Policy guidance on threats to legislative interventions in public health: a realist synthesis.

PubMed

Wong, Geoff; Pawson, Ray; Owen, Lesley

2011-04-10

Legislation is one of the most powerful weapons for improving population health and is often used by policy and decision makers. Little research exists to guide them as to whether legislation is feasible and/or will succeed. We aimed to produce a coherent and transferable evidence based framework of threats to legislative interventions to assist the decision making process and to test this through the 'case study' of legislation to ban smoking in cars carrying children. We conceptualised legislative interventions as a complex social interventions and so used the realist synthesis method to systematically review the literature for evidence. 99 articles were found through searches on five electronic databases (MEDLINE, HMIC, EMBASE, PsychINFO, Social Policy and Practice) and iterative purposive searching. Our initial searches sought any studies that contained information on smoking in vehicles carrying children. Throughout the review we continued where needed to search for additional studies of any type that would conceptually contribute to helping build and/or test our framework. Our framework identified a series of transferable threats to public health legislation. When applied to smoking bans in vehicles; problem misidentification; public support; opposition; and enforcement issues were particularly prominent threats. Our framework enabled us to understand and explain the nature of each threat and to infer the most likely outcome if such legislation were to be proposed in a jurisdiction where no such ban existed. Specifically, the micro-environment of a vehicle can contain highly hazardous levels of second hand smoke. Public support for such legislation is high amongst smokers and non-smokers and their underlying motivations were very similar - wanting to practice the Millian principle of protecting children from harm. Evidence indicated that the tobacco industry was not likely to oppose legislation and arguments that such a law would be 'unenforceable' were

EU alerting and reporting systems for potential chemical public health threats and hazards.

PubMed

Orford, R; Crabbe, H; Hague, C; Schaper, A; Duarte-Davidson, R

2014-11-01

A number of European and international IT platforms are used to notify competent authorities of new potential chemical exposures. Recently the European Parliament and the Council of European Union adopted new legislation that aims to improve the co-ordinated response to cross border health threats (Decision 1082/2013/EU). The Decision, inter alia, sets provisions on notification, ad hoc monitoring and coordination of public health measures following serious cross border threats to health from biological, chemical and environmental events as well as events that have an unknown origin. The legal instrument applies to all European Union Member States and is comparable to the International Health Regulations in its content, requirements and adoption of a multiple hazards approach. An inter-sectoral and multidisciplinary response to events with potentially dangerous cross border exposure pathways is often required. For example, European Poisons Centres may be aware of cases of toxic exposure to a product and, in parallel, trading standards may be aware of the same product due to a breach of consumer product standards. Whilst both cases would have been recorded for separate purposes in different alerting systems, they relate to the same exposure pathway; therefore a process for linking these records would allow a more robust approach to risk assessment and risk mitigation. The Decision seeks to reconcile this issue for serious threats by linking relevant platforms into one overarching higher level risk management IT platform called the Early Warning Response System (EWRS). This system will serve to link other sectors within the European Commission (EC) to public health (e.g. medicines), as well as other EU agencies and international bodies via co-notification features. Other European alert systems will be linked to EWRS to facilitate information sharing at both the assessment and management levels. This paper provides a timely overview of the main systems run by the EC

[Health threats and health system crises. An approach to early warning and response. 2008 SESPAS Report].

PubMed

Simón Soria, Fernando; Guillén Enríquez, Francisco Javier

2008-04-01

The world is changing more and faster than ever before. New diseases are coming to light each year, controlled diseases are reemerging as potential threats, and natural or man-made disasters are increasingly affecting human health. The "International Health Regulations (2005)" reflect the changes in the response of public health to this new situation. Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation. The public health events of international interest are characterized by their seriousness, predictability, the risk of international spread and potential for travel or trade restrictions. The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe, with early detection of and response to public health threats. However, timely risk evaluation and response at a national level requires improved data digitalization and accessibility, automatic notification processes, data analysis and dissemination of information, the combination of information from multiple sources and adaptation of public health services. The autonomous regions in Spain are initiating this adaptation process, but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health. Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises. The profile of public health threats is nonspecific. Early detection of threats requires access to information from multiple sources and efficient risk assessment. Key factors for improving the response to public health threats are the

Policy guidance on threats to legislative interventions in public health: a realist synthesis

PubMed Central

2011-01-01

Background Legislation is one of the most powerful weapons for improving population health and is often used by policy and decision makers. Little research exists to guide them as to whether legislation is feasible and/or will succeed. We aimed to produce a coherent and transferable evidence based framework of threats to legislative interventions to assist the decision making process and to test this through the 'case study' of legislation to ban smoking in cars carrying children. Methods We conceptualised legislative interventions as a complex social interventions and so used the realist synthesis method to systematically review the literature for evidence. 99 articles were found through searches on five electronic databases (MEDLINE, HMIC, EMBASE, PsychINFO, Social Policy and Practice) and iterative purposive searching. Our initial searches sought any studies that contained information on smoking in vehicles carrying children. Throughout the review we continued where needed to search for additional studies of any type that would conceptually contribute to helping build and/or test our framework. Results Our framework identified a series of transferable threats to public health legislation. When applied to smoking bans in vehicles; problem misidentification; public support; opposition; and enforcement issues were particularly prominent threats. Our framework enabled us to understand and explain the nature of each threat and to infer the most likely outcome if such legislation were to be proposed in a jurisdiction where no such ban existed. Specifically, the micro-environment of a vehicle can contain highly hazardous levels of second hand smoke. Public support for such legislation is high amongst smokers and non-smokers and their underlying motivations were very similar - wanting to practice the Millian principle of protecting children from harm. Evidence indicated that the tobacco industry was not likely to oppose legislation and arguments that such a law would be

Sociocultural perspectives on threats, risks, and health

Treesearch

Patricia L. Winter; Jonathan W. Long; Frank K. Lake

2014-01-01

Sociocultural perspectives on threats, risks, and health are explored in this chapter. The authors begin with a discussion of the linkages between well-being in the Sierra Nevada ecosystem and public health and well-being to set the context of socioecological resilience. This is followed by a summary of how trust and confidence influence the management of threats and...

Antimicrobial resistance: A global emerging threat to public health systems.

PubMed

Ferri, Maurizio; Ranucci, Elena; Romagnoli, Paola; Giaccone, Valerio

2017-09-02

Antimicrobial resistance (AMR) became in the last two decades a global threat to public health systems in the world. Since the antibiotic era, with the discovery of the first antibiotics that provided consistent health benefits to human medicine, the misuse and abuse of antimicrobials in veterinary and human medicine have accelerated the growing worldwide phenomenon of AMR. This article presents an extensive overview of the epidemiology of AMR, with a focus on the link between food producing-animals and humans and on the legal framework and policies currently implemented at the EU level and globally. The ways of responding to the AMR challenges foresee an array of measures that include: designing more effective preventive measures at farm level to reduce the use of antimicrobials; development of novel antimicrobials; strengthening of AMR surveillance system in animal and human populations; better knowledge of the ecology of resistant bacteria and resistant genes; increased awareness of stakeholders on the prudent use of antibiotics in animal productions and clinical arena; and the public health and environmental consequences of AMR. Based on the global nature of AMR and considering that bacterial resistance does not recognize barriers and can spread to people and the environment, the article ends with specific recommendations structured around a holistic approach and targeted to different stakeholders.

Public Health Autonomy: A Critical Reappraisal.

PubMed

Zimmerman, Frederick J

2017-11-01

The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework.

PubMed

Gushulak, Bd; Weekers, J; Macpherson, Dw

2009-01-01

International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced

Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework

PubMed Central

Gushulak, BD; Weekers, J; MacPherson, DW

2010-01-01

International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced

Leptospira interrogans at the human-wildlife interface in northern Botswana: a newly identified public health threat.

PubMed

Jobbins, S E; Sanderson, C E; Alexander, K A

2014-03-01

Leptospirosis is the most widespread zoonosis in the world. In northern Botswana, humans live in close proximity to a diversity of wildlife and peridomestic rodents and may be exposed to a variety of zoonotic pathogens. Little is known regarding the occurrence and epidemiology of L. interrogans in Africa despite the recognized global importance of this zoonotic disease and the threat it poses to public health. In Botswana, banded mongooses (Mungos mungo) live in close proximity to humans across protected and unprotected landscapes and may be a useful sentinel species for assessing the occurrence of zoonotic organisms, such as L. interrogans. We utilized PCR to screen banded mongoose kidneys for leptospiral DNA and identified 41.5% prevalence of renal carriage of L. interrogans (exact binomial 95% CI 27.7-56.7%, n = 41). Renal carriage was also detected in one Selous' mongoose (Paracynictis selousi). This is the first published confirmation of carriage of L. interrogans in either species. This is also the first report of L. interrogans occurrence in northern Botswana and the only report of this organism in a wildlife host in the country. Pathogenic Leptospira are usually transmitted indirectly to humans through soil or water contaminated with infected urine. Other avenues, such as direct contact between humans and wildlife, as well as consumption of mongooses and other wildlife as bushmeat, may pose additional exposure risk and must be considered in public health management of this newly identified zoonotic disease threat. There is a critical need to characterize host species involvement and pathogen transmission dynamics, including human-wildlife interactions that may increase human exposure potential and infection risk. We recommend that public health strategy be modified to include sensitization of medical practitioners to the presence of L. interrogans in the region, the potential for human infection, and implementation of clinical screening. This study

Public health and bioterrorism: renewed threat of anthrax and smallpox.

PubMed

Wallin, Arūne; Luksiene, Zivile; Zagminas, Kestutis; Surkiene, Gene

2007-01-01

Bioterrorism is one of the main public health categorical domains. According to sociological analytics, in postmodern society terrorism is one of the real threats of the 21st century. While rare, the use of biological weapons has a long history. Recently, anthrax has been evaluated as one of the most dangerous biological weapons. Naturally occurring anthrax in humans is a disease acquired from contact with anthrax-infected animals or anthrax-contaminated animal products. Usually anthrax infection occurs in humans by three major routes: inhalational, cutaneous, and gastrointestinal. Inhalational anthrax is expected to account for most serious morbidity and most mortality. The clinical presentation of inhalation anthrax has been described as a two-stage illness. Many factors contribute to the pathogenesis of Bacillus anthracis. Antibiotics, anthrax globulin, corticosteroids, mechanical ventilation, vaccine are possible tools of therapy. Smallpox existed in two forms: variola major, which accounted for most morbidity and mortality, and a milder form, variola minor. Smallpox spreads from person to person primarily by droplet nuclei or aerosols expelled from the oropharynx of infected persons and by direct contact. In the event of limited outbreak with few cases, patients should be admitted to the hospital and confined to rooms that are under negative pressure and equipped with high-efficiency particulate air filtration. In larger outbreaks, home isolation and care should be the objective for most patients. Progress in detection, suitable vaccines, postexposure prophylaxis, infection control, and decontamination might be serious tools in fight against the most powerful biological weapon. To assure that the public health and healthcare system can respond to emergencies, the government should direct resources to strengthen the emergency-response system, create medication stockpiles, and improve the public health infrastructure.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

PubMed

Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

PubMed Central

Lister, Cameron; Payne, Hannah; Hanson, Carl L.; Barnes, Michael D.; Davis, Siena F.; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes. PMID:28824899

Use of media and public-domain Internet sources for detection and assessment of plant health threats

PubMed Central

Thomas, Carla S.; Nelson, Noele P.; Jahn, Gary C.; Niu, Tianchan; Hartley, David M.

2011-01-01

Event-based biosurveillance is a recognized approach to early warning and situational awareness of emerging health threats. In this study, we build upon previous human and animal health work to develop a new approach to plant pest and pathogen surveillance. We show that monitoring public domain electronic media for indications and warning of epidemics and associated social disruption can provide information about the emergence and progression of plant pest infestation or disease outbreak. The approach is illustrated using a case study, which describes a plant pest and pathogen epidemic in China and Vietnam from February 2006 to December 2007, and the role of ducks in contributing to zoonotic virus spread in birds and humans. This approach could be used as a complementary method to traditional plant pest and pathogen surveillance to aid global and national plant protection officials and political leaders in early detection and timely response to significant biological threats to plant health, economic vitality, and social stability. This study documents the inter-relatedness of health in human, animal, and plant populations and emphasizes the importance of plant health surveillance. PMID:24149031

Use of media and public-domain Internet sources for detection and assessment of plant health threats.

PubMed

Thomas, Carla S; Nelson, Noele P; Jahn, Gary C; Niu, Tianchan; Hartley, David M

2011-09-05

Event-based biosurveillance is a recognized approach to early warning and situational awareness of emerging health threats. In this study, we build upon previous human and animal health work to develop a new approach to plant pest and pathogen surveillance. We show that monitoring public domain electronic media for indications and warning of epidemics and associated social disruption can provide information about the emergence and progression of plant pest infestation or disease outbreak. The approach is illustrated using a case study, which describes a plant pest and pathogen epidemic in China and Vietnam from February 2006 to December 2007, and the role of ducks in contributing to zoonotic virus spread in birds and humans. This approach could be used as a complementary method to traditional plant pest and pathogen surveillance to aid global and national plant protection officials and political leaders in early detection and timely response to significant biological threats to plant health, economic vitality, and social stability. This study documents the inter-relatedness of health in human, animal, and plant populations and emphasizes the importance of plant health surveillance.

Climate change and ecological public health.

PubMed

Goodman, Benny

2015-02-17

Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological public health. This article briefly outlines climate change and the concept of ecological public health, and discusses a 2012 review of the role of the nurse in health promotion.

Flu, Floods, and Fire: Ethical Public Health Preparedness.

PubMed

Phelan, Alexandra L; Gostin, Lawrence O

2017-05-01

Even as public health ethics was developing as a field, major incidents such as 9/11 and the SARS epidemic propelled discourse around public health emergency preparedness and response. Policy and practice shifted to a multidisciplinary approach, recognizing the broad range of potential threats to public health, including biological, physical, radiological, and chemical threats. This propelled the development of surveillance systems to detect incidents, laboratory capacities to rapidly test for potential threats, and therapeutic and social countermeasures to prepare for and respond to a range of hazards. In bringing public health ethics and emergency preparedness together, Emergency Ethics: Public Health Preparedness and Response adds depth and complexity to both fields. As global threats continue to emerge, the book, edited by Bruce Jennings, John D. Arras, Drue H. Barrett, and Barbara A. Ellis, will offer a vital compass. © 2017 The Hastings Center.

Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012

PubMed Central

Roser-Renouf, Connie; Maibach, Edward W.; Li, Jennifer

2016-01-01

Background Climate change poses a major public health threat. A survey of U.S. local health department directors in 2008 found widespread recognition of the threat, but limited adaptive capacity, due to perceived lack of expertise and other resources. Methods We assessed changes between 2008 and 2012 in local public health departments' preparedness for the public health threats of climate change, in light of increasing national polarization on the issue, and widespread funding cutbacks for public health. A geographically representative online survey of directors of local public health departments was conducted in 2011–2012 (N = 174; response rate = 50%), and compared to the 2008 telephone survey results (N = 133; response rate = 61%). Results Significant polarization had occurred: more respondents in 2012 were certain that the threat of local climate change impacts does/does not exist, and fewer were unsure. Roughly 10% said it is not a threat, compared to 1% in 2008. Adaptation capacity decreased in several areas: perceived departmental expertise in climate change risk assessment; departmental prioritization of adaptation; and the number of adaptation-related programs and services departments provided. In 2008, directors' perceptions of local impacts predicted the number of adaptation-related programs and services their departments offered, but in 2012, funding predicted programming and directors' impact perceptions did not. This suggests that budgets were constraining directors' ability to respond to local climate change-related health threats. Results also suggest that departmental expertise may mitigate funding constraints. Strategies for overcoming these obstacles to local public health departments' preparations for climate change are discussed. PMID:26991658

Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012.

PubMed

Roser-Renouf, Connie; Maibach, Edward W; Li, Jennifer

2016-01-01

Climate change poses a major public health threat. A survey of U.S. local health department directors in 2008 found widespread recognition of the threat, but limited adaptive capacity, due to perceived lack of expertise and other resources. We assessed changes between 2008 and 2012 in local public health departments' preparedness for the public health threats of climate change, in light of increasing national polarization on the issue, and widespread funding cutbacks for public health. A geographically representative online survey of directors of local public health departments was conducted in 2011-2012 (N = 174; response rate = 50%), and compared to the 2008 telephone survey results (N = 133; response rate = 61%). Significant polarization had occurred: more respondents in 2012 were certain that the threat of local climate change impacts does/does not exist, and fewer were unsure. Roughly 10% said it is not a threat, compared to 1% in 2008. Adaptation capacity decreased in several areas: perceived departmental expertise in climate change risk assessment; departmental prioritization of adaptation; and the number of adaptation-related programs and services departments provided. In 2008, directors' perceptions of local impacts predicted the number of adaptation-related programs and services their departments offered, but in 2012, funding predicted programming and directors' impact perceptions did not. This suggests that budgets were constraining directors' ability to respond to local climate change-related health threats. Results also suggest that departmental expertise may mitigate funding constraints. Strategies for overcoming these obstacles to local public health departments' preparations for climate change are discussed.

Recent advances to address European Union Health Security from cross border chemical health threats.

PubMed

Duarte-Davidson, R; Orford, R; Wyke, S; Griffiths, M; Amlôt, R; Chilcott, R

2014-11-01

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

40 CFR 158.2204 - Public health and nonpublic health claims.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Public health and nonpublic health claims. (a) Public health claim. An antimicrobial pesticide is considered to make a public health claim if the pesticide product bears a claim to control pest microorganisms that pose a threat to human health, and whose presence cannot readily be observed by the user...

40 CFR 158.2204 - Public health and nonpublic health claims.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Public health and nonpublic health claims. (a) Public health claim. An antimicrobial pesticide is considered to make a public health claim if the pesticide product bears a claim to control pest microorganisms that pose a threat to human health, and whose presence cannot readily be observed by the user...

How is an international public health threat advanced in Canada? The case of antimicrobial resistance.

