scholarly journals Economic uncertainty and suicide in the United States

2021 ◽  
Author(s):  
Sotiris Vandoros ◽  
Ichiro Kawachi
Keyword(s):  
United States ◽  
Panel Data ◽  
State Level ◽  
The United States ◽  
Demographic Characteristics ◽  
Economic Uncertainty ◽  
Uncertainty Index ◽  
The Us ◽  
Prevention Interventions ◽  
Econometric Approach

AbstractPrevious studies have found an association between recessions and increased rates of suicide. In the present study we widened the focus to examine the association between economic uncertainty and suicides. We used monthly suicide data from the US at the State level from 2000 to 2017 and combined them with the monthly economic uncertainty index. We followed a panel data econometric approach to study the association between economic uncertainty and suicide, controlling for unemployment and other indicators. Economic uncertainty is positively associated with suicide when controlling for unemployment [coeff: 8.026; 95% CI: 3.692–12.360] or for a wider range of economic and demographic characteristics [coeff: 7.478; 95% CI: 3.333–11.623]. An increase in the uncertainty index by one percent is associated with an additional 11–24.4 additional monthly suicides in the US. Economic uncertainty is likely to act as a trigger, which underlines the impulsive nature of some suicides. This highlights the importance of providing access to suicide prevention interventions (e.g. hotlines) during periods of economic uncertainty.

scholarly journals International Religious Freedom Promotion and US Foreign Policy

Religions ◽  
2020 ◽  
Vol 11 (5) ◽  
pp. 260 ◽  
Author(s):  
Lee Marsden
Keyword(s):  
United States ◽  
Religious Freedom ◽  
State Level ◽  
The United States ◽  
Human Right ◽  
National Interests ◽  
Politics And Religion ◽  
The Us ◽  
The World ◽  
Political Background

The freedom to practice one’s religious belief is a fundamental human right and yet, for millions of people around the world, this right is denied. Yearly reports produced by the US State Department, United States Commission on International Religious Freedom, Open Doors International, Aid to the Church in Need and Release International reveal a disturbing picture of increased religious persecution across much of the world conducted at individual, community and state level conducted by secular, religious, terrorist and state actors. While religious actors both contribute to persecution of those of other faiths and beliefs and are involved in peace and reconciliation initiatives, the acceptance of the freedom to practice one’s faith, to disseminate that faith and to change one’s faith and belief is fundamental to considerations of the intersection of peace, politics and religion. In this article, I examine the political background of the United States’ promotion of international religious freedom, and current progress on advancing this under the Trump administration. International Religious Freedom (IRF) is contentious, and seen by many as the advancement of US national interests by other means. This article argues that through an examination of the accomplishments and various critiques of the IRF programme it is possible, and desirable, to discover what works, and where further progress needs to be made, in order to enable people around the world to enjoy freedom of thought, conscience and religion.

scholarly journals Crisis Standards of Care Implementation at the State Level in the United States

2020 ◽  
Vol 35 (6) ◽  
pp. 599-603 ◽  
Author(s):  
Colton Margus ◽  
Ritu R. Sarin ◽  
Michael Molloy ◽  
Gregory R. Ciottone
Keyword(s):  
United States ◽  
Large Scale ◽  
State Level ◽  
The United States ◽  
The State ◽  
Pediatric Care ◽  
Standards Of Care ◽  
Institute Of Medicine ◽  
Full Spectrum ◽  
The Us

AbstractIntroduction:In 2009, the Institute of Medicine published guidelines for implementation of Crisis Standards of Care (CSC) at the state level in the United States (US). Based in part on the then concern for H1N1 pandemic, there was a recognized need for additional planning at the state level to maintain health system preparedness and conventional care standards when available resources become scarce. Despite the availability of this framework, in the years since and despite repeated large-scale domestic events, implementation remains mixed.Problem:Coronavirus disease 2019 (COVID-19) rejuvenates concern for how health systems can maintain quality care when faced with unrelenting burden. This study seeks to outline which states in the US have developed CSC and which areas of care have thus far been addressed.Methods:An online search was conducted for all 50 states in 2015 and again in 2020. For states without CSC plans online, state officials were contacted by email and phone. Public protocols were reviewed to assess for operational implementation capabilities, specifically highlighting guidance on ventilator use, burn management, sequential organ failure assessment (SOFA) score, pediatric standards, and reliance on influenza planning.Results:Thirty-six states in the US were actively developing (17) or had already developed (19) official CSC guidance. Fourteen states had no publicly acknowledged effort. Eleven of the 17 public plans had updated within five years, with a majority addressing ventilator usage (16/17), influenza planning (14/17), and pediatric care (15/17), but substantially fewer addressing care for burn patients (9/17).Conclusion:Many states lacked publicly available guidance on maintaining standards of care during disasters, and many states with specific care guidelines had not sufficiently addressed the full spectrum of hazard to which their health care systems remain vulnerable.

