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Process and Outcome Evaluation of the Centers for Disease Control and Prevention's Think. Test. Treat TB Health Communications Campaign, United States, March-September 2022. 对美国疾病控制和预防中心的 "思考 "项目进行过程和结果评估。测试。治疗结核病健康传播运动,美国,2022 年 3 月至 9 月。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-27 DOI: 10.1177/00333549241268644
Elise Caruso, John Parmer, Leeanna Allen, Allison Maiuri, Joan Mangan, Beth Bouwkamp, Nickolas DeLuca

Objectives: The Think. Test. Treat TB health communications campaign aims to increase the awareness of latent tuberculosis infection (LTBI) primarily among people born in the Philippines and Vietnam and other non-US-born groups (consumers) and the health care providers (providers) who serve them. We conducted a process evaluation to assess reach and audience engagement and an outcome evaluation to assess awareness, knowledge, perceptions, and behavioral intentions among audiences of the campaign.

Methods: To evaluate the process, the Centers for Disease Control and Prevention measured exposure to (eg, with impressions [total advertisements]) and engagement with (eg, online clicks) the campaign during its rollout (March-September 2022). After the rollout, to evaluate outcomes, we administered online surveys to consumers and providers who were exposed and not exposed to the campaign.

Results: The Think. Test. Treat TB campaign resulted in >33 million impressions, >2000 materials downloaded from the internet, and >33 000 materials shipped. Of 173 consumers who completed the evaluation survey, 123 (71.1%) were exposed to the campaign, with 108 (87.8%) reporting intention to ask their provider about tuberculosis (TB) during their next visit. Of 44 providers who completed the evaluation survey, 24 (54.5%) did not feel that they were the intended audience of the campaign, yet all felt the campaign materials were relevant to their patients, and 42 (95.5%) felt the materials were relevant to providers who serve patients at risk for TB.

Conclusion: The Think. Test. Treat TB campaign was successful in raising awareness of LTBI among the intended audiences. Continuing engagement with key audiences about LTBI to encourage testing and treatment is integral to eliminate TB in the United States.

目标:思考。测试。治疗结核病 "健康传播活动旨在主要提高菲律宾和越南出生的人以及其他非美国出生的群体(消费者)和为他们提供服务的医疗服务提供者(提供者)对潜伏肺结核感染(LTBI)的认识。我们进行了过程评估,以评估覆盖范围和受众参与度;还进行了结果评估,以评估受众对该活动的认识、知识、看法和行为意向:为了对过程进行评估,疾病控制与预防中心测量了活动开展期间(2022 年 3 月至 9 月)的接触率(如广告印象[广告总量])和参与率(如在线点击率)。活动结束后,为了评估结果,我们对接触和未接触该活动的消费者和医疗服务提供者进行了在线调查:结果:"思考。结果:Think.结果:"思考、测试、治疗 "结核病宣传活动产生了超过 3300 万次印象,从互联网上下载了超过 2000 份资料,并运送了超过 33000 份资料。在完成评估调查的 173 名消费者中,123 人(71.1%)接触过该活动,108 人(87.8%)表示有意在下次就诊时向医疗服务提供者询问有关结核病(TB)的问题。在 44 位完成评估调查的医疗服务提供者中,有 24 位(54.5%)认为自己不是该活动的目标受众,但他们都认为活动材料与他们的患者相关,42 位(95.5%)认为材料与为结核病高危患者提供服务的医疗服务提供者相关:结论:"思考。结论:"思考。结论:Think.继续与主要受众开展有关 LTBI 的活动,鼓励他们进行检测和治疗,对于在美国消除结核病是不可或缺的。
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引用次数: 0
Response to Griffith: Antiracism in Basic Research on Racial Disparities. 对格里菲斯的回应:种族差异基础研究中的反种族主义。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-24 DOI: 10.1177/00333549241269506
Ian A Myles
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引用次数: 0
COVID-19 and Child Sex Trafficking: Qualitative Insights on the Effect of the Pandemic on Victimization and Service Provision. COVID-19 与儿童性贩运:大流行病对受害者和服务提供的影响的定性分析。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-08-15 DOI: 10.1177/00333549241267721
Jennifer E O'Brien, Lisa M Jones, Kimberly J Mitchell, Gina Zwerling Kahn

Objectives: Child sex trafficking (CST) is the involvement of minors in the commercial exchange of sex for goods, services, drugs, or money. The COVID-19 pandemic negatively affected many risk factors associated with CST victimization and the availability of CST services. We examined service providers' perspectives on how the pandemic affected trajectories of CST victimization among young people in the United States.