PubMed

Tsegaye, L; Huston, P; Milliken, R; Hanniman, K; Nesbeth, C; Noad, L

2016-11-03

On September 21, 2016, the United Nations General Assembly held a high-level meeting on antimicrobial resistance (AMR). Participating political leaders committed to coordinate action across the human and animal health, agriculture and environmental sectors and to work at national, regional and international levels with the public sector, private sector, civil society and all other relevant actors, including the public. The objective of this article is to outline how the Public Health Agency of Canada (PHAC) has been working to address AMR in Canada. PHAC has used a One Health approach and has been working at the federal level with other government departments and nationally with the provinces, territories, professional organizations and other key players to address AMR. To date, the federal response has focused on surveillance, stewardship and innovation across multiple sectors, including human health, animal health, regulatory actions and research. PHAC is currently working with the provinces and territories as well as key experts in the field to develop a pan-Canadian AMR Framework and subsequent action plan that will outline best practices and approaches to AMR across human and animal health. The Framework will build on previous work done by PHAC and the federal/provincial/territorial Pan-Canadian Public Health Network Council, and recognizes the research expertise in Canada, the need to ensure actions are based on evidence, and to combat AMR through infection prevention and control. The three articles in this issue are examples of the foundational work that has been done federally by PHAC, in developing the Canadian AMR Surveillance System (CARSS), and nationally, through task groups of the Public Health Network Council, in identifying where to strengthen human surveillance of AMR and best practices for stewardship in the human health care system. While we remain in an early stage of national, coordinated AMR action, momentum is building to ensure Canada can

Are harmful algal blooms becoming the greatest inland water quality threat to public health and aquatic ecosystems?

PubMed

Brooks, Bryan W; Lazorchak, James M; Howard, Meredith D A; Johnson, Mari-Vaughn V; Morton, Steve L; Perkins, Dawn A K; Reavie, Euan D; Scott, Geoffrey I; Smith, Stephanie A; Steevens, Jeffery A

2016-01-01

In this Focus article, the authors ask a seemingly simple question: Are harmful algal blooms (HABs) becoming the greatest inland water quality threat to public health and aquatic ecosystems? When HAB events require restrictions on fisheries, recreation, and drinking water uses of inland water bodies significant economic consequences result. Unfortunately, the magnitude, frequency, and duration of HABs in inland waters are poorly understood across spatiotemporal scales and differentially engaged among states, tribes, and territories. Harmful algal bloom impacts are not as predictable as those from conventional chemical contaminants, for which water quality assessment and management programs were primarily developed, because interactions among multiple natural and anthropogenic factors determine the likelihood and severity to which a HAB will occur in a specific water body. These forcing factors can also affect toxin production. Beyond site-specific water quality degradation caused directly by HABs, the presence of HAB toxins can negatively influence routine surface water quality monitoring, assessment, and management practices. Harmful algal blooms present significant challenges for achieving water quality protection and restoration goals when these toxins confound interpretation of monitoring results and environmental quality standards implementation efforts for other chemicals and stressors. Whether HABs presently represent the greatest threat to inland water quality is debatable, though in inland waters of developed countries they typically cause more severe acute impacts to environmental quality than conventional chemical contamination events. The authors identify several timely research needs. Environmental toxicology, environmental chemistry, and risk-assessment expertise must interface with ecologists, engineers, and public health practitioners to engage the complexities of HAB assessment and management, to address the forcing factors for HAB formation, and

Ending AIDS as a Public Health Threat: Treatment-as-Usual Risk Reduction Services for Persons With Mental Illness in Brazil.

PubMed

Wainberg, Milton L; McKinnon, Karen; Norcini-Pala, Andrea; Hughes, Olivia K; Schrage, Ezra; Erby, Whitney; Mann, Claudio G; Cournos, Francine

2018-04-01

Persons with mental illness have higher HIV infection rates than the general population. Little is known about whether care systems for this population are effectively participating in global efforts to end AIDS as a public health threat. This study examined treatment-as-usual HIV risk reduction services within public mental health settings. The authors interviewed 641 sexually active adults attending eight public psychiatric clinics in Rio de Janeiro about participation in a sexual risk reduction program, HIV testing, HIV knowledge, and sexual behaviors. Nine percent reported participation in a risk reduction program in the past year, and 75% reported having unprotected sex in the past three months. Program participants had greater HIV knowledge (p=.04) and were more likely to have had HIV testing in the past three months (p=.02), compared with nonparticipants. Participation was not associated with sexual behaviors. Including persons with mental illness in efforts to end AIDS requires a greater commitment to implementing effective interventions in public mental health systems.

The Partnership of Public Health and Anthropology.

PubMed

Jelenc, Marjetka

2016-06-01

Public health focuses on health of the population and it is concerned with threats to health based on population health analysis. Anthropology covers most aspects that concern human beings. Both sciences converge on community and this fact represents a foundation for the partnership between public health and anthropology. Biological/medical anthropology is one of the highly developed fi elds of anthropology and the most important for public health.

Soil: A Public Health Threat or Savior

DOE Office of Scientific and Technical Information (OSTI.GOV)

IL Pepper; CP Gerba; DT Newby

Soil is the most complicated biomaterial on the planet due to complex soil architecture and billions of soil microbes with extreme biotic diversity. Soil is potentially a source of human pathogens, which can be defined as geo-indigenous, geo-transportable, or geotreatable. Such pathogens cumulatively can and do result in multiple human fatalities annually. A striking example is Helminths, with current infections worldwide estimated to be around two billion. However, soil can also be a source of antibiotics and other natural products that enhance human health. Soilborne antibiotics are used to treat human infections, but can also result in antibiotic-resistant bacteria. Naturalmore » products isolated from soil resulted in 60% of new cancer drugs between the period 1983–1994. Soils are also crucial to human health through their impact on human nutrition. Finally, from a global perspective, soils are vital to the future well-being of nations through their impact on climate change and global warming. A critical review of soil with respect to public health leads to the conclusion that overall soil is a public health savior. The value of soil using a systems approach is estimated to be $20 trillion, and is by far the most valuable ecosystem in the world.« less

Chevron v Echazabal: Public Health Issues Raised by the “Threat-to-Self” Defense to Adverse Employment Actions

PubMed Central

Barnes, Mark; Cleaveland, Kimberlee A.; Florencio, Patrik S.

2003-01-01

In June of 2002, the US Supreme Court upheld a regulation that allows employers, under the Americans with Disabilities Act, to make disability-related employment decisions based on risks to an employee’s own personal health or safety. Previous judicial decisions had allowed employers to make employment decisions based on the threat that a worker’s medical condition posed to others but had not addressed the issue of risk posed to an employee’s health by his or her own disability. The authors comment on the potential effects of the court’s decision for occupational health practitioners charged with assessing the degree of risk and harm of a particular workplace environment and for public health efforts aimed at curbing workplace injury and sickness. PMID:12660192

Six challenges in modelling for public health policy.

PubMed

Metcalf, C J E; Edmunds, W J; Lessler, J

2015-03-01

The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014). Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Environmental threats to children's health in Southeast Asia and the Western Pacific.

PubMed Central

Suk, William A; Ruchirawat, Kuhnying Mathuros; Balakrishnan, Kalpana; Berger, Martha; Carpenter, David; Damstra, Terri; de Garbino, Jenny Pronczuk; Koh, David; Landrigan, Philip J; Makalinao, Irma; Sly, Peter D; Xu, Y; Zheng, B S

2003-01-01

The Southeast Asia and Western Pacific regions contain half of the world's children and are among the most rapidly industrializing regions of the globe. Environmental threats to children's health are widespread and are multiplying as nations in the area undergo industrial development and pass through the epidemiologic transition. These environmental hazards range from traditional threats such as bacterial contamination of drinking water and wood smoke in poorly ventilated dwellings to more recently introduced chemical threats such as asbestos construction materials; arsenic in groundwater; methyl isocyanate in Bhopal, India; untreated manufacturing wastes released to landfills; chlorinated hydrocarbon and organophosphorous pesticides; and atmospheric lead emissions from the combustion of leaded gasoline. To address these problems, pediatricians, environmental health scientists, and public health workers throughout Southeast Asia and the Western Pacific have begun to build local and national research and prevention programs in children's environmental health. Successes have been achieved as a result of these efforts: A cost-effective system for producing safe drinking water at the village level has been devised in India; many nations have launched aggressive antismoking campaigns; and Thailand, the Philippines, India, and Pakistan have all begun to reduce their use of lead in gasoline, with resultant declines in children's blood lead levels. The International Conference on Environmental Threats to the Health of Children, held in Bangkok, Thailand, in March 2002, brought together more than 300 representatives from 35 countries and organizations to increase awareness on environmental health hazards affecting children in these regions and throughout the world. The conference, a direct result of the Environmental Threats to the Health of Children meeting held in Manila in April 2000, provided participants with the latest scientific data on children's vulnerability to

Environmental threats to children's health in Southeast Asia and the Western Pacific.

PubMed

Suk, William A; Ruchirawat, Kuhnying Mathuros; Balakrishnan, Kalpana; Berger, Martha; Carpenter, David; Damstra, Terri; de Garbino, Jenny Pronczuk; Koh, David; Landrigan, Philip J; Makalinao, Irma; Sly, Peter D; Xu, Y; Zheng, B S

2003-08-01

The Southeast Asia and Western Pacific regions contain half of the world's children and are among the most rapidly industrializing regions of the globe. Environmental threats to children's health are widespread and are multiplying as nations in the area undergo industrial development and pass through the epidemiologic transition. These environmental hazards range from traditional threats such as bacterial contamination of drinking water and wood smoke in poorly ventilated dwellings to more recently introduced chemical threats such as asbestos construction materials; arsenic in groundwater; methyl isocyanate in Bhopal, India; untreated manufacturing wastes released to landfills; chlorinated hydrocarbon and organophosphorous pesticides; and atmospheric lead emissions from the combustion of leaded gasoline. To address these problems, pediatricians, environmental health scientists, and public health workers throughout Southeast Asia and the Western Pacific have begun to build local and national research and prevention programs in children's environmental health. Successes have been achieved as a result of these efforts: A cost-effective system for producing safe drinking water at the village level has been devised in India; many nations have launched aggressive antismoking campaigns; and Thailand, the Philippines, India, and Pakistan have all begun to reduce their use of lead in gasoline, with resultant declines in children's blood lead levels. The International Conference on Environmental Threats to the Health of Children, held in Bangkok, Thailand, in March 2002, brought together more than 300 representatives from 35 countries and organizations to increase awareness on environmental health hazards affecting children in these regions and throughout the world. The conference, a direct result of the Environmental Threats to the Health of Children meeting held in Manila in April 2000, provided participants with the latest scientific data on children's vulnerability to

Communicating Homeland Security Threats: Government and Public Efforts

DTIC Science & Technology

2010-12-01

States has never operated at a threat level lower than blue - guarded risk. The Homeland Security Advisory Council’s primary recommendations included...changing the alert level baseline to blue (guarded risk). Their rationale for resetting the threat level baseline includes acknowledging that a...accustomed to the guarded blue level indicative of a general threat of terrorist attack. To assume that public officials and citizens would ever

Risk communication: climate change as a human-health threat, a survey of public perceptions in Malta.

PubMed

DeBono, Roberto; Vincenti, Karen; Calleja, Neville

2012-02-01

Scientific evidence shows that climate change is very likely the product of human behaviour and lifestyle. The effects of climate change on human health are diverse in nature and range from direct effects due to extreme weather events such as heat waves, floods and storms, to indirect effects such as those caused by water and food shortages. A telephone survey was conducted between January and February 2009, on a stratified representative random sample of the Maltese population over the age of 18 years (N = 310,819). Five hundred and forty-three individuals successfully participated in the survey giving a response rate of 92.7%. The respondent sample was very similar to the target population by gender (P = 0.977), age (P = 0.767) and district (P = 0.812). The results of the study demonstrate a very strong relationship between the perception of climate change as a threat to health and well-being, support for climate change mitigation policy and a willingness to implement measures to address climate change. The findings of this study show that the perception that climate change may claim lives, cause disease, reduce the standard of living and worsen water shortages, may be the strongest driver behind support for climate change mitigation policy and a willingness to act. It is recommended that, in order to gain more public support, climate change campaigns and risk communication strategies should frame climate change as a threat to human health and general well-being.

Ethics in Public Health Research

PubMed Central

Myers, Julie; Frieden, Thomas R.; Bherwani, Kamal M.; Henning, Kelly J.

2008-01-01

Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies. PMID:18382010

Regulatory Underpinnings of Global Health Security: FDA's Roles in Preventing, Detecting, and Responding to Global Health Threats

PubMed Central

Bond, Katherine C.; Maher, Carmen

2014-01-01

In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a range of efforts in support of global health security. This article provides an overview of FDA's global health security roles, focusing on its responsibilities related to the development and use of medical countermeasures (MCMs) for preventing, detecting, and responding to global infectious disease and other public health emergency threats. The article also discusses several areas—antimicrobial resistance, food safety, and supply chain integrity—in which FDA's global health security roles continue to evolve and extend beyond MCMs and, in some cases, beyond traditional infectious disease threats. PMID:25254912

Regulatory underpinnings of Global Health security: FDA's roles in preventing, detecting, and responding to global health threats.

PubMed

Courtney, Brooke; Bond, Katherine C; Maher, Carmen

2014-01-01

In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a range of efforts in support of global health security. This article provides an overview of FDA's global health security roles, focusing on its responsibilities related to the development and use of medical countermeasures (MCMs) for preventing, detecting, and responding to global infectious disease and other public health emergency threats. The article also discusses several areas-antimicrobial resistance, food safety, and supply chain integrity-in which FDA's global health security roles continue to evolve and extend beyond MCMs and, in some cases, beyond traditional infectious disease threats.

Public health legal preparedness in Indian country.

PubMed

Bryan, Ralph T; Schaefer, Rebecca McLaughlin; DeBruyn, Lemyra; Stier, Daniel D

2009-04-01

American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective public health responses to emerging threats. To analyze how tribal laws support public health practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal public health law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable public health provisions. The public health-related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen public health legal foundations in tribal communities.

Substandard and falsified medical products are a global public health threat. A pilot survey of awareness among physicians in Sweden.

PubMed

Funestrand, H; Liu, R; Lundin, S; Troein, M

2018-06-01

Substandard and falsified medical products are a public health threat, primarily associated with low- and middle-income countries. Today, the phenomenon also exists in high-income countries. Increased Internet access has opened a global market. Self-diagnosis and self-prescription have boosted the market for unregulated websites with access to falsified medicines. To describe the state of knowledge and experience on SF medical products among emergency physicians (EPs) and general practitioners (GPs) in Sweden. An online survey with anonymous answers from 100 EPs and 100 GPs. Physicians were recruited from TNS SIFO's medical database. The term in the survey was 'illegal and falsified medicines' which was common in Sweden at that time. It corresponds well with the term 'substandard and falsified medical products' that the WHO launched shortly after our data collection. We report our results with this term. In Sweden, 78.5% of the physicians had heard the term 'illegal and falsified medicines' and 36.5% had met patients they suspected had taken it. Physicians lacked awareness of the use of the reporting system and wanted more knowledge about how to deal with patients who have possibly used falsified medicines. To meet the public health threat of SF medical products, physicians need more knowledge.

The case for transforming governmental public health.

PubMed

Salinsky, Eileen; Gursky, Elin A

2006-01-01

Changing threats to the public's health necessitate a profound transformation of the public health enterprise. Despite recent attention to the biodefense role of public health, policymakers have not developed a clear, realistic vision for the structure and functionality of the governmental public health system. Lack of leadership and organizational disconnects across levels of government have prevented strategic alignment of resources and undermined momentum for meaningful change. A transformed public health system is needed to address the demands of emergency preparedness and health protection. Such transformation should include focused, risk-based resource allocation; regional planning; technological upgrades; workforce restructuring; improved integration of private-sector assets; and better performance monitoring.

10 CFR 871.2 - Public health and safety exemption.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Public health and safety exemption. 871.2 Section 871.2 Energy DEPARTMENT OF ENERGY AIR TRANSPORTATION OF PLUTONIUM § 871.2 Public health and safety exemption... property damage, or other significant threat to the public health and safety. [42 FR 48332, Sept. 23, 1977...

10 CFR 871.2 - Public health and safety exemption.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Public health and safety exemption. 871.2 Section 871.2 Energy DEPARTMENT OF ENERGY AIR TRANSPORTATION OF PLUTONIUM § 871.2 Public health and safety exemption... property damage, or other significant threat to the public health and safety. [42 FR 48332, Sept. 23, 1977...

10 CFR 871.2 - Public health and safety exemption.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Public health and safety exemption. 871.2 Section 871.2 Energy DEPARTMENT OF ENERGY AIR TRANSPORTATION OF PLUTONIUM § 871.2 Public health and safety exemption... property damage, or other significant threat to the public health and safety. [42 FR 48332, Sept. 23, 1977...

10 CFR 871.2 - Public health and safety exemption.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Public health and safety exemption. 871.2 Section 871.2 Energy DEPARTMENT OF ENERGY AIR TRANSPORTATION OF PLUTONIUM § 871.2 Public health and safety exemption... property damage, or other significant threat to the public health and safety. [42 FR 48332, Sept. 23, 1977...

10 CFR 871.2 - Public health and safety exemption.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Public health and safety exemption. 871.2 Section 871.2 Energy DEPARTMENT OF ENERGY AIR TRANSPORTATION OF PLUTONIUM § 871.2 Public health and safety exemption... property damage, or other significant threat to the public health and safety. [42 FR 48332, Sept. 23, 1977...

Bioterrorism, public health, and the law.

PubMed

Bayer, Ronald; Colgrove, James

2002-01-01

The controversy over the Model State Emergency Health Powers Act has underscored the enduring tension in public health between guarding the common welfare and respecting individual liberty. The current version of the act, crafted in response to extensive public commentary, attempts to strike a balance between these values but has failed to allay the concerns of many civil libertarians and privacy advocates. Although the debates over the model act have been triggered by the threat of bioterrorism, they illustrate broader philosophical differences, with profound implications for all realms of public health policy.

21 CFR 2.5 - Imminent hazard to the public health.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Imminent hazard to the public health. 2.5 Section... GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.5 Imminent hazard to the public health... a significant threat of danger to health, creates a public health situation (1) that should be...

21 CFR 2.5 - Imminent hazard to the public health.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Imminent hazard to the public health. 2.5 Section... GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.5 Imminent hazard to the public health... a significant threat of danger to health, creates a public health situation (1) that should be...

21 CFR 2.5 - Imminent hazard to the public health.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Imminent hazard to the public health. 2.5 Section... GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.5 Imminent hazard to the public health... a significant threat of danger to health, creates a public health situation (1) that should be...

21 CFR 2.5 - Imminent hazard to the public health.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Imminent hazard to the public health. 2.5 Section... GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.5 Imminent hazard to the public health... a significant threat of danger to health, creates a public health situation (1) that should be...

21 CFR 2.5 - Imminent hazard to the public health.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Imminent hazard to the public health. 2.5 Section... GENERAL ADMINISTRATIVE RULINGS AND DECISIONS General Provisions § 2.5 Imminent hazard to the public health... a significant threat of danger to health, creates a public health situation (1) that should be...

