scholarly journals The impact of the COVID-19 response on the provision of other public health services in the U.S.: A cross sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0255844
Author(s):  
Kristina W. Kintziger ◽  
Kahler W. Stone ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney

Introduction Funding and staff formerly dedicated to routine public health tasks (e.g., responding to communicable and non-communicable diseases, investigating foodborne outbreaks, conducting routine surveillance) and services (e.g., environmental health, substance abuse, maternal-child health) may no longer be available in many public health departments due to the COVID-19 response. The objective of this study was to assess the extent to which staffing for essential public health services has been redirected to the COVID-19 response. Materials and methods This is a cross-sectional study using a survey distributed through the Qualtrics platform. Individuals (N = 298) working in public health across governmental and academic public health departments in the U.S. during the ongoing COVID-19 pandemic response were surveyed. Survey items measured multiple domains including professional experience (i.e., training, years of experience, content expertise, job functions, hours worked), mental and physical health status (i.e., generalized anxiety, depression, burnout), and career plans (i.e., pre-pandemic vs. current career plans). Results The total number of content expertise areas and programmatic functions covered by individual public health workers increased between January and September of 2020, with 26% (73 of 282) of respondents reporting an increase in both. The total number of respondents working in infectious disease and preparedness remained constant, while declines were reported in program evaluation (-36%) and health education (-27%) and increases were reported in disease investigation (+35%). Conclusions The provision of many essential public health functions and tasks have been limited or eliminated while the U.S. public health workforce responds to the COVID-19 pandemic. These findings highlight opportunities for funding and professional development of public health systems, both during and after the COVID-19 response, to help ensure the continuity of essential public health services, staffing sustainability, and preparedness for future public health emergencies in the U.S.

2021 ◽  
Author(s):  
Kristina W. Kintziger ◽  
Kahler W. Stone ◽  
Meredith Jagger ◽  
Jennifer A. Horney

Abstract Background Funding and staff formerly dedicated to routine public health tasks (e.g., responding to communicable and non-communicable diseases, investigating foodborne outbreaks, conducting routine surveillance) and services (e.g., environmental health, substance abuse, maternal-child health) may no longer be available in many public health departments due to the COVID-19 response. The objective of this study was to assess the extent to which staffing for essential public health services has been redirected to the COVID-19 response. Methods This is a cross-sectional study using a survey distributed through the Qualtrics platform. Individuals (N = 298) working in public health across governmental and academic public health departments in the U.S. during the ongoing COVID-19 pandemic response were surveyed. Survey items measured multiple domains including professional experience (i.e., training, years of experience, content expertise, job functions), mental and physical health status (i.e., generalized anxiety, depression, burnout), and career plans (i.e., pre-pandemic vs. current career plans). Results The total number of content expertise areas and programmatic functions covered by individual public health workers increased between January and September of 2020, with 26% (73 of 282) of respondents reporting an increase in both. The total number of respondents working in infectious disease and preparedness remained constant, while declines were reported in program evaluation (-36%) and health education (-27%) and increases were reported in disease investigation (+ 35%). Conclusions The provision of many essential public health functions and tasks have been limited or eliminated while the U.S. public health workforce responds to the COVID-19 pandemic. These findings highlight opportunities for funding and professional development of public health systems, both during and after the COVID-19 response, to help ensure the continuity of essential public health services, staffing sustainability, and preparedness for future public health emergencies in the U.S. Trial registration: Not applicable.


2019 ◽  
Vol 135 (1) ◽  
pp. 97-106 ◽  
Author(s):  
Megan Wallace ◽  
Joshua Sharfstein ◽  
Justin Lessler

Objectives: Despite a push for increased local public health capacity, no clear baseline for performance of local health departments (LHDs) exists. The objectives of this study were to quantify the self-reported performance of LHDs on the 10 Essential Public Health Services (EPHSs) and describe the relationships between performance and characteristics of LHDs. Methods: We used data on 2000 LHDs from the 2013 National Profile of Local Health Departments survey to develop principal components analysis–based scores to evaluate each LHD on the performance of EPHSs. Scores ranged from 0 to 100. LHDs that performed no activities within an EPHS had a score of 0, and LHDs that performed all activities within an EPHS had a score of 100. We explored the relationships between EPHS scores and LHD characteristics by using multivariate linear regression and cluster analysis. Results: Performance scores varied greatly by LHDs and EPHSs; however, LHDs typically scored <50, indicating that they performed fewer than half of the activities evaluated. LHDs that served larger populations (vs smaller populations) and LHDs that had higher per-capita funding (vs lower per-capita funding) had higher EPHS scores. We identified 6 EPHS performance score–based LHD clusters, which suggests similarities in which EPHSs LHDs focused on. Conclusions: Our results suggest weaknesses in many LHDs’ fulfillment of the EPHSs, particularly in low-population and low-funding settings. LHDs should be given the resources to increase capacity and ensure the EPHSs are met in communities.


PEDIATRICS ◽  
1971 ◽  
Vol 47 (3) ◽  
pp. 637-641

Course on Tuberculosis: A course on Tuberculosis Today will be offered six times during 1971 by the U.S. Public Health Services Center for Disease Control, Atlanta, Georgia. The course is intended for health workers who are responsible for the management and control of tuberculosis, and for those responsible for providing teaching or training in the fields of tuberculosis or infectious disease. No fees are charged for these courses. Application forms can be obtained from State Health Departments, HEW Regional Offices, or the Tuberculosis Branch, Center for Disease Control, Atlanta, Georgia.