Methods: We collected qualitative data from 80 law enforcement professionals and service providers working with young people affected by CST from 11 US cities. Semistructured interviews lasted approximately 1 hour and were digitally recorded, transcribed verbatim, and coded via a grounded theory approach.

Results: We found 3 overarching themes related to the pandemic's effect on CST victimization trajectories: grooming, perpetration, and service provision. Participants described how increased online activity may have increased the risk of CST, even among children without traditional risk factors. However, technology also facilitated young people's agency in seeking help and receiving services. In addition, participants reported increases in virtual service provision that facilitated access to, and availability of, CST services more generally.

Conclusions: Technology use among young people increased during the pandemic, leading to increases in the risks of experiencing technology-facilitated CST. Technology use among young people who experience CST victimization-and how it may differ from young people more generally-is underexplored and may provide insights into prevention and treatment. Collectively, results highlight the need for epidemiologic research to help identify how global and national events affect trajectories of victimization among young people.

目标:儿童性贩运 (CST) 是指未成年人参与以性换取商品、服务、毒品或金钱的商业交易。COVID-19 大流行对许多与 CST 受害相关的风险因素以及 CST 服务的可用性产生了负面影响。我们研究了服务提供者对大流行如何影响美国青少年 CST 受害轨迹的看法:我们收集了来自美国 11 个城市的 80 名执法专业人员和服务提供者的定性数据,他们都在为受 CST 影响的青少年提供服务。半结构式访谈持续了约 1 个小时,并进行了数字录音、逐字记录和基础理论编码:我们发现了 3 个与大流行病对 CST 受害轨迹的影响有关的首要主题:诱导、犯罪和服务提供。参与者描述了网络活动的增加如何增加了 CST 的风险,即使在没有传统风险因素的儿童中也是如此。不过,技术也为青少年寻求帮助和接受服务提供了便利。此外,与会者还报告了虚拟服务的增加情况,这在更大范围内促进了儿童色情服务的获得和可用性:结论:在大流行病期间,年轻人使用技术的情况有所增加,导致经历技术推动的 CST 的风险增加。对遭受 CST 伤害的年轻人使用技术的情况以及这种情况与一般年轻人的不同之处尚未进行充分的研究,而这些研究可能会为预防和治疗提供启示。总之,研究结果凸显了流行病学研究的必要性,有助于确定全球和国家事件如何影响年轻人的受害轨迹。
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引用次数: 0
Effects of States' Methods for Estimating Nonfatal Overdose, United States, 2021. 各州估算非致命过量用药方法的影响,美国,2021 年。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-27 DOI: 10.1177/00333549241263526
Christian E Johnson, David R Holtgrave, Megan Catlin, Rahul Gupta

Objective: Previous nonfatal overdose is a key risk factor for drug overdose death; however, current nonfatal overdose surveillance is limited to people who receive medical attention. We identified states that tracked nonfatal overdoses treated in prehospital and hospital care settings, assessed the effects of different surveillance methods on the magnitude of nonfatal overdose estimates, and estimated states' nonfatal-to-fatal overdose ratio.

Methods: Two analysts independently reviewed state websites to characterize states' methods of capturing nonfatal overdose events from December 2022 through February 2023. We collected information on surveillance methods in 5 states that met the inclusion criteria, including data source, measure specification, drug(s) involved, and whether states performed deduplication or published mutually exclusive measure specifications to capture unique events across care settings. We calculated nonfatal-to-fatal overdose ratios to assess the effects of different data sources on estimates of nonfatal overdoses.

Results: Illinois, Maine, North Carolina, and West Virginia used syndromic surveillance data and New Jersey used hospital discharge data to track nonfatal overdose-related emergency department visits. Illinois and West Virginia tracked nonfatal overdose-related encounters with emergency medical services. Other states tracked opioid overdoses reversed following naloxone administration by emergency medical services, law enforcement, and community members. Maine, New Jersey, and West Virginia published nonfatal overdose information by using mutually exclusive measure specifications; the number of nonfatal overdoses per fatal overdose in these states ranged from approximately 5:1 to 14:1.

