scholarly journals Syndromic Surveillance on the Mental Health Impact of Political Rallies in Charlottesville, Virginia

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Em Stephens
Keyword(s):  
Public Health ◽  
Mental Health ◽  
African Americans ◽  
Syndromic Surveillance ◽  
Primary Diagnosis ◽  
Chief Complaint ◽  
City Council ◽  
Civil Unrest ◽  
The Right ◽  
The Impact

ObjectiveTo describe the impact of civil unrest on the mental health of a community in near real-time using syndromic surveillance.IntroductionAs part of a wide-spread community discussion on the presence of monuments to Confederate Civil War figures, the Charlottesville city council voted to remove a statue of General Robert E. Lee.1 Multiple rallies were then held to protest the statue’s removal. A Ku Klux Klan (KKK) rally on July 8, 2017 (MMWR Week 27) and a Unite the Right rally on August 12, 2017 (MMWR Week 32) held in Charlottesville both resulted in violence and media attention.2,3 The violence associated with the Unite the Right rally included fatalities connected to motor vehicle and helicopter crashes.Syndromic surveillance has been used to study the impact of terrorism on a community’s mental health4 while more traditional data sources have looked at the impact of racially-charged civil unrest.5 Syndromic surveillance, however, has not previously been used to document the effect of racially-charged violence on the health of a community.MethodsThe Virginia Department of Health (VDH) analyzed syndromic surveillance data from three emergency departments (EDs) in the Charlottesville area (defined to include Charlottesville city and Albemarle county), regardless of patient residence following the Unite the Right rally. Visits to these EDs between January 1 and September 2, 2017 were analyzed using the Enhanced Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) and Microsoft SQL 2012. Encounters were identified as acute anxiety-related visits based on an International Classification of Diseases, Tenth Revision (ICD-10) discharge diagnosis beginning with ’F41’. Analyses were conducted using the ESSENCE algorithm EWMA 1.2 and SAS 9.3.ResultsThe greatest number of visits with a primary diagnosis of anxiety in 2017 (N=20) was observed in MMWR week 34 (August 20-26). This represented a statistically significant increase over baseline with a p-value of 0.01.By race, a significant increase over baseline in visits with a primary diagnosis of anxiety was observed among blacks or African Americans. The largest volume of visits was observed in MMWR week 33 with a total of 8 identified visits or 1.8% of total ED visit volume. The increase in visits for anxiety observed in weeks 33-35 was 2.2 times greater among blacks or African Americans than it was among whites, p = 0.016, 95% CI [1.14, 4.16].ConclusionsPrevious work done in Virginia to identify ED visits related to anxiety included only chief complaint criteria in the syndrome definition. Due to a change in how one ED in the Charlottesville area reported data during the study period, this syndrome definition could not be applied. In order to remove any potential data artifacts, only those visits with an initial diagnosis of anxiety were included in the analysis. The resulting syndrome definition likely underestimated the occurrence of anxiety in the Charlottesville area, both because it lacked chief complaint information and because syndromic surveillance does not include data on visits to mental health providers outside of EDs. This analysis presents a trend over time rather than a true measure of the prevalence of anxiety.This analysis, while conservative in its inclusion criteria, still identified an increase in visits for anxiety, particularly among blacks or African Americans. In today’s political environment of race-related civil unrest, a way to measure the burden of mental illness occurring in the community can be invaluable for public health response. In Charlottesville, the identification of a community-wide need for mental health support prompted many local providers to offer their services to those in need pro-bono.6References1 Suarez, C. (2017, February 6). Charlottesville City Council votes to remove statue from Lee Park. The Daily Progress. Retrieved from http://bit.ly/2wYOHhv2 Spencer, H., & Stevens, M. (2017, July 8). 23 Arrested and Tear Gas Deployed After a K.K.K. Rally in Virginia. The New York Times. Retrieved from http://nyti.ms/2tCiBGU3 Hanna, J., Hartung, K., Sayers, D., & Almasy, S. (2017, August 13). Virginia governor to white nationalists: ‘Go home … shame on you’. CNN. Retrieved from http://cnn.it/2vvAGHt4 Vandentorren, S., Paty, A. C., Baffert, E., Chansard, P., Caserio-Schönemann, C. (2016, February). Syndromic surveillance during the Paris terrorist attacks. The Lancet (387(10021), 846-847. doi:10.1016/S0140-6736(16)00507-95 Yimgang, D. P., Wang, Y., Paik, G., Hager, E. R., & Black, M. M. Civil Unrest in the Context of Chronic Community Violence: Impact on Maternal Depressive Symptoms. American Journal of Public Health 107(9), 1455-1462. doi:10.2105/AJPH.2017.3038766 DeLuca, P. (2017, August 19). Downtown Charlottesville Library Offers Free Counseling. NBC29.com. Retrieved from http://bit.ly/2yIzHbl

