Journal of Public Health Management and Practice最新文献

{"title":"A Promising Opportunity to Address Food Insecurity and Promote Equity: The Crucial Role of Federally Qualified Health Centers.","authors":"Kimberley D Freeman, Karen Peters, Dana Vallangeon","doi":"10.1097/PHH.0000000000002359","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002359","url":null,"abstract":"<p><strong>Objective: </strong>To explore how Federally Qualified Health Centers (FQHCs) are addressing food insecurity by understanding their existing and needed services, policies, and community partnerships using a social determinants of health perspective to promote health equity.</p><p><strong>Design: </strong>A mixed-methods, exploratory case study research design consisting of two phases was conducted in 2023. Phase I involved a survey of FQHC leaders in Ohio. From these data, eight FQHC cases were identified for Phase II qualitative interviews of staff and patients.</p><p><strong>Setting: </strong>Ohio Federally Qualified Health Centers.</p><p><strong>Participants: </strong>Executives, Frontline Staff and Patient Board Members of Federally Qualified Health Centers.</p><p><strong>Main outcome measures: </strong>Policies, services, and community partnerships used by FQHCs to address food insecurity; FQHC screening staff and tools; resources to support food security; facilitators and barriers; FQHC methods to address health equity.</p><p><strong>Results: </strong>The majority of survey respondents (54%) stated that nutrition counseling was the most popular FQHC service provided, followed by the National Diabetes Prevention Program, and National Hypertension Control Initiative each at 24%. Policies related to federal food programs were listed by most respondents (N = 18) for addressing food insecurity, followed by food assistance programs including food pantries and food banks (N = 14). Farmers markets (40.54%) and local health departments (21.62%) were listed most frequently as community partners for FQHCs. Equity-related responses included screening all patients for food insecurity and having the screening tool available in multiple languages.</p><p><strong>Conclusions: </strong>FQHCs provide services to underserved and at-risk patients. The top three diet-related chronic diseases addressed by FQHCs were diabetes, hypertension, and obesity. The most common social determinants of health concerns were food insecurity and transportation. Federally Qualified Health Centers staff and patient board members indicated that there should be an increased focus on equity.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Growing Our Own\": Enhancing the Rural Public Health Workforce's Capacity to Put Equity Into Action.","authors":"Madeleine Fraix, Megan Rogers, Barbara Rose, Betty Bekemeier","doi":"10.1097/PHH.0000000000002352","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002352","url":null,"abstract":"<p><strong>Objectives: </strong>This assessment examined the health equity training needs of public health staff serving rural areas of US Health and Human Services Region 10, focusing on the challenges they face in implementing equity initiatives and the resources needed to advance health equity in their communities.</p><p><strong>Design: </strong>A training needs assessment using interviews with public health staff serving rural areas.</p><p><strong>Setting: </strong>US Health and Human Services Region 10, consisting of Alaska, Idaho, Oregon, and Washington.</p><p><strong>Participants: </strong>Fifteen public health staff working with rural communities, recruited through convenience sampling, representing state, local, and academic organizations.</p><p><strong>Main outcome measure: </strong>Current health equity activities led by public health staff serving rural areas in Region 10, the challenges encountered in implementing health equity initiatives, and the resources required to strengthen capacity and sustain these efforts.</p><p><strong>Results: </strong>The public health staff interviewed describe themselves as regularly involved in and committed to health equity work in their communities. Opportunities were identified regarding desired support for enhanced health equity training, improved data access and literacy, capacity-building for staff by supporting local expertise and technical assistance, and strategies aimed at developing a shared language related to health equity.</p><p><strong>Conclusions: </strong>Rural populations are diverse and experience many challenges when it comes to inequitable health outcomes. Furthermore, public health staff serving rural areas appear to face unique challenges in doing equity-related work. Training interventions need to be tailored to the needs of each place, and ideally led by people within or deeply familiar with the communities they serve.