Journal of Public Health Management and Practice最新文献

Context: There are currently no national estimates of how many people die while unhoused in the US. Local jurisdictions have developed their own approaches for estimating homeless mortality.

Objective: We aimed to examine these local approaches, document what is known about homeless mortality, and summarize local methodologies.

Design: We reviewed 17 publicly available homeless mortality reports (ie, gray literature).

Setting: Reports were sought from government, Health Care for the Homeless, coalition to end homelessness, and other advocacy and social service websites.

Main outcome: From each report, we extracted the number of homeless deaths, dates of observation, data source(s) used, determination of homeless status, manners and causes of death, and decedent demographics.

Results: Data collection and reporting on homeless mortality varied greatly across reports. This variation limits aggregation across reports. Medical examiner data was the most used data source. Manner of death was the most consistently collected field, with accidental deaths reported as the most prevalent manner of homeless deaths. Not all reports listed specific causes of death, but those that did reported toxicity (eg, overdose) and cardiovascular causes as most prevalent. The most granular age category of most homeless decedents was 40 to 60 years. On average, 80% of decedents were of male sex. While over half of reports included race and ethnicity information, disparities could not be estimated without suitable denominators.

Conclusions: Standardized data collection and reporting guidance is needed for homeless mortality. Health departments can work with local Health Care for the Homeless programs and Continuums of Care to establish data sharing processes. Matching vital statistics with homeless service utilization records may be one opportunity to improve these efforts. Until there is federal or national guidance on these standards, localities can consider adding housing or homelessness variables as optional or mandatory fields in electronic death reporting systems.

There are multiple surveillance systems working to address the issue of maternal mortality in Missouri. These surveillance systems have key methodological differences in their definitions, terminology, inclusion criteria, and purpose. This study aims to provide an understanding of the practical effects of these programmatic differences regarding what cases are included and how this can impact the interpretations of the data and influence policy decisions. To accomplish this, death certificates identified by the Missouri Vital Statistics program, the Pregnancy Mortality Surveillance System, and the Pregnancy-Associated Mortality Review (PAMR) program were compared. Commonalities and differences were noted, demonstrating the real-world effects of the methodological differences between programs. In particular, the PAMR program includes injury deaths in the count of pregnancy-related deaths, which are not included by other surveillance systems. These differences highlight the importance of understanding the methodology and limitations of a dataset.

Given the recent implementation and preemption of sugar-sweetened beverage taxes across the United States, we aimed to evaluate the associations between sugar-sweetened beverage (SSB) taxes and adolescent weight-related outcomes using data on 364,540 adolescents drawn from 1999 to 2021 district Youth Risk Behavior Surveys. We used difference-in-differences models to assess the associations and the potential mediating roles of SSBs, milk, and 100% fruit juice consumption. We found that a one cent per ounce increase in SSB taxes was associated with a 0.26 lower body mass index ( P < .01), and a 2.19 ( P < .01) and 1.68 ( P < .01) percentage point decrease in the probability of being affected by overweight and obesity, respectively. SSB consumption had a mediating role, as tax increases were associated with a 2.45 ( P < .01) percentage point decrease in adolescents' probability of drinking any SSB. Milk and 100% fruit juices likely also played a role, as we found changes in their consumption in response to tax increases.

Objective: Child maltreatment is a complex and preventable public health problem that cannot be effectively addressed by a single organization or sector. We examined a network of organizations working to prevent childhood maltreatment before and during COVID-19, including members of the Parents and Children Together-St. Louis Collaborative. The Collaborative is an initiative with the purpose of strengthening ties among service agencies and was new when the COVID-19 shutdowns began.

Design and participants: In September 2020, we surveyed 62 agencies working on childhood maltreatment prevention in the public health, health, or social service sectors. We asked about frequency of contact between organizations before (pre-COVID) and during COVID (in-COVID). We used descriptive and inferential network methods to examine network properties and changes.

Results: There were 360 ties among organizations in the pre-COVID network (density = 0.19) and 321 ties among organizations (density = 0.17) during COVID. The median number of ties per organization decreased from pre- to in-COVID for most organizations and most notably for smaller and newer organizations and mental health care organizations. The only organization type that increased connections was substance abuse organizations. Pre- and in-COVID odds of connection were significantly higher for mental health care, substance abuse, health care, child welfare, and legal-advocacy organizations compared to multisector organizations. Odds of a connection between 2 organizations were significantly higher pre-COVID and in-COVID if one or both organizations were Collaborative members.

