scholarly journals “Back to the Future”: Time for a Renaissance of Public Health Engineering

2019 ◽  
Vol 16 (3) ◽  
pp. 387
Author(s):  
Richard J. Gelting ◽  
Steven C. Chapra ◽  
Paul E. Nevin ◽  
David E. Harvey ◽  
David M. Gute
Keyword(s):  
Public Health ◽  
Native American ◽  
Alaska Native ◽  
Environmental Protection Agency ◽  
Large Scale ◽  
Public Health Practice ◽  
The United States ◽  
Modern World ◽  
Positive Health ◽  
The U.S

Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of engineering that has been known at various times as sanitary engineering, public health engineering, or environmental engineering was integral to the emergence of public health as a distinct discipline. However, in the United States (U.S.) during the 20th century, the academic preparation and practice of this branch of engineering became largely separated from public health. Various factors contributed to this separation, including an evolution in leadership roles within public health; increasing specialization within public health; and the emerging environmental movement, which led to the creation of the U.S. Environmental Protection Agency (EPA), with its emphasis on the natural environment. In this paper, we consider these factors in turn. We also present a case study example of public health engineering in current practice in the U.S. that has had large-scale positive health impacts through improving water and sanitation services in Native American and Alaska Native communities. We also consider briefly how to educate engineers to work in public health in the modern world, and the benefits and challenges associated with that process. We close by discussing the global implications of public health engineering and the need to re-integrate engineering into public health practice and strengthen the connection between the two fields.

Abstract 16822: Dust Storms in the United States are Associated With Increased Cardiovascular Mortality

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
James L Crooks ◽  
Wayne Cascio ◽  
Madelyn Percy ◽  
Jeanette Reyes ◽  
Lucas Neas ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Particulate Matter ◽  
Cardiovascular Mortality ◽  
Environmental Protection Agency ◽  
The United States ◽  
Dust Storms ◽  
Ambient Particulate Matter ◽  
Protection Agency ◽  
The U.S

Introduction: Extreme weather events such as dust storms are predicted to become more frequent as the global climate warms through the 21st century. Studies of Asian, Saharan, Arabian, and Australian dust storms have found associations with cardiovascular and total non-accidental mortality and hospitalizations for stroke. However, the only population-level epidemiological work on dust storms in the United States was focused on a single small metropolitan area (Spokane, WA), and it is uncertain whether its null results are representative of the country as a whole. Hypothesis: Dust storms in the United States are associated with daily cardiovascular mortality. Methods: Dust storm incidence data (N=141), including date and approximate location, as well as meteorological station observations, were taken from the U.S. National Weather Service. County-level mortality data for the years 1993-2005 were acquired from the National Center for Health Statistics. Ambient particulate matter monitor concentrations were obtained from the U.S. Environmental Protection Agency. Inference was performed used conditional logistic regression models under a case-crossover design while accounting for the nonlinear effect of temperature. Results: We found a 9.5% increase in cardiovascular mortality at a two-day lag (95% CI: [0.31%,19.5%], p = 0.042). The results were robust to adjusting for heat waves and ambient particulate matter concentrations. Analysis of storms occurring only on days with <0.1 inches of precipitation strengthened these results and in addition yielded a mean daily increase of 4.0% across lags 0-5 (95% CI: [0.07%,20.8%], p = 0.046). In Arizona, the U.S. state with the largest number of storms, we observed a 13.0% increase at a three-day lag (CI: [0.40%,27.1%], p = 0.043). Conclusions: Dust storms in the U.S. are associated with increases in lagged cardiovascular mortality. This has implications for the development of public health advisories and suggests that further public health interventions may be needed. Disclaimer: This work does not represent official U.S. Environmental Protection Agency policy.

scholarly journals COVID-19 Risk Perception Among U.S. Adults: Changes from February to May 2020

2020 ◽  
Author(s):  
Amyn A Malik ◽  
SarahAnn M McFadden ◽  
Jad A Elharake ◽  
Obianuju Genevieve Aguolu ◽  
Mehr Shafiq ◽  
...  
Keyword(s):  
Native American ◽  
Risk Perception ◽  
Alaska Native ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
The United States ◽  
Culturally Appropriate ◽  
Public Health Officials ◽  
Knowledge And Attitude ◽  
The U.S

The COVID-19 pandemic continues to detrimentally impact the United States. Using a survey, we collected demographic and COVID-19 risk perception, behavior, knowledge, and attitude data from 672 adults across the U.S. in May 2020. These variables were compared with the results from a survey in February 2020. Participants who were older (55+ years; M = 6.3, SD = 2.0), identified as Native American/Alaska Native (M = 6.8, SD = 1.0) or Asian (M = 6.0, SD = 2.0), and those who had contracted (M = 6.8, SD = 2.0) or knew someone who had contracted COVID-19 (M = 6.2, SD = 1.7) reported higher perceived risk. Health behaviors, such as physical distancing, have shown to impact infectious disease trajectories. As the U.S. reopens its economy, public health officials and politicians must formulate culturally appropriate and evidence-based messaging and policies, based on the public's COVID-19 risk perceptions, to encourage preventive behaviors.