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Health of Governance: Identifying and Addressing Burnout Among Public Health Association Board Members.","authors":"Caroline Stampfel, Joe Bohn, Russell S Kirby","doi":"10.1097/PHH.0000000000002347","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002347","url":null,"abstract":"<p><strong>Abstract: </strong>The COVID-19 pandemic caused stress and burnout for governmental public health workers, negatively affecting workers' desire to remain in their professional role. In October 2022, a board for a national association assessed their professional development needs, identified manifestations of burnout, and generated strategies to address burnout. Of 21 board members invited, 16 (76%) responded. Quantitative items were summarized using descriptive analysis. Open-ended responses were summarized with thematic analysis. Board members identified balance between private and professional lives to optimize well-being as a competency growth area. They selected group discussion (56%) as their top learning method. Burnout manifested as frustration, fatigue, disengagement, poor decision making, feeling overwhelmed, and illness. Six categories described strategies to address burnout: positive self-talk, protecting time, modeling, creativity/fun, \"get-out-there,\" and resources/support. To address burnout and support public health workers, associations can prioritize the development and well-being of board members who might not otherwise prioritize their development.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Priorities to Reverse a Statewide Relative Health Decline: Results From a Delphi Study in Kansas.","authors":"Kevin A Kovach, Viktoria Sterkhova, Emma Uridge, Wen-Chieh Lin","doi":"10.1097/PHH.0000000000002360","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002360","url":null,"abstract":"<p><strong>Objective: </strong>To identify and prioritize system-level factors contributing to Kansas' long-term population health decline compared with the United States and demonstrate the application and value of the modified Delphi technique for complex, state-level health assessment.</p><p><strong>Methods: </strong>A modified Delphi study was conducted in Kansas to engage experts and leaders in Kansas' health across sectors. Participants (n = 50 Round 1; n = 67 Round 2; n = 60 Round 3) provided qualitative input and completed quantitative prioritization across 3 Delphi rounds. Issue statements were developed from open-ended responses (Round 1), rated for importance (Round 2), and prioritized through a constant sum resource allocation exercise (Round 3).</p><p><strong>Results: </strong>Participants identified 52 factors contributing to Kansas' health decline. Of these, 4 emerged as the highest priorities: closure of rural hospitals and health care services, failure to expand Medicaid, limited mental health service availability, and low public health funding. Seven additional factors were identified as high priorities. The highest-ranked issues reflected system-level drivers rather than individual behaviors.</p><p><strong>Conclusions: </strong>Kansas' declining health trajectory is primarily driven by structural system vulnerabilities, including policies and infrastructure gaps misaligned with what produces health.</p><p><strong>Policy implications: </strong>Addressing Kansas' health decline will require targeted policy reforms that strengthen system capacity and align with evidence-based approaches used by higher-performing states.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Late-Season Reminder-Recall for Influenza Vaccine Uptake Among Older Adults in Louisiana.","authors":"Sara Brown, Arundhati Bakshi, Ousswa Kudia, Quan Le, Robert Johannessen","doi":"10.1097/PHH.0000000000002285","DOIUrl":"https://doi.org/10.1097/PHH.0000000000002285","url":null,"abstract":"<p><p>The 2019-2020 and 2023-2024 flu seasons had unusually active influenza activity late in the season. As vaccines can be a cost-effective way of avoiding severe illness with the flu resulting in hospitalizations or mortality, the Louisiana Department of Health mailed reminder-recall postcards to adults aged 65 to 70 years to raise awareness about respiratory vaccines, including those for flu. In the 2 weeks following the distribution of reminder-recall mailers (n = 47 587 in February 2020 and n = 42 364 in January 2024), an additional 1017 and 1093 flu shots were administered in 2020 and 2024, respectively. These doses comprised 1% of all flu shots administered in their respective seasons and 2% of people who received the mailers. Together, the results suggest potentially limited value of flu reminder-recall mailers for this population without further research on timing, frequency, and cost-effectiveness of the same.