Practice implications: Establishing a standard framework to combine data from existing national surveillance systems in prehospital and hospital care settings can improve nonfatal overdose estimates and enable comparisons between jurisdictions to help decision makers identify areas most in need of essential services.

目的:既往非致命性用药过量是用药过量致死的一个关键风险因素;然而,目前对非致命性用药过量的监控仅限于接受医疗护理的人群。我们确定了对在院前和医院护理环境中接受治疗的非致命性用药过量进行追踪的州,评估了不同监测方法对非致命性用药过量估计值的影响,并估算了各州的非致命性用药过量与致命性用药过量之比:两位分析师独立审查了各州网站,以了解各州在 2022 年 12 月至 2023 年 2 月期间捕获非致命性用药过量事件的方法。我们收集了符合纳入标准的 5 个州的监控方法信息,包括数据来源、测量规范、涉及的药物,以及各州是否进行了重复数据删除或发布了互斥的测量规范,以捕捉不同护理环境中的独特事件。我们计算了非致命性用药过量与致命性用药过量的比率,以评估不同数据来源对非致命性用药过量估计值的影响:结果:伊利诺伊州、缅因州、北卡罗来纳州和西弗吉尼亚州使用了症候群监测数据,新泽西州则使用了医院出院数据来追踪非致命性用药过量相关的急诊就诊情况。伊利诺伊州和西弗吉尼亚州追踪了非致命性用药过量相关的急诊就诊情况。其他州则追踪了在急救医疗服务、执法部门和社区成员施用纳洛酮后阿片类药物过量的逆转情况。缅因州、新泽西州和西弗吉尼亚州通过使用相互排斥的测量规格公布了非致命性用药过量信息;在这些州,每例致命性用药过量中的非致命性用药过量数量约为 5:1 到 14:1:建立一个标准框架,将院前和医院护理环境中现有的国家监控系统中的数据结合起来,可以提高非致命性用药过量的估计值,并实现辖区之间的比较,帮助决策者确定最需要基本服务的地区。
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引用次数: 0
Effect of Childcare Influenza Vaccine Requirement on Vaccination Rates, New York City, 2012-2020. 托儿所流感疫苗接种要求对接种率的影响,纽约市,2012-2020 年。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 DOI: 10.1177/00333549241260166
Amy E Metroka, Vikki Papadouka, Alexandra Ternier, Iris Cheng, Jane R Zucker

Objectives: In 2014, New York City initiated a childcare influenza vaccine requirement to increase influenza vaccination rates among children aged 6-59 months attending city-regulated childcare, including prekindergarten. We evaluated the requirement's effect on vaccination rates in childcare-aged children in New York City.

Methods: We examined influenza vaccination rates in children aged 6-59 months and by age groups of 1, 2, 3, and 4 years for 8 influenza seasons (2012-2013 through 2019-2020), representing 2 seasons before the requirement, 2 seasons during the requirement, 2 seasons after its suspension, and 2 seasons after its reinstatement. We also assessed rates in a comparison group of children aged 5-8 years. We performed a difference-in-differences analysis to compare rate differences in age groups when the requirement was and was not in effect. We considered P < .05 as significant based on the Wald χ2 test.

Results: Influenza vaccination rates among children aged 6-59 months increased 3.7 percentage points (from 47.7% to 51.4%) by the requirement's second year and declined 6.7 percentage points to 44.7% after suspension. After reinstatement, rates increased 10.7 percentage points to 55.4%. Rate changes were most pronounced among 4-year-olds, increasing 12.7 percentage points (from 45.3% to 58.0%) by the requirement's second year, declining 14.1 percentage points to 43.9% after suspension, and increasing 22.2 percentage points to 66.1% after reinstatement. In the comparison group, rates increased 4.9 percentage points (from 36.5% to 41.4%) after reinstatement. Rates increased significantly among 4-year-olds before versus at the initial requirement and decreased significantly after suspension. After reinstatement, rates increased significantly among all groups except 1-year-olds.

Conclusion: The New York City influenza vaccine requirement improved influenza vaccination rates among preschool-aged children, adding to the evidence base showing that vaccine requirements raise vaccination rates.

