Public Health ReportsPub Date : 2024-09-01Epub Date: 2024-03-19DOI: 10.1177/00333549241236085
Charleigh J Granade, Nathan E Crawford, Michelle Banks, Sam Graitcer
{"title":"Analysis of the Federal Section 317 Immunization Program and Routine Adult Immunization Activities, United States, 2022-2023.","authors":"Charleigh J Granade, Nathan E Crawford, Michelle Banks, Sam Graitcer","doi":"10.1177/00333549241236085","DOIUrl":"10.1177/00333549241236085","url":null,"abstract":"<p><strong>Objectives: </strong>The federal Section 317 Immunization Program, administered by the Centers for Disease Control and Prevention (CDC), provides funding to support adult immunization efforts; however, current information on program implementation at the jurisdictional level is limited. We assessed the use of Section 317 and other funding sources to support routine adult immunization activities among the 64 immunization programs (\"awardees\").</p><p><strong>Methods: </strong>We conducted a survey and key informant interviews with awardees in October to December 2022 to collect quantitative and qualitative data on current adult vaccine purchase and program operation activities funded by Section 317 and other funding sources. We assessed total vaccine cost and data on vaccine purchase projections for each awardee with CDC's Cost and Affordability Tool for 2023.</p><p><strong>Results: </strong>Immunization program managers or their designees from 62 of 64 awardees (97%) completed the survey; 12 awardees participated in key informant interviews. Of 62 awardees, 32 (52%) used a single funding source to support adult vaccine purchases, of which 29 (91%) used only Section 317 funds, 21 (34%) reported not planning to purchase ≥1 age-based recommended vaccine for adults in 2023, and 33 (53%) reported using Section 317 funds only to support adult immunization program operations. Key informant interviews showed varied operational activities among awardees, but 8 awardees stated the need for additional staff to expand adult immunization program services in health care provider education (n = 5), program administration (n = 5), and site visits (n = 6).</p><p><strong>Conclusions: </strong>Additional efforts are needed to understand how to better support routine adult immunization activities implemented at the jurisdictional level.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"626-634"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176155","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}
Public Health ReportsPub Date : 2024-09-01Epub Date: 2024-03-22DOI: 10.1177/00333549241237382
Melissa S Creary, Whitney Peoples, Paul J Fleming
{"title":"Health Equity Requires Working Toward Antiracist Local Public Health Departments.","authors":"Melissa S Creary, Whitney Peoples, Paul J Fleming","doi":"10.1177/00333549241237382","DOIUrl":"10.1177/00333549241237382","url":null,"abstract":"","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"527-531"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194446","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}
Public Health ReportsPub Date : 2024-09-01Epub Date: 2024-03-17DOI: 10.1177/00333549241230921
Karli R Hochstatter, Marlon Williams, Shanna Latham, David Fenton, Andrew L Falzon
{"title":"Rapid Identification of Suspected Drug Overdose Deaths by Death Investigators, New Jersey, 2020.","authors":"Karli R Hochstatter, Marlon Williams, Shanna Latham, David Fenton, Andrew L Falzon","doi":"10.1177/00333549241230921","DOIUrl":"10.1177/00333549241230921","url":null,"abstract":"<p><strong>Objective: </strong>While the number of overdoses in the United States continues to increase, lags in data availability have undermined efforts to monitor, respond to, and prevent drug overdose deaths. We examined the performance of a single-item mandatory radio button implemented into a statewide medical examiner database to identify suspected drug overdose deaths in near-real time.</p><p><strong>Materials and methods: </strong>The New Jersey Office of the Chief State Medical Examiner operates a statewide mandated case management data system to document deaths that fall under the jurisdiction of a medical examiner office. In 2018, the New Jersey Office of the Chief State Medical Examiner implemented a radio button into the case management data system that requires investigators to report whether a death is a suspected drug overdose death. We examined the performance of this tool by comparing confirmed drug overdose deaths in New Jersey during 2020 with suspected drug overdose deaths identified by investigators using the radio button. To measure performance, we calculated sensitivity, specificity, positive predictive value, negative predictive value, and false-positive and false-negative error rates.