scholarly journals Enhancing Drug Overdose Alerts with Spatial Visualization

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Kayley Dotson ◽  
Robert Gottlieb
Keyword(s):  
Public Health ◽  
Drug Overdose ◽  
Surveillance System ◽  
Local Health ◽  
County Level ◽  
Health Departments ◽  
Local Health Departments ◽  
Emergency Department Data ◽  
Drug Overdoses ◽  
Overdose Deaths

ObjectiveThis poster presentation shares Indiana’s approach of alerting local health departments (LHDs) with near real-time drug overdose data and how this process has been enhanced through mapping and analysis with a geographic information system (GIS).IntroductionSince 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana, and the gap continues to widen1. While federal funding opportunities are available for states, it often takes years for best practices to be developed, shared, and published. Similarly, local health departments (LHDs) may experience lengthy delays to receive finalized county health statistics.Indiana collects and stores syndromic emergency department data in the Public Health Emergency Surveillance System (PHESS) and uses the Electronic Surveillance System for the Early Notification of Community-based Epidemics version 1.21 (ESSENCE) to monitor public health events and trends. In July 2017, the Indiana Overdose Surveillance Team (IOST) developed a standard process for monitoring and alerting local health partners of increases in drug overdoses captured in ESSENCE at the county level. ISDH is enhancing these alerts by mapping the data in GIS and providing spatiotemporal data to LHDs to inform more targeted intervention and prevention efforts.MethodsThe IOST monitors drug overdoses statewide by analyzing daily queries from ESSENCE and sending email alerts to LHDs that are experiencing a statistically significant increase in suspected overdose activity at a hospital or county level. The IOST then requests that LHDs complete an overdose response feedback survey describing their actions after receiving an overdose alert.The IOST GIS analyst has enhanced overdose alerts by utilizing daily emergency department data queries from the PHESS database based on chief complaint and diagnosis text. Python™ and ArcGIS™ are used to deduplicate and geocode records, calculate the rate of cases within a hexagonal grid, and calculate the kernel density of case counts to show patterns at the neighborhood level. Comparisons to previous time periods are also calculated. Temporal and spatial scales of analysis are flexible, but 7 days and 30 days are used most often. Results are mapped in an HTML file using an open source Python package for dissemination to LHDs.ResultsBetween July 26, 2017, and Sept. 4, 2018, the IOST sent 89 suspected overdose alerts to LHDs. Alerts were sent to 45 different LHDs, of which 22 received multiple alerts (range: 1-9 repeat alerts). LHDs were requested to complete the survey on their initial alert, and a total of 31 jurisdictions completed this survey (31/45 = 69%). The majority of the LHD respondents (27/31 = 87%) wanted to continue receiving overdose alert emails.Our enhanced spatial analysis project has mapped more than 500 cases per week. Geocoding was successful for approximately 87% of the addresses received through PHESS. Neighborhoods in urban areas with higher counts have been identified, though variability from week to week is high. Areas of high overdose rates that cross county boundaries have also been detected, which would not have been possible using ESSENCE alone.ConclusionsNotifying LHDs of near real-time drug overdose trends is a catalyst for drug overdose planning and response efforts in Indiana. GIS mapping of the data provides an easy way for LHDs to view and share spatial trends with their local planning partners and identify community intervention strategies that can reduce drug overdose rates and improve outcomes for overdose survivors.References1 Overdose Prevention [Internet]. Indianapolis: Indiana State Department of Health; 2017. Indiana Special Emphasis Report: Drug Overdose Deaths 1999-2015; August 2017. [cited 2017 Sept 25]. Available from: http://www.in.gov/isdh/files/2017_SER_Drug_Deaths_Indiana.pdf 

Patterns of Cross-Sector Collaboration in Local Health Departments: A Cluster Analysis

2020 ◽  
pp. 152483992097298
Author(s):  
Alexis K. Grant
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Determinants Of Health ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Structural Determinants ◽  
Cluster Assignment ◽  
Cross Sectional ◽  
Top Executive

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.

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.

Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

2020 ◽  
pp. e1-e8
Author(s):  
Jonathon P. Leider ◽  
Jessica Kronstadt ◽  
Valerie A. Yeager ◽  
Kellie Hall ◽  
Chelsey K. Saari ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Latent Class ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Profile Data ◽  
The Public ◽  
Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

Analysis of the Current Status of Public Health Practice in Local Health Departments

1995 ◽  
Vol 11 (6) ◽  
pp. 51-54 ◽  
Author(s):  
Jane Suen ◽  
Gregory M. Christenson ◽  
Angela Cooper ◽  
Marcia Taylor
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Current Status ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Health Practice
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