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

scholarly journals Are the Self-Employed Mentally Healthier Than Salaried Workers? Evidence From Korea, Mexico, and the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 40-41
Author(s):  
Hankyung Jun
Keyword(s):  
Fixed Effects ◽  
Mental Health Problems ◽  
Unobserved Heterogeneity ◽  
The United States ◽  
Fixed Effects Model ◽  
Reverse Causality ◽  
Positive Health ◽  
Self Employment ◽  
Salaried Workers ◽  
The U.S

Abstract Self-employed workers are often reported to have better health than salaried workers. Whether this is because self-employment has health benefits or healthier workers are self-employed is not clear. Self-employed workers may have higher job satisfaction due to higher levels of self-efficacy and autonomy, but may also experience higher job stress, uncertainty, and lack of health insurance leading to mental health problems. Self-employed workers in the U.S. may have different characteristics than those in Mexico and Korea given different working and living environments as well as different institutional arrangements. This study will examine the association between self-employment and mental and cognitive health for older adults in the U.S., Mexico, and South Korea. It uses harmonized panel data from the Health and Retirement Study, the Korean Longitudinal Study of Aging, and the Mexican Health and Aging Study. We compare the health and selection effect of self-employment using a pooled logistic model, fixed-effects model, and a bivariate probit model. In addition to comparing self-employed and salaried workers, we analyze differences between self-employed with and without employees. By using rich data and various models, we address reverse causality and estimate the relationship between self-employment and health. We show that the positive health effects of self-employed workers in the U.S. disappear once controlled for unobserved heterogeneity, indicating the possibility of healthier workers selecting into self-employment. Interestingly, for Korea and Mexico, healthier individuals seem to select into wage work which reflects the difference in working conditions across countries. Further analysis will show effects by business size.

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.

An Innovative United States–Mexico Community Outreach Initiative for Hispanic and Latino People in the United States: A Collaborative Public Health Network

2021 ◽  
pp. 003335492097269
Author(s):  
Michael A. Flynn ◽  
Alfonso Rodriguez Lainz ◽  
Juanita Lara ◽  
Cecilia Rosales ◽  
Federico Feldstein ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Services ◽  
Alaska Native ◽  
Underserved Populations ◽  
Community Outreach ◽  
The United States ◽  
Native People ◽  
Hispanic People ◽  
Mexican Government

Collaborative partnerships are a useful approach to improve health conditions of disadvantaged populations. The Ventanillas de Salud (VDS) (“Health Windows”) and Mobile Health Units (MHUs) are a collaborative initiative of the Mexican government and US public health organizations that use mechanisms such as health fairs and mobile clinics to provide health information, screenings, preventive measures (eg, vaccines), and health services to Mexican people, other Hispanic people, and underserved populations (eg, American Indian/Alaska Native people, geographically isolated people, uninsured people) across the United States. From 2013 through 2019, the VDS served 10.5 million people (an average of 1.5 million people per year) at Mexican consulates in the United States, and MHUs served 115 461 people from 2016 through 2019. We describe 3 community outreach projects and their impact on improving the health of Hispanic people in the United States. The first project is an ongoing collaboration between VDS and the Centers for Disease Control and Prevention (CDC) to address occupational health inequities among Hispanic people. The second project was a collaboration between VDS and CDC to provide Hispanic people with information about Zika virus infection and health education. The third project is a collaboration between MHUs and the University of Arizona to provide basic health services to Hispanic communities in Pima and Maricopa counties, Arizona. The VDS/MHU model uses a collaborative approach that should be further assessed to better understand its impact on both the US-born and non–US-born Hispanic population and the public at large in locations where it is implemented.