目标:2014 年,纽约市启动了一项托儿所流感疫苗接种要求,以提高参加市监管托儿所(包括学前班)的 6-59 个月儿童的流感疫苗接种率。我们评估了该要求对纽约市托儿所适龄儿童疫苗接种率的影响:我们对 8 个流感季节(2012-2013 年至 2019-2020 年)中 6-59 个月大的儿童以及 1、2、3 和 4 岁年龄组的流感疫苗接种率进行了调查,这 8 个流感季节分别为要求实施前的 2 个季节、要求实施期间的 2 个季节、要求暂停实施后的 2 个季节以及要求恢复实施后的 2 个季节。我们还评估了对比组 5-8 岁儿童的发病率。我们进行了差异分析,以比较要求生效和未生效时各年龄组的发病率差异。我们考虑了 P 2 检验:在规定实施的第二年,6-59 个月儿童的流感疫苗接种率提高了 3.7 个百分点(从 47.7% 提高到 51.4%),而在规定暂停实施后,接种率下降了 6.7 个百分点,降至 44.7%。恢复后,比率增加了 10.7 个百分点,达到 55.4%。4 岁儿童的比率变化最为明显,到要求实施的第二年,比率上升了 12.7 个百分点(从 45.3% 上升到 58.0%),停学后下降了 14.1 个百分点,为 43.9%,复学后上升了 22.2 个百分点,为 66.1%。在对比组中,复学后的比率增加了 4.9 个百分点(从 36.5%增至 41.4%)。4 岁儿童中,停学前与最初要求停学时的比率明显上升,停学后则明显下降。恢复接种后,除 1 岁儿童外,其他年龄组的接种率均大幅上升:结论:纽约市的流感疫苗接种要求提高了学龄前儿童的流感疫苗接种率,为疫苗接种要求提高接种率的证据基础做出了补充。
{"title":"Effect of Childcare Influenza Vaccine Requirement on Vaccination Rates, New York City, 2012-2020.","authors":"Amy E Metroka, Vikki Papadouka, Alexandra Ternier, Iris Cheng, Jane R Zucker","doi":"10.1177/00333549241260166","DOIUrl":"https://doi.org/10.1177/00333549241260166","url":null,"abstract":"<p><strong>Objectives: </strong>In 2014, New York City initiated a childcare influenza vaccine requirement to increase influenza vaccination rates among children aged 6-59 months attending city-regulated childcare, including prekindergarten. We evaluated the requirement's effect on vaccination rates in childcare-aged children in New York City.</p><p><strong>Methods: </strong>We examined influenza vaccination rates in children aged 6-59 months and by age groups of 1, 2, 3, and 4 years for 8 influenza seasons (2012-2013 through 2019-2020), representing 2 seasons before the requirement, 2 seasons during the requirement, 2 seasons after its suspension, and 2 seasons after its reinstatement. We also assessed rates in a comparison group of children aged 5-8 years. We performed a difference-in-differences analysis to compare rate differences in age groups when the requirement was and was not in effect. We considered <i>P</i> < .05 as significant based on the Wald χ<sup>2</sup> test.</p><p><strong>Results: </strong>Influenza vaccination rates among children aged 6-59 months increased 3.7 percentage points (from 47.7% to 51.4%) by the requirement's second year and declined 6.7 percentage points to 44.7% after suspension. After reinstatement, rates increased 10.7 percentage points to 55.4%. Rate changes were most pronounced among 4-year-olds, increasing 12.7 percentage points (from 45.3% to 58.0%) by the requirement's second year, declining 14.1 percentage points to 43.9% after suspension, and increasing 22.2 percentage points to 66.1% after reinstatement. In the comparison group, rates increased 4.9 percentage points (from 36.5% to 41.4%) after reinstatement. Rates increased significantly among 4-year-olds before versus at the initial requirement and decreased significantly after suspension. After reinstatement, rates increased significantly among all groups except 1-year-olds.</p><p><strong>Conclusion: </strong>The New York City influenza vaccine requirement improved influenza vaccination rates among preschool-aged children, adding to the evidence base showing that vaccine requirements raise vaccination rates.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760596","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}
引用次数: 0
Regional Differences in Hepatitis C-Related Hospitalization Rates, United States, 2012-2019. 2012-2019 年美国丙型肝炎相关住院率的地区差异。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 DOI: 10.1177/00333549241260252
Megan G Hofmeister, Yuna Zhong, Anne C Moorman, Eyasu H Teshale, Christina R Samuel, Philip R Spradling

Objectives: In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)-related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination.

Methods: We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease-related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions.

Results: During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region.

