scholarly journals Epidemiology Workforce Capacity in 27 Large Urban Health Departments in the United States, 2017

2019 ◽  
Vol 134 (4) ◽  
pp. 386-394
Author(s):  
Meghan D. McGinty ◽  
Nancy Binkin ◽  
Jessica Arrazola ◽  
Mia N. Israel ◽  
Chrissie Juliano
Keyword(s):  
Public Health ◽  
United States ◽  
Urban Health ◽  
The United States ◽  
Health Problems ◽  
Full Time ◽  
Health Departments ◽  
Public Health Services ◽  
Full Time Equivalent ◽  
Workforce Capacity

Objectives: The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments. Methods: BCHC, in partnership with CSTE, modified the 2017 State Epidemiology Capacity Assessment for its 30 member departments. Topics in the assessment included epidemiology leadership, staffing, funding, capacity to perform 4 epidemiology-related Essential Public Health Services, salary ranges, hiring requirements, use of competencies, training needs, and job vacancies. Results: The 27 (90%) BCHC-member health departments that completed the assessment employed 1091 full-time equivalent epidemiologists. All or nearly all health departments provided epidemiology services for programs in infectious disease (n = 27), maternal and child health (n = 27), preparedness (n = 27), chronic diseases (n = 25), vital statistics (n = 25), and environmental health (n = 23). On average, funding for epidemiology activities came from local (47%), state (24%), and federal (27%) sources. Health departments reported needing a 40% increase from the current number of epidemiologists to achieve ideal epidemiology capacity. Twenty-five health departments reported substantial-to-full capacity to monitor health problems, 21 to diagnose health problems, 11 to conduct evaluations, and 9 to perform applied research. Conclusions: Strategies to meet 21st century challenges and increase substantial-to-full epidemiological capacity include seeking funds from nongovernmental sources, partnering with schools and programs of public health, and identifying creative solutions to hiring and retaining epidemiologists.

Workforce demographics and unit structure in paediatric cardiac critical care in the United States

2021 ◽  
pp. 1-5
Author(s):  
Robin V. Horak ◽  
Shasha Bai ◽  
Bradley S. Marino ◽  
David K. Werho ◽  
Leslie A. Rhodes ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Heart Surgery ◽  
Age Groups ◽  
The United States ◽  
Work Hours ◽  
Full Time ◽  
Full Time Equivalent ◽  
Unit Structure ◽  
Cardiac Critical Care

Abstract Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

2020 ◽  
pp. e1-e8
Author(s):  
Jonathon P. Leider ◽  
Jessica Kronstadt ◽  
Valerie A. Yeager ◽  
Kellie Hall ◽  
Chelsey K. Saari ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Latent Class ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Profile Data ◽  
The Public ◽  
Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

Increases in Premature Mortality Due to Homicide — United States, 1968-1985

1989 ◽  
Vol 4 (4) ◽  
pp. 287-293 ◽  
Author(s):  
Beverly Martinez-Schnell ◽  
Richard J. Waxweiler
Keyword(s):  
Public Health ◽  
United States ◽  
Interpersonal Violence ◽  
Causes Of Death ◽  
Premature Mortality ◽  
The United States ◽  
Health Problems ◽  
Relative Impact ◽  
Age At Death

From 1968 to 1985, the rate of homicide in the United States has increased 44%. Its relative impact on premature mortality, as measured by the percentage of years of potential life lost (YPLL) before age 65 from all causes of death due to homicide, has nearly doubled (93% increase). This increase calls attention to the emerging importance of interpersonal violence relative to all public health problems affecting persons under 65 years of age. The percentage of YPLL from all causes of death due to homicide increased in each race/sex group and for both firearm and nonfirearm means of homicide. The increase in homicide YPLL was traced mainly to an increase in the number of homicide deaths and, to a smaller extent, to a decrease in the average age at death of homicide victims.

scholarly journals The Consequences of Neoliberalism in the Current Pandemic

2020 ◽  
Vol 50 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Vicente Navarro
Keyword(s):  
Public Health ◽  
United States ◽  
Social Policy ◽  
Health Services ◽  
North Atlantic ◽  
The United States ◽  
Public Health Services ◽  
The North ◽  
Neoliberal Policies ◽  
The North Atlantic