Cluster munitions: a threat to health and human rights.

PubMed

Parikh, Sujal M

2010-01-01

Over the course of 2009, dozens of nations signed a new convention on cluster munitions, and several nations ratified the convention. To determine how public health professionals can participate in preventing death and injury from cluster munitions, we review the history of these weapons, their effects on individuals and communities, the history of efforts to limit their use, the Convention on Cluster Munitions, and ways that health professionals can support efforts to ban their use. Cluster munitions are a threat to civilians in conflict and post-conflict settings. They render homes, farms and businesses dangerous and inaccessible, and delay resettlement after the end of a conflict. Health professionals have led efforts to limit the use and proliferation of other weapons, and global collaboration to support the Convention on Cluster Munitions would be a step towards protecting the public's health.

Advancing health rights in a globalized world: responding to globalization through a collective human right to public health.

PubMed

Meier, Benjamin Mason

2007-01-01

The right to health was codified in Article 12 of the International Covenant on Economic, Social and Cultural Rights as an individual right, focusing on individual health services at the expense of public health systems. This article assesses the ways in which the individual human right to health has evolved to meet collective threats to the public's health. Despite its repeated expansions, the individual right to health remains normatively incapable of addressing the injurious societal ramifcations of economic globalization, advancing individual rights to alleviate collective inequalities in underlying determinants of health. By examining modern changes to underlying determinants of health, this article concludes that responding to globalized health threats necessitates a collective right to public health.

Tetanus: A Potential Public Health Threat in Times of Disaster.

PubMed

Finkelstein, Paige; Teisch, Laura; Allen, Casey J; Ruiz, Gabriel

2017-06-01

for trauma and critical patients to become familiar with the protocols for treatment and immunization of patients that have tetanus-prone wounds, as well as recognize the potential for outbreaks in the settings of major natural disasters. Finkelstein P , Teisch L , Allen CJ , Ruiz G . Tetanus: a potential public health threat in times of disaster. Prehosp Disaster Med. 2017;32(3):339-342.

Community Response to a Public Health Threat-VEE

ERIC Educational Resources Information Center

McDonald, John L.; Vuturo, Anthony F.

1975-01-01

After identifying the mosquito as the Venezuelan equine encephalitis vector, health officials worked with the community to eliminate mosquito breeding sites. By educating the public first, cooperation was received in opening drainage areas and stocking water collection areas with mosquito eating fish to interrupt the host-vector-recipient cycle.…

Measles during the Gulf War: a public health threat in Israel, the West Bank, and Gaza.

PubMed

Tulchinsky, T H; Belmaker, I; Raabi, S; Acker, C; Arbeli, Y; Lobel, R; Abed, Y; Toubassi, N; Goldberg, E; Slater, P E

A measles outbreak began in Ramallah District in the West Bank in the period just before the outbreak of the Gulf War in 1991. After a local control program, the outbreak was contained to a total of 236 reported cases, including one death, but sporadic cases appeared over the ensuing months. An epidemic of measles followed 2-3 weeks later in Beer Sheva district in Israel, initially among the Bedouin population just prior to the outbreak of the war, then spreading to the Jewish population. The epidemic reached its peak during the war in February, continuing into March. There were a total of over 433 reported cases, with 203 hospitalizations and 7 deaths. The epidemic was slowed by curtailment of school and other civilian activities, and a mass vaccination campaign reaching 60,000 children, but was spread by crowded conditions in hospital, and was spread to other parts of the country by internal population migration. An epidemic of a preventable disease occurring during a national emergency adds to the burdens of the health system. The public health system must be prepared to contain epidemics and other public health threats in wartime, employing standard control methods developed and practiced during peacetime. Routine immunization policies should take into account the possibility of a civilian epidemic during national emergencies, and the need to assure protection of both the civilian and military population in preparation for such contingencies.

Public health in Canada: a difficult history.

PubMed

Mowat, David L; Butler-Jones, David

2007-01-01

Although the outbreak of severe acute respiratory syndrome in 2003 was the event that focused attention on Canada's capacity in public health, there have been, and will be, many other public health challenges, not just in the form of outbreaks but of a diverse set of threats to health, both infectious and non-infectious. Like many other countries, Canada must face the challenge of building and sustaining the capacity to respond to this broad range of challenges. Recently, there has been an emphasis on strengthening the public health infrastructure, including inter-jurisdictional agreements, research, knowledge translation, information systems and the workforce.

Climate Change, Public Health, and Decision Support: The New Threat of Vector-borne Disease

NASA Astrophysics Data System (ADS)

Grant, F.; Kumar, S.

2011-12-01

Climate change and vector-borne diseases constitute a massive threat to human development. It will not be enough to cut emissions of greenhouse gases-the tide of the future has already been established. Climate change and vector-borne diseases are already undermining the world's efforts to reduce extreme poverty. It is in the best interests of the world leaders to think in terms of concerted global actions, but adaptation and mitigation must be accomplished within the context of local community conditions, resources, and needs. Failure to act will continue to consign developed countries to completely avoidable health risks and significant expense. Failure to act will also reduce poorest of the world's population-some 2.6 billion people-to a future of diminished opportunity. Northrop Grumman has taken significant steps forward to develop the tools needed to assess climate change impacts on public health, collect relevant data for decision making, model projections at regional and local levels; and, deliver information and knowledge to local and regional stakeholders. Supporting these tools is an advanced enterprise architecture consisting of high performance computing, GIS visualization, and standards-based architecture. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. For the present climate WRF was forced with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model 20th century simulation. For the 21th century climate, we used an ECHAM5 simulation with the Special Report on Emissions (SRES) A1B emissions scenario. WRF was run in nested mode at spatial resolution of 108 km, 36 km and 12 km and 28 vertical levels

Health for all: a fundamental goal of public health in our region.

PubMed

Binns, Colin; Lee, Mi Kyung

2015-01-01

Since its foundation 30 years ago, the mission of the Asia-Pacific Academic Consortium for Public Health has been promoting "health for all" through public health. "Health for all" became the theme of Walter Patrick's public health career and inspired his contribution to APACPH. However, the universality of health care is now under threat, more from economists and politicians than public health workers. Health for all remains a continuing challenge for all public health workers in our region. Progress is being made toward this goal as life expectancy in the Western Pacific has increased from 64 to 78 in the past 3 decades. Prof Walter Patrick was strong public health advocate, and this review was written as a tribute to good friend and inspiring colleague who believed in, and worked for "health for all." © 2014 APJPH.

Public health preparedness in Alberta: a systems-level study.

PubMed

Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

2006-12-28

Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

The globalization of public health: the first 100 years of international health diplomacy.

PubMed Central

Fidler, D. P.

2001-01-01

Global threats to public health in the 19th century sparked the development of international health diplomacy. Many international regimes on public health issues were created between the mid-19th and mid-20th centuries. The present article analyses the global risks in this field and the international legal responses to them between 1851 and 1951, and explores the lessons from the first century of international health diplomacy of relevance to contemporary efforts to deal with the globalization of public health. PMID:11584732

Public Health System Response to Extreme Weather Events.

PubMed

Hunter, Mark D; Hunter, Jennifer C; Yang, Jane E; Crawley, Adam W; Aragón, Tomás J

2016-01-01

Extreme weather events, unpredictable and often far-reaching, constitute a persistent challenge for public health preparedness. The goal of this research is to inform public health systems improvement through examination of extreme weather events, comparing across cases to identify recurring patterns in event and response characteristics. Structured telephone-based interviews were conducted with representatives from health departments to assess characteristics of recent extreme weather events and agencies' responses. Response activities were assessed using the Centers for Disease Control and Prevention Public Health Emergency Preparedness Capabilities framework. Challenges that are typical of this response environment are reported. Forty-five local health departments in 20 US states. Respondents described public health system responses to 45 events involving tornadoes, flooding, wildfires, winter weather, hurricanes, and other storms. Events of similar scale were infrequent for a majority (62%) of the communities involved; disruption to critical infrastructure was universal. Public Health Emergency Preparedness Capabilities considered most essential involved environmental health investigations, mass care and sheltering, surveillance and epidemiology, information sharing, and public information and warning. Unanticipated response activities or operational constraints were common. We characterize extreme weather events as a "quadruple threat" because (1) direct threats to population health are accompanied by damage to public health protective and community infrastructure, (2) event characteristics often impose novel and pervasive burdens on communities, (3) responses rely on critical infrastructures whose failure both creates new burdens and diminishes response capacity, and (4) their infrequency and scale further compromise response capacity. Given the challenges associated with extreme weather events, we suggest opportunities for organizational learning and

The Interconnectedness of Water and Health: Translating Science Into Public Health-driven Policy

NASA Astrophysics Data System (ADS)

Lichtveld, M.

2017-12-01

Louisiana and other U.S. Gulf Coast communities' unique vulnerability stems from three interconnected stressors they face: historic health disparities, persistent environmental stressors, and a geography prone to both natural and technological disasters. The health of the ecosystem is inextricably linked to that of humans. Specifically, water presents both a central asset and an intransigent environmental health threat. Waterborne illnesses associated with infectious organisms, chemical contaminants, coastal erosion, natural and technological disasters such as hurricanes and oil spills, as well as climate change-associated sea level rise and dead zones, all can negatively impact human health. Existing water-related policies at the federal, state, and local levels have failed to effectively protect the health of communities and their environment to date. For example, despite the existence of the Clean Water Act and the Safe Drinking Water Act, oil spills and drinking water contamination continue to pose significant threats to communities' health and wellbeing. This presentation will examine water-related threats to Gulf Coast communities and their ecosystem. Emphasis will be placed on key examples of policy failure and the impact such failures. A public health-driven framework will demonstrate how science can inform evidence- based policy and in turn prevention-driven public health practice.

Integrating public health and medical intelligence gathering into homeland security fusion centres.

PubMed

Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

Office of the Assistant Secretary for Preparedness and Response; HHS Public Health Emergency Medical Countermeasures Enterprise implementation plan for chemical, biological, radiological and nuclear threats. Notice.

PubMed

2007-04-23

The United States faces serious public health threats from the deliberate use of weapons of mass destruction (WMD)--chemical, biological, radiological, or nuclear (CBRN)--by hostile States or terrorists, and from naturally emerging infectious diseases that have a potential to cause illness on a scale that could adversely impact national security. Effective strategies to prevent, mitigate, and treat the consequences of CBRN threats is an integral component of our national security strategy. To that end, the United States must be able to rapidly develop, stockpile, and deploy effective medical countermeasures to protect the American people. The HHS Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has taken a holistic, end-to-end approach that considers multiple aspects of the medical countermeasures mission including research, development, acquisition, storage, maintenance, deployment, and guidance for utilization. Phase one of this approach established the HHS PHEMCE Strategy for Chemical, Biological, Radiological, and Nuclear Threats (HHS PHEMCE Strategy). The HHS PHEMCE Strategy, published in the Federal Register on March 20, 2007, described a framework of strategic policy goals and objectives for identifying medical countermeasure requirements and establishing priorities for medical countermeasure evaluation, development and acquisition. These strategic policy goals and objectives were used to establish the Four Pillars upon which this HHS Public Health Emergency Medical Countermeasures Enterprise Implementation Plan (HHS PHEMCE Implementation Plan) is based. The HHS PHEMCE Implementation Plan considers the full spectrum of medical countermeasures-related activities, including research, development, acquisition, storage/maintenance, deployment, and utilization. The HHS PHEMCE Implementation Plan is consistent with the President's Biodefense for the 21st Century and is aligned with the National Strategy for Medical Countermeasures against

Frightfully funny: combining threat and humour in health messages for men and women.

PubMed

Hendriks, Hanneke; Janssen, Loes

2018-05-01

It is imperative for public health to investigate what factors may reduce defensive responses and increase the effectiveness of health information. The present research investigated gender differences in responses to threatening health-promoting information communicated with humour. Male and female participants were exposed to a health message stressing the negative consequences of binge drinking (Experiment 1; N = 209) or caffeine consumption (Experiment 2; N = 242), that did or did not contain a funny visual metaphor (Experiment 1) or a slapstick cartoon (Experiment 2). Message evaluation, message attention, and attitudes and intentions towards the behaviour were measured. Results showed that health messages were more persuasive when communicated with humour, although humour played a different role for men and women. Whereas men responded more in line with message goals when the message combined high threat with humour, women preferred the low threat humour messages. By uncovering the moderating role of gender as a key audience characteristic, this research contributes to designing effective future health campaigns and provides important insights for future studies investigating the underlying mechanisms responsible for the different effects of threat and humour appeals for men and women.

Environmental Health: Threats and their Interactions

PubMed Central

Holdstock, Douglas

2008-01-01

Improvements in the provision of an acceptable standard of health care, particularly in the developing world, will be undermined by three ongoing processes: ongoing armed conflicts; the threat of global warming due to rising levels of greenhouse gases, particularly carbon dioxide emitted by developed countries; and by rapidly rising populations. The key features of these three threats are summarised, and it is shown that interactions between them increase both the likelihood of their occurrence and the probable harm that they will cause. Some of the interactions are described, with ways of providing health care taking into account the threats and their interactions, and the paradox is emphasised that better health care in the developing world will further increase population growth followed by increased greenhouse gas emissions. Improved education for women and free and unlimited access to modern methods of contraception are vital. PMID:21572838

Botulinum neurotoxin detection methods for public health response and surveillance

USDA-ARS?s Scientific Manuscript database

A single suspected case of foodborne botulism caused by food contaminated with botulinum neurotoxin (BoNTs) could evoke public health emergency. The threat of bioterrorism through deliberate distribution in food sources and/or aerosolization of BoNTs raises global public health and security concerns...

Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents

PubMed Central

Hunter, Jennifer C.; Yang, Jane E.; Crawley, Adam W.; Biesiadecki, Laura; Aragón, Tomás J.

2013-01-01

As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. PMID:24236137

Preparing for climate change: a perspective from local public health officers in California.

PubMed

Bedsworth, Louise

2009-04-01

The most recent scientific findings show that even with significant emission reductions, some amount of climate change is likely inevitable. The magnitude of the climate changes will depend on future emissions and climate sensitivity. These changes will have local impacts, and a significant share of coping with these changes will fall on local governmental agencies. Public health is no exception, because local public health agencies are crucial providers of disease prevention, health care, and emergency preparedness services. This article presents the results of a survey of California's local pubic health officers conducted between August and October 2007. The survey gauged health officers' concerns about the public health impacts of climate change, programs in place that could help to mitigate these health effects, and information and resource needs for better coping with a changing climate. The results of this survey show that most public health officers feel that climate change poses a serious threat to public health but that they do not feel well equipped in terms of either resources or information to cope with that threat. Nonetheless, public health agencies currently implement a number of programs that will help these agencies handle some of the challenges posed by a changing climate. Overall, the results suggest that local public health agencies in California are likely in a better position than they perceive to address the threats associated with climate change but that there is a larger role for them to play in climate policy.

An Assessment of Coherence Between Early Warning and Response Systems and Serious Cross-Border Health Threats in the European Union and Turkey.

PubMed

Ekmekci, Perihan Elif

2016-12-01

Disease outbreaks have attracted the attention of the public health community to early warning and response systems (EWRS) for communicable diseases and other cross-border threats to health. The European Union (EU) and the World Health Organization (WHO) have published regulations in this area. Decision 1082/2013/EU brought a new approach the management of public health threats in EU member states. Decision 1082/2013/EU brought several innovations, which included establishing a Health Security Committee; preparedness and response planning; joint procurement of medical countermeasures; ad hoc monitoring for biological, chemical, and environmental threats; EWRS; and recognition of an emergency situation and interoperability between various sectors. Turkey, as an acceding country to the EU and a member of the WHO, has been improving its national public health system to meet EU legislations and WHO standards. This article first explains EWRS as defined in Decision 1082/2013/EU and Turkey's obligations to align its public health laws to the EU acquis. EWRS in Turkey are addressed, particularly their coherence with EU policies regarding preparedness and response, alert notification, and interoperability between health and other sectors. Finally, the challenges and limitations of the current Turkish system are discussed and further improvements are suggested. (Disaster Med Public Health Preparedness. 2016;10:883-892).

Preparing for Climate Change: A Perspective from Local Public Health Officers in California

PubMed Central

Bedsworth, Louise

2009-01-01

Background The most recent scientific findings show that even with significant emission reductions, some amount of climate change is likely inevitable. The magnitude of the climate changes will depend on future emissions and climate sensitivity. These changes will have local impacts, and a significant share of coping with these changes will fall on local governmental agencies. Public health is no exception, because local public health agencies are crucial providers of disease prevention, health care, and emergency preparedness services. Methods This article presents the results of a survey of California’s local pubic health officers conducted between August and October 2007. The survey gauged health officers’ concerns about the public health impacts of climate change, programs in place that could help to mitigate these health effects, and information and resource needs for better coping with a changing climate. Results The results of this survey show that most public health officers feel that climate change poses a serious threat to public health but that they do not feel well equipped in terms of either resources or information to cope with that threat. Nonetheless, public health agencies currently implement a number of programs that will help these agencies handle some of the challenges posed by a changing climate. Conclusions Overall, the results suggest that local public health agencies in California are likely in a better position than they perceive to address the threats associated with climate change but that there is a larger role for them to play in climate policy. PMID:19440502

Health system strengthening: prospects and threats for its sustainability on the global health policy agenda.