</p><p><strong>Results: </strong>During 2020, New Jersey medical examiners investigated 26 527 deaths: 2952 were confirmed by the state medical examiner as a drug overdose death and 3050 were identified by investigators using the radio button as a suspected drug overdose death. Sensitivity was calculated as 96.1% (2837/2952), specificity as 99.1% (23 362/23 575), positive predictive value as 93.0% (2837/3050), negative predictive value as 99.5% (23 362/23 477), false-positive error rate as 7.0% (213/3050), and false-negative error rate as 3.9% (115/2952).</p><p><strong>Practice implications: </strong>Implementation of a radio button into death investigation databases provides a simple and accurate method for identifying and tracking drug overdose deaths in near-real time.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"549-556"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144006","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}
Public Health ReportsPub Date : 2024-09-01Epub Date: 2024-03-15DOI: 10.1177/00333549241230479
Heleen Vermandere, Gisela Martínez-Silva, Santiago Aguilera-Mijares, Araczy Martínez-Dávalos, Sergio Bautista-Arredondo
{"title":"Evaluating the Screening and Enrollment of People at Risk of HIV in Mexico's Preexposure Prophylaxis Demonstration Project, 2018-2020.","authors":"Heleen Vermandere, Gisela Martínez-Silva, Santiago Aguilera-Mijares, Araczy Martínez-Dávalos, Sergio Bautista-Arredondo","doi":"10.1177/00333549241230479","DOIUrl":"10.1177/00333549241230479","url":null,"abstract":"<p><strong>Objectives: </strong>Screening tools in which participants self-report sexual behaviors can identify people at risk of HIV acquisition for enrollment in preexposure prophylaxis (PrEP). We compared enrollment outcomes (ie, receiving PrEP vs being excluded by a counselor or declining PrEP) in Mexico's PrEP demonstration project and evaluated the validity of a 4-criteria PrEP eligibility tool in which participants self-reported risk behavior-having condomless anal sex, transactional sex, a partner living with HIV, or a sexually transmitted infection-as compared with PrEP eligibility assessed by a counselor.</p><p><strong>Methods: </strong>We recruited men who have sex with men and transwomen who were offered PrEP services in Mexico. We characterized participants according to enrollment outcome and identified underlying factors through logistic regression analyses. We calculated the sensitivity and specificity of the self-reported risk criteria, using the counselor's risk assessment as the point of reference.</p><p><strong>Results: </strong>Of 2460 participants, 2323 (94%) had risk criteria of HIV acquisition according to the 4-criteria tool; 1701 (73%) received PrEP, 247 (11%) were excluded by a counselor, and 351 (15%) declined PrEP despite being considered eligible by the counselor. Participants who were excluded or who declined PrEP were less likely to report HIV risk behaviors than those who received PrEP, and participants who declined PrEP were more likely to be transwomen (vs men who have sex with men) and aged ≤25 years (vs >25 y). The 4-criteria risk tool had high sensitivity (98.6%) and low specificity (29.8%).</p><p><strong>Conclusion: </strong>The screening tool identified most participants at risk of HIV acquisition, but counselors' assessment helped refine the decision for enrollment in PrEP by excluding those with low risk. Public health strategies are needed to enhance enrollment in PrEP among some groups.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"606-614"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140630","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}
Public Health ReportsPub Date : 2024-09-01Epub Date: 2024-03-19DOI: 10.1177/00333549241236629
Khaleel S Hussaini, Romeo Galang, Rui Li
{"title":"Differences in Cesarean Rates for Nulliparous, Term, Singleton, Vertex Births Among Racial and Ethnic Groups and States Before and After Stay-at-Home Orders During the COVID-19 Pandemic, United States, 2017-2021.","authors":"Khaleel S Hussaini, Romeo Galang, Rui Li","doi":"10.1177/00333549241236629","DOIUrl":"10.1177/00333549241236629","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence is limited on differences in cesarean rates for nulliparous, term, singleton, vertex (NTSV) births across racial and ethnic groups at the national and state level during the COVID-19 pandemic. We assessed changes in levels and trends of NTSV cesarean rates before and after stay-at-home orders (SAHOs) were implemented in the United States (1) overall, (2) by racial and ethnic groups, and (3) by 50 US states from January 2017 through December 2021.