Conclusions: Disruptions during COVID-19 coincided with fewer connections among organizations. Collaborative members had higher odds of connection before and during COVID-19, suggesting a potential strategy for building and maintaining a cross-sector service network. Understanding network structure and change in the early stages of COVID-19 provides an opportunity to work on building and sustaining inter-organizational connections essential in violence prevention and child well-being and other areas of public health.

Context: Federal public health travel restrictions (FPHTR) in the United States are implemented for persons who meet specific criteria to prevent spread of communicable diseases of public health concern. FPHTR can mitigate the risk of disease transmission during air travel and mitigating disease translocation between geographic areas.

Objective: To characterize and determine the extent of FPHTR implementation during the COVID-19 pandemic.

Design: Secondary data analysis.

Setting and participants: This report reviewed the U.S. public health response for 3010 persons traveling within, into, and out of, the U.S. who were placed on federal public health travel restrictions during the COVID-19 outbreak from January 1, 2020 to April 6, 2022.

Main outcome measure: Total number and characteristics of persons with SARS-CoV-2 infection or high-risk exposure added to FPHTR.

Results: During this period, FPHTR were implemented for 3010/5460 (55%) persons who were reported to CDC as having tested positive for SARS-CoV-2, or being identified as close contacts of a person with COVID-19, with intention to travel. Of those added to FPHTR lists, 2023/3010 (67%) had confirmed SARS-CoV-2 infection, 975/3010 (32%) were close contacts, and 12/3010 (0.4%) were reasonably believed to have COVID-19 but later confirmed to have another diagnosis and removed. Twenty-six percent (793/3010) of SARS-CoV-2-related FPHTR were for persons reported to CDC after testing positive for SARS-CoV-2 at a testing site located within a U.S. airport.

Conclusions: The extensive application of FPHTR for more than 3000 persons over a period of 29 months during the COVID-19 pandemic was unprecedented. The additional use of FPHTR required extraordinary effort and collaboration among CDC staff and local/state public health agencies for case investigation, reporting, exchange of information, and communication with travelers for case management. Use of this tool should be considered within the context current transmission risk and disease severity.

Compared with traditional measures of scientific impact, the CDC Science Impact Framework more broadly, directly, and quickly assesses impact of public health science. For 20 CDC-funded HIV prevention projects that were conducted during 2018-2022, health departments documented impact, based on CDC Science Impact Framework domains: Disseminating Science, Creating Awareness, Catalyzing Action, Effecting Change , and Shaping the Future . Health departments reported 282 impacts: the most common were new partnerships (n = 17, Catalyzing Action ), capacity building (n = 16, Effecting Change ), new projects or initiatives begun (n = 15, Shaping the Future ), new collaborations (n = 14, Catalyzing Action ), improved program (n = 13, Shaping the Future ), new guidelines or practices (n = 13, Effecting Change ), and informed persons affected by work (n = 13, Creating Awareness ). Health departments documented substantial impact with a simple, timely, and broad approach. Demonstrating impact is important for community-based organizations, funders, and others interested in public health and helps them better understand the value of public health.

Objective: This study aimed to assess the opinions, attitudes, and behaviors of family physicians in Türkiye regarding mandatory communicable disease notification.

Design: Cross-sectional study.

Setting: A national online survey in Türkiye.

Participants: This study was conducted among 397 family physicians from different geographical regions in Türkiye.

Main outcome measures: Family physicians' opinions, attitudes, and behaviors regarding infectious disease notification.

Results: The majority of family physicians (69.3%) felt inadequate in terms of knowledge about the notification system and 70.3% desired post-graduation training on communicable disease reporting. About one-third of the participants were dissatisfied with the current notification system. Reasons for under-reporting included lack of time, lack of feedback, and uncertainty about post-notification procedures. Factors significantly associated with higher infectious disease notification attitude scores (IDNAS) were receiving training on communicable disease reporting, feeling competent about reporting, and being satisfied with the reporting system ( P < .001). However, physicians who admitted choosing a different ICD code to avoid filling out an infectious disease notification form had lower IDNAS scores ( P < .001).

Conclusion: This study highlights knowledge gaps and negative attitudes among family physicians in Türkiye regarding infectious disease reporting. Addressing these challenges requires continuous education and training programs. Feedback mechanisms should be improved to enhance physicians' engagement in the notification process. Reducing the workload of family physicians and simplifying the reporting process may also contribute to higher compliance with mandatory communicable disease reporting.