PubMed

Naimoli, Joseph F; Saxena, Sweta; Hatt, Laurel E; Yarrow, Kristina M; White, Trenton M; Ifafore-Calfee, Temitayo

2018-01-01

In 2013, Hafner and Shiffman applied Kingdon's public policy process model to explain the emergence of global attention to health system strengthening (HSS). They questioned, however, HSS's sustainability on the global health policy agenda, citing various concerns. Guided by the Grindle and Thomas interactive model of policy implementation, we advance and elaborate a proposition: a confluence of developments will contribute to maintaining HSS's prominent place on the agenda until at least 2030. Those developments include (1) technical, managerial, financial, and political responses to unpredictable public health crises that imperil the routine functioning of health systems, such as the 2014-2015 Ebola virus disease (Ebola) epidemic in West Africa; (2) similar responses to non-crisis situations requiring fully engaged, robust health systems, such as the pursuit of the new Sustainable Development Goal for health (SDG3); and (3) increased availability of new knowledge about system change at macro, meso, and micro levels and its effects on people's health and well-being. To gauge the accuracy of our proposition, we carried out a speculative assessment of credible threats to our premise by discussing all of the Hafner-Shiffman concerns. We conclude that (1) the components of our proposition and other forces that have the potential to promote continuing attention to HSS are of sufficient strength to counteract these concerns, and (2) prospective monitoring of HSS agenda status and further research on agenda sustainability can increase confidence in our threat assessment. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Assessment of Coherence Between Early Warning and Response Systems and Serious Cross-Border Health Threats in the European Union and Turkey

PubMed Central

Elif Ekmekci, Perihan

2017-01-01

Disease outbreaks have attracted the attention of the public health community to early warning and response systems (EWRS) for communicable diseases and other cross-border threats to health. The European Union (EU) and the World Health Organization (WHO) have published regulations in this area. Decision 1082/2013/EU brought a new approach the management of public health threats in EU member states. Decision 1082/2013/EU brought several innovations, which included establishing a Health Security Committee; preparedness and response planning; joint procurement of medical countermeasures; ad hoc monitoring for biological, chemical, and environmental threats; EWRS; and recognition of an emergency situation and interoperability between various sectors. Turkey, as an acceding country to the EU and a member of the WHO, has been improving its national public health system to meet EU legislations and WHO standards. This article first explains EWRS as defined in Decision 1082/2013/EU and Turkey’s obligations to align its public health laws to the EU acquis. EWRS in Turkey are addressed, particularly their coherence with EU policies regarding preparedness and response, alert notification, and interoperability between health and other sectors. Finally, the challenges and limitations of the current Turkish system are discussed and further improvements are suggested. PMID:27511433

Integrating Climate Change Adaptation into Public Health Practice: Using Adaptive Management to Increase Adaptive Capacity and Build Resilience

PubMed Central

McDowell, Julia Z.; Luber, George

2011-01-01

Background: Climate change is expected to have a range of health impacts, some of which are already apparent. Public health adaptation is imperative, but there has been little discussion of how to increase adaptive capacity and resilience in public health systems. Objectives: We explored possible explanations for the lack of work on adaptive capacity, outline climate–health challenges that may lie outside public health’s coping range, and consider changes in practice that could increase public health’s adaptive capacity. Methods: We conducted a substantive, interdisciplinary literature review focused on climate change adaptation in public health, social learning, and management of socioeconomic systems exhibiting dynamic complexity. Discussion: There are two competing views of how public health should engage climate change adaptation. Perspectives differ on whether climate change will primarily amplify existing hazards, requiring enhancement of existing public health functions, or present categorically distinct threats requiring innovative management strategies. In some contexts, distinctly climate-sensitive health threats may overwhelm public health’s adaptive capacity. Addressing these threats will require increased emphasis on institutional learning, innovative management strategies, and new and improved tools. Adaptive management, an iterative framework that embraces uncertainty, uses modeling, and integrates learning, may be a useful approach. We illustrate its application to extreme heat in an urban setting. Conclusions: Increasing public health capacity will be necessary for certain climate–health threats. Focusing efforts to increase adaptive capacity in specific areas, promoting institutional learning, embracing adaptive management, and developing tools to facilitate these processes are important priorities and can improve the resilience of local public health systems to climate change. PMID:21997387

Understanding the Threats Posed by Non-Native Species: Public vs. Conservation Managers

PubMed Central

Gozlan, Rodolphe E.; Burnard, Dean; Andreou, Demetra; Britton, J. Robert

2013-01-01

Public perception is a key factor influencing current conservation policy. Therefore, it is important to determine the influence of the public, end-users and scientists on the prioritisation of conservation issues and the direct implications for policy makers. Here, we assessed public attitudes and the perception of conservation managers to five non-native species in the UK, with these supplemented by those of an ecosystem user, freshwater anglers. We found that threat perception was not influenced by the volume of scientific research or by the actual threats posed by the specific non-native species. Media interest also reflected public perception and vice versa. Anglers were most concerned with perceived threats to their recreational activities but their concerns did not correspond to the greatest demonstrated ecological threat. The perception of conservation managers was an amalgamation of public and angler opinions but was mismatched to quantified ecological risks of the species. As this suggests that invasive species management in the UK is vulnerable to a knowledge gap, researchers must consider the intrinsic characteristics of their study species to determine whether raising public perception will be effective. The case study of the topmouth gudgeon Pseudorasbora parva reveals that media pressure and political debate has greater capacity to ignite policy changes and impact studies on non-native species than scientific evidence alone. PMID:23341931

The unfulfilled promise of public health: déjà vu all over again.

PubMed

Fee, Elizabeth; Brown, Theodore M

2002-01-01

Many complain about public health's weak infrastructure and poor capacity to respond to threats of bioterrorism. Such complaints are but the anxiety-heightened expression of a periodic rediscovery of the deficiencies and unfulfilled promise of U.S. public health. An overview of more than two centuries suggests that where we are now with public health has been shaped by our earlier, limited, and crisis-focused responses to changing disease threats. We have failed to sustain progress in any coherent manner. If we do not wish to repeat past mistakes, we should learn lessons from the past to guide us in the future.

25 CFR 1000.304 - What is imminent jeopardy to public health and safety?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false What is imminent jeopardy to public health and safety...-DETERMINATION AND EDUCATION ACT Reassumption § 1000.304 What is imminent jeopardy to public health and safety? Imminent jeopardy to public health and safety means an immediate and significant threat of serious harm to...

25 CFR 1000.304 - What is imminent jeopardy to public health and safety?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false What is imminent jeopardy to public health and safety...-DETERMINATION AND EDUCATION ACT Reassumption § 1000.304 What is imminent jeopardy to public health and safety? Imminent jeopardy to public health and safety means an immediate and significant threat of serious harm to...

Drinking Water in Nigeria: A Public Health Threat and Burden

DTIC Science & Technology

2009-04-01

solutions. Statistical data is incorporated to substantiate the significance of the disease burden and display the access to safe drinking water...the Nigerian government ministry information and updated health statistics , and the lack of public health related resources at the Muir S...fluctuates based on the statistical source, but the largest figure is estimated at 140 million according to that latest census conducted in 2006. The

Unhealthy interactions: the role of stereotype threat in health disparities.

PubMed

Aronson, Joshua; Burgess, Diana; Phelan, Sean M; Juarez, Lindsay

2013-01-01

Stereotype threat is the unpleasant psychological experience of confronting negative stereotypes about race, ethnicity, gender, sexual orientation, or social status. Hundreds of published studies show how the experience of stereotype threat can impair intellectual functioning and interfere with test and school performance. Numerous published interventions derived from this research have improved the performance and motivation of individuals targeted by low-ability stereotypes. Stereotype threat theory and research provide a useful lens for understanding and reducing the negative health consequences of interracial interactions for African Americans and members of similarly stigmatized minority groups. Here we summarize the educational outcomes of stereotype threat and examine the implications of stereotype threat for health and health-related behaviors.

Unhealthy Interactions: The Role of Stereotype Threat in Health Disparities

PubMed Central

Burgess, Diana; Phelan, Sean M.; Juarez, Lindsay

2013-01-01

Stereotype threat is the unpleasant psychological experience of confronting negative stereotypes about race, ethnicity, gender, sexual orientation, or social status. Hundreds of published studies show how the experience of stereotype threat can impair intellectual functioning and interfere with test and school performance. Numerous published interventions derived from this research have improved the performance and motivation of individuals targeted by low-ability stereotypes. Stereotype threat theory and research provide a useful lens for understanding and reducing the negative health consequences of interracial interactions for African Americans and members of similarly stigmatized minority groups. Here we summarize the educational outcomes of stereotype threat and examine the implications of stereotype threat for health and health-related behaviors. PMID:23153125

Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies

PubMed Central

Mackey, Tim K.; Nayyar, Gaurvika

2016-01-01

Background Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. Sources of data A review was conducted of the English literature with search terms ‘online pharmacies’, ‘Internet pharmacies’, ‘cyber pharmacies’, ‘rogue pharmacies’, and ‘e-pharmacies’ using PubMed, JSTOR, and Google Scholar from 1999–2005. Areas of agreement Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Areas of controversy Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Growing points Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. Areas timely for developing research There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. PMID:27151957

Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies.

PubMed

Mackey, Tim K; Nayyar, Gaurvika

2016-06-01

Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005. Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Globalisation and global health governance: implications for public health.

PubMed

Kruk, Margaret E

2012-01-01

Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.

Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy.

PubMed

Moulton, Anthony Drummond; Schramm, Paul John

Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic plan to create and sustain that capacity.

Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy

PubMed Central

Moulton, Anthony Drummond; Schramm, Paul John

2017-01-01

Context Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity. Objective Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted. Methods Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations. Findings Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity. Conclusions A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic

Attentional bias towards health-threat information in chronic fatigue syndrome.

PubMed

Hou, Ruihua; Moss-Morris, Rona; Bradley, Brendan P; Peveler, Robert; Mogg, Karin

2008-07-01

To investigate whether individuals with chronic fatigue syndrome (CFS) show an attentional bias towards health-threat information. Attentional bias (AB) was assessed in individuals with CFS and healthy controls using a visual probe task which presented health-threat and neutral words and pictures for 500 ms. Self-report questionnaires were used to assess CFS symptoms, depression, anxiety, and social desirability. Compared to a healthy control group, the CFS group showed an enhanced AB towards heath-threat stimuli relative to neutral stimuli. The AB was not influenced by the type of stimulus (pictures vs. words). The finding of an AB towards health-threat information in individuals with CFS is supportive of models of CFS which underlie cognitive behavior therapy.

Investigations of Selected Historically Important Syndromic Outbreaks: Impact and Lessons Learned for Public Health Preparedness and Response

PubMed Central

Posid, Joseph M.; Popovic, Tanja

2012-01-01

Public health readiness has increased at all jurisdictional levels because of increased sensitivity to threats. Since 2001, with billions of dollars invested to bolster the public health system’s capacity, the public expects that public health will identify the etiology of and respond to events more rapidly. However, when etiologies are unknown at the onset of the investigation but interventions must be implemented, public health practitioners must benefit from past investigations’ lessons to strengthen preparedness for emerging threats. We have identified such potentially actionable lessons learned from historically important public health events that occurred primarily as syndromes for which the etiological agent initially was unknown. Ongoing analysis of investigations can advance our capability to recognize and investigate syndromes and other problems and implement the most appropriate interventions. PMID:22571706

Towards public health decision support: a systematic review of bidirectional communication approaches

PubMed Central

Dixon, Brian E; Gamache, Roland E; Grannis, Shaun J

2013-01-01

Objective To summarize the literature describing computer-based interventions aimed at improving bidirectional communication between clinical and public health. Materials and Methods A systematic review of English articles using MEDLINE and Google Scholar. Search terms included public health, epidemiology, electronic health records, decision support, expert systems, and decision-making. Only articles that described the communication of information regarding emerging health threats from public health agencies to clinicians or provider organizations were included. Each article was independently reviewed by two authors. Results Ten peer-reviewed articles highlight a nascent but promising area of research and practice related to alerting clinicians about emerging threats. Current literature suggests that additional research and development in bidirectional communication infrastructure should focus on defining a coherent architecture, improving interoperability, establishing clear governance, and creating usable systems that will effectively deliver targeted, specific information to clinicians in support of patient and population decision-making. Conclusions Increasingly available clinical information systems make it possible to deliver timely, relevant knowledge to frontline clinicians in support of population health. Future work should focus on developing a flexible, interoperable infrastructure for bidirectional communications capable of integrating public health knowledge into clinical systems and workflows. PMID:23467470

Towards public health decision support: a systematic review of bidirectional communication approaches.

PubMed

Dixon, Brian E; Gamache, Roland E; Grannis, Shaun J

2013-05-01

To summarize the literature describing computer-based interventions aimed at improving bidirectional communication between clinical and public health. A systematic review of English articles using MEDLINE and Google Scholar. Search terms included public health, epidemiology, electronic health records, decision support, expert systems, and decision-making. Only articles that described the communication of information regarding emerging health threats from public health agencies to clinicians or provider organizations were included. Each article was independently reviewed by two authors. Ten peer-reviewed articles highlight a nascent but promising area of research and practice related to alerting clinicians about emerging threats. Current literature suggests that additional research and development in bidirectional communication infrastructure should focus on defining a coherent architecture, improving interoperability, establishing clear governance, and creating usable systems that will effectively deliver targeted, specific information to clinicians in support of patient and population decision-making. Increasingly available clinical information systems make it possible to deliver timely, relevant knowledge to frontline clinicians in support of population health. Future work should focus on developing a flexible, interoperable infrastructure for bidirectional communications capable of integrating public health knowledge into clinical systems and workflows.

Mental Health Problems in Adolescence and the Interpretation of Unambiguous Threat

PubMed Central

Henry, Julie D.; Moses, Ernestina; Castellini, Julieta; Scott, James

2015-01-01

Aberrant threat perception has been linked to paranoia, anxiety and other mental health problems, and is widely considered to be a core, transdiagnostic feature of psychopathology. However, to date there has been only limited investigation of whether mental health problems are associated with a biased interpretation of stimuli that have explicit (as opposed to ambiguous) connotations of threat. In the present study, 41 adolescents diagnosed with a mental illness and 45 demographically matched controls were asked to provide danger ratings of stimuli normatively rated as being either low or high in potential threat. All participants were also asked to complete background measures of cognitive function, mental health and wellbeing. The results indicated that the two groups did not differ in their capacity to discriminate between low and high threat stimuli, nor did they differ in the absolute level of threat that they attributed to these stimuli. However, for the control group, the overall level of threat perceived in facial stimuli was correlated with two important indices of mental health (depression and anxiety). No associations emerged in the clinical group. These data are discussed in relation to their potential implications for the role of aberrant threat perception in transdiagnostic models of mental health. PMID:26039081

Sexual orientation and self-rated health: the role of social capital, offence, threat of violence, and violence.

PubMed

Axelsson, Jakob; Modén, Birgit; Rosvall, Maria; Lindström, Martin

2013-07-01

To study the association between sexual orientation and self-rated health, including trust, offence, threat of violence, and violence. DESIGN/SETTING/PARTICIPANTS/MEASUREMENT: The 2008 Public Health Survey in Skåne is a cross-sectional postal questionnaire study. A total of 28,198 persons aged 18-80 years responded (55%). Logistic regressions analysed the association between sexual orientation and self-rated health. 27.4% of all men and 30.0% of all women rated their health as poor. Poor self-rated health was significantly more prevalent in higher age, among immigrants, people with lower education, low social support, low trust, experience of being offended, experience of threat of violence and violence, and bisexual and other orientation. Homosexual and bisexual men and women had higher age-adjusted odds ratios of having felt offended compared to heterosexual respondents. The odds ratios of low trust, threat of violence (men), and experience of violence (women) were significant for respondents with bisexual orientation but not for respondents with homosexual orientation. In the age-adjusted model, no significant association was observed between homosexual orientation and poor self-rated health among women. All other associations between sexual orientation and health were significant in the age-adjusted model but non-significant in the multiple models. Associations between sexual orientation and health disappear after multiple adjustments including trust and experience of offence, threat of violence, and violence. The study suggests that the group with bisexual orientation seems to be more exposed to low social capital (trust), threat of violence, and violence than the group with homosexual orientation.

[Tuberculosis and refusal of treatment: resorting to legislation on serious health threats].

PubMed

Bouvet, R; Le Gueut, M

2013-06-01

Clinicians are regularly confronted with the question of refusal of treatment from patients with tuberculosis. For several years, the French public health authorities have been studying the possibility of compelling treatment or isolation, but no plan has been implemented even though European and American experiences have shown the effectiveness of restrictive measures. Neither the statutory exceptions to the principle of consent to medical treatment nor the conditions of implementation of "required care" allow legally binding measures against patients refusing care or isolation. The legislation on serious health threats has recently been applied to the situation of a refusal of treatment in the context of tuberculosis. It allowed the patient to be ordered to observe prescribed care and the possibility of forced isolation in the event of breach of this order. The legislation on serious health threats is a response to the question of refusal of treatment from patients with tuberculosis. However the opinion of the legal authority as to its necessity and proportionality to the risk remains unknown. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Legal access to medications: a threat to Brazil's public health system?

PubMed

Chieffi, Ana Luiza; Barradas, Rita De Cassia Barata; Golbaum, Moisés

2017-07-19

lawyers and physicians in filing lawsuits. The judicialization of health in the State of São Paulo with the characteristics presented herein is a threat to the SUS.

Globalisation and public health.

PubMed

Bettcher, D; Lee, K

2002-01-01

At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

Terrorism threats and preparedness in Canada: the perspective of the Canadian public.

PubMed

Gibson, Stacey; Lemyre, Louise; Clément, Mélanie; Markon, Marie-Pierre L; Lee, Jennifer E C

2007-06-01

Although Canada has not experienced a major terrorist attack, an increased global pending threat has put preparedness at the top of the Canadian government's agenda. Given its strong multicultural community and close proximity to the recently targeted United States, the Canadian experience is unique. However, minimal research exists on the public's reactions to terrorism threats and related preparedness strategies. In order for response initiatives to be optimally effective, it is important that the public's opinions regarding terrorism and preparedness be considered. This qualitative study examined perceptions of terrorism threats among Canadians living in Central and Eastern Canada (N = 75) in the fall of 2004. Conceptualizations of terrorism threat, psychosocial impacts, and sense of preparedness were explored in a series of qualitative interviews. Findings revealed that the majority of Canadians did not feel overly threatened by terrorist attacks, due in part to a perception of terrorist threats as related to global sociopolitical events and a positive Canadian identity. In addition, while most respondents did not feel they were individually affected by the threat of terrorism, there was some concern regarding larger societal impacts, such as increased paranoia, discrimination, and threats to civil liberties. Participants' views on preparedness focused largely on the utility of emergency preparedness strategies and the factors that could mitigate or inhibit preparedness at the individual and institutional levels, with a specific focus on education. Finally, the significant relevance of these findings in shaping terrorism preparedness, both in Canada and generally, is discussed.

Ending AIDS as a public health threat by 2030: Scientific Developments from the 2016 INTEREST Conference in Yaoundé, Cameroon

PubMed Central

Hankins, Catherine A; Koulla-Shiro, Sinata; Kilmarx, Peter; Ferrari, Guido; Schechter, Mauro; Kane, Coumba Touré; Venter, François; Boucher, Charles AB; Ross, Anna-Laura; Zewdie, Debrework; Eholié, Serge Paul; Katabira, Elly

2017-01-01

The underpinning theme of the 2016 INTEREST Conference held in Yaoundé, Cameroon, 3–6 May 2016 was ending AIDS as a public health threat by 2030. Focused primarily on HIV treatment, pathogenesis and prevention research in resource-limited settings, the conference attracted 369 active delegates from 34 countries, of which 22 were in Africa. Presentations on treatment optimization, acquired drug resistance, care of children and adolescents, laboratory monitoring and diagnostics, implementation challenges, HIV prevention, key populations, vaccine and cure, hepatitis C, mHealth, financing the HIV response and emerging pathogens, were accompanied by oral, mini-oral and poster presentations. Spirited plenary debates on the UNAIDS 90-90-90 treatment cascade goal and on antiretroviral pre-exposure prophylaxis took place. Joep Lange career guidance sessions and grantspersonship sessions attracted early career researchers. At the closing ceremony, the Yaoundé Declaration called on African governments; UNAIDS; development, bilateral, and multilateral partners; and civil society to adopt urgent and sustained approaches to end HIV by 2030. PMID:28387654

Funding Public Health Emergency Preparedness in the United States

PubMed Central

Attal-Juncqua, Aurelia; Fischer, Julie E.