Window of Opportunity for New Disease Surveillance: Developing Keyword Lists for Monitoring Mental Health and Injury Through Syndromic Surveillance

2016 ◽  
Vol 11 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Ursula Lauper ◽  
Jian-Hua Chen ◽  
Shao Lin
Keyword(s):  
Public Health ◽  
Mental Health ◽  
New York ◽  
Syndromic Surveillance ◽  
New York State ◽  
Hurricane Sandy ◽  
York State Department ◽  
Free Text ◽  
York State ◽  
The Impact

AbstractStudies have documented the impact that hurricanes have on mental health and injury rates before, during, and after the event. Since timely tracking of these disease patterns is crucial to disaster planning, response, and recovery, syndromic surveillance keyword filters were developed by the New York State Department of Health to study the short- and long-term impacts of Hurricane Sandy. Emergency department syndromic surveillance is recognized as a valuable tool for informing public health activities during and immediately following a disaster. Data typically consist of daily visit reports from hospital emergency departments (EDs) of basic patient data and free-text chief complaints. To develop keyword lists, comparisons were made with existing CDC categories and then integrated with lists from the New York City and New Jersey health departments in a collaborative effort. Two comprehensive lists were developed, each containing multiple subcategories and over 100 keywords for both mental health and injury. The data classifiers using these keywords were used to assess impacts of Sandy on mental health and injuries in New York State. The lists will be validated by comparing the ED chief complaint keyword with the final ICD diagnosis code. (Disaster Med Public Health Preparedness. 2017;11:173–178)

scholarly journals 4.K. Workshop: What is going on? New inequalities emerging from the COVID-19 syndemic

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Gender Inequalities ◽  
Cognitive Changes ◽  
Public Health Professionals ◽  
Measurement Framework ◽  
Wide Range ◽  
The Difference ◽  
The Right ◽  
The Impact

Abstract   COVID-19 pandemic interacts with the pandemic of chronic non-communicable diseases and is exacerbated in different social and societal contexts through existing health inequalities - resulting in a syndemic. The socio-economically weakest groups of the population have been most affected (Bambra, 2020, Horton, 2020). In 2020, most activities were focused on controlling the epidemic through a biomedical approach, and only in the second half of the year, with the onset of the second wave, did the understanding that we are dealing with a syndemic, emerge in public health, societal and lately political discourse at the national and EU levels. There is increasing indirect damage to public health due to the loss of jobs and income, the long-term closure of certain activities, difficult access to health systems for those with non-COVID-19 health problems, and general uncertainty about the present and future. Different dimensions of syndemic inequalities (e.g. mental health, cognitive decline, lifestyles, gender, intergenerational) are the main focus of the workshop, including inequalities that were traditionally perceived in public health, as well as new emerging inequalities. In Slovenia we are conducting a study on the impact of the syndemic on people's lives (SI-PANDA 2020/2021), to (1) better understand human behaviour in COVID-19 pandemic and (2) to identify and address the impact of the governmental decisions, pandemic measures and recommendations. The workshop will aim to: Showcase the value of timely measurement and surveying of the COVID-19 syndemic's influences on society; Increase participants' understanding and awareness of the opportunities and challenges associated with different types of inequalities linked to COVID-19; Increase awareness of public health professionals on the importance of overcoming the difference between the biomedical approach and psychosocial paradigms; The workshop will offer an opportunity to: Present some of the outputs of the PANDA research and outline the influences of COVID-19 on lifestyle, mental health and cognitive changes Inform participants about the benefits of the comprehensive national approach in measuring COVID-19 syndemic consequences, embedded in a broader internationally comparative WHO measurement framework; Explore traditional inequalities with new dimensions, such as gender inequalities, newly emerging economic vulnerabilities and transformational inequalities, such as intergenerational inequality. Identify possible syndemic outcome measures at the national and EU levels, while identifying gaps between employing biomedical versus psychosocial approach in controlling conditions. Key messages Present new evidence on a wide range of inequalities emerging from the COVID-19 syndemic and its approach to mitigate it. Showcase an example from Slovenia (within the WHO internationally harmonized approach) of timely measuring the right data to inform a biomedical response as well as psychosocial measures.

scholarly journals Customizing ESSENCE Queries for Select Mental Health Sub-indicators

