Medical Spending for the 2001 Anthrax Letter Attacks

2018 ◽  
Vol 13 (03) ◽  
pp. 539-546 ◽  
Author(s):  
Nicholas A. Zacchia ◽  
Ketra Schmitt
Keyword(s):  
Public Health ◽  
Prophylactic Treatment ◽  
Economic Impacts ◽  
Cost Model ◽  
Medical Costs ◽  
Cost Data ◽  
Public Health Preparedness ◽  
News Reports ◽  
Medical Spending ◽  
The Us

ABSTRACTIntroductionThis paper assesses the total medical costs associated with the US anthrax letter attacks of 2001. This information can be used to inform policies, which may help mitigate the potential economic impacts of similar bioterrorist attacks.MethodsJournal publications and news reports were reviewed to establish the number of people who were exposed, were potentially exposed, received prophylactics, and became ill. Where available, cost data from the anthrax letter attacks were used. Where data were unavailable, high, low, and best cost estimates were developed from the broader literature to create a cost model and establish economic impacts.ResultsMedical spending totaled approximately $177 million.ConclusionsThe largest expenditures stemmed from self-initiated prophylaxis (worried well): people who sought prophylactic treatment without any indication that they had been exposed to anthrax letters. This highlights an area of focus for mitigating the economic impacts of future disasters. (Disaster Med Public Health Preparedness. 2019;13:539-546)

Value-Based Emergency Management

2016 ◽  
Vol 10 (1) ◽  
pp. 158-160
Author(s):  
Zachary Corrigan ◽  
Walter Winslow ◽  
Charlie Miramonti ◽  
Tim Stephens
Keyword(s):  
Public Health ◽  
Health Care ◽  
Emergency Management ◽  
Health Care System ◽  
Health Care Organizations ◽  
Public Health Preparedness ◽  
Value Based Purchasing ◽  
Compensation Systems ◽  
The Us ◽  
Care System

ABSTRACTThis article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management. (Disaster Med Public Health Preparedness. 2016;10:158–160)

scholarly journals US Public Health Preparedness for Zika and Other Threats Remains Vulnerable

2016 ◽  
Vol 10 (2) ◽  
pp. 298-299 ◽  
Author(s):  
Jeffrey S. Duchin
Keyword(s):  
Public Health ◽  
Emergency Preparedness ◽  
Public Health Preparedness ◽  
The Us ◽  
Response Capacity ◽  
National Public Health ◽  
Emergency Preparedness And Response ◽  
Public Health Emergency Preparedness ◽  
Core Areas ◽  
Solid Foundation

AbstractThe unanticipated global outbreak of Zika virus infection is the most current but certainly not the last emerging infectious disease challenge to confront the US public heath system. Despite a number of such threats in recent years, significant gaps remain in core areas of public health system readiness. Stable, sustained investments are required to establish a solid foundation for achieving necessary national public health emergency preparedness and response capacity. (Disaster Med Public Health Preparedness. 2016;10:298–299)

Trends in the incidence and mortality of oral cancer in Nevada (Preprint)

2020 ◽  
Author(s):  
Kevin Foote ◽  
Karl Kingsley
Keyword(s):  
Public Health ◽  
Oral Cancer ◽  
Cancer Incidence ◽  
Cancer Control ◽  
Cancer Registries ◽  
Public Health Research ◽  
Chi Square ◽  
Incidence And Mortality ◽  
The Us ◽  
Chi Square Analysis

BACKGROUND Reviews of national and state-specific cancer registries have revealed differences in rates of oral cancer incidence and mortality that have implications for public health research and policy. Many significant associations between head and neck (oral) cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans – including the Nevada Clean Indoor Act of 2006 (and subsequent modification in 2011). OBJECTIVE Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral cancer incidence and mortality in Nevada. METHODS Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012 – 2016 and are age-adjusted to the year 2000 standard US population. Comparisons of any differences between Nevada and the overall US population were evaluated using Chi square analysis. RESULTS This analysis revealed that the overall rates of incidence and mortality from oral cancer in Nevada differs from that observed in the overall US population. For example, although the incidence of oral cancer among Caucasians is increasing in Nevada and the US overall, it is increasing at nearly twice that rate in Nevada, P=0.0002. In addition, although oral cancer incidence among Minorities in the US is declining, it is increasing in Nevada , P=0.0001. Analysis of reported mortality causes revealed that mortality from oral cancer increased in the US overall but declined in Nevada during the same period (2012-2016). More specifically, mortality among both Males and Females in the US is increasing, but is declining in Nevada, P=0.0027. CONCLUSIONS Analysis of the epidemiologic data from Nevada compared with the overall US revealed significant differences in rates of oral cancer incidence and mortality. More specifically, oral cancer incidence increased in Nevada between 2012-2016 among all groups analyzed (Males, Females, White, Minority), while decreases were observed nationally among Females and Minorities. Although mortality in Nevada decreased over this same time period (in contrast to the national trends), the lag time between diagnosis (incidence) and mortality suggests that these trends will change in the near future. CLINICALTRIAL Not applicable

State Intervention During Public Health Emergencies: Is the United States Prepared for an Ebola Outbreak?