Conclusions: HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission.

目标:在美国,丙型肝炎是最常见的血液传播感染。丙型肝炎是导致肝癌和肝病死亡的主要原因之一,并给住院治疗带来沉重负担。我们试图描述 2012 年至 2019 年期间丙型肝炎病毒(HCV)相关住院治疗的地区差异,以指导消除丙型肝炎的规划:我们分析了 2012 年至 2019 年全国住院患者样本的出院数据。如果(1)丙型肝炎是主要诊断,或(2)丙型肝炎是任何次要诊断,且主要诊断是肝病相关疾病,则我们认为住院治疗与丙型肝炎相关。我们分析了HCV相关住院患者的人口统计学和临床特征,并根据美国人口普查局的9个地理分区模拟了全国HCV相关住院率的年度百分比变化:2012-2019年期间,美国约有55.39万例HCV相关住院病例。中南部西部地区的住院率最高(每 10 万人 34.7 例),而中北部西部地区的住院率最低(每 10 万人 17.6 例)。2012-2019 年期间,各地区的年住院率均有所下降,降幅从中南部东部地区的 15.3% 到太平洋地区的 48.8%。按医疗保险类型划分,医疗补助计划的住院率在全国最高,除一个地区外,其他地区均为最高:2012-2019年间,全国及各地区的HCV相关住院率均有所下降,但降幅并不一致。扩大早期丙型肝炎患者获得直接作用抗病毒治疗的机会将减少未来与晚期肝病相关的住院率,并阻断 HCV 传播。
{"title":"Regional Differences in Hepatitis C-Related Hospitalization Rates, United States, 2012-2019.","authors":"Megan G Hofmeister, Yuna Zhong, Anne C Moorman, Eyasu H Teshale, Christina R Samuel, Philip R Spradling","doi":"10.1177/00333549241260252","DOIUrl":"https://doi.org/10.1177/00333549241260252","url":null,"abstract":"<p><strong>Objectives: </strong>In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)-related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination.</p><p><strong>Methods: </strong>We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease-related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions.</p><p><strong>Results: </strong>During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region.</p><p><strong>Conclusions: </strong>HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760597","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}
引用次数: 0
US State and Territorial Indigenous Consultation Laws: A Potential Strategy to Improve the Social Determinants of Health. 美国各州和地区土著咨询法:改善健康的社会决定因素的潜在战略。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 DOI: 10.1177/00333549241260636
Lorinda Riley, Kristina Hulama, Ian Tapu, Anna Weightmann, Tehani Louis-Perkins, Carly Kajiwara, Kamaile Maldanado, Meldrick Ravida

Objectives: The United Nations (UN) has articulated the right to self-determination as a human right for Indigenous people; however, US states and territories have been slow to operationalize this aspect of the UN Declaration on the Rights of Indigenous Peoples. Indigenous consultation laws require all federal executive agencies to consult with tribal nations before implementing policies that have a "tribal implication," and these form the cornerstone of US efforts to implement the UN Declaration on the Rights of Indigenous Peoples. Despite these federal efforts, less is known about the degree to which state and territorial laws require consultation with Indigenous communities.

Methods: We reviewed all Indigenous consultation laws identified through a search of 50 US states, the District of Columbia, and 5 territories to provide a holistic picture of how jurisdictions have regulated Indigenous consultation efforts.

Results: Of the 56 states, 49 (87.5%) had at least 1 Indigenous consultation law; the remaining 7 jurisdictions had none. States engaged in Indigenous consultation in various ways, generally falling into 1 of 3 categories: (1) centralized consultation facilitated through an agency or department, (2) indirect consultation through a designated commission, and (3) fragmented Indigenous consultation through discrete laws. Important gaps were identified, including the lack of a definition for Indigenous consultation, the absence of an appeal process, and the need to train state officials on existing policies.

Conclusions: The results provide a baseline on the degree to which US states and territories consult with Indigenous communities and can be used to identify gaps in US compliance with UN human rights mandates.