scholarly journals Estimating the Early Outbreak Cumulative Incidence of COVID-19 in the United States: Three Complementary Approaches

2020 ◽  
Author(s):  
Fred S. Lu ◽  
Andre T. Nguyen ◽  
Nicholas B. Link ◽  
Marc Lipsitch ◽  
Mauricio Santillana
Keyword(s):  
United States ◽  
Cumulative Incidence ◽  
State Level ◽  
The United States ◽  
Positive Test ◽  
Influenza Surveillance ◽  
Accurate Estimation ◽  
Surveillance Systems ◽  
Influenza Like Illness ◽  
The Us

AbstractEffectively designing and evaluating public health responses to the ongoing COVID-19 pandemic requires accurate estimation of the weekly incidence of COVID-19. Unfortunately, a lack of systematic testing across the United States (US) due to equipment shortages and varying testing strategies has hindered the usefulness of the reported positive COVID-19 case counts. We introduce three complementary approaches to estimate the cumulative incidence of symptomatic COVID-19 during the early outbreak in each state in the US as well as in New York City, using a combination of excess influenza-like illness reports, COVID-19 test statistics, and COVID-19 mortality reports. Instead of relying on an estimate from a single data source or method that may be biased, we provide multiple estimates, each relying on different assumptions and data sources. Across our three approaches, there is a consistent conclusion that estimated state-level COVID-19 symptomatic case counts from March 1 to April 4, 2020 varied from 5 to 50 times greater than the official positive test counts. Nationally, our estimates of COVID-19 symptomatic cases in the US as of April 4 have a likely range of 2.2 to 5.1 million cases, with possibly as high as 8.1 million cases, up to 26 times greater than the cumulative confirmed cases of about 311,000. Extending our method to May 16, 2020, we estimate that cumulative symptomatic incidence ranges from 6.0 to 12.2 million, which compares with 1.5 million positive test counts. Our approaches demonstrate the value of leveraging existing influenza-like-illness surveillance systems during the flu season for measuring the burden of new diseases that share symptoms with influenza-like-illnesses. Our methods may prove useful in assessing the burden of COVID-19 during upcoming flu seasons in the US and other countries with comparable influenza surveillance systems.

scholarly journals Measuring Job Creation, Growth, and Survival among the Universe of Start-ups in the United States Using a Combined Start-up Panel Data Set

ILR Review ◽  
2019 ◽  
Vol 72 (5) ◽  
pp. 1262-1277 ◽  
Author(s):  
Robert W. Fairlie ◽  
Javier Miranda ◽  
Nikolas Zolas
Keyword(s):  
United States ◽  
Panel Data ◽  
The United States ◽  
Future Research ◽  
Data Set ◽  
Growth And Survival ◽  
Start Up ◽  
The Us ◽  
Start Ups ◽  
The Universe

The field of entrepreneurship is growing rapidly and expanding into new areas. This article presents a new compilation of administrative panel data on the universe of business start-ups in the United States, which will be useful for future research in entrepreneurship. To create the US start-up panel data set, the authors link the universe of non-employer firms to the universe of employer firms in the Longitudinal Business Database (LBD). Start-up cohorts of more than five million new businesses per year, which create roughly three million jobs, can be tracked over time. To illustrate the potential of the new start-up panel data set for future research, the authors provide descriptive statistics for a few examples of research topics using a representative start-up cohort.

scholarly journals The United States: The First Formalization of Banking Supervision

2021 ◽  
pp. 23-41
Author(s):  
Eiji Hotori ◽  
Mikael Wendschlag ◽  
Thibaud Giddey
Keyword(s):  
United States ◽  
Banking System ◽  
State Level ◽  
The United States ◽  
State Governments ◽  
Banking Supervision ◽  
The Great Depression ◽  
The Us ◽  
Social And Economic Development ◽  
National Banking System

