scholarly journals Estimating Prevalent Diagnoses and Rates of New Diagnoses of HIV at the State Level by Age Group Among Men who Have Sex With Men in the United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jeb Jones ◽  
Jeremy A Grey ◽  
David W Purcell ◽  
Kyle T Bernstein ◽  
Patrick S Sullivan ◽  
...  
Keyword(s):  
United States ◽  
Age Groups ◽  
State Level ◽  
The United States ◽  
The State ◽  
Surveillance Data ◽  
Age Group ◽  
Population Size Estimates ◽  
Sex With Men ◽  
New Diagnosis

Abstract Background Men who have sex with men (MSM) in the United States experience a disproportionate rate of diagnosis of HIV. Surveillance data demonstrate age-based disparities among MSM, with higher rates of diagnosis among MSM age ≤34 years nationally. Population size estimates within age group at the state level have not been available to determine rates for each state. We estimated the size of the MSM population in 5 age groups in each state and estimated the rate of prevalent HIV diagnoses in 2013 and new HIV diagnoses in 2014. Methods We used data from the General Social Survey, American Community Survey, and previously published estimates from the National Health and Nutrition Examination Survey to estimate the population of MSM in 5 age groups at the state level. We combined these estimates with surveillance data to estimate age-stratified rates of prevalent diagnoses in 2013 and new diagnoses in 2014 in each state. We estimated standardized prevalence and diagnosis ratios comparing the Northeast, South, and West regions with the Midwest. Results Rates of prevalent diagnoses increased with increasing age, and rates of new diagnoses were highest among younger age groups. In the United States, the new diagnosis rate among those age 18–24 years in 2014 was 1.4 per 100 MSM without a diagnosis. The highest diagnosis rates were observed among men age ≤34 years in the South. Conclusions Age-stratified estimates of HIV prevalence and new diagnosis rates at the state level can inform public health prevention strategies and resource allocation.

Governance models of public utility commissions in the United States

2019 ◽  
Vol 20 (3) ◽  
pp. 229-239 ◽  
Author(s):  
Douglas J. Howe
Keyword(s):  
United States ◽  
Political Action ◽  
State Level ◽  
The United States ◽  
State Legislature ◽  
The State ◽  
Public Utility ◽  
Political Action Committees ◽  
Special Interest Groups ◽  
Governance Model

Regulation of utilities at the state level in the United States is undertaken by a commission on which anywhere from three to seven commissioners sit and must vote on virtually all significant utility actions, including rate requests, resource plans, acquisitions and mergers, and financing mechanisms. Public utility commissions (PUCs) are, in a very real sense, courts with adjudicatory responsibility over the area of state utility laws. In hearing a utility case, they must follow the state’s statutes and court rules. The commissioners function as judges in this court of public utility law. In a majority of states, commissioners are appointed by the state’s governor with the advice and consent of the state legislature. In a significant minority of states, commissioners are elected by popular vote. However, recent changes in US election law have made it easier for corporations and special interest groups, called political action committees, to influence elections through donations targeting direct voter outreach on behalf of specific candidates. This chapter examines what the entry of political spending in PUC elections means, and whether elected commissioners can adjudicate in the public interest, or will adjudicate for special interests. The chapter concludes that while both the appointment and election governance model can produce both “good” and “bad” commissioners, it is the elected commission that is most at risk of selecting commissioners that will not be truly independent and objective arbiters of the law.

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.

Peak Car Travel in the United States: Two-Decade-Long Phenomenon at the State Level

2015 ◽  
Vol 2531 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Timothy J. Garceau ◽  
Carol Atkinson-Palombo ◽  
Norman Garrick
Keyword(s):  
United States ◽  
Economic Growth ◽  
State Level ◽  
Developed Countries ◽  
The United States ◽  
The State ◽  
Economic Consequences ◽  
National Scale ◽  
Peak Car ◽  
Car Travel

