scholarly journals COVID-19 Upends Pandemic Plan

2020 ◽  
Vol 50 (6-7) ◽  
pp. 467-479 ◽  
Author(s):  
John Kirlin
Keyword(s):  
Public Health ◽  
United States ◽  
Public Policy ◽  
Decision Making ◽  
The United States ◽  
Basic Question ◽  
Data Systems ◽  
Influenza Pandemics ◽  
Policy Choices ◽  
Policies And Procedures

COVID-19 quickly spread worldwide, with over 113,000 deaths in the United States by June 2020. Governments at all levels in this nation responded. This analysis starts with a basic question: How did prior planning for pandemics shape responses? A second question emerges: why were data systems inadequate? Expectations, policies, and procedures focused on addressing influenza pandemics shaped responses to COVID-19. Crippled by inadequate data, federal experts did not fully understand likely impacts of COVID-19 until early March. Planned public health processes were overwhelmed by a surge in infections and deaths. Decision making planned to be responses by experts moved to elected officials. Needed data were provided by sources outside government. Governors in 42 states issued stay-at-home orders, causing severe dislocations in the economy and society at a scale never experienced before as the result of deliberate public policy choices. Possible improvements for the future are discussed.

scholarly journals Patterns and correlates of mis-implementation in state chronic disease public health practice in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Margaret M. Padek ◽  
Stephanie Mazzucca ◽  
Peg Allen ◽  
Emily Rodriguez Weno ◽  
Edward Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Public Health Practice ◽  
State Level ◽  
The United States ◽  
Organizational Level ◽  
Effective Programs

Abstract Background Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Methods A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation. Results Half (50.7%) of respondents were chronic disease program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40). Conclusion The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.

scholarly journals Patterns and Correlates of Mis-implementation in State Chronic Disease Public Health Practice in the United States

2021 ◽  
Author(s):  
Margaret Padek ◽  
Stephanie Mazzucca ◽  
Peg Allen ◽  
Emily Rodriguez Weno ◽  
Edward Tsai ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Chronic Disease ◽  
Multinomial Logistic Regression ◽  
Public Health Practice ◽  
State Level ◽  
The United States ◽  
Organizational Level ◽  
Effective Programs

Abstract Background: Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Methods: A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation. Results: Half (50.7%) of respondents were chronic disease program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40). Conclusion: The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.

Regulatory Decision-Making and Economic Analysis

2017 ◽  
Author(s):  
Mariano-Florentino Cuéllar ◽  
Jerry L. Mashaw
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
Economic Analysis ◽  
National Security ◽  
Technology Policy ◽  
The United States ◽  
Regulatory Activity ◽  
Regulatory Decision ◽  
Over Time

The economic analysis of regulation is a broad topic, with implications for environmental protection, communications and technology policy, public health, immigration, national security, and other areas affecting risk and welfare in society. This chapter covers only a portion of the relevant ground, focusing on the following essential topics: First, what do we mean by “economic analysis” and what do we mean by “regulation”? Second, why has this topic become an important one, not only the United States, but in most advanced democracies? Third, why is economic analysis and regulation a contested, even contentious, aspect of modern regulatory activity? Finally, and most important, how is economic analysis structured into regulatory decision-making, and how might existing arrangements evolve over time?

Introduction

2019 ◽  
pp. 1-8
Author(s):  
Vanessa A. Edkins ◽  
Allison D. Redlich
Keyword(s):  
United States ◽  
Public Policy ◽  
Decision Making ◽  
Current System ◽  
Social Science Research ◽  
Science Research ◽  
Plea Bargaining ◽  
The United States ◽  
Legal Research ◽  
Defense Attorneys

While a great deal of psycho-legal research has focused on the trial process—and the decision making of jurors and juries, in particular—trials are not reflective of the current system of justice in the United States. Instead, we find ourselves within a system of pleas (Lafler v. Cooper, 2012) with a scarcity of social science research available to guide us. With this volume, we hope to integrate the current plea bargaining research that informs the field, from charging and defendant decision making, to attorney influences, to the ramifications at the larger system and institutional levels. Spanning multiple disciplines, the research and theories related to plea bargaining have much to contribute to public policy and to changes that individual actors (e.g., defense attorneys, prosecutors, and judges) may decide to incorporate in their daily interactions within our system of pleas.

Losing Common Ground: Feminists, Conservatives and Public Policy in Canada during the Mulroney Years

1996 ◽  
Vol 29 (2) ◽  
pp. 211-242 ◽  
Author(s):  
Sylvia Bashevkin
Keyword(s):  
United States ◽  
Public Policy ◽  
Decision Making ◽  
Social Movement ◽  
Women's Movement ◽  
Common Ground ◽  
The United States ◽  
Policy Action ◽  
Conservative Government ◽  
The United Kingdom

AbstractThis article examines relations between organized feminism and the federal Conservative government of Brian Mulroney, focusing on elements of the Canadian women's movement that targeted federal policy change from 1984 to 1993. In questioning the main priorities of both sides and the potential for conflict between them, the discussion uses the conceptual literature on social movement evolution as a base. It assesses formal decision making across five major policy sectors identified by Canadian feminism and presents the perspectives of movement activists on the Mulroney period. Although comparisons with policy action under the Thatcher and Reagan governments indicate a more pro-feminist record in Canada than the United Kingdom or the United States, Canadian materials suggest a narrowing of common ground between the organized women's movement and federal elites during the Mulroney years.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Individualized Decision

Abstract Background: The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.Methods: Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between R t and NPIs through a generalized linear model (GLM). Results: Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46%-57%), wearing (face) masks 29% (15%-42%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-14%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 7% (2%-11%).Conclusions: This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
The Us ◽  
The Impact ◽  
Individualized Decision

Abstract The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs) to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is in great need to assist in guiding the individualized decision making for adjustment of interventions in the US and around the world. However, the impact of these approaches remain uncertain. Based on the reported cases, the effective reproduction number of COVID-19 epidemic for 50 states in the US was estimated. The measurement on the effectiveness of eight different NPIs was conducted by assessing risk ratios (RRs) between and NPIs through a generalized linear model (GLM). Different NPIs were found to have led to different levels of reduction in. Stay-at-home contributed approximately 51% (95% CI 46%-57%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-13%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 6% (2%-11%). This retrospective assessment of NPIs on has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

Why Does Planning Matter in Microclimate Management and Urban Heat Mitigation?

2019 ◽  
pp. 0739456X1988300 ◽  
Author(s):  
Mehdi P. Heris ◽  
Brian Muller ◽  
Alana M. Wilson
Keyword(s):  
United States ◽  
Decision Making ◽  
The United States ◽  
Design Guidelines ◽  
Policy Choices ◽  
Mixed Use ◽  
Decision Making Processes ◽  
Key Variables ◽  
Urban Heat ◽  
Main Factors

In this paper, we examine two mixed-use redevelopment projects in the United States, including both regulatory and procedural contexts, to assess how decision-making processes affected microclimate outcomes. We investigate Belmar in Lakewood, CO and 29th Street Mall in Boulder, CO. Measurements and simulations of microclimate show that Belmar mitigates urban heat more effectively. Policies including building height, street patterns, and landscaping standards were key variables in this outcome. Through interviews and content analysis, we found five main factors shaping those policy choices: (1) urban vision, (2) land use and form controls, (3) design guidelines, (4) public financing, and (5) ownership/condemnation factors.

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