Administrative Law and the Public's Health

2002 ◽  
Vol 30 (2) ◽  
pp. 212-223 ◽  
Author(s):  
Eleanor D. Kinney
Keyword(s):  
Public Health ◽  
New York ◽  
Health System ◽  
Homeland Security ◽  
Public Health System ◽  
The United States ◽  
Public Health Agencies ◽  
Aids Pandemic ◽  
Major Outbreak ◽  
Public Health Regulation

Today, public health regulation at all levels faces unprecedented challenges both at home and abroad. The September 11, 2001 attacks on New York and Washington, D.C., by the Al Qaeda terrorist network and the anthrax bioterrorism that followed shortly thereafter have put public health regulation at the forefront of homeland security. The anthrax scare, in particular, has greatly tested the American public health system, calling into question whether the United States and its component states and localities are prepared to handle a major outbreak of infectious disease, such as smallpox, in a future bioterrorist action. While the response of public health agencies was commendable, especially in light of the magnitude of the assaults, it is manifestly clear that the American public health system will be hard pressed to meet similar challenges that may lie ahead.The events of fall 2001 follow a period of major challenges for public health. The AIDS pandemic has killed millions of people throughout the globe, especially in Africa and other parts of the developing world.

scholarly journals Reform of the New York’s public health system in the context of rapid urban development (turn of the XIX – XX centuries)

2020 ◽  
pp. 1-10
Author(s):  
Evgeniya Vladimirovna Zhilina
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
York City ◽  
Preventive Measures ◽  
Public Health System ◽  
The United States ◽  
Administrative Reforms ◽  
The City

This article explores the factors for conducting administrative reforms in the United States in the area of public health. For detailed consideration, the author selected New York City as an example the largest metropolitan area that faced aggravation of social problems due to the shortcomings in the existing public health system. Rapid increase in the number of resident in the conditions of significant growth of population density led to proliferation of the dangerous infectious diseases, for elimination of which local authorities had to take prompt actions of state regulation, including creation of the new administrative branches. Special attention is given to the treatment of tuberculosis and preventive measures thereof, namely the importance of tracking all new cases. In studying public health system of New York City, the author applied interdisciplinary approach that ensured comprehensive and objective outlook upon the problems of poorest population groups of the city. Comparative-historical method was used juxtapose the situation in New York and typologically similar US metropolises. Chronological method allowed tracing the patterns in evolution of administrative innovations, and assessing them in a single historical perspective. The main conclusion consists in the statement that private medicine appeared to be insufficient due to the drastic changes of social conditions in the densely populated metropolises, as the constantly growing population of poor immigrant neighborhoods was capable of paying for medical services. At the same time, namely the residents of such ghettos were most vulnerable category of population from the standpoint of epidemiology. Taking preventive measures by the municipal authorities, which included mass vaccination and clearing New York streets from dirt and trash, became an effective way to alleviate the situation. The administrative reforms in the city significantly improved the situation, which laid the foundation for sweeping changes in the future.

New York State Public Health System Response to Hurricane Sandy: An Analysis of Emergency Reports

2015 ◽  
Vol 10 (3) ◽  
pp. 308-313 ◽  
Author(s):  
Asante Shipp Hilts ◽  
Stephanie Mack ◽  
Millicent Eidson ◽  
Trang Nguyen ◽  
Guthrie S. Birkhead
Keyword(s):  
Public Health ◽  
New York ◽  
Health System ◽  
Key Words ◽  
Public Health System ◽  
New York State ◽  
Hurricane Sandy ◽  
System Response ◽  
Emergency Operations ◽  
York State

AbstractObjectiveAnalyzing Hurricane Sandy emergency reports to assess the New York State (NYS) public health system response will help inform and improve future disaster preparedness and response.MethodsQualitative analysis of NYS Department of Health (NYSDOH) and Nassau and Suffolk County local health department (LHD) emergency reports was conducted. Three after-action reports and 48 situation reports were reviewed, grouped by key words and sorted into 16 Public Health Preparedness Capabilities. Within each capability, key words were labeled as strengths, challenges, or recommendations.ResultsThe NYSDOH capability most cited as a strength was successful emergency operations coordination, eg, interagency conference calls (27.4% of 1681 strengths). The most cited challenge was environmental health protection, eg, mold and oil spills (28% of 706 challenges). The LHD capability most cited both as a strength (46.7% of 30 strengths) and as a challenge (32.5% of 123 challenges) was emergency operations coordination. Strengths were exemplified by sharing local resources and challenges by insufficient memorandums of understanding for coordination.ConclusionsPost-disaster emergency reports should be systematically reviewed to highlight both successes and areas for improvement. Future studies should prioritize collecting feedback from a wider spectrum of public health and service provider staff for planning of preparedness and response activities. (Disaster Med Public Health Preparedness. 2015;10:308–313)

scholarly journals Geographical surveillance of COVID-19: Diagnosed cases and death in the United States