2017-01-01

The historical precedents that support state and local leadership in preparedness for and response to disasters are in many ways at odds with the technical demands of preparedness and response for incidents affecting public health. New and revised laws and regulations, executive orders, policies, strategies, and plans developed in response to biological threats since 2001 address the role of the federal government in the response to public health emergencies. However, financial mechanisms for disaster response—especially those that wait for gubernatorial request before federal assistance can be provided—do not align with the need to prevent the spread of infectious agents or efficiently reduce the impact on public health. We review key US policies and funding mechanisms relevant to public health emergencies and clarify how policies, regulations, and resources affect coordinated responses. PMID:28892446

Healthcare Stereotype Threat in Older Adults in the Health and Retirement Study.

PubMed

Abdou, Cleopatra M; Fingerhut, Adam W; Jackson, James S; Wheaton, Felicia

2016-02-01

Healthcare stereotype threat is the threat of being personally reduced to group stereotypes that commonly operate within the healthcare domain, including stereotypes regarding unhealthy lifestyles and inferior intelligence. The objective of this study was to assess the extent to which people fear being judged in healthcare contexts on several characteristics, including race/ethnicity and age, and to test predictions that experience of such threats would be connected with poorer health and negative perceptions of health care. Data were collected as part of the 2012 Health and Retirement Study (HRS). A module on healthcare stereotype threat, designed by the research team, was administered to a random subset (n=2,048 of the total 20,555) of HRS participants. The final sample for the present healthcare stereotype threat experiment consists of 1,479 individuals. Logistic regression was used to test whether healthcare stereotype threat was associated with self-rated health, reported hypertension, and depressive symptoms, as well as with healthcare-related outcomes, including physician distrust, dissatisfaction with health care, and preventative care use. Seventeen percent of respondents reported healthcare stereotype threat with respect to one or more aspects of their identities. As predicted, healthcare stereotype threat was associated with higher physician distrust and dissatisfaction with health care, poorer mental and physical health (i.e., self-rated health, hypertension, and depressive symptoms), and lower odds of receiving the influenza vaccine. The first of its kind, this study demonstrates that people can experience healthcare stereotype threat on the basis of various stigmatized aspects of social identity, and that these experiences can be linked with larger health and healthcare-related outcomes, thereby contributing to disparities among minority groups. Copyright © 2016. Published by Elsevier Inc.

Public health surveillance and infectious disease detection.

PubMed

Morse, Stephen S

2012-03-01

Emerging infectious diseases, such as HIV/AIDS, SARS, and pandemic influenza, and the anthrax attacks of 2001, have demonstrated that we remain vulnerable to health threats caused by infectious diseases. The importance of strengthening global public health surveillance to provide early warning has been the primary recommendation of expert groups for at least the past 2 decades. However, despite improvements in the past decade, public health surveillance capabilities remain limited and fragmented, with uneven global coverage. Recent initiatives provide hope of addressing this issue, and new technological and conceptual advances could, for the first time, place capability for global surveillance within reach. Such advances include the revised International Health Regulations (IHR 2005) and the use of new data sources and methods to improve global coverage, sensitivity, and timeliness, which show promise for providing capabilities to extend and complement the existing infrastructure. One example is syndromic surveillance, using nontraditional and often automated data sources. Over the past 20 years, other initiatives, including ProMED-mail, GPHIN, and HealthMap, have demonstrated new mechanisms for acquiring surveillance data. In 2009 the U.S. Agency for International Development (USAID) began the Emerging Pandemic Threats (EPT) program, which includes the PREDICT project, to build global capacity for surveillance of novel infections that have pandemic potential (originating in wildlife and at the animal-human interface) and to develop a framework for risk assessment. Improved understanding of factors driving infectious disease emergence and new technological capabilities in modeling, diagnostics and pathogen identification, and communications, such as using the increasing global coverage of cellphones for public health surveillance, can further enhance global surveillance.

Media, racism and public health psychology.

PubMed

Nairn, Raymond; Pega, Frank; McCreanor, Tim; Rankine, Jenny; Barnes, Angela

2006-03-01

International literature has established that racism contributes to ill-health of migrants, ethnic minorities and indigenous peoples. Racism generally negates wellbeing, adversely affecting physical and psychological health. Numerous studies have shown that media contribute marginalizing particular ethnic and cultural groups depicting them primarily as problems for and threats to the dominant. This articles frames media representations of, and their effect on, the indigenous Maori of Aotearoa, New Zealand within the ongoing processes of colonization. We argue that reflects the media contribution to maintenance and naturalisation of colonial relationships and seek to include critical media scholarship in a critical public health psychology.

Learning Disabilities: A Multifaceted Health Threat

ERIC Educational Resources Information Center

Williams, J. Floyd

1976-01-01

Learning disabilities are a health threat because they prevent a state of complete physical, mental, and social well-being, and they should be treated with a variety of remedial strategies reflecting their multiple causes. (MB)

Disaster Preparedness: Biological Threats and Treatment Options.

PubMed

Narayanan, Navaneeth; Lacy, Clifton R; Cruz, Joseph E; Nahass, Meghan; Karp, Jonathan; Barone, Joseph A; Hermes-DeSantis, Evelyn R

2018-02-01

Biological disasters can be natural, accidental, or intentional. Biological threats have made a lasting impact on civilization. This review focuses on agents of clinical significance, bioterrorism, and national security, specifically Category A agents (anthrax, botulism, plague, tularemia, and smallpox), as well as briefly discusses other naturally emerging infections of public health significance, Ebola virus (also a Category A agent) and Zika virus. The role of pharmacists in disaster preparedness and disaster response is multifaceted and important. Their expertise includes clinical knowledge, which can aid in drug information consultation, patient-specific treatment decision making, and development of local treatment plans. To fulfill this role, pharmacists must have a comprehensive understanding of medical countermeasures for these significant biological threats across all health care settings. New and reemerging infectious disease threats will continue to challenge the world. Pharmacists will be at the forefront of preparedness and response, sharing knowledge and clinical expertise with responders, official decision makers, and the general public. © 2017 Pharmacotherapy Publications, Inc.

Big Data and Health Economics: Strengths, Weaknesses, Opportunities and Threats.

PubMed

Collins, Brendan

2016-02-01

'Big data' is the collective name for the increasing capacity of information systems to collect and store large volumes of data, which are often unstructured and time stamped, and to analyse these data by using regression and other statistical techniques. This is a review of the potential applications of big data and health economics, using a SWOT (strengths, weaknesses, opportunities, threats) approach. In health economics, large pseudonymized databases, such as the planned care.data programme in the UK, have the potential to increase understanding of how drugs work in the real world, taking into account adherence, co-morbidities, interactions and side effects. This 'real-world evidence' has applications in individualized medicine. More routine and larger-scale cost and outcomes data collection will make health economic analyses more disease specific and population specific but may require new skill sets. There is potential for biomonitoring and lifestyle data to inform health economic analyses and public health policy.

Mobilising "vulnerability" in the public health response to pandemic influenza.

PubMed

Stephenson, Niamh; Davis, Mark; Flowers, Paul; MacGregor, Casimir; Waller, Emily

2014-02-01

Analysis of public health's growing interest in "vulnerability" has largely focused on health policy, with little interrogation of how vulnerability is being actively appropriated, countered, ignored or reworked by the publics whose health such policy is designed to protect. Once the assemblage of public health is understood as comprised of different forms of expertise and actors, including publics, addressing this gap matters. We examine the use of vulnerability in the specific context of pandemic influenza preparedness. Pandemic preparedness raises some familiar dilemmas for public health governance: how to engage with publics without fuelling social divisions and disruption; and whether to invoke publics as passive recipients of public health advice or to recognise publics as collective agents responding to the threat of pandemic influenza. Thus, we ask how the mobilisation of vulnerability connects with these dilemmas. To examine vulnerability in pandemic preparedness, two forms of qualitative data are analysed: 1) interviews and focus groups with "vulnerable" and "healthy" people (conducted 2011-12) discussing seasonal and pandemic influenza and; 2) international, Australian national and state level pandemic plans (1999-2013). Vulnerability is variously used in plans as a way to identify groups at particular risk of infection because of pre-existing clinical conditions, and as a free-floating social category that could apply to a broad range of people potentially involved in the social disruption a pandemic might entail. Our interview and focus group data indicate that healthy people rework the free-floating extension of vulnerability, and that people designated vulnerable encounter an absence of any collective responsibility for the threat of pandemic influenza. Our analysis suggests that vulnerability's mobilisation in pandemic preparedness limits the connection between public health governance and its publics: here, the openness and unpredictability of

Developing Workforce Capacity in Public Health Informatics: Core Competencies and Curriculum Design.

PubMed

Wholey, Douglas R; LaVenture, Martin; Rajamani, Sripriya; Kreiger, Rob; Hedberg, Craig; Kenyon, Cynthia

2018-01-01

We describe a master's level public health informatics (PHI) curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a Master's and Certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies and result of a pilot PHI program is presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs.

Public Figure Fixation: Cautionary Findings for Mental Health Practitioners.

PubMed

Pathé, Michele T; Lowry, Timothy J; Haworth, Debbie J; Winterbourne, Paul; Day, Leanne

2016-09-01

Research in western nations has found that pathologically fixated individuals pose a risk of serious harm to public figures, and that many of these fixated persons are mentally ill and require treatment. Over the past decade, integrated fixated threat assessment agencies have been established in western Europe and Australia to specifically assess and manage this group. The current study examines 400 consecutive referrals to a fixated threat assessment center in Queensland, Australia, with a particular focus on the mental health and risk profile of those who engage in inappropriate contact with public office holders. It considers the high proportion of delusional disorders in this cohort, and their identification and management by psychiatric services. The authors conclude with a discussion of the mental health response to this group and impediments to mitigating the risks posed by fixated persons. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Orthodontic treatment with fixed appliances and biofilm formation--a potential public health threat?

PubMed

Ren, Yijin; Jongsma, Marije A; Mei, Li; van der Mei, Henny C; Busscher, Henk J

2014-09-01

Orthodontic treatment is highly popular for restoring functional and facial esthetics in juveniles and adults. As a downside, prevalence of biofilm-related complications is high. Objectives of this review are to (1) identify special features of biofilm formation in orthodontic patients and (2) emphasize the need for strong concerted action to prevent biofilm-related complications during orthodontic treatment. Literature on biofilm formation in the oral cavity is reviewed to identify special features of biofilm formation in orthodontic patients. Estimates are made of juvenile and adult orthodontic patient population sizes, and biofilm-related complication rates are used to indicate the costs and clinical workload resulting from biofilm-related complications. Biofilm formation in orthodontic patients is governed by similar mechanisms as common in the oral cavity. However, orthodontic appliances hamper the maintenance of oral hygiene and provide numerous additional surfaces, with properties alien to the oral cavity, to which bacteria can adhere and form a biofilm. Biofilm formation may lead to gingivitis and white spot lesions, compromising facial esthetics. Whereas gingivitis after orthodontic treatment is often transient, white spot lesions may turn into cavities requiring professional restoration. Complications requiring professional care develop in 15 % of all orthodontic patients, implying an annual cost of over US$500,000,000 and a workload of 1,000 full-time dentists in the USA alone. Improved preventive measures and antimicrobial materials are urgently required to prevent biofilm-related complications of orthodontic treatment from overshadowing its functional and esthetic advantages. High treatment demand and occurrence of biofilm-related complications requiring professional care make orthodontic treatment a potential public health threat.

Zoonotic pathogens from feral swine that pose a significant threat to public health.

PubMed

Brown, V R; Bowen, R A; Bosco-Lauth, A M

2018-06-01

The natural fecundity of suids, great ability to adapt to new habitats and desire for local hunting opportunities leading to translocation of feral pigs to regions where they are not yet established have all been instrumental in the home range expansion of feral swine. Feral swine populations in the United States continue to expand, wreaking havoc on agricultural lands, further compromising threatened and endangered species, and posing a microbiological threat to humans, domestic livestock and companion animals. This manuscript thoroughly reviews zoonotic diseases of concern including brucellosis, bovine tuberculosis, leptospirosis, enteric pathogens, both Salmonella spp. and shiga toxin-producing Escherichia coli, and hepatitis E. These pathogens are not a comprehensive list of microbes that are capable of infecting both humans and feral swine, but rather have been selected as they are known to infect US feral swine, direct transmission between wild suids and humans has previously been documented, or they have been shown to be readily transmitted during processing or consumption of feral swine pork. Humans that interact directly or indirectly with feral swine are at much higher risk for the development of a number of zoonotic pathogens. Numerous case reports document transmission events from feral swine and wild boar to humans, and the resulting diseases may be mild and self-limiting, chronic or fatal. Individuals that interact with feral swine should take preventative measures to minimize the risk of disease transmission and all meat should be thoroughly cooked. Additionally, public health campaigns to increase knowledge of the risks associated with feral swine are imperative. © 2018 Blackwell Verlag GmbH.

Global climate change and children's health: threats and strategies for prevention.

PubMed

Sheffield, Perry E; Landrigan, Philip J

2011-03-01

Global climate change will have multiple effects on human health. Vulnerable populations-children, the elderly, and the poor-will be disproportionately affected. We reviewed projected impacts of climate change on children's health, the pathways involved in these effects, and prevention strategies. We assessed primary studies, review articles, and organizational reports. Climate change is increasing the global burden of disease and in the year 2000 was responsible for > 150,000 deaths worldwide. Of this disease burden, 88% fell upon children. Documented health effects include changing ranges of vector-borne diseases such as malaria and dengue; increased diarrheal and respiratory disease; increased morbidity and mortality from extreme weather; changed exposures to toxic chemicals; worsened poverty; food and physical insecurity; and threats to human habitation. Heat-related health effects for which research is emerging include diminished school performance, increased rates of pregnancy complications, and renal effects. Stark variation in these outcomes is evident by geographic region and socioeconomic status, and these impacts will exacerbate health disparities. Prevention strategies to reduce health impacts of climate change include reduction of greenhouse gas emissions and adaptation through multiple public health interventions. Further quantification of the effects of climate change on children's health is needed globally and also at regional and local levels through enhanced monitoring of children's environmental health and by tracking selected indicators. Climate change preparedness strategies need to be incorporated into public health programs.

Public health and national security: the critical role of increased federal support.

PubMed

Frist, Bill

2002-01-01

Protecting the public's health historically has been a state and local responsibility. However, the growing threat of bioterrorism has highlighted the importance of a strong public health infrastructure to the nation's homeland security and has focused increased attention on the preparedness of the public health system. As a result, federal public health funding has increased exponentially since the anthrax attacks of late 2001, and Congress has passed sweeping new federal legislation intended to strengthen the nation's public health system. This heightened level of federal interest and support should yield important public health benefits. Most recognize that after years of neglect the public health infrastructure cannot be rebuilt overnight. As we implement a comprehensive strategy to increase the capabilities and capacity of our nation's public health system, it is essential to address a series of important policy questions, including the appropriate level of ongoing public health investments from local, state, and federal sources.

Assessing barriers to health insurance and threats to equity in comparative perspective: The Health Insurance Access Database

PubMed Central

2012-01-01

Background Typologies traditionally used for international comparisons of health systems often conflate many system characteristics. To capture policy changes over time and by service in health systems regulation of public and private insurance, we propose a database containing explicit, standardized indicators of policy instruments. Methods The Health Insurance Access Database (HIAD) will collect policy information for ten OECD countries, over a range of eight health services, from 1990–2010. Policy indicators were selected through a comprehensive literature review which identified policy instruments most likely to constitute barriers to health insurance, thus potentially posing a threat to equity. As data collection is still underway, we present here the theoretical bases and methodology adopted, with a focus on the rationale underpinning the study instruments. Results These harmonized data will allow the capture of policy changes in health systems regulation of public and private insurance over time and by service. The standardization process will permit international comparisons of systems’ performance with regards to health insurance access and equity. Conclusion This research will inform and feed the current debate on the future of health care in developed countries and on the role of the private sector in these changes. PMID:22551599

Appalachian Women’s Perceptions of Their Community’s Health Threats

PubMed Central

Schoenberg, Nancy E.; Hatcher, Jennifer; Dignan, Mark B.

2011-01-01

Context Decades of behavioral research suggest that awareness of health threats is a necessary precursor to engage in health promotion and disease prevention, findings that can be extended to the community level. Purpose We sought to better understand local perspectives on the main health concerns of rural Appalachian communities in order to identify the key health priorities. While Kentucky Appalachian communities are often described as suffering from substandard health, resource, and socioeconomic indicators, strong traditions of community mobilization make possible positive, home-grown change. Methods To assess what women, the key health gatekeepers, perceive as the most significant health threats to their rural communities, 10 focus groups were held with 52 Appalachian women from diverse socioeconomic backgrounds. Tape-recorded narratives were content analyzed and a codebook was developed. Measures designed to increase data trustworthiness included member checks, negative case evidence, and multiple coding. Findings The following rank-ordered conditions emerged as posing the greatest threat to the health of rural Appalachian communities: (1) drug abuse/medication dependence; (2) cancer; (3) heart disease and diabetes (tied); (4) smoking; (5) poor diet/overweight; (6) lack of exercise; and (7) communicable diseases. These health threats were described as specific to the local environment, deriving from broad ecological problems and were connected to one another. Conclusion Drawing on participants’ community-relevant suggestions, we suggest ways in which rural communities may begin to confront these health concerns. These suggestions range from modest, individual-level changes to broader structural-level recommendations. PMID:18257874

Developing Workforce Capacity in Public Health Informatics: Core Competencies and Curriculum Design

PubMed Central

Wholey, Douglas R.; LaVenture, Martin; Rajamani, Sripriya; Kreiger, Rob; Hedberg, Craig; Kenyon, Cynthia

2018-01-01

We describe a master’s level public health informatics (PHI) curriculum to support workforce development. Public health decision-making requires intensive information management to organize responses to health threats and develop effective health education and promotion. PHI competencies prepare the public health workforce to design and implement these information systems. The objective for a Master’s and Certificate in PHI is to prepare public health informaticians with the competencies to work collaboratively with colleagues in public health and other health professions to design and develop information systems that support population health improvement. The PHI competencies are drawn from computer, information, and organizational sciences. A curriculum is proposed to deliver the competencies and result of a pilot PHI program is presented. Since the public health workforce needs to use information technology effectively to improve population health, it is essential for public health academic institutions to develop and implement PHI workforce training programs. PMID:29770321

A profession under threat? An exploratory case study of changes in Norwegian public health nursing.