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Achintya N. Dey ◽  
Michael Coletta ◽  
Hong Zhou ◽  
Nelson Adekoya ◽  
Deborah Gould
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Anxiety Disorders ◽  
Syndromic Surveillance ◽  
Depressive Disorders ◽  
National Level ◽  
Chief Complaint ◽  
Co Morbidity ◽  
Icd 10 ◽  
Ed Visits

ObjectiveEmergency department (ED) visits related to mental health (MH) disorders have increased since 2006 (1), indicating a potential burden on the healthcare delivery system. Surveillance systems has been developed to identify and understand these changing trends in how EDs are used and to characterize populations seeking care. Many state and local health departments are using syndromic surveillance to monitor MH-related ED visits in near real-time. This presentation describes how queries can be created and customized to identify select MH sub-indicators (for adults) by using chief complaint text terms and diagnoses codes. The MH sub-indicators examined are mood and depressive disorders, schizophrenic disorders, and anxiety disorders. Wider adoption of syndromic surveillance for characterizing MH disorders can support long-term planning for healthcare resources and service delivery.IntroductionSyndromic surveillance systems, although initially developed in response to bioterrorist threats, are increasingly being used at the local, state, and national level to support early identification of infectious disease and other emerging threats to public health. To facilitate detection, one of the goals of CDC’s National Syndromic Surveillance Program (NSSP) is to develop and share new sets of syndrome codes with the syndromic surveillance Community of Practice. Before analysts, epidemiologists, and other practitioners begin customizing queries to meet local needs, especially monitoring ED visits in near-real time during public health emergencies, they need to understand how syndromes are developed.More than 4,000 hospital routinely send data to NSSP’s BioSense Platform, representing about 55 percent of ED visits in the United States (2). The platform’s surveillance component, ESSENCE,* is a web-based application for analyzing and visualizing prediagnostic hospital ED data. ESSENCE’s Chief Complaint Query Validation (CCQV) data source, which is a national-level data source with access to chief complaint (CC) and discharge diagnoses (DD) from reporting sites, was designed for testing new queries.MethodsWe used ESSENCE CCQV to query weekly data for the nine week period from the first quarter of 2018 and looked at three common MH sub-indicators: mood and depressive disorders, schizophrenic disorders, and anxiety disorders. We developed four query types for each MH sub-indicator. Query-1 focused on DD codes; query-2 focused on CC text terms; query-3 focused on a combination of CC, DD, and no exclusion for mental health co-morbidity; and query-4 focused on a combination of CC and DD and excluded mental health co-morbidity. We also examined the summary distribution of CC texts to identify keywords related to MH sub-indicators.For mood and depressive disorders, we queried ICD-9 codes 296, 311; ICD-10 codes F30–F39; CC text terms for words “depressive disorder,” bipolar disorder,” “mood disorder,” “depression,” “manic episodes,” and “psychotic.” For schizophrenic disorders, we queried ICD-9 codes 295; ICD-10 codes F20–F29; CC text terms for words “psychosis,” “psychotic,” “schizo,” “delusional,” “paranoid,” “auditory,” “hallucinations,” and “hearing voices.” For anxiety disorders, we queried ICD-9 codes 300, 306, 307, 308, 309; ICD-10 codes F40–F48; CC text terms for words “anxiety,” “anexiy,” “aniety,” “aniexty,” “ansiety,” “anxety,” “anxity,” “anxiety,” “phobia,” and “panic attack.”ResultsWe identified 2.3 million average weekly ED visits for the 9-week period queried. Table 1 shows average weekly ED visits of select MH sub-indicators from the four query types. Because query 4 focused on specific MH outcomes and excluded MH co-morbidities, the average weekly ED visit for all three sub-indicators was almost half that of query 3, which focused on broader concepts by including MH co-morbidities. Among mood and depressive disorders, query 4 identified on average 23,352 ED visits per week versus 45,504 visits per week for query 3. Similarly, for schizophrenic disorders and anxiety disorders, query 4 identified on average 4,988 and 32,790 visits per week compared with 9,816 and 53,868 visits, respectively, for query 3. Further, more MH-related visits were identified using the DD-coded query (query 1) than CC-based text terms (query 2).ConclusionsAnalysts can benefit from having queries on select sub-indicators readily available and can use these to facilitate routine MH-related monitoring of ED visits, or customize the queries by including local text terms. Consistent with our previous work (3), this analysis demonstrated that MH-related ED visits are more likely to be found in DD codes than in CC alone.* Electronic Surveillance for the Early Notification of Community-based EpidemicsReferences[1] Weiss AJ, Barrett ML, Heslin KC , Stocks C. Trends in Emergency Department Visits Involving Mental and Substance Use Disorders, 2006–2013. HCUP Statistical Brief #216 [Internet]. Rockville (MD): Agency for Healthcare Research and Quality; 2016 Dec [cited 2018 Aug 14]. Available from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb216-Mental-Substance-Use-Disorder-ED-Visit-Trends.pdf.[2] Gould DW, Walker D, Yoon PW. The Evolution of BioSense: Lessons Learned and Future Directions. Public Health Reports. 2017 Jul/Aug;132(Suppl 1):S7–S11.[3] Dey AN, Gould D, Adekoya N, Hicks P, Ejigu GS, English R, Couse J, Zhou H. Use of Diagnosis Code in Mental Health Syndrome Definition. Online Journal of Public Health Informatics [Internet]. 2018 [cited 2018 Aug 14];10(1). Available from: https://doi.org/10.5210/ojphi.v10i1.8983

