Faculty Opinions recommendation of Potential population health outcomes and expenditures of HIV vaccination strategies in the United States.

Among the myriad collateral consequences of the high level of incarceration in the United States is its detrimental effects on public health. Just as there are geographic variations in level of incarceration within the United States, so too are there variations in health outcomes. This study examines the relationship between incarceration rates and population health for a national sample of counties from 2015, with a focus on how this relationship is influenced by both region (South vs. non-South) and whether a jurisdiction is rural. To obtain unbiased estimates of the effect of incarceration rates on two alternate health outcomes, it employs two-stage least-squares modeling, which accounts for the endogeneity of incarceration rates when determining their effect on population health. Results indicate that level of incarceration has a detrimental effect on both mortality (i.e., premature death) and morbidity (i.e., self-reported health), and that these effects are more pronounced in rural and Southern counties. Implications of these findings for both policy and research are considered.

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Effects of Varying Approaches to Lifting COVID-19 Pandemic Restrictions in the United States

10.1101/2022.01.04.22268766 ◽

2022 ◽

Author(s):

Jessica E Galarraga ◽

Daniel Popovsky ◽

Kevin Delijani ◽

Hannah Hanson ◽

Mark Hanlon

Keyword(s):

United States ◽

Health Outcomes ◽

Population Health ◽

Large Scale ◽

The United States ◽

Negative Effects ◽

Difference In Differences ◽

Social Distancing ◽

Fold Reduction ◽

Control And Prevention

Background Policy approaches to lifting COVID-19 restrictions have varied significantly across the United States. An evaluation of the effects of state reopening policies on population health outcomes can inform ongoing and future pandemic responses. This study evaluates the approaches to lifting social distancing restrictions based on adherence to the Centers for Disease Control and Prevention (CDC) guidance established during the first wave of the COVID-19 pandemic. Methods We performed a retrospective study using difference-in-differences analyses to examine the effects of reopening policies on COVID-19 outcomes with risk-adjustment for population density, temporal changes, and concurrent mask policy implementation. We examined the effects of reopening policies on per capita case rates and rates of severe COVID-19 outcomes, including hospitalizations and deaths. Results Adherence to CDC reopening gating metrics and phased social distancing guidelines resulted in fewer COVID-19 cases, hospitalizations, and deaths. Phase one adherent states exhibited a 50-fold reduction in daily new cases and a 3-fold reduction in daily new deaths after reopening. Phase two adherent states experienced improvements in COVID-19 outcomes after reopening, while non-adherent states had a resurgence of worsening outcomes after lifting restrictions. Conclusions Our study findings indicate that adherence to CDC reopening guidance after implementing social distancing restrictions during the COVID-19 pandemic substantially prevents new cases, hospitalizations, and deaths. Following a stepwise reopening strategy and ensuring a sustained decline in case rates and test positivity rates before lifting restrictions can mitigate on a large scale the negative effects of a pandemic on population health outcomes.

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Health Outcomes and Health Care Utilization Among Obstetric Deliveries With Concurrent CKD in the United States

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2019.07.007 ◽

2020 ◽

Vol 75 (1) ◽

pp. 148-150 ◽

Cited By ~ 2

Author(s):

Andrea L. Oliverio ◽

Lindsay K. Admon ◽

Laura H. Mariani ◽

Tyler N.A. Winkelman ◽

Vanessa K. Dalton

Keyword(s):

United States ◽

Health Care ◽

Health Care Utilization ◽

Health Outcomes ◽

The United States ◽

Care Utilization

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Dual MD–MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health

Public Health Reports ◽

10.1177/0033354920978422 ◽

2021 ◽

pp. 003335492097842

Author(s):

Jo Marie Reilly ◽

Christine M. Plepys ◽

Michael R. Cousineau

Keyword(s):

Public Health ◽

United States ◽

Population Health ◽

Health Care Policy ◽

The United States ◽

Extensive Literature ◽

Master Of Public Health ◽

Telephone Interviews ◽

Public Health Training ◽

The Impact

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.

