging leaders capable of addressing infectious disease threats in CDC's international country offices. This 3-year program provided leadership training, international public health practice, and post-FLIGHT employment opportunities at CDC host sites. FLIGHT participants (14 total; 12 graduates) gained valuable international experience and leadership training, contributed to public health emergency responses, and developed scientific leadership skills. We describe program implementation and findings from internal program evaluation activities conducted among participating officers and host sites. FLIGHT faced structural limitations that affected its overall effectiveness. Recruitment challenges stemmed from the program's duration and lack of direct-hire mechanisms, whereas limited cohort sizes restricted scalability and evaluation. Limited host site engagement and misalignment among program design, host site commitments, and post-FLIGHT career pathways further constrained long-term sustainability and effectiveness. Lessons learned from FLIGHT emphasize the importance of aligning program objectives with agency workforce needs, establishing clear career pathways for graduates, and considering evaluation approaches for programs with limited cohort sizes. As FLIGHT sunsets in 2026 amid funding concerns, these findings can guide development of future public health leadership trainings.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261480983"},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policy Versus Lived Reality: Recreation Time and Physical Activity in Arizona Jails.","authors":"Ricky Camplain, Elizabeth Schmitter, Meredith Brown, Isabel Fangman, Riley Woodland, Morgan Occhino, Carly Camplain","doi":"10.1177/00333549261480977","DOIUrl":"10.1177/00333549261480977","url":null,"abstract":"<p><strong>Objective: </strong>Recreation time provides important opportunities for physical activity, time outdoors, and stress reduction during incarceration, yet little is known about how recreation time policies are documented and implemented in US jails. We documented recreation time policies in Arizona county jails and assessed the degree to which written policies align with operational practices.</p><p><strong>Methods: </strong>Using a modified policy surveillance approach, we abstracted recreation‑related policies from 14 Arizona jail handbooks. We documented operational practices through structured interviews with administrators from 10 Arizona jails and calculated policy-practice agreements for each county and recreation domain.</p><p><strong>Results: </strong>All handbooks and all interviewed facilities indicated that recreation time was provided. However, detailed policy content varied widely. Recreation time frequency was documented in only 43% of handbooks but was reported in 90% of interviews. Similarly, the duration of recreation time was documented in only 36% of handbooks compared with 100% of interviews. Policy-practice agreement ranged from 100% for recreation availability and location to 10% for equipment availability. No handbook documented physical activity programs, and only 2 facilities reported offering them.</p><p><strong>Conclusions: </strong>Recreation time policies in Arizona jails are inconsistently documented and often omit essential details, limiting transparency. Improving policy clarity and alignment with practice may enhance equitable access to recreation opportunities for incarcerated individuals.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261480977"},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Overdose Risk and Recovery Barriers: A Mixed Methods Study of Perspectives From a Community.","authors":"Timothy C Guetterman, Leah Casanave, Nicole Horio, Kurt Parker, Martha Koenig, Sydney Ball, Luke Baxter, Dhitinut Ratnapradipa","doi":"10.1177/00333549261477063","DOIUrl":"10.1177/00333549261477063","url":null,"abstract":"<p><strong>Objectives: </strong>According to the Centers for Disease Control and Prevention, opioid-related deaths in the United States have increased steadily during the past 20 years, contributing to a major public health emergency. In Nebraska's most populous county, Douglas County, the drug overdose mortality rate nearly doubled from 2015 to 2021. This study assessed the current needs, barriers, and priorities related to opioid use and overdose in Douglas County to inform local response strategies.</p><p><strong>Methods: </strong>We used a mixed methods explanatory sequential design that included (1) surveys of people with lived and living experience of substance use and their family members or support people and (2) interviews with leaders and staff of community-based organizations in Douglas County.</p><p><strong>Results: </strong>Seventy-three people completed surveys, and 8 community partners participated in qualitative interviews. The main service needs identified were (1) specific treatment options for women with children, (2) primary care providers offering medication-assisted therapy, and (3) peer-run services. In addition, individuals who were recently incarcerated had distinct challenges. A cross-cutting theme was the need for community understanding and education about substance use, particularly as it relates to stigma as a barrier to treatment and to obtaining naloxone. Both survey and qualitative results indicated a need to improve access to naloxone and to strengthen community-level understanding of its use. Unmet social needs, including unstable housing, food insecurity, and transportation barriers, were identified as contributing factors to substance use and to difficulties accessing treatment.