PubMed

Clancy, Anne

2007-06-01

The first courses for public health nurses in Norway were held in the 1920s-1930s. In 1957, the Act regulating public health nursing was passed. Norwegian public health nurses have a primary role in promoting health and preventing illnesses. Their role has changed with a changing society. This article shows some of the challenges the nurses have faced. It focuses on collaboration, tasks, leadership and authority/status. The study's intentions are exploratory. It looks into how the nurses experience their changing role. A single case with an embedded design is the method chosen; the case is 'Changes in the role of the Norwegian public health nurse during the period 1984-2005'. Document analysis and interviews are sources of evidence. The findings show that public health nurses' visibility seems to be an important issue. There are some divergences between relevant literature on the nurses' professional status and the views of the nurses in the study. Several other public health professionals have lost tasks and formal positions of authority. The nurses interviewed still feel that they are a respected and trusted profession despite being less visible. A recent study among parents who frequent local clinics confirms their important role. Can the nurses' lack of visibility have undesired outcomes? A profession that is unassuming, not visible and that fights silent battles may have problems being heard when it tries to promote issues concerning family health. Further studies are indicated.

Workplace threats to health and job turnover among women workers.

PubMed

Gucer, Patricia W; Oliver, Marc; McDiarmid, Melissa

2003-07-01

Is job turnover related to concern about workplace health risks? Using data from a national sample of working women, we examined the relationships among workplace risk communications, worker concerns about workplace threats from hazardous substances, indoor air quality, and job change. Eight percent reported changing a job as a result of concern over workplace threats to health. Previous workplace injury predicted concern about hazardous materials and indoor air quality as well as job change, but employer communication about workplace health risks was associated with less job change and less concern about indoor air quality. Women worry about workplace threats to their health enough to change their jobs, but employers may have the power to cut turnover costs and reduce disruption to workers' lives through the use of risk communication programs.

Establishing public health security in a postwar Iraq: constitutional obstacles and lessons for other federalizing states.

PubMed

Wilson, Kumanan; Fidler, David P; McDougall, Christopher W; Lazar, Harvey

2009-06-01

The public health consequences of the conflict in Iraq will likely continue after the violence has subsided. Reestablishing public health security will require large investments in infrastructure and the creation of effective systems of governance. On the question of governance, the allocation of powers in the new constitution of Iraq is critical. Given the ease with which public health threats cross borders, the constitution needs to grant to the federal government the legal authority to manage such threats and simultaneously meet international requirements. Unfortunately, the draft constitution does not accomplish this objective. If politically possible, the constitution should be amended to provide the federal government with this authority. If not possible, the Iraqi federal government would have two options. It could attempt to use alternative constitutional powers, such as national security powers. This option would be contentious and the results uncertain. Alternatively, the federal government could attempt to establish collaborative relationships with regional governments. Residual sectarian tensions create potential problems for this option, however. Reflecting on the Iraqi situation, we conclude that other federalizing countries emerging from conflict should ensure that their constitutions provide the federal government with the necessary authority to manage threats to public health security effectively.

The Public Health Threat of Road Traffic Accidents in Nigeria: A Call to Action.

PubMed

Onyemaechi, Noc; Ofoma, U R

2016-01-01

Public health experts worldwide concede that there is a global epidemic of road traffic accidents (RTA). Globally, RTA is the leading cause of injury-related deaths. In Nigeria, injuries and deaths resulting from RTA are on the rise and are Nigeria's third-leading cause of overall deaths, the leading cause of trauma-related deaths and the most common cause of disability. Do RTA constitute a public health problem in Nigeria? If so, is there a pragmatic approach to combat this problem? A systematic literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google, and directory of open access journals was carried out using the key words " RTA, public health problem, government response, Nigeria." Out of initial 850 articles retrieved from the search 15 articles that suited the study were included in this review. There is need to view RTA s as an issue of urgent national importance that needs urgent attention aimed at reducing the health, social, and economic impact. Policy makers at the various levels of government need to recognize this growing problem as a public health crisis and design appropriate policy responses that will back up with meticulous implementation.

Emergency preparedness and public health systems lessons for developing countries.

PubMed

Kruk, Margaret E

2008-06-01

Low- and middle-income countries, where emerging diseases often make their debut, are also likely to bear the harshest consequences of a potential influenza pandemic. Yet public health systems in developing countries are underfunded, understaffed, and in many cases struggling to deal with the existing burden of disease. As a result, developed countries are beginning to expand assistance for emergency preparedness to the developing world. Given developing countries' weak infrastructure and many competing public health priorities, it is not clear how to best direct these resources. Evidence from the U.S. and other developed countries suggests that some investments in bioterror and pandemic emergency preparedness, although initially implemented as vertical programs, have the potential to strengthen the general public health infrastructure. This experience may hold some lessons for how global funds for emergency preparedness could be invested in developing countries to support struggling public health systems in responding to current health priorities as well as potential future public health threats.

Health security as a public health concept: a critical analysis.

PubMed

Aldis, William

2008-11-01

There is growing acceptance of the concept of health security. However, there are various and incompatible definitions, incomplete elaboration of the concept of health security in public health operational terms, and insufficient reconciliation of the health security concept with community-based primary health care. More important, there are major differences in understanding and use of the concept in different settings. Policymakers in industrialized countries emphasize protection of their populations especially against external threats, for example terrorism and pandemics; while health workers and policymakers in developing countries and within the United Nations system understand the term in a broader public health context. Indeed, the concept is used inconsistently within the UN agencies themselves, for example the World Health Organization's restrictive use of the term 'global health security'. Divergent understandings of 'health security' by WHO's member states, coupled with fears of hidden national security agendas, are leading to a breakdown of mechanisms for global cooperation such as the International Health Regulations. Some developing countries are beginning to doubt that internationally shared health surveillance data is used in their best interests. Resolution of these incompatible understandings is a global priority.

Land application of organic residuals: Public health threat or environmental benefit

USDA-ARS?s Scientific Manuscript database

Waste residuals consist of manure and biosolids produced by concentrated animal feeding operations and municipal waste water treatment plants. All wastes need to be disposed of in a proper manner, protecting public and environmental health, but also in a sustainable fashion to ensure that no system...

The Smallpox Threat: The School Nurse's Role

ERIC Educational Resources Information Center

Martin, Mary E.; Didion, Judy

2003-01-01

Today, with the threat of bioterrorism and war, there is a new dimension to the traditional role of the school nurse. The smallpox threat to public health will invoke the school nurse's role as an educator, liaison, and consultant in the community. This article discusses smallpox, the vaccination process, adverse effects, and postvaccination care.…

Malware and Disease: Lessons from Cyber Intelligence for Public Health Surveillance.

PubMed

Smith, Frank L

2016-01-01

Malicious software and infectious diseases are similar is several respects, as are the functional requirements for surveillance and intelligence to defend against these threats. Given these similarities, this article compares and contrasts the actors, relationships, and norms at work in cyber intelligence and disease surveillance. Historical analysis reveals that civilian cyber defense is more decentralized, private, and voluntary than public health in the United States. Most of these differences are due to political choices rather than technical necessities. In particular, political resistance to government institutions has shaped cyber intelligence over the past 30 years, which is a troubling sign for attempts to improve disease surveillance through local, state, and federal health departments. Information sharing about malware is also limited, despite information technology being integral to cyberspace. Such limits suggest that automation through electronic health records will not automatically improve public health surveillance. Still, certain aspects of information sharing and analysis for cyber defense are worth emulating or, at the very least, learning from to help detect and manage health threats.

Malware and Disease: Lessons from Cyber Intelligence for Public Health Surveillance

PubMed Central

Smith, Frank L.

2016-01-01

Malicious software and infectious diseases are similar is several respects, as are the functional requirements for surveillance and intelligence to defend against these threats. Given these similarities, this article compares and contrasts the actors, relationships, and norms at work in cyber intelligence and disease surveillance. Historical analysis reveals that civilian cyber defense is more decentralized, private, and voluntary than public health in the United States. Most of these differences are due to political choices rather than technical necessities. In particular, political resistance to government institutions has shaped cyber intelligence over the past 30 years, which is a troubling sign for attempts to improve disease surveillance through local, state, and federal health departments. Information sharing about malware is also limited, despite information technology being integral to cyberspace. Such limits suggest that automation through electronic health records will not automatically improve public health surveillance. Still, certain aspects of information sharing and analysis for cyber defense are worth emulating or, at the very least, learning from to help detect and manage health threats. PMID:27564783

Public Health Ethics, Legitimacy, and the Challenges of Industrial Wind Turbines: The Case of Ontario, Canada

ERIC Educational Resources Information Center

Shain, Martin

2011-01-01

While industrial wind turbines (IWTs) clearly raise issues concerning threats to the health of a few in contrast to claimed health benefits to many, the trade-off has not been fully considered in a public health framework. This article reviews public health ethics justifications for the licensing and installation of IWTs. It concludes that the…

The Public Health Threat of Road Traffic Accidents in Nigeria: A Call to Action

PubMed Central

Onyemaechi, NOC; Ofoma, UR

2016-01-01

Public health experts worldwide concede that there is a global epidemic of road traffic accidents (RTA). Globally, RTA is the leading cause of injury-related deaths. In Nigeria, injuries and deaths resulting from RTA are on the rise and are Nigeria's third-leading cause of overall deaths, the leading cause of trauma-related deaths and the most common cause of disability. Do RTA constitute a public health problem in Nigeria? If so, is there a pragmatic approach to combat this problem? A systematic literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google, and directory of open access journals was carried out using the key words “ RTA, public health problem, government response, Nigeria.” Out of initial 850 articles retrieved from the search 15 articles that suited the study were included in this review. There is need to view RTA s as an issue of urgent national importance that needs urgent attention aimed at reducing the health, social, and economic impact. Policy makers at the various levels of government need to recognize this growing problem as a public health crisis and design appropriate policy responses that will back up with meticulous implementation. PMID:28480093

Lost Dollars Threaten Research in Public Academic Health Centers.

PubMed

Bourne, Henry R; Vermillion, Eric B

2017-03-01

The decrease of federal and state support threatens long-term sustainability of research in publicly supported academic health centers. In weathering these financial threats, research at the University of California, San Francisco (UCSF), has undergone 3 substantial changes: institutional salary support goes preferentially to senior faculty, whereas the young increasingly depend on grants; private and government support for research grows apace in clinical departments but declines in basic science departments; and research is judged more on its quantity (numbers of investigators and federal and private dollars) than on its goals, achievements, or scientific quality. We propose specific measures to alleviate these problems. Other large public academic health centers probably confront similar issues, but-except for UCSF-such centers have not been subjected to detailed public analysis.-Bourne, H. R., Vermillion, E. B. Lost dollars threaten research in public academic health centers. © FASEB.

What we are watching—five top global infectious disease threats, 2012: a perspective from CDC’s Global Disease Detection Operations Center

PubMed Central

Christian, Kira A.; Ijaz, Kashef; Dowell, Scott F.; Chow, Catherine C.; Chitale, Rohit A.; Bresee, Joseph S.; Mintz, Eric; Pallansch, Mark A.; Wassilak, Steven; McCray, Eugene; Arthur, Ray R.

2013-01-01

Disease outbreaks of international public health importance continue to occur regularly; detecting and tracking significant new public health threats in countries that cannot or might not report such events to the global health community is a challenge. The Centers for Disease Control and Prevention’s (CDC) Global Disease Detection (GDD) Operations Center, established in early 2007, monitors infectious and non-infectious public health events to identify new or unexplained global public health threats and better position CDC to respond, if public health assistance is requested or required. At any one time, the GDD Operations Center actively monitors approximately 30–40 such public health threats; here we provide our perspective on five of the top global infectious disease threats that we were watching in 2012: (1) avian influenza A (H5N1), (2) cholera, (3) wild poliovirus, (4) enterovirus-71, and (5) extensively drug-resistant tuberculosis. PMID:23827387

Public Health Nurses’ Knowledge and Attitudes Regarding Climate Change

PubMed Central

Chaudry, Rosemary V.; Mac Crawford, John

2011-01-01

Background: Climate change affects human health, and health departments are urged to act to reduce the severity of these impacts. Yet little is known about the perspective of public health nurses—the largest component of the public health workforce—regarding their roles in addressing health impacts of climate change. Objectives: We determined the knowledge and attitudes of public health nurses concerning climate change and the role of public health nursing in divisions of health departments in addressing health-related impacts of climate change. Differences by demographic subgroups were explored. Methods: An online survey was distributed to nursing directors of U.S. health departments (n = 786) with Internet staff directories. Results: Respondents (n = 176) were primarily female, white public health nursing administrators with ≥ 5 years of experience. Approximately equal percentages of respondents self-identified as having moderate, conservative, and liberal political views. Most agreed that the earth has experienced climate change and that climate change is somewhat controllable. Respondents identified an average of 5 of the 12 listed health-related impacts of climate change, but the modal response was zero impact. Public health nursing was perceived as having responsibility to address health-related impacts of climate change but lacking the ability to address these impacts. Conclusions: Public health nurses view the environment as under threat and see a role for nursing divisions in addressing health effects of climate change. However, they recognize the limited resources and personnel available to devote to this endeavor. PMID:22128069

Appalachian Women's Perceptions of Their Community's Health Threats

ERIC Educational Resources Information Center

Schoenberg, Nancy E.; Hatcher, Jennifer; Dignan, Mark B.

2008-01-01

Context: Decades of behavioral research suggest that awareness of health threats is a necessary precursor to engage in health promotion and disease prevention, findings that can be extended to the community level. Purpose: We sought to better understand local perspectives on the main health concerns of rural Appalachian communities in order to…

Future Infectious Disease Threats to Europe

PubMed Central

Suk, Jonathan E.

2011-01-01

We examined how different drivers of infectious disease could interact to threaten control efforts in Europe. We considered projected trends through 2020 for 3 broad groups of drivers: globalization and environmental change, social and demographic change, and health system capacity. Eight plausible infectious disease threats with the potential to be significantly more problematic than they are today were identified through an expert consultation: extensively drug-resistant bacteria, vector-borne diseases, sexually transmitted infections, food-borne infections, a resurgence of vaccine-preventable diseases, health care–associated infections, multidrug-resistant tuberculosis, and pandemic influenza. Preemptive measures to be taken by the public health community to counteract these threats were identified. PMID:21940915

Stereotype Threat Among Black and White Women in Health Care Settings

PubMed Central

Abdou, Cleopatra M.; Fingerhut, Adam W.

2016-01-01

The first of its kind, the present experiment applied stereotype threat—the threat of being judged by or confirming negative group-based stereotypes—to the health sciences. Black and White women (N = 162) engaged in a virtual health care situation. In the experimental condition, one’s ethnic identity and negative stereotypes of Black women specifically were made salient. As predicted, Black women in the stereotype threat condition who were strongly identified as Black (in terms of having explored what their ethnic identity means to them and the role it plays in their lives) reported significantly greater anxiety while waiting to see the doctor in the virtual health care setting than all other women. It is hypothesized that stereotype threat experienced in health care settings is one overlooked social barrier contributing to disparities in health care utilization and broader health disparities among Black women. PMID:25045944

The vulnerability of being ill informed: the Trans-Pacific Partnership Agreement and Global Public Health.

PubMed

Greenberg, Henry; Shiau, Stephanie

2014-09-01

The Trans Pacific Partnership Agreement (TPPA) is a regional trade agreement currently being negotiated by 11 Pacific Rim countries, excluding China. While the negotiations are being conducted under a veil of secrecy, substantive leaks over the past 4 years have revealed a broad view of the proposed contents. As it stands the TPPA poses serious risks to global public health, particularly chronic, non-communicable diseases. At greatest risk are national tobacco regulations, regulations governing the emergence of generic drugs and controls over food imports by transnational corporations. Aside from a small group of public health professionals from Australia, the academic public health community has missed these threats to the global community, although many other health-related entities, international lawyers and health-conscious politicians have voiced serious concerns. As of mid-2014 there has been no comment in the leading public health journals. This large lacuna in interest or recognition reflects the larger problem that the public health education community has all but ignored global non-communicable diseases. Without such a focus, the risks are unseen and the threats not perceived. This cautionary tale of the TPPA reflects the vulnerability of being ill informed of contemporary realities. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Climate change and public health policy: translating the science.

PubMed

Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

2013-12-19

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character.

Climate Change and Public Health Policy: Translating the Science

PubMed Central

Braks, Marieta; van Ginkel, Rijk; Wint, William; Sedda, Luigi; Sprong, Hein

2013-01-01

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character. PMID:24452252

Public Health Investigation After the Discovery of Ricin in a South Carolina Postal Facility

PubMed Central

Schier, Joshua G.; Patel, Manish M.; Belson, Martin G.; Patel, Amee; Schwartz, Michael; Fitzpatrick, Nicole; Drociuk, Dan; Deitchman, Scott; Meyer, Richard; Litovitz, Toby; Watson, William A.; Rubin, Carol H.; Kiefer, Max

2007-01-01

Objectives. In October 2003, a package containing ricin and a note threatening to poison water supplies was discovered in a South Carolina postal facility, becoming the first potential chemical terrorism event involving ricin in the United States. We examined the comprehensive public health investigation that followed and discuss the lessons learned from it. Methods. An investigation consisting primarily of environmental sampling for ricin contamination, performance of health assessments on affected personnel, and local, regional, and national surveillance for ricin-associated illness. Results. Laboratory analysis of 75 environmental sampling specimens revealed no ricin contamination. Health assessments of 36 affected employees were completed. Local surveillance initially identified 3 suspected cases, and national surveillance identified 399 outliers during the 2-week period after the incident. No confirmed cases of ricin-associated illness were identified. Conclusions. A multifaceted and multidisciplinary approach is required for an effective public health response to a chemical threat such as ricin. The results of all of the described activities were used to determine that the facility was safe to reopen and that no public health threat existed. PMID:17413057

Acid Rain: The Silent Environmental Threat.

ERIC Educational Resources Information Center

Zmud, Mia

1992-01-01

Describes the silent environmental threat posed by acid rain. Caused mainly by manmade pollutants, acid rain damages water and trees, decreases visibility, corrodes monuments, and threatens public health. The article includes guidelines for action. (SM)

Strategic planning for public health practice using macroenvironmental analysis.