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":"32 3","pages":"414-419"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Local Epidemiology-Results From the 2024 Big Cities Health Coalition Epidemiology Capacity Assessment.","authors":"Sarah Auer, Emily Armstrong, Jessica Arrazola, Chrissie Juliano, Kate Donaldson","doi":"10.1097/PHH.0000000000002323","DOIUrl":"10.1097/PHH.0000000000002323","url":null,"abstract":"<p><strong>Context: </strong>Epidemiologists in local health departments are central to ensuring healthy, thriving communities and responding to public health threats, particularly in big cities where diseases often emerge and spread quickly due to their landscape.</p><p><strong>Program: </strong>In Spring 2024, the Council of State and Territorial Epidemiologists and the Big Cities Health Coalition (BCHC) collaborated to field the third Epidemiology Capacity Assessment in 35 large, urban health departments, who were BCHC members at the time. The assessment aimed to track workforce capacity by understanding the number of epidemiologists currently in departments, the number of epidemiologists needed, current funding status and other key metrics of capacity.</p><p><strong>Implementation: </strong>The 30-question assessment was distributed electronically to the 35 BCHC member jurisdictions, and data collection took place from March to June 2024.</p><p><strong>Evaluation: </strong>Quantitative results were analyzed in R Studio software and Excel 2008 through a combination of descriptive statistics, cross-tabulations, and tests of significance. Qualitative results were coded and grouped thematically.</p><p><strong>Discussion: </strong>There is a need for additional epidemiologists at the local level, even in the nation's largest cities, to effectively deliver the Essential Public Health Services, and many existing staff will be lost with the end of pandemic funding. Flexible, sustained funding would allow epidemiologists to prioritize the unique needs of their communities, retain current staff and institutional knowledge, and proactively build a workforce prepared to respond to future public health emergencies.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"333-340"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State Initiatives to Promote Cannabis Industry Entrepreneurship Among Disproportionately Impacted Communities: A Multi-State Analysis.","authors":"Rishika Chakraborty, Morgan Speer, Cassidy R LoParco, Y Tony Yang, Carla J Berg","doi":"10.1097/PHH.0000000000002317","DOIUrl":"10.1097/PHH.0000000000002317","url":null,"abstract":"<p><strong>Objectives: </strong>Given the historic cannabis-related injustices in the US, several states with legalized nonmedical cannabis have initiatives to promote industry participation among disproportionately impacted communities and areas (DICAs). This study assessed these initiatives and relevant outcomes across states.</p><p><strong>Design: </strong>This was a mixed-methods study using publicly available data.</p><p><strong>Setting: </strong>Evaluation was attempted among 17 states with non-medical cannabis retail (as of May 2025) and state-level social equity (SE) entrepreneurship initiatives.</p><p><strong>Main outcome measures: </strong>Data were collected regarding: (1) characteristics of state SE entrepreneurship initiatives, including: (a) licenses available and/or reserved, (b) selection process, (c) eligibility criteria, and (d) training and financial support; and (2) relevant outcomes, including: (a) number of SE applications and SE licenses issued; and (b) percent of: SE applications licensed, total licenses issued to SE entrepreneurs, and total licenses held by each sex, race, and ethnicity.</p><p><strong>Results: </strong>Eleven states reserved a number/percentage of licenses, and certain states reserved specific licenses (n = 2) or specified licenses available (n = 3) for SE entrepreneurs. Each state required majority ownership, and most considered DICA as possible (n = 12) or required criteria (n = 3), required state residency (n = 2) or included other criteria (eg, DICA, farming-related) integrating residency (n = 13), and considered cannabis-related convictions as possible (n = 12) or required criteria (n = 2). Most provided support (training n = 14, financial n = 12, reduced fees n = 10). Percentages ranged for SE applications licensed (Arizona: 2.0% to Massachusetts/Michigan: 100%), licenses issued to SE entrepreneurs (Washington: 2.4% to Maryland: 100%), female-held licenses (Illinois: 22.0% to New Jersey: 44.0%), and minority-held licenses (Vermont: 11.3% to New Jersey: 60.3%).