</p><p><strong>Conclusions: </strong>This study identified current community needs and barriers in addressing the opioid crisis in Douglas County. The findings provide guidance for ongoing efforts to reduce opioid-related overdose deaths.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261477063"},"PeriodicalIF":2.3,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Message From the Editor.","authors":"Zygmunt F Dembek","doi":"10.1177/00333549261482085","DOIUrl":"10.1177/00333549261482085","url":null,"abstract":"","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261482085"},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking, Nicotine Dependence, and Suicide Risk: A Dose-Response Analysis Using the Heavy Smoking Index.","authors":"Hee-Soo Lee, Wanhyung Lee, Seunghyun Lee","doi":"10.1177/00333549261477722","DOIUrl":"10.1177/00333549261477722","url":null,"abstract":"<p><strong>Objectives: </strong>Although smoking is a risk factor for suicide, the role of nicotine dependence is unclear. We evaluated whether the Heavy Smoking Index (HSI) could serve as a brief screening tool to identify Korean adults at elevated risk of suicidal ideation, suicide planning, and suicide attempts in population health settings.</p><p><strong>Methods: </strong>We analyzed data from the 2019 and 2022 Korea National Health and Nutrition Examination Survey using multivariable logistic regression to estimate adjusted odds ratios (AORs) for suicidal ideation, suicide planning, and suicide attempts by smoking status and HSI-defined nicotine dependence.</p><p><strong>Results: </strong>Among 9321 participants aged ≥19 years, 4.7% reported suicidal ideation, 1.1% had a suicide plan, and 0.5% had attempted suicide. Compared with nonsmokers, smokers had higher odds of suicidal ideation (AOR = 1.75; 95% CI, 1.33-2.31) and suicide planning (AOR = 3.33; 95% CI, 1.99-5.58); the odds of suicide attempts were not significantly higher (AOR = 1.17; 95% CI, 0.53-2.59). Among current smokers, higher HSI-defined nicotine dependence was associated with greater risk of suicidal ideation and suicidal planning, consistent with a dose-response relationship across dependence levels.</p><p><strong>Conclusions: </strong>Nicotine dependence influenced suicidal behaviors beyond smoking status alone, supporting the integration of targeted cessation programs into national suicide prevention frameworks. Future longitudinal studies with biochemical assessment should clarify the underlying causal pathways.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549261477722"},"PeriodicalIF":2.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capacity of Medicaid Providers to Implement and Sustain Evidence-Based Practices for Behavioral Health Services, Louisiana, 2022.","authors":"Lisa Staples, Gabrielle Gonzalez, Alice Yeh, Ronnie Rubin, Stephen Phillippi","doi":"10.1177/00333549261434126","DOIUrl":"10.1177/00333549261434126","url":null,"abstract":"<p><p>The Center for Evidence to Practice at Louisiana State University Health Sciences School of Public Health (hereinafter, the Center) is committed to strengthening the capacity of Medicaid providers to implement and sustain evidence-based practices (EBPs) for behavioral health services. With funding from the Louisiana Department of Health-Office of Behavioral Health, the Center conducted the EBP Capacity and Sustainability Funding Initiative to expand the use and accessibility of EBPs in Louisiana. This case study examined how targeted financial incentives and technical assistance supported clinicians in qualifying for, billing, and delivering 7 EBPs within Louisiana's Medicaid behavioral health system. Thirty EBP-qualified clinicians delivered 361 sessions to 93 clients during a 5-month funding period (March-July 2022) and earned $167 500 in incentives across 25 entities. A survey of these clinicians found that 96% (24 of 25) would recommend this type of incentive, reporting increased motivation, professional recognition, and capacity to grow their practices. However, Medicaid claims data showed that the use of EBP tracking codes decreased after the incentive period ended, suggesting that short-term funding alone was insufficient for long-term sustainability. Clinicians identified administrative and technical barriers, including inconsistent managed care organization requirements and nonstandardized billing processes. A simplified billing infrastructure and ongoing funding incentives are needed to reduce the administrative burden of billing and promote EBP implementation. Findings highlight the strengths and limitations of short-term incentive programs for advancing EBP delivery within a Medicaid system.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"633-639"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}