PubMed Central

Ginter, P M; Duncan, W J; Capper, S A

1991-01-01

Macroenvironmental analysis is the initial stage in comprehensive strategic planning. The authors examine the benefits of this type of analysis when applied to public health organizations and present a series of questions that should be answered prior to committing resources to scanning, monitoring, forecasting, and assessing components of the macroenvironment. Using illustrations from the public and private sectors, each question is examined with reference to specific challenges facing public health. Benefits are derived both from the process and the outcome of macroenvironmental analysis. Not only are data acquired that assist public health professionals to make decisions, but the analytical process required assures a better understanding of potential external threats and opportunities as well as an organization's strengths and weaknesses. Although differences exist among private and public as well as profit and not-for-profit organizations, macroenvironmental analysis is seen as more essential to the public and not-for-profit sectors than the private and profit sectors. This conclusion results from the extreme dependency of those areas on external environmental forces that cannot be significantly influenced or controlled by public health decision makers. PMID:1902305

What We Are Watching-Top Global Infectious Disease Threats, 2013-2016: An Update from CDC's Global Disease Detection Operations Center.

PubMed

Christian, Kira A; Iuliano, A Danielle; Uyeki, Timothy M; Mintz, Eric D; Nichol, Stuart T; Rollin, Pierre; Staples, J Erin; Arthur, Ray R

To better track public health events in areas where the public health system is unable or unwilling to report the event to appropriate public health authorities, agencies can conduct event-based surveillance, which is defined as the organized collection, monitoring, assessment, and interpretation of unstructured information regarding public health events that may represent an acute risk to public health. The US Centers for Disease Control and Prevention's (CDC's) Global Disease Detection Operations Center (GDDOC) was created in 2007 to serve as CDC's platform dedicated to conducting worldwide event-based surveillance, which is now highlighted as part of the "detect" element of the Global Health Security Agenda (GHSA). The GHSA works toward making the world more safe and secure from disease threats through building capacity to better "Prevent, Detect, and Respond" to those threats. The GDDOC monitors approximately 30 to 40 public health events each day. In this article, we describe the top threats to public health monitored during 2012 to 2016: avian influenza, cholera, Ebola virus disease, and the vector-borne diseases yellow fever, chikungunya virus, and Zika virus, with updates to the previously described threats from Middle East respiratory syndrome-coronavirus (MERS-CoV) and poliomyelitis.

Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers.

PubMed

Carey, Rachel N; Sarma, Kiran M

2016-07-27

Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These 'threat appeals' feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers. To address limitations of previous research, we first identified a road safety advertisement that objectively and subjectively elicited fear using physiological and subjective measures. Study 1 (n = 62) examined the effect of this advertisement, combined with a manipulation designed to increase perceived efficacy, on speed choice. Study 2 (n = 81) investigated whether a state emotion, anger, impacts on the effectiveness of the advertisement in changing four distinct driving behaviours. Both studies examined short-term effects only. Study 1 findings indicated that a high threat message, when combined with high perceived efficacy, can lead to a decrease in speed choice. Study 2 results suggested that increased levels of state anger may counteract the potential value of combining fear-arousing threats and efficacy-building messages. Findings suggest that threat-based road safety communications that target affective (fear) and cognitive (perceived efficacy) mechanisms can positively affect driving behaviours. State emotions, such as anger, may negatively impact on the effectiveness of the message. Taken together, these findings provide additional support for the use of efficacy-building messages in threat-based communications, but highlight the need for further research into the complex array of affective influences on driving.

Using exercises to improve public health preparedness in Asia, the Middle East and Africa

PubMed Central

2014-01-01

Background Exercises are increasingly common tools used by the health sector and other sectors to evaluate their preparedness to respond to public health threats. Exercises provide an opportunity for multiple sectors to practice, test and evaluate their response to all types of public health emergencies. The information from these exercises can be used to refine and improve preparedness plans. There is a growing body of literature about the use of exercises among local, state and federal public health agencies in the United States. There is much less information about the use of exercises among public health agencies in other countries and the use of exercises that involve multiple countries. Results We developed and conducted 12 exercises (four sub-national, five national, three sub-regional) from August 2006 through December 2008. These 12 exercises included 558 participants (average 47) and 137 observers (average 11) from 14 countries. Participants consistently rated the overall quality of the exercises as very good or excellent. They rated the exercises lowest on their ability to identifying key gaps in performance. The vast majority of participants noted that they would use the information they gained at the exercise to improve their organization’s preparedness to respond to an influenza pandemic. Participants felt the exercises were particularly good at raising awareness and understanding about public health threats, assisting in evaluating plans and identifying priorities for improvement, and building relationships that strengthen preparedness and response across sectors and across countries. Participants left the exercises with specific ideas about the most important actions that they should engage in after the exercise such as improved planning coordination across sectors and countries and better training of health workers and response personnel. Conclusions These experiences suggest that exercises can be a valuable, low-burden tool to improve emergency

Challenges and Opportunities for Advancing Work on Climate Change and Public Health.

PubMed

Gould, Solange; Rudolph, Linda

2015-12-09

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

Challenges and Opportunities for Advancing Work on Climate Change and Public Health

PubMed Central

Gould, Solange; Rudolph, Linda

2015-01-01

Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

The Public/Private Dichotomy: A Threat to Children's Fellow Citizenship?

ERIC Educational Resources Information Center

Ostrem, Solveig

2008-01-01

When child-raising involves violence, a conflict of values arises between the parents' autonomy and the children's right to equal participation in a democratic society. In this article I discuss, from the perspective of discourse analysis, how a dichotomous understanding of the public versus private sphere can constitute a threat to children's…

25 CFR 1000.304 - What is imminent jeopardy to public health and safety?

Code of Federal Regulations, 2012 CFR

2012-04-01

... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF...? Imminent jeopardy to public health and safety means an immediate and significant threat of serious harm to...

25 CFR 1000.304 - What is imminent jeopardy to public health and safety?

Code of Federal Regulations, 2014 CFR

2014-04-01

... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF...? Imminent jeopardy to public health and safety means an immediate and significant threat of serious harm to...

25 CFR 1000.304 - What is imminent jeopardy to public health and safety?

Code of Federal Regulations, 2013 CFR

2013-04-01

... INTERIOR ANNUAL FUNDING AGREEMENTS UNDER THE TRIBAL SELF-GOVERNMENT ACT AMENDMENTS TO THE INDIAN SELF...? Imminent jeopardy to public health and safety means an immediate and significant threat of serious harm to...

Preparedness for Threat of Chikungunya in the Pacific

PubMed Central

Hoy, Damian; Horwood, Paul F.; Ropa, Berry; Hancock, Thane; Guillaumot, Laurent; Rickart, Keith; Frison, Pascal; Pavlin, Boris; Souares, Yvan

2014-01-01

Chikungunya virus (CHIKV) caused significant outbreaks of illness during 2005–2007 in the Indian Ocean region. Chikungunya outbreaks have also occurred in the Pacific region, including in Papua New Guinea in 2012; New Caledonia in April 2013; and Yap State, Federated States of Micronesia, in August 2013. CHIKV is a threat in the Pacific, and the risk for further spread is high, given several similarities between the Pacific and Indian Ocean chikungunya outbreaks. Island health care systems have difficulties coping with high caseloads, which highlights the need for early multidisciplinary preparedness. The Pacific Public Health Surveillance Network has developed several strategies focusing on surveillance, case management, vector control, laboratory confirmation, and communication. The management of this CHIKV threat will likely have broad implications for global public health. PMID:25062306

WILDLIFE HEALTH AND PUBLIC TRUST RESPONSIBILITIES FOR WILDLIFE RESOURCES.

PubMed

Decker, Daniel J; Schuler, Krysten; Forstchen, Ann B; Wild, Margaret A; Siemer, William F

2016-10-01

A significant development in wildlife management is the mounting concern of wildlife professionals and the public about wildlife health and diseases. Concurrently, the wildlife profession is reexamining implications of managing wildlife populations as a public trust and the concomitant obligation to ensure the quality (i.e., health) and sustainability of wildlife. It is an opportune time to emphasize the importance of wildlife health, specifically to advocate for comprehensive and consistent integration of wildlife health in wildlife management. We summarize application of public trust ideas in wildlife population management in the US. We argue that wildlife health is essential to fulfilling public trust administration responsibilities with respect to wildlife, due to the central responsibility of trustees for ensuring the well-being of wildlife species (i.e., the core resources of the trust). Because both health of wildlife and risk perceptions regarding threats posed by wildlife disease to humans and domestic animals are issues of growing concern, managing wildlife disease and risk communication vis-à-vis wildlife health is critical to wildlife trust administration. We conclude that wildlife health professionals play a critical role in protecting the wildlife trust and that current conditions provide opportunities for important contributions by wildlife health professionals in wildlife management.

Greening Australia's public health system: the role of public hospitals in responding to climate change.

PubMed

Primozic, Lauren

2010-05-01

Climate change is one of the most important social, economic, ecological and ethical issues of the 21st century. The effects of climate change on human health are now widely accepted as a genuine threat and the Australian Government has initiated policy and legislative responses. In addition, in the 2009-2010 budget the Australian Government has committed A$64 billion to public health and hospital reform. But will this Commonwealth funding support--and should it support--the government's high-profile climate change policy? Does Commonwealth funding translate to an obligation to support Commonwealth policies? This article explores the role of public hospitals as champions and role models of the Australian Government's climate change policy and how this might be done without detracting from the primary purpose of public hospital funding: improving patient care.

What We Are Watching—Top Global Infectious Disease Threats, 2013-2016: An Update from CDC's Global Disease Detection Operations Center

PubMed Central

Iuliano, A. Danielle; Uyeki, Timothy M.; Mintz, Eric D.; Nichol, Stuart T.; Rollin, Pierre; Staples, J. Erin; Arthur, Ray R.

2017-01-01

To better track public health events in areas where the public health system is unable or unwilling to report the event to appropriate public health authorities, agencies can conduct event-based surveillance, which is defined as the organized collection, monitoring, assessment, and interpretation of unstructured information regarding public health events that may represent an acute risk to public health. The US Centers for Disease Control and Prevention's (CDC's) Global Disease Detection Operations Center (GDDOC) was created in 2007 to serve as CDC's platform dedicated to conducting worldwide event-based surveillance, which is now highlighted as part of the “detect” element of the Global Health Security Agenda (GHSA). The GHSA works toward making the world more safe and secure from disease threats through building capacity to better “Prevent, Detect, and Respond” to those threats. The GDDOC monitors approximately 30 to 40 public health events each day. In this article, we describe the top threats to public health monitored during 2012 to 2016: avian influenza, cholera, Ebola virus disease, and the vector-borne diseases yellow fever, chikungunya virus, and Zika virus, with updates to the previously described threats from Middle East respiratory syndrome-coronavirus (MERS-CoV) and poliomyelitis. PMID:28805465

On Management Matters: Why We Must Improve Public Health Management Through Action: Comment on "Management Matters: A Leverage Point for Health Systems Strengthening in Global Health".

PubMed

Willacy, Erika; Bratton, Shelly

2015-09-30

Public health management is a pillar of public health practice. Only through effective management can research, theory, and scientific innovation be translated into successful public health action. With this in mind, the U.S. Centers for Disease Control and Prevention (CDC) has developed an innovative program called Improving Public Health Management for Action (IMPACT) which aims to address this critical need by building an effective cadre of public health managers to work alongside scientists to prepare for and respond to disease threats and to effectively implement public health programs. IMPACT is a 2-year, experiential learning program that provides fellows with the management tools and opportunities to apply their new knowledge in the field, all while continuing to serve the Ministry of Health (MoH). IMPACT will launch in 2016 in 2 countries with the intent of expanding to additional countries in future years resulting in a well-trained cadre of public health managers around the world. © 2016 by Kerman University of Medical Sciences.

Education for public health in Europe and its global outreach

PubMed Central

Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert

2014-01-01

Introduction At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice. PMID:24560263

Education for public health in Europe and its global outreach.

PubMed

Bjegovic-Mikanovic, Vesna; Jovic-Vranes, Aleksandra; Czabanowska, Katarzyna; Otok, Robert

2014-01-01

At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice.

Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries.

PubMed

Nsubuga, Peter; Nwanyanwu, Okey; Nkengasong, John N; Mukanga, David; Trostle, Murray

2010-12-03

There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system. To accomplish this, it is essential to first identify the components of the system that require modification. The World Health Organization (WHO) has proposed health system building blocks, which are now widely recognized as essential components of health systems strengthening.With increased travel and urbanization, the threat of emerging diseases of pandemic potential is increasing alongside endemic diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and hepatitis virus infections. At the same time, the epidemiologic patterns are shifting, giving rise to a concurrent increase in disease burden due to non-communicable diseases. These diseases can be addressed by public health surveillance and response systems that are operated by competent public health workers in core public health positions at national and sub-national levels with a focus on disease prevention.We describe two ways that health ministries in developing countries could leverage President Obama's Global Health Initiative (GHI) to build public health surveillance and response systems using proven models for public health systems strengthening and to create the public health workforce to operate those systems. We also offer suggestions for how health ministries could strengthen public health systems within the broad health systems strengthening agenda. Existing programs (e.g., the Global Vaccine Alliance [GAVI] and the Global Fund Against Tuberculosis, AIDS, and Malaria [GFTAM]) can also adapt their current health systems strengthening programs to build sustainable public health systems.

A Public Health Preparedness Logic Model: Assessing Preparedness for Cross-border Threats in the European Region

PubMed Central

Nelson, Christopher; Savoia, Elena; Ljungqvist, Irina; Ciotti, Massimo

2017-01-01

Improving preparedness in the European region requires a clear understanding of what European Union (EU) member states should be able to do, whether acting internally or in cooperation with each other or the EU and other multilateral organizations. We have developed a preparedness logic model that specifies the aims and objectives of public health preparedness, as well as the response capabilities and preparedness capacities needed to achieve them. The capabilities, which describe the ability to effectively use capacities to identify, characterize, and respond to emergencies, are organized into 5 categories. The first 3 categories—(1) assessment; (2) policy development, adaptation, and implementation; and (3) prevention and treatment services in the health sector—represent what the public health system must accomplish to respond effectively. The fourth and fifth categories represent a series of interrelated functions needed to ensure that the system fulfills its assessment, policy development, and prevention and treatment roles: (4) coordination and communication regards information sharing within the public health system, incident management, and leadership, and (5) emergency risk communication focuses on communication with the public. This model provides a framework for identifying what to measure in capacity inventories, exercises, critical incident analyses, and other approaches to assessing public health emergency preparedness, not how to measure them. Focusing on a common set of capacities and capabilities to measure allows for comparisons both over time and between member states, which can enhance learning and sharing results and help identify both strengths and areas for improvement of public health emergency preparedness in the EU. PMID:29058967

A Public Health Preparedness Logic Model: Assessing Preparedness for Cross-border Threats in the European Region.

PubMed

Stoto, Michael A; Nelson, Christopher; Savoia, Elena; Ljungqvist, Irina; Ciotti, Massimo

Improving preparedness in the European region requires a clear understanding of what European Union (EU) member states should be able to do, whether acting internally or in cooperation with each other or the EU and other multilateral organizations. We have developed a preparedness logic model that specifies the aims and objectives of public health preparedness, as well as the response capabilities and preparedness capacities needed to achieve them. The capabilities, which describe the ability to effectively use capacities to identify, characterize, and respond to emergencies, are organized into 5 categories. The first 3 categories-(1) assessment; (2) policy development, adaptation, and implementation; and (3) prevention and treatment services in the health sector-represent what the public health system must accomplish to respond effectively. The fourth and fifth categories represent a series of interrelated functions needed to ensure that the system fulfills its assessment, policy development, and prevention and treatment roles: (4) coordination and communication regards information sharing within the public health system, incident management, and leadership, and (5) emergency risk communication focuses on communication with the public. This model provides a framework for identifying what to measure in capacity inventories, exercises, critical incident analyses, and other approaches to assessing public health emergency preparedness, not how to measure them. Focusing on a common set of capacities and capabilities to measure allows for comparisons both over time and between member states, which can enhance learning and sharing results and help identify both strengths and areas for improvement of public health emergency preparedness in the EU.

Bio-Terrorism Threat and Casualty Prevention

DOE Office of Scientific and Technical Information (OSTI.GOV)

NOEL,WILLIAM P.

2000-01-01

The bio-terrorism threat has become the ''poor man's'' nuclear weapon. The ease of manufacture and dissemination has allowed an organization with only rudimentary skills and equipment to pose a significant threat with high consequences. This report will analyze some of the most likely agents that would be used, the ease of manufacture, the ease of dissemination and what characteristics of the public health response that are particularly important to the successful characterization of a high consequence event to prevent excessive causalities.

Financing public health: diminished funding for core needs and state-by-state variation in support.

PubMed

Levi, Jeffrey; Juliano, Chrissie; Richardson, Maxwell

2007-01-01

This article documents the instability and variation in public financing of public health functions at the federal and state levels. Trust for America's Health has charted federal funding for the Centers of Disease Control and Prevention, which in turn provides a major portion of financing for state and local public health departments, and has compiled information about state-generated revenue commitments to public health activities nationwide. The federal-level analysis shows that funding has been marked by diminished support for "core" public health functions. The state-level analysis shows tremendous variation in use of state revenues to support public health functions. The combination of these factors results in very different public health capacities across the country, potentially leaving some states more vulnerable, while simultaneously posing a general threat to the nation since public health problems do not honor state borders. On the basis of this analysis, the authors suggest changes in the financing arrangements for public health, designed to assure a more stable funding stream for core public health functions and a more consistent approach to financing public health activities across the country.

Waterborne Disease Case Investigation: Public Health Nursing Simulation.

PubMed

Alexander, Gina K; Canclini, Sharon B; Fripp, Jon; Fripp, William

2017-01-01

The lack of safe drinking water is a significant public health threat worldwide. Registered nurses assess the physical environment, including the quality of the water supply, and apply environmental health knowledge to reduce environmental exposures. The purpose of this research brief is to describe a waterborne disease simulation for students enrolled in a public health nursing (PHN) course. A total of 157 undergraduate students completed the simulation in teams, using the SBAR (Situation-Background-Assessment-Recommendation) reporting tool. Simulation evaluation consisted of content analysis of the SBAR tools and debriefing notes. Student teams completed the simulation and articulated the implications for PHN practice. Student teams discussed assessment findings and primarily recommended four nursing interventions: health teaching focused on water, sanitation, and hygiene; community organizing; collaboration; and advocacy to ensure a safe water supply. With advanced planning and collaboration with partners, waterborne disease simulation may enhance PHN education. [J Nurs Educ. 2017;56(1):39-42.]. Copyright 2017, SLACK Incorporated.