</p><p><strong>Conclusions: </strong>This multistate assessment marks a key step in evaluating SE entrepreneurship initiatives. However, outcomes (eg, licenses issued to SE entrepreneurs or DICA subgroups) were not clearly associated with characteristics of these initiatives, suggesting the need to consider different outcomes or allow greater time for SE initiatives to mature and have an impact.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E126-E139"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Birth Outcomes Through Increasing Access to Long-acting Reversible Contraception: An Impact Analysis of a State-funded Program in North Carolina.","authors":"Christine Tucker, Alison B Singer, Olivia E Horton, Lindsey Yates, Dorothy Cilenti, Jeremy Moulton","doi":"10.1097/PHH.0000000000002334","DOIUrl":"10.1097/PHH.0000000000002334","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between a state-funded program in North Carolina (NC) to increase access to long-acting reversible contraception (LARC) through local health departments and to reduce preterm birth (PTB) and low birthweight (LBW).</p><p><strong>Design: </strong>This population-based cohort study used a difference-in-differences approach to determine if PTB and LBW in the postintervention period (2018-2019) differed from the preintervention period (2013-2015) comparing treatment to comparator counties.</p><p><strong>Setting and intervention: </strong>Improving Community Outcomes for Maternal and Child Health funding began in June 2016 in 13 counties to improve access to LARC.</p><p><strong>Outcome measures: </strong>PTB and LBW data came from the NC Consolidated Linked Birth File, live birth certificate data probabilistically linked with other public health sources.</p><p><strong>Results: </strong>Our sample included 150 045 births from 13 treatment counties grouped into three treatment groups and 249 173 births from 56 comparator counties. There was no statistically significant decrease in PTB, and a 0.4 percentage point decrease in LBW (95% CI, -0.7, -0.1) comparing all ICO4MCH counties to comparators. We observed a one-percentage point decrease in PTB in two of the three ICO4MCH groups compared to comparator counties [Durham: -1.0 (95% CI, -1.7, -0.2) and High Country-Robeson-Sandhills: -0.9 (95% CI, -1.5, -0.4)]. For LBW, in the more rural treatment counties, there was a 1.2 percentage point difference (95% CI, -1.7, -0.8) in average predicted prevalence comparing the post- to preintervention period compared to the comparator counties. There was a statistically significant reduction in LBW for White and Black mothers in the more rural treatment counties compared to counterparts in comparator counties.</p><p><strong>Conclusions: </strong>Findings from this evaluation showed a small reduction in PTB and LBW at the population level, particularly in rural counties and among Black or African American women residing in rural counties.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"303-312"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective Cognitive Decline Among Adults Aged ≥45 Years-United States, 2023.","authors":"DaJuandra Y Eugene, Greta Kilmer, Akilah R Ali, J'Neka S Claxton, Rebecca Woodruff, Fatima Coronado, Andrea E Strahan","doi":"10.1097/PHH.0000000000002338","DOIUrl":"10.1097/PHH.0000000000002338","url":null,"abstract":"<p><p>In 2025, an estimated 7.2 million Americans aged ≥65 years had Alzheimer's disease. Subjective cognitive decline (SCD) is an early indicator of possible future dementia. Using 2023 Behavioral Risk Factor Surveillance System data, this study described the SCD prevalence among US adults aged ≥45 years. Estimates were examined by selected characteristics, state, and SCD-related features, including worry, functional limitations, and discussions about SCD with a health care provider. Overall, SCD prevalence was 16.9% (95% confidence interval [CI] = 16.5-17.3). Among those reporting SCD, 59.3% (95% CI = 57.9-60.7) were worried about it and 42.8% (95% CI = 41.4-44.1) reported having discussed SCD with a health care provider. Engaging health care providers about concerns related to memory loss or increasing confusion is a key to early identification, diagnosis, and management. These findings emphasize the need for targeted public health efforts to support individuals with SCD-especially among high-risk populations.</p>","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"E105-E110"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting Practical: 10 Ways to Put Equity and Justice into Practice: Erratum.","authors":"Jamila M Porter, Aysha Dominguez Pamukcu","doi":"10.1097/PHH.0000000000002356","DOIUrl":"10.1097/PHH.0000000000002356","url":null,"abstract":"","PeriodicalId":47855,"journal":{"name":"Journal of Public Health Management and Practice","volume":" ","pages":"430"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}