2015 ◽  
Vol 12 (2) ◽  
Author(s):  
Marie-Helen Maras ◽  
Michelle D. Miranda
Keyword(s):  
Public Health ◽  
State Intervention ◽  
The United States ◽  
International Travel ◽  
American Government ◽  
Training And Education ◽  
Public Health Emergencies ◽  
The Us ◽  
Bioterrorism Agent ◽  
Legal Guidelines

AbstractIn the fall of 2014, the US was faced with the reality that a deadly, foreign virus had entered its borders. Ebola, a disease thought to be of little threat to the US yet classified as a major bioterrorism agent, became a reality for the American government and its citizens. The introduction of Ebola unveiled many deficiencies in the country’s health care system, international travel policies, and ability to control or restrict the movement of exposed individuals in order to protect the larger population. The need to review and establish legal guidelines and policies to deal with these deficiencies is paramount: the inherent lack of training and education; weaknesses in monitoring, maintenance, and treatment; and the lack of uniform guidelines to isolate international travelers have all demonstrated that the country may not be able to control a larger-scale threat in the future.

A Preliminary Report on Alcohol-Associated DNA Methylation Changes and Suicidal Behavior: Evidence Using Mendelian Randomization

2021 ◽  
pp. 105413732095224
Author(s):  
Charleen D. Adams
Keyword(s):  
Public Health ◽  
Dna Methylation ◽  
Suicidal Behavior ◽  
Genome Wide Association Study ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Economic Stress ◽  
Self Report ◽  
Health Concern ◽  
The Us

Suicide is a major public health concern. In 2015, it was the 10th leading cause of death in the US. The number of suicides increased by 30% in the US from 1999 to 2016, and a greater uptick in suicides is predicted to occur as a result of the COVID-19 crisis, for which the primary public-health strategy is physical distancing and during which alcohol sales have soared. Thus, current strategies for identifying at-risk individuals and preventing suicides, such as relying on self-reported suicidal ideation, are insufficient, especially under conditions of physical distancing, which exacerbate isolation, loneliness, economic stress, and possibly alcohol consumption. New strategies are urgent now and into the future. To that aim, here, a two-sample Mendelian randomization (an instrumental variables technique using public genome-wide association study data as data sources) was performed to determine whether alcohol-associated changes in DNA methylation mediate risk for suicidal behavior. The results suggest that higher alcohol-associated DNA methylation levels at cg18120259 confer a weak causal effect. Replication and triangulation of the results, both experimentally and with designs other than Mendelian randomization, are needed. If the findings replicate, the information might be utilized to raise awareness about the biological links between alcohol and suicide and possibly explored as a biomarker of risk, perhaps especially for early detection of those who may not self-report suicidal intent.

scholarly journals Actionable lessons for the US COVID vaccine program

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gary L. Freed
Keyword(s):  
Public Health ◽  
Local Health ◽  
National Strategy ◽  
Individual State ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
The Us ◽  
Vaccine Distribution

AbstractWhen attempting to provide lessons for other countries from the successful Israeli COVID-19 vaccine experience, it is important to distinguish between the modifiable and non-modifiable components identified in the article by Rosen, et al. Two specific modifiable components included in the Israeli program from which the US can learn are (a) a national (not individual state-based) strategy for vaccine distribution and administration and (b) a functioning public health infrastructure. As a federal government, the US maintains an often complex web of state and national authorities and responsibilities. The federal government assumed responsibility for the ordering, payment and procurement of COVID vaccine from manufacturers. In designing the subsequent steps in their COVID-19 vaccine distribution and administration plan, the Trump administration decided to rely on the states themselves to determine how best to implement guidance provided by the Centers for Disease Control and Prevention (CDC). This strategy resulted in 50 different plans and 50 different systems for the dissemination of vaccine doses, all at the level of each individual state. State health departments were neither financed, experienced nor uniformly possessed the expertise to develop and implement such plans. A national strategy for the distribution, and the workforce for the provision, of vaccine beyond the state level, similar to that which occurred in Israel, would have provided for greater efficiency and coordination across the country. The US public health infrastructure was ill-prepared and ill-staffed to take on the responsibility to deliver > 450 million doses of vaccine in an expeditious fashion, even if supply of vaccine was available. The failure to adequately invest in public health has been ubiquitous across the nation at all levels of government. Since the 2008 recession, state and local health departments have lost > 38,000 jobs and spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%. Hopefully, COVID-19 will be a wakeup call to the US with regard to the need for both a national strategy to address public health emergencies and the well-maintained infrastructure to make it happen.

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