American journal of public health最新文献

Objectives. To describe racial and ethnic representativeness of the local health department (LHD) workforce compared with the populations served. Methods. In this study, we used a cross-sectional design of the 2021 Public Health Workforce Interests and Needs Survey, 2019 National Association of County and City Health Officials Profile data, and other sources to estimate the racial and ethnic representativeness of LHD workforce. We calculated representativeness as a binary measure of at least representative of the populations served for each race and ethnicity group. We present bivariate analyses comparing LHD representativeness by region and rurality, and multivariate analyses to estimate the associations between representativeness, agency, and jurisdiction characteristics. This study was conducted in Tennessee in 2023. Results. Sixty percent of LHDs in the sample were at least representative of the Black, Indigenous, and People of Color populations they serve. For most race and ethnicity groups, urban-serving LHDs were more representative of the populations they serve than rural-serving LHDs. Conclusions. Racial and ethnic representativeness of the LHD workforce varies by rurality, region, and race or ethnicity. These findings may help inform training, recruitment, and retention efforts in public health. (Am J Public Health. 2025;115(3):333-343. https://doi.org/10.2105/AJPH.2024.307903).

Objectives. To assess the impact of state COVID-19 vaccine mandates for health care workers (HCWs) on health sector employment in the United States. Methods. Using monthly state-level employment data from the Quarterly Census of Employment and Wages between January and October 2021, we employed a partially pooled synthetic control method that accounted for staggered mandate adoption and heterogeneous treatment effects. We conducted analyses separately for the 4 health care subsectors-ambulatory health care services, hospitals, nursing and residential care, and social assistance-with an additional analysis of 2 industry groups-skilled nursing care and community care for the elderly-under the nursing and residential care subsector. We further explored possible heterogeneous impacts according to the test-out option availability. Results. Mandate impact estimates were statistically indistinguishable from zero. Results further ruled out a mandate-associated decrease in employment larger than 2.1% of premandate employment levels for the 6 health care domains examined and for states with no test-out option. Conclusions. State COVID-19 vaccine mandates for HCWs were not found to be associated with significant adverse impacts on health sector employment even in states without a testing alternative to vaccination. The findings support vaccine mandates as a viable preventive measure without material disruption to the health care workforce, including in times of public health emergencies. (Am J Public Health. 2025;115(3):344-348. https://doi.org/10.2105/AJPH.2024.307906).

Objectives. To assess contraceptive service changes during the Family Planning Elevated (FPE) Contraceptive Access Program in Utah clinics from 2018 to 2023. Methods. We assessed de-identified electronic health record data on female clients aged 18 to 50 years from intervention and matched control sites. We used comparative interrupted time series analyses comparing total number of contraceptive services and their proportion relative to visits between intervention and control sites before, during, and after FPE. Results. Intervention sites provided on average 1.76 (95% confidence interval [CI] = 1.17, 2.66) times as many contraceptive services per month as controls during the 24-month intervention period, with no significant decreases in services noted in the postintervention period. The proportions of total visits related to family planning decreased by a factor of 0.70 (95% CI = 0.52, 0.94) during the intervention period. However, this effect was mitigated at intervention sites where proportions of contraceptive services were 1.44 (95% CI = 0.97, 2.14) times greater than control sites and did not significantly decrease after the intervention. Conclusions. Contraceptive access initiatives have capacity to make meaningful change in communities where they are employed, even after they end. (Am J Public Health. 2025;115(3):387-396. https://doi.org/10.2105/AJPH.2024.307917).

We examined the impacts of interior border checkpoints on access to higher-level medical care via ground ambulance for undocumented immigrants in South Texas. Using purposive sampling, we conducted interviews (n = 30) with ground ambulance personnel in the lower Rio Grande Valley, Texas. Procedures implemented in 2018 mandate that hospitals notify Border Patrol of a patient's legal status before transfer. Undocumented immigrants cannot access higher-level medical care through ground ambulance transport without notifying Border Patrol. (Am J Public Health. 2025;115(3):292-295. https://doi.org/10.2105/AJPH.2024.307927).

Objectives. To investigate trends in awards funded by the National Institutes of Health (NIH) focusing on sexual and gender minoritized (SGM) populations from 2012 to 2022 in the United States. Methods. Replicating the method of Coulter et al., we identified NIH-funded awards for SGM research from 2012 to 2022 using the NIH RePORTER (Research Portfolio Online Reporting Tools Expenditures and Results) system. We coded for SGM subpopulations, demographics, and health content areas. We also inflation adjusted awards to 2022 dollar values. Results. NIH funded 1093 unique awards concerning SGM health, which totaled $491.7 million in first-year funding and made up 0.8% of the NIH portfolio. Frequency of awards nearly tripled over our study period. Most awards focused on HIV/AIDS (65.5%), mental health (29.5%), illicit drug use (19.9%), or sexual health issues (17.0%). We found funding differences across subpopulations: sexually minoritized men (67.8%; $357.9 million), transgender women (18.1%; $77.6 million), sexually minoritized women (13.9%; $57.6 million), transgender men (8.2%; $37.6 million), and nonbinary people (4.4%; $17.6 million). Only 42.2% of awards explicitly examined racial/ethnic identities of participants. Conclusions. Although NIH funding for SGM-related research has increased, persistent inequities indicate the need for systemic changes to advance health equity. (Am J Public Health. 2025;115(3):374-386. https://doi.org/10.2105/AJPH.2024.307913).

For much of the 20th century, Black readers turned to Black newspapers for health information and advice. The messages reached hundreds of thousands across the United States during a period when the nation's racially separate and unequal health care system limited the ability of Black communities to access vital resources, including public health education. This article, based on an analysis of several hundred health columns published between the 1910s and 1970, traces the origins and evolving role Black newspapers played as trusted messengers of health information. In doing so, it details the strategic ways Black health professionals as well as readers leveraged this form of media to promote health knowledge, address the prevention needs in Black communities, and advocate for better care. (Am J Public Health. 2025;115(3):326-332. https://doi.org/10.2105/AJPH.2024.307897).