2020 ◽  
Author(s):  
Raid Amin ◽  
Terri Hall ◽  
Jacob Church ◽  
Daniela Schlierf ◽  
Martin Kulldorff
Keyword(s):  
Public Health ◽  
New York ◽  
New England ◽  
Disease Surveillance ◽  
Multiple Testing ◽  
The United States ◽  
Space Time ◽  
Scan Statistics ◽  
Public Health Agencies ◽  
Incidence And Mortality

AbstractBackgroundCOVID-19 is a new coronavirus that has spread from person to person throughout the world. Geographical disease surveillance is a powerful tool to monitor the spread of epidemics and pandemic, providing important information on the location of new hot-spots, assisting public health agencies to implement targeted approaches to minimize mortality.MethodsCounty level data from January 22-April 28 was downloaded from USAfacts.org to create heat maps with ArcMap™ for diagnosed COVID-19 cases and mortality. The data was analyzed using spatial and space-time scan statistics and the SaTScan™ software, to detect geographical cluster with high incidence and mortality, adjusting for multiple testing. Analyses were adjusted for age. While the spatial clusters represent counties with unusually high counts of COVID-19 when averaged over the time period January 22-April 20, the space-time clusters allow us to identify groups of counties in which there exists a significant change over time.ResultsThere were several statistically significant COVID-19 clusters for both incidence and mortality. Top clusters with high rates included the areas in and around New York City, New Orleans and Chicago, but there were also several small rural clusters. Top clusters for a recent surge in incidence and mortality included large parts of the Midwest, the Mid-Atlantic Region, and several smaller areas in and around New York and New England.ConclusionsSpatial and space-time surveillance of COVID-19 can be useful for public health departments in their efforts to minimize mortality from the disease. It can also be applied to smaller regions with more granular data.

scholarly journals A Bayesian framework for estimating the risk ratio of hospitalization for people with comorbidity infected by SARS-CoV-2 virus

2020 ◽  
Author(s):  
Xiang Gao ◽  
Qunfeng Dong
Keyword(s):  
Public Health ◽  
New York ◽  
General Population ◽  
Risk Ratio ◽  
Bayesian Approach ◽  
Large Scale ◽  
The United States ◽  
Chronic Respiratory Disease ◽  
Infected People ◽  
Public Health Agencies

Abstract Objective Estimating the hospitalization risk for people with comorbidities infected by the SARS-CoV-2 virus is important for developing public health policies and guidance. Traditional biostatistical methods for risk estimations require: (i) the number of infected people who were not hospitalized, which may be severely undercounted since many infected people were not tested; (ii) comorbidity information for people not hospitalized, which may not always be readily available. We aim to overcome these limitations by developing a Bayesian approach to estimate the risk ratio of hospitalization for COVID-19 patients with comorbidities. Materials and Methods We derived a Bayesian approach to estimate the posterior distribution of the risk ratio using the observed frequency of comorbidities in COVID-19 patients in hospitals and the prevalence of comorbidities in the general population. We applied our approach to 2 large-scale datasets in the United States: 2491 patients in the COVID-NET, and 5700 patients in New York hospitals. Results Our results consistently indicated that cardiovascular diseases carried the highest hospitalization risk for COVID-19 patients, followed by diabetes, chronic respiratory disease, hypertension, and obesity, respectively. Discussion Our approach only needs (i) the number of hospitalized COVID-19 patients and their comorbidity information, which can be reliably obtained using hospital records, and (ii) the prevalence of the comorbidity of interest in the general population, which is regularly documented by public health agencies for common medical conditions. Conclusion We developed a novel Bayesian approach to estimate the hospitalization risk for people with comorbidities infected with the SARS-CoV-2 virus.

scholarly journals Outcomes of COVID-19 Admissions in the New York City Public Health System and Variations by Hospitals and Boroughs During the Initial Pandemic Response

2021 ◽  
Vol 9 ◽  
Author(s):  
Anant Dinesh ◽  
Taha Mallick ◽  
Tatiana M. Arreglado ◽  
Brian L. Altonen ◽  
Ryan Engdahl
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
York City ◽  
Public Health System ◽  
Public Hospitals ◽  
Mortality Trends ◽  
The Public ◽  
Pandemic Response

