scholarly journals Indicators to Guide and Monitor Climate Change Adaptation in the US Pacific Northwest

2020 ◽  
Vol 110 (2) ◽  
pp. 180-188
Author(s):  
Annie Doubleday ◽  
Nicole A. Errett ◽  
Kristie L. Ebi ◽  
Jeremy J. Hess
Keyword(s):  
Climate Change ◽  
Pacific Northwest ◽  
Climate Change Adaptation ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
The Us ◽  
State And Local ◽  
Context Specific

Objectives. To develop a set of indicators to guide and monitor climate change adaptation in US state and local health departments. Methods. We performed a narrative review of literature on indicators of climate change adaptation and public health service capacity, mapped the findings onto activities grouped by the Centers for Disease Control and Prevention’s Ten Essential Services, and drafted potential indicators to discuss with practitioners. We then refined the indicators after key informant interviews with 17 health department officials in the US Pacific Northwest in fall 2018. Results. Informants identified a need for clarity regarding state and local public health’s role in climate change adaptation, integration of adaptation into existing programs, and strengthening of communication, partnerships, and response capacity to increase resilience. We propose a set of climate change indicators applicable for state and local health departments. Conclusions. With additional context-specific refinement, the proposed indicators can aid agencies in tracking adaptation efforts. The generalizability, robustness, and relevance of the proposed indicators should be explored in other settings with a broader set of stakeholders.

scholarly journals The Financial Burden of Public Health Responses to Hepatitis A Cases Among Food Handlers, 2012-2014

2017 ◽  
Vol 132 (4) ◽  
pp. 443-447 ◽  
Author(s):  
Rebecca J. Morey ◽  
Melissa G. Collier ◽  
Noele P. Nelson
Keyword(s):  
Public Health ◽  
Hepatitis A ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Food Handlers ◽  
The Mean ◽  
State And Local ◽  
Mean Cost

When food handlers become ill with hepatitis A virus (HAV) infection, state and local health departments must assess the risk of HAV transmission through prepared food and recommend or provide postexposure prophylaxis (PEP) for those at risk for HAV infection. Providing PEP (eg, hepatitis A [HepA] vaccine or immunoglobulin), however, is costly. To describe the burden of these responses on state and local health departments, we determined the number of public health responses to HAV infections among food handlers by reviewing public internet sources of media articles. We then contacted each health department to collect data on whether PEP was recommended to food handlers or restaurant patrons, the number of PEP doses given, the number of HepA vaccine or immunoglobulin doses given as PEP, and the mean number of health department person-hours required for the response. Of 32 public health responses identified from Twitter, HealthMap, and Google alerts from January 1, 2012, to December 31, 2014, a total of 27 (84%) recommended PEP for other food handlers or restaurant patrons or both. Per public health response, the mean cost per dose of the HepA vaccine or immunoglobulin was $34 139; the mean personnel cost per response was $7329; and the total mean cost of each response was $41 468. PEP is expensive. Less aggressive approaches to PEP, such as limiting PEP to fellow food handlers in nonoutbreak situations, should be considered in the postvaccination era. HepA vaccine for PEP provides long-term immunity and can be used when immunoglobulin is unavailable or cannot be administered within 14 days of exposure to HAV.

scholarly journals Actionable lessons for the US COVID vaccine program

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gary L. Freed
Keyword(s):  
Public Health ◽  
Local Health ◽  
National Strategy ◽  
Individual State ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
The Us ◽  
Vaccine Distribution

AbstractWhen attempting to provide lessons for other countries from the successful Israeli COVID-19 vaccine experience, it is important to distinguish between the modifiable and non-modifiable components identified in the article by Rosen, et al. Two specific modifiable components included in the Israeli program from which the US can learn are (a) a national (not individual state-based) strategy for vaccine distribution and administration and (b) a functioning public health infrastructure. As a federal government, the US maintains an often complex web of state and national authorities and responsibilities. The federal government assumed responsibility for the ordering, payment and procurement of COVID vaccine from manufacturers. In designing the subsequent steps in their COVID-19 vaccine distribution and administration plan, the Trump administration decided to rely on the states themselves to determine how best to implement guidance provided by the Centers for Disease Control and Prevention (CDC). This strategy resulted in 50 different plans and 50 different systems for the dissemination of vaccine doses, all at the level of each individual state. State health departments were neither financed, experienced nor uniformly possessed the expertise to develop and implement such plans. A national strategy for the distribution, and the workforce for the provision, of vaccine beyond the state level, similar to that which occurred in Israel, would have provided for greater efficiency and coordination across the country. The US public health infrastructure was ill-prepared and ill-staffed to take on the responsibility to deliver > 450 million doses of vaccine in an expeditious fashion, even if supply of vaccine was available. The failure to adequately invest in public health has been ubiquitous across the nation at all levels of government. Since the 2008 recession, state and local health departments have lost > 38,000 jobs and spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%. Hopefully, COVID-19 will be a wakeup call to the US with regard to the need for both a national strategy to address public health emergencies and the well-maintained infrastructure to make it happen.