</p><p><strong>Methods: </strong>We used birth certificate data from 2017 through 2021, restricted to hospital births, to calculate monthly NTSV cesarean rates for the United States and for racial and ethnic groups and to calculate quarterly NTSV cesarean rates for the 50 states. We used interrupted time-series analysis to measure changes in NTSV cesarean rates before and after implementation of SAHOs (March 1 through May 31, 2020).</p><p><strong>Results: </strong>Of 6 022 552 NTSV hospital births, 1 579 645 (26.2%) were cesarean births. Before implementation of SAHOs, NTSV cesarean rates were declining in the United States overall; were declining among births to non-Hispanic Asian, non-Hispanic Black, Hispanic, and non-Hispanic White women; and were declining in 6 states. During the first month of implementation of SAHOs in May 2020, monthly NTSV rates increased in the United States by 0.55%. Monthly NTSV rates increased by 1.20% among non-Hispanic Black women, 0.90% among Hispanic women, and 0.28% among non-Hispanic White women; quarterly NTSV rates increased in 6 states.</p><p><strong>Conclusion: </strong>In addition to emergency preparedness planning, hospital monitoring, and reporting of NTSV cesarean rates to increase provider awareness, reallocation and prioritization of resources may help to identify potential strains on health care systems during public health emergencies such as the COVID-19 pandemic.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"615-625"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176157","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}
Amanda D Tran, Alice E White, Rachel H Jervis, Ingrid Hewitson, Elaine J Scallan Walter
{"title":"Characteristics of People Who Do Not Complete a Public Health Interview: An Assessment of Colorado Enteric Disease Surveillance Data.","authors":"Amanda D Tran, Alice E White, Rachel H Jervis, Ingrid Hewitson, Elaine J Scallan Walter","doi":"10.1177/00333549241269483","DOIUrl":"10.1177/00333549241269483","url":null,"abstract":"<p><strong>Objectives: </strong>Although enteric disease case interviews are critical for control measures and education, not all case-patients are interviewed. We evaluated systematic differences between people with an enteric disease in Colorado who were and were not interviewed to identify ways to increase response rates and reduce biases in the surveillance data used to guide public health interventions.</p><p><strong>Methods: </strong>We obtained data from the Colorado Electronic Disease Reporting System from March 1, 2017, through December 31, 2019. Among case-patients not interviewed and interviewed, we used univariate analyses to describe sociodemographic characteristics, timing of contact attempts, and effect of additional funding.</p><p><strong>Results: </strong>As compared with case-patients who were interviewed, case-patients who were not interviewed were significantly more likely to be aged 18 to 39 years (35.7% vs 31.7%; <i>P</i> < .001); identify as male, Hispanic, or Black; be experiencing homelessness or hospitalization; reside in rural/frontier areas or an institution; or live in areas with lower levels of education, life expectancy, and income. Time to first contact attempt was longer for case-patients who were not interviewed than for those who were (mean days from specimen collection to first contact attempt, 9.8 vs 6.8; <i>P</i> < .001). Residing in a jurisdiction with additional funding for interviewing was associated with increased interview rates (87.7% vs 68.8%) and timeliness of public health report and first contact attempt (2.3 vs 4.4 days; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Findings can guide efforts to improve response rates in groups least likely to be interviewed, resulting in reduced biases in surveillance data, better disease mitigation, and increased efficiency in case investigations. Timeliness of case interviews and additional funding to conduct case investigations were factors in increasing response rates.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549241269483"},"PeriodicalIF":3.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111367","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}
Stacy Davis, Devin English, Stephanie Shiau, Rajita Bhavaraju, Shauna Downs, Gwyneth M Eliasson, Kristen D Krause, Emily V Merchant, Tess Olsson, Michelle M Ruidíaz-Santiago, Nimit N Shah, Laura E Liang, Teri Lassiter