scholarly journals Emotional and Mental Wellbeing Following COVID-19 Public Health Measures on People Living With Dementia and Carers

2021 ◽  
pp. 089198872199681
Author(s):  
Kerry Hanna ◽  
Clarissa Giebel ◽  
Hilary Tetlow ◽  
Kym Ward ◽  
Justine Shenton ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Social Support ◽  
Support Services ◽  
Mental Wellbeing ◽  
Daily Lives ◽  
Health Measures ◽  
Social Support Services ◽  
The Uk ◽  
The Impact

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of public health measures. Conclusions: The findings from this research shed light on the longer-term psychological impacts of the UK Government’s public health measures on PLWD and their carers. The loss of social support services was key in impacting this cohort mentally and emotionally, displaying a need for better psychological support, for both carers and PLWD.

scholarly journals Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 73S-79S ◽  
Author(s):  
Elizabeth R. Daly ◽  
Kenneth Dufault ◽  
David J. Swenson ◽  
Paul Lakevicius ◽  
Erin Metcalf ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
New Hampshire ◽  
Syndromic Surveillance ◽  
Situational Awareness ◽  
The United States ◽  
Chief Complaint ◽  
Public Health Response ◽  
Syndromic Surveillance System ◽  
Icd Codes

Objectives: Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. Methods: We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire’s syndromic surveillance ED data system by querying for (1) chief complaint text related to the words “fentanyl,” “heroin,” “opiate,” and “opioid” and (2) opioid-related International Classification of Diseases ( ICD) codes. We then analyzed the data to calculate frequencies of opioid-related ED encounters by age, sex, residence, chief complaint text values, and ICD codes. Results: Opioid-related ED encounters increased by 70% during the study period, from 3300 in 2011 to 5603 in 2015; the largest increases occurred in adults aged 18-29 and in males. Of 20 994 total opioid-related ED visits, we identified 18 554 (88%) using ICD code alone, 690 (3%) using chief complaint text alone, and 1750 (8%) using both chief complaint text and ICD code. For those encounters identified by ICD code only, the corresponding chief complaint text included varied and nonspecific words, with the most common being “pain” (n = 3335, 18%), “overdose” (n = 1555, 8%), “suicidal” (n = 816, 4%), “drug” (n = 803, 4%), and “detox” (n = 750, 4%). Heroin-specific encounters increased by 827%, from 4% of opioid-related encounters in 2011 to 24% of encounters in 2015. Conclusions: Opioid-related ED encounters in New Hampshire increased substantially from 2011 to 2015. Data from New Hampshire’s ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic.

scholarly journals Exploring experiences and impact of the COVID-19 pandemic on young racially minoritised people in the United Kingdom: A Qualitative Study

2021 ◽  
Author(s):  
Rochelle Ann Burgess ◽  
Nancy Kanu ◽  
Tanya Matthews ◽  
Owen Mukotekwa ◽  
Amina Smith-Gul ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Young People ◽  
Survival Strategies ◽  
Emotional Wellbeing ◽  
Policy And Practice ◽  
Public Health Response ◽  
Significant Research ◽  
The Impact