This article analyzes how the neoliberal policies, such as the politics of austerity (with considerable cuts to social policy expenditures including medical care and public health services) and the privatization of health services, imposed by many governments on both sides of the North Atlantic, considerably weakened the capacity of the response to the coronavirus pandemic in Italy, Spain, and the United States.

scholarly journals Cracks in the System: The Effects of the Coronavirus Pandemic on Public Health Systems

2020 ◽  
Vol 50 (6-7) ◽  
pp. 455-466 ◽  
Author(s):  
Kate Tulenko ◽  
Dominique Vervoort
Keyword(s):  
Public Health ◽  
United States ◽  
Health Systems ◽  
Disease Outbreaks ◽  
State Level ◽  
The United States ◽  
Public Health Services ◽  
Health Security ◽  
Public Health Systems ◽  
The Impact

The novel coronavirus disease 2019 (COVID-19) pandemic has rapidly wrought havoc on the world, exposing the gaps in public health systems of countries that were previously considered most prepared for infectious disease outbreaks. Notably, despite being ranked highest on the Global Health Security Index, the United States has been severely hit with nearly two million confirmed cases and one hundred thousand deaths by the end of May 2020. In addition to the public health fragmentation from the federal to the state level and lagging regulations, early reports highlight substantial socioeconomic disparities and health system barriers contributing to the spread and impact of the pandemic in the United States. In this review, we explore the impact of COVID-19 on public health systems by assessing systems through the lens of the Centers for Disease Control and Prevention’s Ten Essential Public Health Services. Building on prepandemic and COVID-19 observations and lessons, we propose recommendations moving forward to prepare for future waves and other disease outbreaks.

scholarly journals 604. Gram-Negative Bacilli Carrying Multiple Carbapenemases: the United States, 2012–2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S283-S283
Author(s):  
David Ham ◽  
Garrett Mahon ◽  
Sandeep Bhaurla ◽  
Sam Horwich-Scholefield ◽  
Liore Klein ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Acute Care ◽  
Treatment Options ◽  
The United States ◽  
Culture Collection ◽  
Health Departments ◽  
Gram Negative ◽  
Healthcare Facilities ◽  
Acute Care Facilities

Abstract Background Gram-negative bacilli carrying multiple carbapenemase genes (multi-CP-GNB) present an emerging public health threat; to date, most isolates reported in the literature have been from outside the United States. We reviewed multi-CP-GNB reported to CDC. Methods Reports of multi-CP-GNB isolates carrying genes encoding >1 targeted carbapenemases (i.e., KPC, NDM, OXA-48-type, VIM, or IMP) were received from healthcare facilities, health departments, and public health laboratories, and included isolates tested through the AR Laboratory Network (ARLN) beginning in 2017 as well as isolates sent to CDC for reference testing. Epidemiologic data were gathered by health departments during public health investigations. Results From October 2012 to November 2018, 111 multi-CP-GNB isolates from 71 patients in 20 states were identified. Two patients had three different multi-CP-GNB and one patient had two different multi-CP-GNB. The majority of cases (76%) were reported in 2017 or later, after ARLN testing began. Among patients with multi-CP-GNB, the most common organism-mechanisms combination was Klebsiella pneumoniae carrying NDM and OXA-48-type enzymes (table). Urine (44%) and rectal (20%) were the most frequent specimen sources for isolates. The median age of patients was 63 years (range 2–89 years); most had specimens collected at acute care hospitals (87%) or post-acute care facilities (9%). Of 50 patients with information available, 37 traveled internationally in the 12 months prior to culture collection. Among these, 88% were hospitalized for ≥1 night while outside the United States with 10 countries reported, of which India was most common (n = 18). All 5 patients with Pseudomonas aeruginosa co-carrying carbapenemases reported recent hospitalization outside the United States. Conclusion The multi-CP-GNB reported to CDC include diverse organisms and carbapenemase combinations and often harbored carbapenemases from different β-lactamase classes, which may severely limit treatment options. Healthcare exposures outside the United States were common; providers should ask about this exposure at healthcare admission and, when present, institute interventions to stop transmission in order to slow further US emergence. Disclosures All authors: No reported disclosures.

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