{"title":"Developing and Implementing a Diversity, Equity, and Inclusion Curriculum Self-reflection Process at a School of Public Health.","authors":"Stacy Davis, Devin English, Stephanie Shiau, Rajita Bhavaraju, Shauna Downs, Gwyneth M Eliasson, Kristen D Krause, Emily V Merchant, Tess Olsson, Michelle M Ruidíaz-Santiago, Nimit N Shah, Laura E Liang, Teri Lassiter","doi":"10.1177/00333549241271728","DOIUrl":"10.1177/00333549241271728","url":null,"abstract":"<p><p>We critically reviewed the motivations, processes, and implementation methods underlying a faculty-driven diversity, equity, and inclusion (DEI) curriculum self-reflection project in the Rutgers School of Public Health. This case study offers guidance on a curriculum self-reflection tool that was developed through the school's Curriculum Committee to promote DEI throughout the school's curricula. We review the key steps in this process and the unique aspects of developing and implementing such evaluations within higher education. The study draws on faculty experience, was informed by students and staff within the Curriculum Committee, and builds on existing knowledge and tools. A flexible 6-step framework-including guiding principles and strategic approaches to planning, developing, and implementing a DEI curriculum self-assessment-is provided to assist instructors, curriculum committees, DEI groups, and academic leaders at schools of public health interested in refining their courses and curricula. Academic units experience contextual challenges, and while each is at a different stage in curriculum reform, our findings provide lessons about integrating the assessment of DEI in school curriculum in a systematic and iterative way. Our approach can be applied to diverse academic settings, including those experiencing similar implementation challenges.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549241271728"},"PeriodicalIF":3.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073661","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}
Katharine L Thomas, Tricia A Aden, Patricia A Blevins, Amanda J Raziano, Tyler Wolford, Margaret A Honein, Julie M Villanueva
{"title":"Evaluation of the Laboratory Response Network and Testing Access During the First 10 Weeks of the Mpox Response, United States, May 17-July 31, 2022.","authors":"Katharine L Thomas, Tricia A Aden, Patricia A Blevins, Amanda J Raziano, Tyler Wolford, Margaret A Honein, Julie M Villanueva","doi":"10.1177/00333549241269497","DOIUrl":"10.1177/00333549241269497","url":null,"abstract":"<p><strong>Objectives: </strong>The Laboratory Response Network (LRN) consists of US and international laboratories that respond to public health emergencies, such as biothreats. We used a qualitative approach to assess the successes and challenges of the LRN during the initial 10 weeks of the 2022 mpox outbreak (May 17-July 31, 2022).</p><p><strong>Methods: </strong>We conducted 9 unstructured interviews, which included 3 interviews with subject matter experts from the Centers for Disease Control and Prevention (CDC) and 6 interviews with state and local public health laboratories and epidemiologists and Association of Public Health Laboratories (APHL) staff. We asked guiding questions on investments in preparedness, successes, and challenges during the initial mpox response and asked for suggestions to improve future LRN responses to infectious disease outbreaks. We also reviewed data from 2 contemporaneous APHL surveys conducted in June and July 2022 in 84 LRN public health laboratories.</p><p><strong>Results: </strong>Notable successes included availability of an assay that had received clearance from the US Food and Drug Administration (FDA) for testing orthopoxviruses (non-variola <i>Orthopoxvirus</i> [NVO] assay) and a trained workforce; strong relationships among FDA, CDC, and the LRN; and strong communications between LRN laboratories and CDC. Challenges included variability among LRN laboratories in self-reported testing capacity, barriers to accessing the NVO assay for health care providers, and gaps in LRN function during surges of testing needs.</p><p><strong>Conclusions: </strong>The LRN system plays an essential role in the response to emerging infectious disease outbreaks in the United States. Lessons learned from the LRN's initial response to the mpox outbreak can help guide improvements to better position the LRN for future responses, including continued engagement with health care providers, commercial laboratories, and laboratories in health care settings.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"333549241269497"},"PeriodicalIF":3.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073662","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}
Public Health ReportsPub Date : 2024-07-01Epub Date: 2024-02-15DOI: 10.1177/00333549231223140
Tina J Benoit, Yun Kim, Yangyang Deng, Zheng Li, Lee Harding, Ryan Wiegand, Xiaoyi Deng, Jefferson M Jones, Iachan Ronaldo, Kristie E N Clarke