目标:联合国(UN)已将自决权明确规定为土著人民的一项人权;然而,美国各州和地区在落实《联合国土著人民权利宣言》这方面的工作进展缓慢。土著协商法要求所有联邦行政机构在实施具有 "部落影响 "的政策之前与部落民族进行协商,这些法律构成了美国实施《联合国土著人民权利宣言》的基石。尽管联邦做出了这些努力,但人们对各州和地区法律要求与土著社区协商的程度却知之甚少:我们审查了通过对美国 50 个州、哥伦比亚特区和 5 个领地进行搜索而确定的所有土著咨询法律,以全面了解各司法管辖区如何规范土著咨询工作:在 56 个州中,49 个州(87.5%)至少有一部土著咨询法;其余 7 个辖区没有土著咨询法。各州参与土著咨询的方式多种多样,一般分为以下三类:(1)通过机构或部门促进集中咨询;(2)通过指定委员会进行间接咨询;(3)通过独立法律进行零散的土著咨询。研究发现了一些重要的不足,包括缺乏土著磋商的定义、缺乏上诉程序,以及需要对国家官员进行现行政策培训:研究结果提供了美国各州和地区与土著社区协商程度的基线,可用于确定美国在遵守联合国人权任务方面的差距。
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引用次数: 0
Association Between Social Vulnerability and SARS-CoV-2 Seroprevalence in Specimens Collected From Commercial Laboratories, United States, September 2021-February 2022. 2021 年 9 月至 2022 年 2 月美国商业实验室采集的标本中社会易感性与 SARS-CoV-2 血清流行率之间的关系。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-02-15 DOI: 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

Objective: 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.

Methods: 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).

Results: 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.

Conclusions: 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.

目的:我们在美国开展了一项按社会脆弱性指数(SVI)划分的 SARS-CoV-2 血清流行率的全国性研究,其中包括儿科数据,并对 COVID-19 大流行期间的 Delta 和 Omicron 阶段进行了比较。本研究的目的是按时期(Delta 与 Omicron)和年龄组评估 SVI 与感染诱发的 SARS-CoV-2 抗体血清流行率之间的关联:我们利用 2021 年 9 月至 2022 年 2 月期间美国 50 个州的临床血清标本(N = 406 469)的感染诱导 SARS-CoV-2 抗体检测结果来估算总体血清流行率和各县 SVI 三元组血清流行率。双变量分析和多层次逻辑回归模型评估了血清阳性与 SVI 的相关性,并按年龄组(0-17 岁,≥18 岁)和时间段(Delta:2021 年 9 月至 11 月;Omicron:2021 年 12 月至 2022 年 2 月)对其主题进行了分析:结果:在所有 3 个 SVI 水平上,感染引起的 SARS-CoV-2 抗体血清阳性反应率都有所上升;2021 年 9 月为 25.8%-33.5%,2022 年 2 月为 53.1%-63.5%。在 4 个 SVI 主题中,社会经济地位与血清流行率的关系最为密切。在德尔塔期间,我们发现生活在高 SVI 县的人每报告一例感染病例的几率 [OR] = 2.76;95% CI,2.31-3.21)明显高于生活在低 SVI 县的人每报告一例感染病例的几率(OR = 1.65;95% CI,1.33-1.97);在欧米克隆期间,我们没有发现显著差异。除此之外,不同年龄组和不同时期的子分析结果是一致的:结论:在儿童和成人中,在德尔塔期和奥密克隆期,SVI 高的县的 SARS-CoV-2 抗体血清流行率明显高于 SVI 低的县。这些差异加强了 SVI 的价值,它可以确定在公共卫生突发事件期间需要有针对性的预防工作的社区,以及需要从其影响中恢复的资源。
{"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":null,"pages":null},"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}
引用次数: 0
Ensuring an Equitable Response to the COVID-19 Pandemic in Pima County, Arizona, Through Local Political Support and Policy Action. 通过地方政治支持和政策行动,确保亚利桑那州皮马县公平应对COVID-19大流行。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2023-11-13 DOI: 10.1177/00333549231206404
Amanda Monroy, Jennifer Berry, Selene Brambl, Jennie Mullins, Theresa A Cullen

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.