AbstractThis chapter examines the formalization of banking supervision in the United States (US), focusing on the federal level. During the “free banking era” from the late 1830s to 1864, several state governments created banking supervisory systems at the state level. Triggered by the fiscal needs of the Civil War, as well as the demand for a national currency, the US became the first country to introduce uniform nationwide banking supervision with the creation of the Office of the Comptroller of the Currency (OCC) and the national banking system. The main purpose of the OCC was to ensure that the national banks did not violate the regulations related to the new currency, the US dollar. From a historical perspective, the rapid social and economic development of the US from the 1850s provided the background for this institutional change. Although the US case demonstrates that financial crises have not always driven the formalization of banking supervision, the crises of 1907 and the Great Depression served to further strengthen the formalization of banking supervision by prompting the introduction of multi-agency banking supervision in the US.

scholarly journals Epidemiology of mucopolysaccharidoses (MPS) in United States: challenges and opportunities

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yana Puckett ◽  
Alejandra Mallorga-Hernández ◽  
Adriana M. Montaño
Keyword(s):  
United States ◽  
Disease Incidence ◽  
State Level ◽  
The United States ◽  
Incidence Rates ◽  
Mandated Reporting ◽  
Prevalence Rates ◽  
Lysosomal Storage ◽  
Live Births ◽  
The Us

Abstract Background Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US), showing considerable variation by country. This study aimed to identify MPS incidence and prevalence in the US at a national and state level to guide clinicians and policy makers. Methods This retrospective study examined all diagnosed cases of MPS from 1995 to 2015 in the US using the National MPS Society database records. Data included year of birth, patient geographic location, and MPS variant type. US population information was obtained from the National Center for Health Statistics. The incidence and prevalence rates were calculated for each disease. Incidence rates were calculated for each state. Results We obtained information from 789 MPS patients during a 20-year period. Incidence of MPS in the US was found to be 0.98 per 100,000 live births. Prevalence was found to be 2.67 per 1 million. MPS I, II, and III had the highest incidence rate at birth (0.26/100,000) and prevalence rates of 0.70–0.71 per million. Birth incidences of MPS IV, VI, and VII were 0.14, 0.04 and 0.027 per 100,000 live births. Conclusions This is the most comprehensive review of MPS incidence and prevalence rates in the US. Due to the large US population and state fragmentation, US incidence and prevalence were found to be lower than other countries. Nonetheless, state-level studies in the US supported these figures. Efforts should be focused in the establishment of a national rare disease registry with mandated reporting from every state as well as newborn screening of MPS.

scholarly journals Early COVID-19 Interventions Failed to Replicate 1918 St. Louis vs. Philadelphia Outcomes in the United States

2020 ◽  
Author(s):  
Aliea M. Jalali ◽  
Brent M. Peterson ◽  
Thushara Galbadage
Keyword(s):  
Public Health ◽  
United States ◽  
State Level ◽  
The United States ◽  
The State ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Public Health Response ◽  
Health Response ◽  
The Us

The Coronavirus disease 2019 (COVID-19) pandemic has elicited an abrupt pause in the United States in multiple sectors of commerce and social activity. As the US faces this health crisis, the magnitude, and rigor of their initial public health response was unprecedented. As a response, the entire nation shutdown at the state-level for the duration of approximately one to three months. These public health interventions, however, were not arbitrarily decided, but rather, implemented as a result of evidence-based practices. These practices were a result of lessons learned during the 1918 influenza pandemic and the city-level non-pharmaceutical interventions (NPIs) taken across the US. During the 1918 pandemic, two model cities, St. Louis, MO, and Philadelphia, PA, carried out two different approaches to address the spreading disease, which resulted in two distinctly different outcomes. Our group has evaluated the state-level public health response adopted by states across the US, with a focus on New York, California, Florida, and Texas, and compared the effectiveness of reducing the spread of COVID-19. Our assessments show that while the states mentioned above benefited from the implementations of early preventative measures, they inadequately replicated the desired outcomes observed in St. Louis during the 1918 crisis. Our study indicates that there are other factors, including health disparities that may influence the effectiveness of public health interventions applied. Identifying more specific health determinants may help implement targeted interventions aimed at preventing the spread of COVID-19 and improving health equity.