{"title":"Association Between Social Vulnerability and SARS-CoV-2 Seroprevalence in Specimens Collected From Commercial Laboratories, United States, September 2021-February 2022.","authors":"Tina J Benoit, Yun Kim, Yangyang Deng, Zheng Li, Lee Harding, Ryan Wiegand, Xiaoyi Deng, Jefferson M Jones, Iachan Ronaldo, Kristie E N Clarke","doi":"10.1177/00333549231223140","DOIUrl":"10.1177/00333549231223140","url":null,"abstract":"<p><strong>Objective: </strong>We conducted a national US study of SARS-CoV-2 seroprevalence by Social Vulnerability Index (SVI) that included pediatric data and compared the Delta and Omicron periods during the COVID-19 pandemic. The objective of the current study was to assess the association between SVI and seroprevalence of infection-induced SARS-CoV-2 antibodies by period (Delta vs Omicron) and age group.</p><p><strong>Methods: </strong>We used results of infection-induced SARS-CoV-2 antibody assays of clinical sera specimens (N = 406 469) from 50 US states from September 2021 through February 2022 to estimate seroprevalence overall and by county SVI tercile. Bivariate analyses and multilevel logistic regression models assessed the association of seropositivity with SVI and its themes by age group (0-17, ≥18 y) and period (Delta: September-November 2021; Omicron: December 2021-February 2022).</p><p><strong>Results: </strong>Aggregate infection-induced SARS-CoV-2 antibody seroprevalence increased at all 3 SVI levels; it ranged from 25.8% to 33.5% in September 2021 and from 53.1% to 63.5% in February 2022. Of the 4 SVI themes, socioeconomic status had the strongest association with seroprevalence. During the Delta period, we found significantly more infections per reported case among people living in a county with high SVI (odds ratio [OR] = 2.76; 95% CI, 2.31-3.21) than in a county with low SVI (OR = 1.65; 95% CI, 1.33-1.97); we found no significant difference during the Omicron period. Otherwise, findings were consistent across subanalyses by age group and period.</p><p><strong>Conclusions: </strong>Among both children and adults, and during both the Delta and Omicron periods, counties with high SVI had significantly higher SARS-CoV-2 antibody seroprevalence than counties with low SVI did. These disparities reinforce SVI's value in identifying communities that need tailored prevention efforts during public health emergencies and resources to recover from their effects.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"501-511"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735977","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}
Public Health ReportsPub Date : 2024-07-01Epub Date: 2023-11-13DOI: 10.1177/00333549231206404
Amanda Monroy, Jennifer Berry, Selene Brambl, Jennie Mullins, Theresa A Cullen
{"title":"Ensuring an Equitable Response to the COVID-19 Pandemic in Pima County, Arizona, Through Local Political Support and Policy Action.","authors":"Amanda Monroy, Jennifer Berry, Selene Brambl, Jennie Mullins, Theresa A Cullen","doi":"10.1177/00333549231206404","DOIUrl":"10.1177/00333549231206404","url":null,"abstract":"<p><p>In the United States, persistent health disparities and preexisting gaps in local public health infrastructure led to disproportionate effects of COVID-19 across populations at high risk of COVID-19-related morbidity and mortality. In Pima County, Arizona, equity-centered local government engagement and policy action, multipronged community-based responses, and expansion of historically underfunded local public health infrastructure improved equitable outcomes and addressed multiple systemic factors. This case study examined Pima County's 3-pronged public health response to COVID-19 using an equity-based approach. As a result, COVID-19 was the third leading cause of death in Pima County in 2021, compared with being the leading cause of death in Arizona. Strong political support from local elected officials created the authorizing environment for the Pima County Health Department to advance health equity. Passage of a resolution in December 2020, which framed the racial and ethnic health and socioeconomic inequities as a public health crisis, supported innovation and fostered the creation of an Office of Health Equity, a public health policy program, and a data and informatics program. New structures for community engagement were formed, including an ethics committee and a community advisory committee, to ensure a formalized process for community participation in public health actions, during and after the pandemic response. Key lessons learned included (1) the importance of local government support, codified to allow implementation of creative strategies; (2) opening avenues for community voice and engagement in planning and implementation to respond in areas of greatest need; and (3) having flexible funding to sustain an equitable response.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":" ","pages":"16S-22S"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156268","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}