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Cardiovascular disease risk in patients with hepatitis C infection: Results from two general population health surveys in Canada and the United States (2007-2017)

PLoS ONE ◽

10.1371/journal.pone.0208839 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0208839 ◽

Cited By ~ 4

Author(s):

Alaa Badawi ◽

Giancarlo Di Giuseppe ◽

Paul Arora

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Hepatitis C ◽

General Population ◽

Population Health ◽

Health Surveys ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

The United States ◽

Hepatitis C Infection

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Should We Put a Thin Subsidy on the Policy Table in the Fight against Obesity?

Forum for Health Economics & Policy ◽

10.2202/1558-9544.1235 ◽

2011 ◽

Vol 14 (2) ◽

Cited By ~ 2

Author(s):

Grace Lordan ◽

John Quiggin

Keyword(s):

United States ◽

Health Outcomes ◽

The United States ◽

Soft Drinks ◽

Economic Effects ◽

Sugar Sweetened Beverages ◽

President Obama ◽

Sweetened Beverages ◽

The Relationship ◽

Artificially Sweetened Beverages

The idea of using 'fat taxes’ to curb obesity rates has been raised by many. In particular, the idea of taxing sugar-sweetened beverages (SSBs) has received considerable attention in the United States and has recently been discussed by President Obama. Rather less attention has been given to the alternative of 'thin subsidies’, that is, subsidies for the consumption of foods or beverages likely to be associated with reduced incidence of obesity. This commentary examines the case for a subsidy for artificially sweetened beverages (ASBs) or 'diet soft drinks’. In this commentary, we outline the evidence on the relationship between health outcomes, most notably obesity, and the consumption of SSBs and ASBs. In the light of the evidence we consider the economic effects of taxing SSBs, and the way in which those effects would be modified by the adoption of the alternative 'thin subsidy’ based on subsidising ASBs.

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Implementing a Data to Care Strategy to Improve Health Outcomes for People With HIV: A Report From the Care and Prevention in the United States Demonstration Project

Public Health Reports ◽

10.1177/0033354918805987 ◽

2018 ◽

Vol 133 (2_suppl) ◽

pp. 60S-74S ◽

Cited By ~ 13

Author(s):

Patricia Sweeney ◽

Tamika Hoyte ◽

Mesfin S. Mulatu ◽

Jacquelyn Bickham ◽

Antoine D. Brantley ◽

...

Keyword(s):

United States ◽

Health Outcomes ◽

Medical Care ◽

Treatment Adherence ◽

Viral Suppression ◽

The United States ◽

Health Departments ◽

State Health ◽

Improve Health

Objectives: The Care and Prevention in the United States Demonstration Project included implementation of a Data to Care strategy using surveillance and other data to (1) identify people with HIV infection in need of HIV medical care or other services and (2) facilitate linkages to those services to improve health outcomes. We present the experiences of 4 state health departments: Illinois, Louisiana, Tennessee, and Virginia. Methods: The 4 state health departments used multiple databases to generate listings of people with diagnosed HIV infection (PWH) who were presumed not to be in HIV medical care or who had difficulty maintaining viral suppression from October 1, 2013, through September 29, 2016. Each health department prioritized the listings (eg, by length of time not in care, by viral load), reviewed them for accuracy, and then disseminated the listings to staff members to link PWH to HIV care and services. Results: Of 16 391 PWH presumed not to be in HIV medical care, 9852 (60.1%) were selected for follow-up; of those, 4164 (42.3%) were contacted, and of those, 1479 (35.5%) were confirmed to be not in care. Of 794 (53.7%) PWH who accepted services, 694 (87.4%) were linked to HIV medical care. The Louisiana Department of Health also identified 1559 PWH as not virally suppressed, 764 (49.0%) of whom were eligible for follow-up. Of the 764 PWH who were eligible for follow-up, 434 (56.8%) were contacted, of whom 269 (62.0%) had treatment adherence issues. Of 153 PWH who received treatment adherence services, 104 (68.0%) showed substantial improvement in viral suppression. Conclusions: The 4 health departments established procedures for using surveillance and other data to improve linkage to HIV medical care and health outcomes for PWH. To be effective, health departments had to enhance coordination among surveillance, care programs, and providers; develop mechanisms to share data; and address limitations in data systems and data quality.

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