Public Health Reports最新文献

Objectives: Cardiometabolic diseases (CMDs) are highly prevalent in Mexico. We analyzed the evolution of mortality from CMDs in Mexico at the national and state level, as well as their contribution to years of life lost (YLL), from 1998 through 2022.

Methods: We conducted an observational study based on a public database. We calculated age-standardized mortality rates, conducted joinpoint regression analyses to determine changes in the trend and magnitude of mortality over time, and calculated YLL from CMDs among people in Mexico nationally and by state.

Results: From 1998 through 2022, the age-standardized mortality rate from CMDs increased by 14.9% in Mexico. These rates reached their highest levels in 2020 and 2021 during the COVID-19 pandemic. In 2022, people aged 0 through 84 years had 3.9 YLL from CMDs, which represented an increase of 0.4 years compared with 1998. From 1998 through 2022, age-standardized mortality rates increased for heart disease, diabetes mellitus, and hypertension but decreased for stroke.

Conclusions: Mortality and YLL from CMDs have steadily increased among people in Mexico, driven mainly by heart disease and diabetes mellitus. YLL attributable to CMDs could be prevented by early care and health prevention policies. Decision makers should work to implement robust and enduring health policies focused on shared risk factors underlying these diseases.

The COVID-19 pandemic magnified long-standing health disparities, showing that certain populations are at higher risk for effects of public health emergencies than others. The pandemic response also put demands on the nation's health departments and stretched their limited resources. In 2021, the Centers for Disease Control and Prevention launched the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities (hereinafter, COVID-19 Health Disparities Grant) to reduce COVID-19 health disparities and advance health equity. Health departments in all 50 states, 50 localities, 5 territories, and 3 freely associated states were recipients of approximately $2.25 billion. This study explored the extent to which investments from the COVID-19 Health Disparities Grant, through the allocation of funds across 5 strategies, correspond to reported changes in recipient health departments' capacity to address the COVID-19 public health emergency and future emergencies as measured in the Health Department and Jurisdiction Capacity Survey in 2023. The survey measured capacity along 4 domains: workforce and human resources, interorganizational relationships, data and informational resources, and governance and planning. In total, 70 of 75 recipients who responded to the survey reported that they began with low capacity in at least 1 capacity domain and advanced their capacity during grant implementation. This study demonstrated the reported value of investments in health departments to build capacity and infrastructure to address health disparities and advance health equity to respond to future public health emergencies.

Objectives: Disaggregated data on Asian ethnic groups are needed to identify health disparities among Asian people. We examined COVID-19 incidence, deaths, and vaccinations among Asian ethnic groups in Santa Clara County, California.

Methods: We extracted data on SARS-CoV-2 infections and COVID-19 vaccinations from December 15, 2020, through August 6, 2021, from the California Reportable Diseases Information Exchange and the California Immunization Registry. We assigned Asian ethnic group based on name for missing self-reported information. We calculated age-adjusted rates and rate ratios of infections and deaths and percentages of vaccinations by race and ethnicity and Asian ethnic group. We conducted multivariable logistic regression to examine factors associated with COVID-19 deaths.

Results: Although Asian residents had the lowest rate of SARS-CoV-2 infections per 100 000 people (1801.9; 95% CI, 1771.5-1832.7) among all racial and ethnic groups, when disaggregated by Asian ethnicity, Filipino (3169.0; 95% CI, 3049.1-3292.4) and Vietnamese (3008.4; 95% CI, 2916.9-3102.1) residents had the highest age-adjusted rates. Asian (38.7; 95% CI, 33.7-44.3) and non-Hispanic White (42.3; 95% CI, 37.5-47.5) residents had the lowest rate of COVID-19 deaths compared with all other racial and ethnic groups; however, Filipino (67.6; 95% CI, 49.1-90.8) and Vietnamese (63.7; 97% CI, 48.9-81.6) residents had significantly higher rates than the aforementioned groups did. Among all racial and ethnic groups, Asian residents had the highest completion rate of primary COVID-19 vaccine series by August 6, 2021 (87.0%; 95% CI, 86.8%-87.3%). Within Asian ethnic groups, Filipino residents had the lowest vaccination rate (65.0%; 95% CI, 64.4%-65.6%).