在美国,持续存在的健康差距和当地公共卫生基础设施先前存在的差距导致COVID-19对COVID-19相关发病率和死亡率高风险人群的影响不成比例。在亚利桑那州皮马县,以公平为中心的地方政府参与和政策行动、多管齐下的社区应对措施,以及扩大历来资金不足的地方公共卫生基础设施,改善了公平结果,解决了多个系统性因素。本案例研究考察了皮马县采用基于公平的方法三管齐下应对COVID-19的公共卫生措施。因此,2019冠状病毒病是2021年皮马县第三大死亡原因,而亚利桑那州是第一大死亡原因。当地民选官员的大力政治支持为皮马县卫生部促进卫生公平创造了授权环境。2020年12月通过了一项决议,将种族和族裔健康和社会经济不平等视为公共卫生危机,支持创新,并促进了卫生公平办公室、公共卫生政策方案以及数据和信息学方案的建立。建立了社区参与的新结构,包括一个道德委员会和一个社区咨询委员会,以确保社区在大流行应对期间和之后参与公共卫生行动的正式进程。吸取的主要教训包括:(1)地方政府支持的重要性,将其编纂为允许实施创造性战略;(2)为社区在规划和实施方面的声音和参与开辟渠道,以应对最需要的领域;(3)拥有灵活的资金,以维持公平的反应。
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引用次数: 0
Public Health Accountability in Action: The King County Pandemic and Racism Community Advisory Group. 行动中的公共卫生问责制:金县大流行病和种族主义社区咨询小组。
IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-01 Epub Date: 2024-02-12 DOI: 10.1177/00333549231223923
Kirsten Wysen, Matías Valenzuela, Wendy E Barrington, Yordanos Teferi, Aselefech Evans, Bereket Kiros, Michelle Merriweather, Martha Zuniga

After a tumultuous 3 years of pandemic-, political-, and race-related unrest in the United States, the public is demanding accountability to communities of color (defined here as American Indian/Alaska Native, Asian, Black, Native Hawaiian/Pacific Islander, and Hispanic people) to rectify historic and contemporary injustices that perpetuate health inequities and threaten public health. Structural racism pervades all major societal systems and exposes people to detrimental social determinants of health. Disrupting structural racism within public health systems is essential to advancing health equity and requires organized partnerships between health departments and community leaders. As those who are most affected by structural racism, communities of color are the experts in knowing its impacts. This case study describes the King County Pandemic and Racism Community Advisory Group (PARCAG) and its use of an innovative accountability tool. The tool facilitated institutional transparency and accountability in the adoption of community recommendations. PARCAG was influential in shaping Public Health-Seattle & King County's COVID-19 and antiracism work, with 66 of 75 (88%) recommendations adopted partially or fully. For example, a fully adopted recommendation in May 2020 was to report King County COVID-19 case data by race and ethnicity, and a partially adopted recommendation was to translate COVID-19 information into additional languages. PARCAG members were recruited from a 2019 advisory board on Census 2020 and were adept at shifting to advising on COVID-19 and equitable practices and policies. Organizations that have made declarations that racism is a public health crisis should center the experiences, expertise, and leadership of communities of color in accountable ways when developing and implementing strategies to disrupt and repair the effects of structural racism and efforts to promote and protect public health.

在美国经历了与大流行病、政治和种族有关的动荡不安的 3 年之后,公众要求对有色人种社区(此处定义为美国印第安人/阿拉斯加原住民、亚裔、黑人、夏威夷原住民/太平洋岛民和西班牙裔)负责,纠正历史上和当代的不公正现象,这些不公正现象使健康不公平现象长期存在,并威胁到公众健康。结构性种族主义充斥着所有主要的社会体系,使人们面临不利于健康的社会决定因素。打破公共卫生系统中的结构性种族主义对促进健康公平至关重要,需要卫生部门与社区领袖之间建立有组织的伙伴关系。作为受结构性种族主义影响最严重的群体,有色人种社区是了解其影响的专家。本案例研究介绍了金县流行病与种族主义社区咨询小组(PARCAG)及其对创新问责工具的使用。在采纳社区建议的过程中,该工具促进了机构的透明度和问责制。PARCAG 对公共卫生-西雅图和金县的 COVID-19 和反种族主义工作的影响很大,75 项建议中有 66 项(88%)被部分或全部采纳。例如,2020 年 5 月完全采纳的一项建议是按种族和民族报告金县 COVID-19 病例数据,部分采纳的一项建议是将 COVID-19 信息翻译成更多语言。PARCAG 成员是从 2019 年 2020 年人口普查咨询委员会招募的,他们善于转变为 COVID-19 以及公平实践和政策的建议者。已宣布种族主义是公共卫生危机的组织,在制定和实施战略以破坏和修复结构性种族主义的影响以及努力促进和保护公共卫生时,应以有色人种社区的经验、专业知识和领导力为中心。
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引用次数: 0
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