Within high-income-countries, the COVID-19 pandemic has disproportionately impacted people from racially minoritised backgrounds. There has been significant research interrogating the disparate impact of the virus, and recently, interest in the long-term implications of the global crisis on young people’s mental health and wellbeing. However, less work explores the experiences of young people from racialised backgrounds as they navigate the pandemic, and the specific consequences this has for their mental health. Forty young people (age 16-25) from black, mixed and other minority backgrounds and living in London, participated in consecutive focus group discussions over a two-month period, to explore the impact of the pandemic on their lives and emotional wellbeing. Thematic analysis identified seven categories describing the impact of the pandemic, indicating: deepening of existing socioeconomic and emotional challenges; efforts to navigate racism and difference within the response; and survival strategies drawing on communal and individual resources. Young people also articulated visions for a future public health response which addressed gaps in current strategies. Findings point to the need to contextualize public health responses to the pandemic in line with the lived experiences of racialised young people. We specifically note the importance of long-term culturally and socio-politically relevant support interventions. Implications for policy and practice are discussed

s.Two Implementation and Accountability, 8 Justiciability of Human Rights for Health

2020 ◽  
Author(s):  
Flood Colleen M ◽  
Thomas Bryan
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Right To Health ◽  
Health And Human Rights ◽  
Proper Role ◽  
Health Related ◽  
State Obligations ◽  
The Right ◽  
The Impact

This chapter examines both the power and limitations of litigation as a means of facilitating accountability for the advancement of public health. While almost half of the world’s constitutions now contain a justiciable right to health, the impact of litigation has been mixed. Judicial accountability has, in some cases, advanced state obligations to realize the highest attainable standard of health, but in other cases, litigation has threatened the solidarity undergirding public health systems. There is significant country-to-country variation in interpreting health-related human rights, as well as differing views of the proper role of courts in interpreting and enforcing these rights. Surveying regional human rights systems and national judicial efforts to address health and human rights, it is necessary to analyze how courts have approached—and how they should approach—litigation of the right to health and health-related human rights to improve health for all.

scholarly journals Changes in Physical Activity and Sedentary Behavior in Response to COVID-19 and Their Associations with Mental Health in 3052 US Adults

2020 ◽  
Vol 17 (18) ◽  
pp. 6469 ◽  
Author(s):  
Jacob Meyer ◽  
Cillian McDowell ◽  
Jeni Lansing ◽  
Cassandra Brower ◽  
Lee Smith ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Physical Activity ◽  
Sedentary Behavior ◽  
Screen Time ◽  
Social Connectedness ◽  
Anxiety Symptoms ◽  
Cross Sectional ◽  
Societal Changes ◽  
The Impact

The COVID-19 pandemic altered many facets of life. We aimed to evaluate the impact of COVID-19-related public health guidelines on physical activity (PA), sedentary behavior, mental health, and their interrelations. Cross-sectional data were collected from 3052 US adults 3–8 April 2020 (from all 50 states). Participants self-reported pre- and post-COVID-19 levels of moderate and vigorous PA, sitting, and screen time. Currently-followed public health guidelines, stress, loneliness, positive mental health (PMH), social connectedness, and depressive and anxiety symptoms were self-reported. Participants were grouped by meeting US PA guidelines, reporting ≥8 h/day of sitting, or ≥8 h/day of screen time, pre- and post-COVID-19. Overall, 62% of participants were female, with age ranging from 18–24 (16.6% of sample) to 75+ (9.3%). Self-reported PA was lower post-COVID among participants reporting being previously active (mean change: −32.3% [95% CI: −36.3%, −28.1%]) but largely unchanged among previously inactive participants (+2.3% [−3.5%, +8.1%]). No longer meeting PA guidelines and increased screen time were associated with worse depression, loneliness, stress, and PMH (p < 0.001). Self-isolation/quarantine was associated with higher depressive and anxiety symptoms compared to social distancing (p < 0.001). Maintaining and enhancing physical activity participation and limiting screen time increases during abrupt societal changes may mitigate the mental health consequences.

scholarly journals Eugenics and public health in Britain, 1900–40: scenes from provincial life

Urban History ◽  
1997 ◽  
Vol 24 (1) ◽  
pp. 56-75 ◽  
Author(s):  
John Welshman
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Policy ◽  
Birth Control ◽  
Turning Point ◽  
National Level ◽  
Intellectual Life ◽  
The Impact ◽  
Public Health Provision ◽  
Voluntary Sterilization

Historians have attempted to assess the impact of eugenics on public health provision in a number of fields including mental health, birth control, voluntary sterilization and housing. However, most of this work has concentrated on debates at the national level, and we know much less about the ways in which eugenics may have helped shape health services in provincial cities. It has been suggested that Leicester was a city in which eugenicists were particularly prominent, and this article examines the impact of eugenics on three aspects of public health between 1900 and 1940; mental health, birth control and housing. It concludes that while eugenics did have a practical outcome in mental health and birth control, its influence on housing policy was more elusive, and 1935 marked a turning-point after which eugenics was less significant in health policy and intellectual life.

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