Conclusions: Differences in COVID-19 incidence, deaths, and vaccinations among Asian ethnic groups highlight the importance of data collection of ethnic groups as a standard practice.

Objectives: Communication plays a pivotal role in addressing modern and complex public health challenges. Our study assessed the extent to which communication-related course outlines in Canadian master of public health (MPH) programs aligned with national and international public health competency frameworks in their coverage of communication competencies.

Methods: We conducted an environmental scan and content analysis of MPH courses relevant to public health communication in 2022 and 2023. We used university and program websites and Google to conduct initial searches and obtain course outlines, supplementing these searches with a survey. We developed a codebook based on public health competencies and pedagogical best practices, capturing variables for communication competencies, audiences, channels, tools, and techniques. Two researchers independently coded course outlines. Descriptive statistics evaluated how these courses address communication-related public health competencies.

Results: We obtained 11 course outlines offered from 2010 through 2023. The focus of the included courses varied, with health communication (n = 3), knowledge mobilization (n = 3), and risk and/or crisis communication (n = 2) being the most common. All courses broadly aligned with communication competencies related to communication with different audiences (n = 11), and mobilizing (n = 9), interpreting (n = 11), tailoring (n = 9), and facilitating (n = 9) communication. Using technology (n = 4) and media (n = 6), addressing mis/disinformation (n = 1), and communicating with diverse audiences (n = 3) had less alignment.

Conclusions: Findings revealed gaps in the coverage of key competencies, particularly in addressing mis/disinformation, leveraging technology and media, communicating with diverse populations, health literacy, and crisis communication. Ongoing review of curriculum would ensure alignment with evolving competencies and public health demands.

Objectives: In 2003, the Institute of Medicine released the report Who Will Keep the Public Healthy?, in which the authors recommended that "all undergraduates have access to education in public health." The objective of this study was to explore the current status of that recommendation in public institutions in the United States with schools or programs accredited by the Council on Education for Public Health (CEPH).

Methods: We used a systematic qualitative content analysis approach, specifically a manifest analysis strategy, focusing on data that were available, tangible, and observable. To provide a snapshot of public health coursework in the general education curriculum, we reviewed the spring 2023 curriculum posted in online catalogs at US public colleges and universities with CEPH-accredited schools or programs of public health.

Results: Of the 132 institutions represented in the analysis, 100 (75.8%) offered at least 1 public health course in their general education course offerings in the spring 2023 term and 32 (24.2%) offered no public health-related courses. None of the institutions required a public health course to graduate.

Conclusion: The recommendation for all students to have access to public health education in undergraduate programs was a timely and relevant imperative in 2003, and it is increasingly so today. We encourage colleges and universities with schools and programs accredited by CEPH to lead a renewed effort to expand access to public health education for undergraduates in the United States through general education programs.

Data science is an emerging field that provides new analytical methods. It incorporates novel data sources (eg, internet data) and methods (eg, machine learning) that offer valuable and timely insights into public health issues, including injury and violence prevention. The objective of this research was to describe ethical considerations for public health data scientists conducting injury and violence prevention-related data science projects to prevent unintended ethical, legal, and social consequences, such as loss of privacy or loss of public trust. We first reviewed foundational bioethics and public health ethics literature to identify key ethical concepts relevant to public health data science. After identifying these ethics concepts, we held a series of discussions to organize them under broad ethical domains. Within each domain, we examined relevant ethics concepts from our review of the primary literature. Lastly, we developed questions for each ethical domain to facilitate the early conceptualization stage of the ethical analysis of injury and violence prevention projects. We identified 4 ethical domains: privacy, responsible stewardship, justice as fairness, and inclusivity and engagement. We determined that each domain carries equal weight, with no consideration bearing more importance than the others. Examples of ethical considerations are clearly identifying project goals, determining whether people included in projects are at risk of reidentification through external sources or linkages, and evaluating and minimizing the potential for bias in data sources used. As data science methodologies are incorporated into public health research to work toward reducing the effect of injury and violence on individuals, families, and communities in the United States, we recommend that relevant ethical issues be identified, considered, and addressed.