Peak car travel is an international phenomenon that became evident in the United States on a national scale in 2004. Potentially related to peak car travel is the decoupling of economic growth from driving levels. A wealth of research has addressed these phenomena on a national scale in the United States and other developed countries. Yet few studies have been undertaken on other geographic scales, especially the statewide scale in the United States. This study investigated U.S. state-level driving and economic patterns from 1980 to 2011 to understand occurring changes. The research results showed that peak car travel first occurred at the state level as early as 1992 in Washington State, whereas another 10 states peaked in 2000. By 2011, 48 of the 50 states had peaked. The longevity of this phenomenon at the state level provided evidence that peak car travel in the United States was a more permanent phenomenon than previously thought. In addition, the decoupling of economic growth from driving was evident at the state level. In the 1980s, these indicators were positively correlated at the state level. A significant change occurred by the 2000s, however, when any significant connection ceased for most states. For four of the earliest peak car travel states, the relationship between economic growth and driving turned negative. This finding showed that decreases in driving were not associated with negative economic consequences. Rather, in several states, driving reductions were now associated with increased, rather than decreased, economic growth.

Inequality and growth in the United States: is there asymmetric response at the state level?

2017 ◽  
Vol 50 (10) ◽  
pp. 1074-1092 ◽  
Author(s):  
Mohsen Bahmani-Oskooee ◽  
Amid Motavallizadeh-Ardakani
Keyword(s):  
United States ◽  
State Level ◽  
The United States ◽  
The State ◽  
Asymmetric Response

Causal Relationship between Asset Prices and Output in the United States: Evidence from the State-Level Panel Granger Causality Test

2015 ◽  
Vol 50 (10) ◽  
pp. 1728-1741 ◽  
Author(s):  
Furkan Emirmahmutoglu ◽  
Mehmet Balcilar ◽  
Nicholas Apergis ◽  
Beatrice D. Simo-Kengne ◽  
Tsangyao Chang ◽  
...  
Keyword(s):  
United States ◽  
Causal Relationship ◽  
Granger Causality ◽  
Asset Prices ◽  
State Level ◽  
Granger Causality Test ◽  
The United States ◽  
The State ◽  
Causality Test ◽  
Panel Granger Causality

scholarly journals Contact surveys reveal heterogeneities in age-group contributions to SARS-CoV-2 dynamics in the United States

2021 ◽  
Author(s):  
Taylor Chin ◽  
Dennis M. Feehan ◽  
Caroline O. Buckee ◽  
Ayesha S. Mahmud
Keyword(s):  
United States ◽  
Age Groups ◽  
The United States ◽  
Contact Rate ◽  
Age Group ◽  
Contact Rates ◽  
Contact Patterns ◽  
Age Structured ◽  
The Impact ◽  
Over Time

SARS-CoV-2 is spread primarily through person-to-person contacts. Quantifying population contact rates is important for understanding the impact of physical distancing policies and for modeling COVID-19, but contact patterns have changed substantially over time due to shifting policies and behaviors. There are surprisingly few empirical estimates of age-structured contact rates in the United States both before and throughout the COVID-19 pandemic that capture these changes. Here, we use data from six waves of the Berkeley Interpersonal Contact Survey (BICS), which collected detailed contact data between March 22, 2020 and February 15, 2021 across six metropolitan designated market areas (DMA) in the United States. Contact rates were low across all six DMAs at the start of the pandemic. We find steady increases in the mean and median number of contacts across these localities over time, as well as a greater proportion of respondents reporting a high number of contacts. We also find that young adults between ages 18 and 34 reported more contacts on average compared to other age groups. The 65 and older age group consistently reported low levels of contact throughout the study period. To understand the impact of these changing contact patterns, we simulate COVID-19 dynamics in each DMA using an age-structured mechanistic model. We compare results from models that use BICS contact rate estimates versus commonly used alternative contact rate sources. We find that simulations parameterized with BICS estimates give insight into time-varying changes in relative incidence by age group that are not captured in the absence of these frequently updated estimates. We also find that simulation results based on BICS estimates closely match observed data on the age distribution of cases, and changes in these distributions over time. Together these findings highlight the role of different age groups in driving and sustaining SARS-CoV-2 transmission in the U.S. We also show the utility of repeated contact surveys in revealing heterogeneities in the epidemiology of COVID-19 across localities in the United States.

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