Commissioned Corps Deployments & Family Resiliency

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Janice Arceneaux ◽  
James Dickens ◽  
Wanza Bacon
Keyword(s):  
Public Health ◽  
Health And Safety ◽  
United States Public Health ◽  
Disease Outbreaks ◽  
The United States ◽  
Humanitarian Assistance ◽  
Family Resiliency ◽  
Public Health Emergencies ◽  
National Public Health ◽  
The U.S

Established in 1889, the United States Public Health Service Commissioned Corps (Corps) is one of the seven uniformed services and is part of the U.S. Department of Health and Human Services. The Corps is committed to protecting, promoting and advancing the health and safety of the nation with a history that dates back over two centuries, beginning as the U.S. Marine Hospital Service. Today, the Corps responds and serves in many areas impacted by natural disasters, disease outbreaks, terrorist attacks and public health emergencies. Corps officers have deployed to provide assistance during national public health emergencies (e.g., hurricanes, bombings, flooding and wild fires); to combat the Ebola epidemic in West Africa; and to provide humanitarian assistance in Latin America and the Caribbean. Corps deployments impact not only service members but also their families. This article offers a brief overview of the Corps and discusses how deployments impact families. Family resiliency and future implications for research and practice will also be examined.

scholarly journals Public Health and Epidemiology Informatics: Recent Research and Trends in the United States

2015 ◽  
Vol 24 (01) ◽  
pp. 199-206 ◽  
Author(s):  
B. E. Dixon ◽  
H. Kharrazi ◽  
H. P. Lehmann
Keyword(s):  
Public Health ◽  
Workforce Development ◽  
Health Informatics ◽  
English Language ◽  
Health Management ◽  
Public Health Practice ◽  
The United States ◽  
Public Health Workforce ◽  
Public Health Informatics ◽  
Essential Services

Summary Objectives: To survey advances in public health and epidemiology informatics over the past three years. Methods: We conducted a review of English-language research works conducted in the domain of public health informatics (PHI), and published in MEDLINE between January 2012 and December 2014, where information and communication technology (ICT) was a primary subject, or a main component of the study methodology. Selected articles were synthesized using a thematic analysis using the Essential Services of Public Health as a typology. Results: Based on themes that emerged, we organized the advances into a model where applications that support the Essential Services are, in turn, supported by a socio-technical infrastructure that relies on government policies and ethical principles. That infrastructure, in turn, depends upon education and training of the public health workforce, development that creates novel or adapts existing infrastructure, and research that evaluates the success of the infrastructure. Finally, the persistence and growth of infrastructure depends on financial sustainability. Conclusions: Public health informatics is a field that is growing in breadth, depth, and complexity. Several Essential Services have benefited from informatics, notably, “Monitor Health,” “Diagnose & Investigate,” and “Evaluate.” Yet many Essential Services still have not yet benefited from advances such as maturing electronic health record systems, interoperability amongst health information systems, analytics for population health management, use of social media among consumers, and educational certification in clinical informatics. There is much work to be done to further advance the science of PHI as well as its impact on public health practice.

scholarly journals Cuba, United States and fight against drug trafficking: ups and downs of a necessary cooperation

2021 ◽  
Vol 8 (4) ◽  
pp. 54-64
Author(s):  
Santiago E. Bejerano
Keyword(s):  
United States ◽  
Drug Trafficking ◽  
The United States ◽  
Barack Obama ◽  
Modern World ◽  
American Continent ◽  
Bilateral Relations ◽  
Alternative Scenarios ◽  
The U.S ◽  
Common Security

Given the geostrategic importance of Cuba for the entire American continent and the increasing complexity of the nature of security as such, and accordingly, of the mechanisms of ensuring it in the modern world, the problem of drug trafficking is rather high on the agenda of the U.S.-Cuban relations. The article examines the issue of combating drug trafficking in the context of bilateral relations between Cuba and the United States in order to assess the prospects for joint efforts on this track. The author presents a retrospective of mostly unilateral initiatives by U.S. presidents that did not lead to real tangible results, in particular due to the prevailing erroneous approach of militarization in the fight against drug trafficking. The new century requires new forms and a qualitatively higher level of interaction. With a noticeable warming in the dialogue with Cuba under Barack Obama the situation has changed in many respects, and quite a few initiatives of bilateral nature began to bear fruit. Nevertheless, with Donald Trump’s rise to power, there is an obvious setback in the rapprochement, in proof of which the author gives examples of specific destructive steps, although this position of the administration met if not open criticism, then proposals for alternative scenarios of the development of contacts between the states. The potential that exists in both countries for cooperation in this area can be realized provided that the interests of common security prevail over political disagreements and state channels of cooperation are strengthened, with the dynamics of this process being reflected in the situation in the region as a whole.

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.

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