Water reuse criteria in the United States

2005 ◽  
Vol 5 (3-4) ◽  
pp. 1-7 ◽  
Author(s):  
J. Crook ◽  
R.Y. Surampalli
Keyword(s):  
United States ◽  
Environmental Protection Agency ◽  
Water Reuse ◽  
Potable Water ◽  
Reclaimed Water ◽  
State Level ◽  
The United States ◽  
Protection Agency ◽  
The Us ◽  
Public Health Protection

Water reuse is well established in the United States, with uses ranging from pasture irrigation using reclaimed water that has received a low level of treatment, to augmentation of potable water supplies with highly treated reclaimed water. There are no federal regulations governing water reuse and criteria are developed at the state level. Criteria differ between states that have adopted regulations or guidelines, but criteria among states where water reuse is prevalent are similar and tend to be conservative, with public health protection being the most important consideration. The US Environmental Protection Agency (EPA) has published guidelines for water reuse that include recommended criteria for various reclaimed water applications.

scholarly journals Impacts of social distancing policies on mobility and COVID-19 case growth in the US

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Gregory A. Wellenius ◽  
Swapnil Vispute ◽  
Valeria Espinosa ◽  
Alex Fabrikant ◽  
Thomas C. Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Infection Control ◽  
State Level ◽  
The United States ◽  
Social Consequences ◽  
Social Distancing ◽  
Mobility Data ◽  
The Us ◽  
Public Health Officials

AbstractSocial distancing remains an important strategy to combat the COVID-19 pandemic in the United States. However, the impacts of specific state-level policies on mobility and subsequent COVID-19 case trajectories have not been completely quantified. Using anonymized and aggregated mobility data from opted-in Google users, we found that state-level emergency declarations resulted in a 9.9% reduction in time spent away from places of residence. Implementation of one or more social distancing policies resulted in an additional 24.5% reduction in mobility the following week, and subsequent shelter-in-place mandates yielded an additional 29.0% reduction. Decreases in mobility were associated with substantial reductions in case growth two to four weeks later. For example, a 10% reduction in mobility was associated with a 17.5% reduction in case growth two weeks later. Given the continued reliance on social distancing policies to limit the spread of COVID-19, these results may be helpful to public health officials trying to balance infection control with the economic and social consequences of these policies.

scholarly journals An Evaluation of the Vulnerable Physician Workforce in the United States During the Coronavirus Disease-19 Pandemic

2020 ◽  
Author(s):  
Rohan Khera ◽  
Lovedeep Singh Dhingra ◽  
Snigdha Jain ◽  
Harlan M Krumholz
Keyword(s):  
United States ◽  
New York ◽  
State Level ◽  
The United States ◽  
Adverse Outcomes ◽  
Physician Workforce ◽  
Median Proportion ◽  
The Us ◽  
State Medical Boards ◽  
Age Over 60

BackgroundThe coronavirus disease-19 (COVID-19) pandemic threatens to overwhelm the healthcare resources of the country, but also poses a personal hazard to healthcare workers, including physicians. To address the potential impact of excluding physicians with a high risk of adverse outcomes based on age, we evaluated the current patterns of age of licensed physicians across the United States.MethodsWe compiled information from the 2018 database of actively licensed physicians in the Federation of State Medical Boards (FSMB) across the US. Both at a national- and the state-level, we assessed the number and proportion of physicians who would be at an elevated risk due to age over 60 years.ResultsOf the 985,026 licensed physicians in the US, 235857 or 23.9% were aged 25-40 years, 447052 or 45.4% are 40-60 years, 191794 or 19.5% were 60-70 years, and 106121 or 10.8% were 70 years or older. Age was not reported in 4202 or 0.4% of physicians. Overall, 297915 or 30.2% of physicians were 60 years of age or older, 246167 (25.0%) 65 years and older, and 106121 (10.8%) 70 years or older. States in the US reported that a median 5470 licensed physicians (interquartile range [IQR], 2394 to 10108) were 60 years of age or older. Notably, states of North Dakota (n=1180) and Vermont (n = 1215) had the lowest and California (n=50786) and New York (n=31582) the highest number of physicians over the age of 60 years (Figure 1). Across states, the median proportion of physicians aged 60 years and older was 28.9% (IQR, 27.2%, 31.4%), and ranged between 25.9% for Nebraska to 32.6% for New Mexico (Figure 2).DiscussionOlder physicians represent a large proportion of the US physician workforce, particularly in states with the worst COVID-19 outbreak. Therefore, their exclusion from patient care will be impractical. Optimizing care practices by limiting direct patient contact of physicians vulnerable to adverse outcomes from COVID-19, potentially by expanding their participation in telehealth may be a strategy to protect them.

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