2021 ◽  
Author(s):  
Liange Zhao ◽  
hongbin yuan ◽  
Xueyuan Wang

Abstract Objective This paper evaluates the effect of National Basic Public Health Services (NBPHS) on the health of internal migrants in China. Study design: The study design used in this research is a cross-sectional study. Methods Data were obtained from the China Migrants Dynamic Survey (CMDS) of 2017, including 150,384 internal migrants at the age of 15–59. Propensity score matching (PSM) was used to estimate the effect of NBPHS. Results The findings indicate that NBPHS is successful in improving the health of internal migrants. Different matching algorithms showed the improvement ranging from 2.7 to 2.9 percentage points for the indicator of self-reported health, compared with the reduction of the probability of having disease ranging from 3.3 to 3.7 percentage points in the past year. However, gains are not shared equally. Heterogeneity analysis found significant improvement in the health of patients with hypertension, but the health improvement of diabetics was relatively small. There was also no significant effect on patients with both hypertension and diabetes. Similarly, less improvement was observed in those over 65 years old. Conclusions This research suggests that policymakers should not only pay attention to the equalization of project implementation but also focus on narrowing the benefits gap between different groups of internal migrants. This finding highlights the importance of encouraging more young doctors to provide health services in primary institutions and promoting the sinking of high-quality medical resources.


2005 ◽  
Vol 39 (4) ◽  
pp. 662-668 ◽  
Author(s):  
Fernando Vinholes Siqueira ◽  
Luiz Augusto Facchini ◽  
Pedro Curi Hallal

OBJECTIVE: To analyze the prevalence of physiotherapy utilization and to explore the variables associated to its utilization. METHODS: A population-based cross-sectional study, including 3,100 subjects aged 20 years or more living in the urban area of Pelotas, southern Brazil, was carried out. The sample was selected following a multiple-stage protocol; the census tracts delimited by the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics) were the primary sample units. Following descriptive and crude analyses, Poisson regression models taking the clustering of the sample into account were carried out. Data were collected through face-to-face interviews using a standardized and pre-tested questionnaire. RESULTS: The lifetime utilization of physiotherapy was 30.2%; and physiotherapy utilization in the 12 months prior to the interview was reported by 4.9%. Women, elderly subjects, and those from higher socioeconomic levels were more likely to use physiotherapy. Restricting analysis to subjects who attended physiotherapy, 66% used public health services, 25% used insurance health services and 9% had private sessions. CONCLUSIONS: This is the first population-based study on physiotherapy utilization carried out in Brazil. Utilization of physio therapy was lower than reported in both developed and developing countries. The study findings might help public health authorities to organize healthcare service in terms of this important demand.


2021 ◽  
Author(s):  
Damián E. Blasi ◽  
Vishala Mishra ◽  
Adolfo M. García ◽  
Joseph P. Dexter

Lack of high-quality multilingual resources can contribute to disparities in the availability of medical and public health information. The COVID-19 pandemic has required rapid dissemination of essential guidance to diverse audiences and therefore provides an ideal context in which to study linguistic fairness in the U.S. Here we report a cross-sectional study of official non-English information about COVID-19 from the Centers for Disease Control and Prevention, the Food and Drug Administration, and the health departments of all 50 U.S. states. We find that multilingual information is limited in many states, such that almost half of all individuals not proficient in English or Spanish lack access to state-specific COVID-19 guidance in their primary language. Although Spanish-language information is widely available, we show using automated readability formulas that most materials do not follow standard recommendations for clear communication in medicine and public health. In combination, our results provide a snapshot of linguistic unfairness across the U.S. and highlight an urgent need for the creation of plain language, multilingual resources about COVID-19.


2021 ◽  
Author(s):  
Jun Wang ◽  
Jingmin Zhu ◽  
Xueyao Wang ◽  
Yue Che ◽  
Yang Bai ◽  
...  

Abstract Background: Migrants account for a large part of China’s population. Many policies and inventions have been taken to improve access to public health services and the health of migrants. China’s Basic Public Health Services(BPHS) are a series of public health services in this policy domain, which aims at promoting the access of public health sevices and improve health equity of residents.The establishment of health records is the fundamental service of BPHS. However,there is little known about the establishment of health records among migrants in China, which hinders the more efficient provision of health services for migrants, and health equity is difficult to achieve. Based on the research gap, this study aims at showing the sociodemographic disparities in the establishment rate of health records, and identifying priorities and recommendations for promoting health equity of migrants in China.Methods: This study used national data from China Migrants Dynamic Survey(CMDS) from 2014 to 2017 to evaluate the sociodemographic disparities in the establishment rate of health records and utilization of relevant public health services.The study included 539926 respondents. Following the descriptive statistics of migrants, we showed the establishment rate of health records by sociodemographic characteristics and migrating related characteristics. Multivariate analysis was conducted to explore the associations between sociodemographic charicteristics, migrating related charicteristics and the establishment of health records.Results: The establishment rate of health records among migrants in the sampled years were 22.99%, 38.44%, 27.29% respectively, and 29.18% in general, and there existed heterogeneity in the establishment rate of health records by sociodemographic charicteristics and migrating related charicteristics. Female migrants who were older, from middle age, married or living with partner, with higher educational attainment, with urban household registration, migrated for longer time, migrated for the reason of studying or family issues, migrated in province were more likely to establish health records.Conclusion: There existed sociodemographic disparities in the establishment rate of health records and inequalities in the utilization of health records services among migrants in China. Migrating related characteristics also had impact on the establishment status. Policies should take both supply side and demand side of health services to improve the health equity of migrants, which means that relative departments should continue to invest in primary healthcare centers to improve their ability to provide services as well as migrants’ health literacy.


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