scholarly journals HIV Testing and Positivity Patterns of Partners of HIV-Diagnosed People in Partner Services Programs, United States, 2013-2014

2017 ◽  
Vol 132 (4) ◽  
pp. 455-462 ◽  
Author(s):  
Wei Song ◽  
Mesfin S. Mulatu ◽  
Michele Rorie ◽  
Hui Zhang ◽  
John W. Gilford
Keyword(s):  
Hiv Testing ◽  
Hiv Infections ◽  
Geographic Region ◽  
Hiv Positive ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Immunodeficiency Virus ◽  
Undiagnosed Hiv ◽  
State And Local

Objective: Human immunodeficiency virus (HIV) partner services are an integral part of comprehensive HIV prevention programs. We examined the patterns of HIV testing and positivity among partners of HIV-diagnosed people who participated in partner services programs in CDC-funded state and local health departments. Methods: We analyzed data on 21 484 partners submitted in 2013-2014 by 55 health departments. We conducted descriptive and multivariate analyses to examine patterns of HIV testing and positivity by demographic characteristics and geographic region. Results: Of 21 484 partners, 16 275 (75.8%) were tested for HIV; 4503 of 12 886 (34.9%) partners with test results were identified as newly HIV-positive. Compared with partners aged 13-24, partners aged 35-44 were less likely to be tested for HIV (adjusted odds ratio [aOR] = 0.86; 95% confidence interval [CI], 0.78-0.95) and more likely to be HIV-positive (aOR = 1.35; 95% CI, 1.20-1.52). Partners who were male (aOR = 0.89; 95% CI, 0.81-0.97) and non-Hispanic black (aOR = 0.68; 95% CI, 0.63-0.74) were less likely to be tested but more likely to be HIV-positive (male aOR = 1.81; 95% CI, 1.64-2.01; non-Hispanic black aOR = 1.52; 95% CI, 1.38-1.66) than partners who were female and non-Hispanic white, respectively. Partners in the South were more likely than partners in the Midwest to be tested for HIV (aOR = 1.56; 95% CI, 1.35-1.80) and to be HIV-positive (aOR = 2.18; 95% CI, 1.81-2.65). Conclusions: Partner services programs implemented by CDC-funded health departments are successful in providing HIV testing services and identifying previously undiagnosed HIV infections among partners of HIV-diagnosed people. Demographic and regional differences suggest the need to tailor these programs to address unique needs of the target populations.

scholarly journals Building Back Better: Local Health Department Engagement and Integration of Health Promotion into Hurricane Harvey Recovery Planning and Implementation

2019 ◽  
Vol 16 (3) ◽  
pp. 299 ◽  
Author(s):  
Mallory Kennedy ◽  
Shannon Gonick ◽  
Hendrika Meischke ◽  
Janelle Rios ◽  
Nicole Errett
Keyword(s):  
Disaster Recovery ◽  
Technical Assistance ◽  
Health Department ◽  
Decision Makers ◽  
Health Impacts ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Recovery Planning ◽  
Resilient Communities

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.

Employer Requirements to Work during Emergency Responses: Key Ethics Considerations

2017 ◽  
Vol 45 (S1) ◽  
pp. 73-76 ◽  
Author(s):  
Lainie Rutkow ◽  
Holly A. Taylor ◽  
Tia Powell
Keyword(s):  
Emergency Preparedness ◽  
Health Workers ◽  
Health Department ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Local Public Health ◽  
Public Health Workers ◽  
Emergency Responses

Local health departments and their employees are at the forefront of emergency preparedness and response. Yet, recent studies have found that some local public health workers are unwilling to report to work in a variety of disaster scenarios. This can greatly compromise a response, as many local health departments need “all hands on deck” to effectively meet increased demands. To address these concerns, local health departments have employed varied policy strategies to ensure that employees do report to work. After describing different approaches taken by local health departments throughout the United States, we briefly identify and explore key ethics considerations that arise for local health departments when employees are required to report to work for emergency responses. We then discuss how these ethics considerations may inform local health department practices intended to promote a robust emergency response.

RECOMMENDATIONS TO STATE AND LOCAL HEALTH DEPARTMENTS

1942 ◽  
Vol 120 (11) ◽  
pp. 828 ◽  
Author(s):  
OTIS L. ANDERSON ◽  
WALTER CLARKE ◽  
WALDEMAR C. DREESSEN ◽  
EMERY R. HAYHURST ◽  
EDWARD C. HOLMBLAD ◽  
...  
Keyword(s):  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
State And Local
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