Objectives: Studies suggest that people experiencing housing insecurity and homelessness (HIH) have varying experiences with food insecurity. We estimated the prevalence of food insecurity and identified the factors associated with it among people experiencing HIH in the United States.

Methods: We conducted a meta-analysis of the prevalence of food insecurity among people experiencing HIH and a systematic review of associated factors through a comprehensive search of 8 academic databases. We identified 3398 unique articles and included 40 studies in the review that met the following criteria: included observational or experimental data on the prevalence of food insecurity among people experiencing HIH, conducted in the United States, and written in English.

Results: The overall prevalence of food insecurity was 57% (95% CI, 48%-65%). Most people experiencing HIH had food insecurity, and our estimated prevalence among people experiencing HIH was >4 times higher than the prevalence in the US population. Experiencing symptoms of a mental health condition (eg, depression, posttraumatic stress disorder, anxiety) in addition to HIH was most frequently (7 datasets) associated with increased odds of food insecurity. Social and institutional support was most frequently (5 datasets) associated with decreased odds of food insecurity.

Conclusion: Our findings suggest that multisector coordination is needed to address individual- and system-level factors associated with food insecurity and HIH.

In response to the COVID-19 pandemic, a multidisciplinary team at the University of Kentucky developed an interdisciplinary science, technology, engineering, and mathematics and environmental health unit-the Wastewater Assessment for Coronavirus in Kentucky: Implementing Enhanced Surveillance Technology (WACKIEST) Unit-for high school students in summer 2022. This case study outlines the WACKIEST Unit, which focused on wastewater surveillance and COVID-19, the obstacles faced during development and recruitment, and implementation of the WACKIEST Unit in conjunction with a rural wastewater surveillance initiative. The unit was implemented in spring 2023 at a rural high school in Kentucky, spanning 12 days and engaging 190 students. Lessons emphasized the importance of wastewater testing in public health decision-making, particularly in the context of COVID-19. A mobile laboratory provided students with hands-on experience in conducting preliminary analyses of wastewater, and a field trip to the local wastewater treatment plant allowed them to observe real-world wastewater management practices. At the unit's conclusion, students created a public health report aligned with the Evidence-Informed Decision Making in Public Health model, reinforcing the goal of fostering community health resilience. The initiative's success-measured by the unit's completion and positive feedback from students and teachers-supports the creation of online modules for broader dissemination. This case study demonstrates how adaptable interdisciplinary approaches can integrate real-world scientific issues into secondary education, offering valuable insights for future efforts in public health education.

To reduce opioid-related morbidity and mortality, local coalitions on substance use prevention in Kern County, California, have sought to increase equitable engagement and reengagement with harm reduction supplies, including naloxone. Through a community-academic partnership and funding from the local managed health care plan in Kern County, we ordered, stocked, and monitored a temperature-controlled outdoor harm reduction vending machine (HRVM) in Bakersfield, California. We outlined the necessary steps for successful procurement and implementation of community-based HRVMs. To increase acceptability, we engaged in open dialogue with our partners, interested parties, and people with lived experience of substance use to inform the contents of the harm reduction supply kits. In addition, we consulted the literature, physicians, and epidemiologists to inform best practices for the quantity of supplies per kit and the frequency limits for dispensation. To ensure long-term sustainability, we secured grant funding from the California Harm Reduction Supply Clearinghouse to maintain a backstock of harm reduction supplies for the kits, successfully applied for the Naloxone Distribution Project through the California Department of Health Care Services for a continuous supply of free naloxone, and developed student internship and research assistant positions through our academic partner to support participant recruitment and data collection and management efforts. Our efforts culminated in the launch of the county's first HRVM and orders for 2 additional HRVMs. Through our experiences, we gained insight on how to improve the feasibility, acceptability, and sustainability of community-based HRVMs, which can enhance health equity.