Introduction: In the initial pandemic regional differences may have existed in COVID-19 hospitalizations and patient outcomes in New York City. Whether these patterns were present in public hospitals is unknown. The aim of this brief study was to investigate COVID-19 hospitalizations and outcomes in the public health system during the initial pandemic response.Methods: A retrospective review was conducted on COVID-19 admissions in New York City public hospitals during the exponential phase of the pandemic. All data were collected from an integrated electronic medical records system (Epic Health Systems, Verona, WI). Overall, 5,422 patients with at least one admission each for COVID-19 were reviewed, with a study of demographic characteristics (including age, gender, race, BMI), pregnancy status, comorbidities, facility activity, and outcomes. Data related to hospitalization and mortality trends were also collected from City of New York website. These data often involved more than one facility and/or service line resulting in more location or treatment facility counts than patients due to utilization of services at more than one location and transfers between locations and facilities.Results: Higher mortality was associated with increasing age with the highest death rate (51.9%) noted in the age group >75 years (OR 7.88, 95%CI 6.32–10.08). Comorbidities with higher mortality included diabetes (OR 1.5, 95% CI 1.33–1.70), hypertension (OR 1.62, 95% CI 1.44–1.83), cardiovascular conditions (OR 1.66, 95% CI 1.47–1.87), COPD (OR 1.86, 95% CI 1.39–2.50). It was deduced that 20% of all New York City COVID-19 positive admissions were in public health system during this timeframe. A high proportion of admissions (21.26%) and deaths (19.93%) were at Elmhurst Hospital in Queens. Bellevue and Metropolitan Hospitals had the lowest number of deaths, both in borough of Manhattan. Mortality in public hospitals in Brooklyn was 29.9%, Queens 28.1%, Manhattan 20.4%.Conclusion: Significant variations existed in COVID-19 hospitalizations and outcomes in the public health system in New York City during the initial pandemic. Although outcomes are worse with older age and those with comorbidities, variations in hospitals and boroughs outside of Manhattan are targets to investigate and strategize efforts.

scholarly journals Challenges of Conducting Point-Of-Care Testing Operations During The COVID-19 Pandemic In The Municipal Public Health System Based Ambulatory Care And School Health Clinics In New York City

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S115-S115
Author(s):  
T Sherpa ◽  
T Choesang ◽  
S Ahmad ◽  
F M Huq Ronny
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
Health System ◽  
Ambulatory Care ◽  
York City ◽  
Public Health System ◽  
Point Of Care ◽  
Ambulatory Care Clinics

Abstract Introduction/Objective Our New York City Municipal Public Health System based multisite ambulatory clinics and school-based clinics, offer various waived POCT (point of care tests) and provider performed microscopy (PPM). To ensure standardization and quality of POC testing across our health system, our laboratory service conducts system wide centralized implementation, monitoring and oversight of the POCT operations in regard to regulatory compliance, test performance, quality control and training. With the emergence of the COVID-19 infection in the New York City, like all other clinical laboratories, our ambulatory care clinics encountered numerous hurdles and challenges. Here we elaborated the issues that we encountered and how we managed to overcome during the COVID-19 Pandemic. Methods/Case Report We categorized the challenges that affected our managers as well as field level laboratory operations and have devised a plane to deal with COVID-19 related predicaments. Results (if a Case Study enter NA) Among the staffing issues, staff relocation to the acute care hospital laboratories during the peak of the pandemic caused massive delay or cessation of POCT operations in our ambulatory care clinics. Manual result entry, for COVID-19 testing, at the patient portals due to lack of interface with the reference testing labs, staff shortages and frequent absences due to illness and fatigue were primary issues noted at technical level. Furthermore, there were notable delays in the processing of paper works and new staff recruitments. The lack of and significant delays in the critical laboratory supplies was another major management issue. Conclusion Given the vastness and complexity of our multisite ambulatory care network, the COVID -19 pandemic impacted our ambulatory care clinic POCT operation in a very challenging way. However, our timeliness, coordinated interventions, close communications and initiatives handled the obstacles that arose very effectively to the ensure quality of POC testing, patient safety and quality care across our health system.

scholarly journals Aging, Diabetes, and the Public Health System in the United States

2012 ◽  
Vol 102 (8) ◽  
pp. 1482-1497 ◽  
Author(s):  
Carl J. Caspersen ◽  
G. Darlene Thomas ◽  
Letia A. Boseman ◽  
Gloria L. A. Beckles ◽  
Ann L. Albright
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Public Health System ◽  
The United States ◽  
The Public
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