Driver distraction: a perennial but preventable public health threat to adolescents.

PubMed

Bingham, C Raymond

2014-05-01

Although public health efforts have made some progress in reducing risk of adolescent motor vehicle crashes over the last three decades, new technologies and evolving behavior patterns have focused attention on the risk of distracted driving. For many of the same reasons that alcohol-impaired driving represents a distinct risk for adolescents, distracted driving has an elevated impact on this age group. Similarly, many of the strategies used to reduce alcohol-impaired driving among adolescents might be applied to driver distraction, including adults serving as role models with high standards of behavior. The unique challenge posed by the proliferation of new technological distractions may accelerate this risk behavior and may lend itself to innovative prevention efforts. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Qualitative Assessment of a Novel Efficacy-Focused Training Intervention for Public Health Workers in Disaster Recovery.

PubMed

Tower, Craig; Altman, Brian A; Strauss-Riggs, Kandra; Iversen, Annelise; Garrity, Stephanie; Thompson, Carol B; Walsh, Lauren; Rutkow, Lainie; Schor, Kenneth; Barnett, Daniel J

2016-08-01

We trained local public health workers on disaster recovery roles and responsibilities by using a novel curriculum based on a threat and efficacy framework and a training-of-trainers approach. This study used qualitative data to assess changes in perceptions of efficacy toward Hurricane Sandy recovery and willingness to participate in future disaster recoveries. Purposive and snowball sampling were used to select trainers and trainees from participating local public health departments in jurisdictions impacted by Hurricane Sandy in October 2012. Two focus groups totaling 29 local public health workers were held in April and May of 2015. Focus group participants discussed the content and quality of the curriculum, training logistics, and their willingness to engage in future disaster recovery efforts. The training curriculum improved participants' understanding of and confidence in their disaster recovery work and related roles within their agencies (self-efficacy); increased their individual- and agency-level sense of role-importance in disaster recovery (response-efficacy); and enhanced their sense of their agencies' effective functioning in disaster recovery. Participants suggested further training customization and inclusion of other recovery agencies. Threat- and efficacy-based disaster recovery trainings show potential to increase public health workers' sense of efficacy and willingness to participate in recovery efforts. (Disaster Med Public Health Preparedness. 2016;10:615-622).

Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health

PubMed Central

2013-01-01

Background Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies are engaged in the sale of purportedly safe, legitimate product that may in fact be counterfeit or substandard. These cybercriminal actors exploit available eDTCA mediums over the Internet to market their suspect products globally. Despite these risks, a detailed assessment of the public health, patient safety, and cybersecurity threats and governance mechanisms to address them has not been conducted. Discussion Illicit online pharmacies represent a significant global public health and patient safety risk. Existing governance mechanisms are insufficient and include lack of adequate adoption in national regulation, ineffective voluntary governance mechanisms, and uneven global law enforcement efforts that have allowed proliferation of these cybercriminals on the web. In order to effectively address this multistakeholder threat, inclusive global governance strategies that engage the information technology, law enforcement and public health sectors should be established. Summary Effective global “eHealth Governance” focused on cybercrime is needed in order to effectively combat illicit online pharmacies. This includes building upon existing Internet governance structures and coordinating partnership between the UN Office of Drugs and Crime that leads the global fight against transnational organized crime and the Internet Governance Forum that is shaping the future of Internet governance. Through a UNODC-IGF governance mechanism, investigation, detection and coordination of activities against illicit online pharmacies and their misuse of eDTCA can commence. PMID:24131576

Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health.

PubMed

Mackey, Tim K; Liang, Bryan A

2013-10-16

Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies are engaged in the sale of purportedly safe, legitimate product that may in fact be counterfeit or substandard. These cybercriminal actors exploit available eDTCA mediums over the Internet to market their suspect products globally. Despite these risks, a detailed assessment of the public health, patient safety, and cybersecurity threats and governance mechanisms to address them has not been conducted. Illicit online pharmacies represent a significant global public health and patient safety risk. Existing governance mechanisms are insufficient and include lack of adequate adoption in national regulation, ineffective voluntary governance mechanisms, and uneven global law enforcement efforts that have allowed proliferation of these cybercriminals on the web. In order to effectively address this multistakeholder threat, inclusive global governance strategies that engage the information technology, law enforcement and public health sectors should be established. Effective global "eHealth Governance" focused on cybercrime is needed in order to effectively combat illicit online pharmacies. This includes building upon existing Internet governance structures and coordinating partnership between the UN Office of Drugs and Crime that leads the global fight against transnational organized crime and the Internet Governance Forum that is shaping the future of Internet governance. Through a UNODC-IGF governance mechanism, investigation, detection and coordination of activities against illicit online pharmacies and their misuse of eDTCA can commence.

Denormalizing a Historical Problem: Teen Pregnancy, Policy, and Public Health Action

ERIC Educational Resources Information Center

Kandakai, Tina L.; Smith, Leonie C. R.

2007-01-01

Objective: To explore the impact of teen-adult sexual relationships as a public health threat and the effectiveness of statutory rape laws in protecting adolescent children. Methods: A comprehensive review of current literature surrounding child abuse, teen pregnancy, and statutory rape was conducted. Results: Of one million teen girls who become…

Considering Weight Loss Programs and Public Health Partnerships in American Evangelical Protestant Churches.

PubMed

Miller, D Gibbes

2018-06-01

The obesity epidemic is a critical public health threat facing the USA. With the advent of American Evangelical Protestant (AEP) weight loss guides and narratives, AEP churches could potentially aid public health agencies in combatting obesity, and some scholars have called for investment in partnerships between public health agencies and religious institutions. This paper examines the theological and social underpinnings of AEP weight loss programs and considers the potential benefits and risks of public health partnerships with AEP churches to combat obesity. While AEP churches may be successful at empowering people to lose weight, AEP weight loss also carries several risks. These risks include reinforcing gendered bodily norms, stigmatizing both overweight bodies and unhealthy behaviors deemed to be sinful (for example, overeating), and failing to acknowledge social factors that promote obesity. These risks must be assessed and minimized to create appropriate public health weight loss partnerships with AEP communities.

Sugary beverages represent a threat to global health.

PubMed

Popkin, Barry M

2012-12-01

Sugary beverages represent a major global threat to the health of all populations. The shifts in distribution, marketing, and sales have made them the plague of the globe in terms of obesity, diabetes, and a host of other chronic health problems. The fructose-laden beverages have unique properties that lead to lack of dietary compensation and direct adverse effects on our health. Global efforts to limit marketing and sales are necessary to protect the health of the planet. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using a digital storytelling assignment to teach public health advocacy.

PubMed

de Castro, A B; Levesque, Salem

2018-03-01

The need and expectation for advocacy is central to public health nursing practice. Advocacy efforts that effectively call attention to population health threats and promote the well-being of communities rely on strategies that deliver influential messaging. The digital story is a lay method to capture meaningful, impactful stories that can be used to advocate for public health concerns. Readily available, user-friendly digital technologies allow engagement in digital media production to create digital stories. This paper describes how digital story making can be utilized as an academic assignment to teach public health advocacy within an undergraduate nursing curriculum. Providing nursing students this artistic outlet can facilitate meeting academic learning goals, while also equipping them with creative skills that can be applied in future professional practice. Nursing educators can take advantage of institutional resources and campus culture to support the use of novel digital media assignments that facilitate application of advocacy concepts. © 2017 Wiley Periodicals, Inc.

Environmental health, public safety, and social impacts associated with transportation accidents involving hazardous substances

DOT National Transportation Integrated Search

2000-12-31

Accidents involving chemicals or radioactive materials represent a significant threat to the environment, public : health and safety, and community well-being. In an increasingly complex and interconnected world, no community : is immune from the thr...

Earth Day plus 30 years: public concern and support for environmental health.

PubMed Central

Greenberg, M

2001-01-01

A clear majority of Americans are concerned about environmental threats to public health and do not want to weaken antipollution regulations. The strongest supporters for maintaining environmental regulations are affluent mainstream White suburban populations who are thriving economically, but support is also strong in every other major segment of the population. Overt attempts to weaken the basic regulations are unlikely, barring an obvious economic downturn that would cause a large proportion of the public to consider loosening standards in the belief that such changes would increase the number of available jobs. Given this context, environmental health was and will continue to be a core topic in the Journal. We will emphasize the nexus of environmental health and policy by publishing research, exemplary public health practice, and the views of key decision makers. PMID:11291364

Knowledge-based public health situation awareness

NASA Astrophysics Data System (ADS)

Mirhaji, Parsa; Zhang, Jiajie; Srinivasan, Arunkumar; Richesson, Rachel L.; Smith, Jack W.

2004-09-01

There have been numerous efforts to create comprehensive databases from multiple sources to monitor the dynamics of public health and most specifically to detect the potential threats of bioterrorism before widespread dissemination. But there are not many evidences for the assertion that these systems are timely and dependable, or can reliably identify man made from natural incident. One must evaluate the value of so called 'syndromic surveillance systems' along with the costs involved in design, development, implementation and maintenance of such systems and the costs involved in investigation of the inevitable false alarms1. In this article we will introduce a new perspective to the problem domain with a shift in paradigm from 'surveillance' toward 'awareness'. As we conceptualize a rather different approach to tackle the problem, we will introduce a different methodology in application of information science, computer science, cognitive science and human-computer interaction concepts in design and development of so called 'public health situation awareness systems'. We will share some of our design and implementation concepts for the prototype system that is under development in the Center for Biosecurity and Public Health Informatics Research, in the University of Texas Health Science Center at Houston. The system is based on a knowledgebase containing ontologies with different layers of abstraction, from multiple domains, that provide the context for information integration, knowledge discovery, interactive data mining, information visualization, information sharing and communications. The modular design of the knowledgebase and its knowledge representation formalism enables incremental evolution of the system from a partial system to a comprehensive knowledgebase of 'public health situation awareness' as it acquires new knowledge through interactions with domain experts or automatic discovery of new knowledge.

Role of pharmacogenetics in public health and clinical health care: a SWOT analysis

PubMed Central

Kapoor, Ritika; Tan-Koi, Wei Chuen; Teo, Yik-Ying

2016-01-01

Pharmacogenomics has been lauded as an important innovation in clinical medicine as a result of advances in genomic science. As one of the cornerstones in precision medicine, the vision to determine the right medication in the right dosage for the right treatment with the use of genetic information has not exactly materialised, and few genetic tests have been implemented as the standard of care in health systems worldwide. Here we review the findings from a SWOT analysis to examine the strengths, weaknesses, opportunities and threats around the role of pharmacogenetics in public health and clinical health care, at the micro, meso and macro levels corresponding to the perspectives of the individuals (scientists, patients and physicians), the health-care institutions and the health systems, respectively. PMID:27577547

Role of pharmacogenetics in public health and clinical health care: a SWOT analysis.

PubMed

Kapoor, Ritika; Tan-Koi, Wei Chuen; Teo, Yik-Ying

2016-12-01

Pharmacogenomics has been lauded as an important innovation in clinical medicine as a result of advances in genomic science. As one of the cornerstones in precision medicine, the vision to determine the right medication in the right dosage for the right treatment with the use of genetic information has not exactly materialised, and few genetic tests have been implemented as the standard of care in health systems worldwide. Here we review the findings from a SWOT analysis to examine the strengths, weaknesses, opportunities and threats around the role of pharmacogenetics in public health and clinical health care, at the micro, meso and macro levels corresponding to the perspectives of the individuals (scientists, patients and physicians), the health-care institutions and the health systems, respectively.

Does air pollution pose a public health problem for New Zealand?

PubMed

Scoggins, Amanda

2004-02-01

Air pollution is increasingly documented as a threat to public health and a major focus of regulatory activity in developed and developing countries. Air quality indicators suggest New Zealand has clean air relative to many other countries. However, media releases such as 'Christchurch wood fires pump out deadly smog' and 'Vehicle pollution major killer' have sparked public health concern regarding exposure to ambient air pollution, especially in anticipation of increasing emissions and population growth. Recent evidence is presented on the effects of air quality on health, which has been aided by the application of urban airshed models and Geographic Information Systems (GIS). Future directions for research into the effects of air quality on health in New Zealand are discussed, including a national ambient air quality management project: HAPINZ--Health and Air Pollution in New Zealand.

Stigmatized ethnicity, public health, and globalization.

PubMed

Ali, S Harris

2008-01-01

The prejudicial linking of infection with ethnic minority status has a long-established history, but in some ways this association may have intensified under the contemporary circumstances of the "new public health" and globalization. This study analyzes this conflation of ethnicity and disease victimization by considering the stigmatization process that occurred during the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) in Toronto. The attribution of stigma during the SARS outbreak occurred in multiple and overlapping ways informed by: (i) the depiction of images of individuals donning respiratory masks; (ii) employment status in the health sector; and (iii) Asian-Canadian and Chinese-Canadian ethnicity. In turn, stigmatization during the SARS crisis facilitated a moral panic of sorts in which racism at a cultural level was expressed and rationalized on the basis of a rhetoric of the new public health and anti-globalization sentiments. With the former, an emphasis on individualized self-protection, in the health sense, justified the generalized avoidance of those stigmatized. In relation to the latter, in the post-9/11 era, avoidance of the stigmatized other was legitimized on the basis of perceiving the SARS threat as a consequence of the mixing of different people predicated by economic and cultural globalization.

SARS: An Emerging Global Microbial Threat.

PubMed Central

Hughes, James M.

2004-01-01

In March 2003, the Institute of Medicine published an update to its 1992 landmark report on emerging infections. The new report, Microbial Threats to Health: Emergence, Detection, and Response, describes the current spectrum of global microbial threats, factors affecting their emergence or resurgence, and measures that should be undertaken to effectively address them. Coincident with this publication came increasing reports of severe atypical pneumonia of unknown etiology among persons in southeast Asia. This new disease, designated severe acute respiratory syndrome (SARS), spread globally in a matter of weeks, infecting primarily close contacts of index patients (e.g., household members and healthcare workers caring for index patients) but also resulting in community transmission in some areas. An unprecedented worldwide collaborative effort was undertaken to determine the cause of the illness and implement prevention measures. A previously unrecognized coronavirus was identified as the causative agent, and health officials throughout the world struggled to implement measures to contain its spread, including isolation of suspect SARS cases and quarantine of exposed persons. The emergence of SARS is a timely reminder of the need to expect the unexpected and to ensure strong national and global public health partnerships when preparing for and responding to infectious diseases. Effectively addressing the threat of SARS will require enhanced global infectious disease surveillance, the development of rapid diagnostics, new therapies, and vaccines, implementation of aggressive evidence-based infection control strategies, and effective communication. Images Fig. 2 Fig. 3 PMID:17060979

Tracking uptake of innovations from the European Union Public Health Programme.

PubMed

Voss, Margaretha; Alexanderson, Kristina; McCarthy, Mark

2013-11-01

The European Commission developed the Public Health Programme to enable cross-national innovation and transfer in fields of health information, health threats and health promotion. PHIRE (Public Health Innovation and Research in Europe), a collaboration of the European Public Health Association (EUPHA) with seven partners, addressed the uptake of these public health innovation projects at country level. EUPHA thematic sections lead on areas of public health practice and research and experts can choose to be section members. The section presidents of seven sections chose eight European public health projects, starting in the EU Public Health Programme in 2003-05, that provided new knowledge for practice and covered a majority of the EU countries. A web-based questionnaire recorded country informants' (CIs) perceptions of uptake, assessed as relevance and dissemination to a range of public and non-governmental organizations. 108 CIs individually described the eight innovations in an average of 14 (46%) of the 30 European countries. Three of the eight innovations were considered of high relevance by >60% of respondents and at least 70% of informants considered seven of the eight innovation projects as of high or moderate relevance. Dissemination was noted across governmental, professional and academic settings, with high impact on knowledge/awareness for at least 30% of CIs. Some projects had uptake within the policy cycle in particular countries and connected strongly with academics and professionals. Projects working at local level had less visibility nationally and some projects were unknown to national respondents. European Union funding for public health can contribute to cross-national knowledge transfer and uptake of innovations. More attention is needed to classify, characterize and identify public health innovations and to demonstrate their direct contribution to European health and well-being.

Zika Virus -10 Public Health Achievements in 2016 and Future Priorities.

PubMed

Oussayef, Nadia L; Pillai, Satish K; Honein, Margaret A; Ben Beard, C; Bell, Beth; Boyle, Coleen A; Eisen, Lars M; Kohl, Katrin; Kuehnert, Matthew J; Lathrop, Eva; Martin, Stacey W; Martin, Rebecca; McAllister, Janet C; McClune, Elizabeth Pantino; Mead, Paul; Meaney-Delman, Dana; Petersen, Brett; Petersen, Lyle R; Polen, Kara N D; Powers, Ann M; Redd, Stephen C; Sejvar, James J; Sharp, Tyler; Villanueva, Julie; Jamieson, Denise J

2017-01-06

The introduction of Zika virus into the Region of the Americas (Americas) and the subsequent increase in cases of congenital microcephaly resulted in activation of CDC's Emergency Operations Center on January 22, 2016, to ensure a coordinated response and timely dissemination of information, and led the World Health Organization to declare a Public Health Emergency of International Concern on February 1, 2016. During the past year, public health agencies and researchers worldwide have collaborated to protect pregnant women, inform clinicians and the public, and advance knowledge about Zika virus (Figure 1). This report summarizes 10 important contributions toward addressing the threat posed by Zika virus in 2016. To protect pregnant women and their fetuses and infants from the effects of Zika virus infection during pregnancy, public health activities must focus on preventing mosquito-borne transmission through vector control and personal protective practices, preventing sexual transmission by advising abstention from sex or consistent and correct use of condoms, and preventing unintended pregnancies by reducing barriers to access to highly effective reversible contraception.

Public health laboratory quality management in a developing country.

PubMed

Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut

2012-01-01

The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.

The public health disaster trust scale: validation of a brief measure.

PubMed

Eisenman, David P; Williams, Malcolm V; Glik, Deborah; Long, Anna; Plough, Alonzo L; Ong, Michael

2012-01-01

Trust contributes to community resilience by the critical influence it has on the community's responses to public health recommendations before, during, and after disasters. However, trust in public health is a multifactorial concept that has rarely been defined and measured empirically in public health jurisdictional risk assessment surveys. Measuring trust helps public health departments identify and ameliorate a threat to effective risk communications and increase resilience. Such a measure should be brief to be incorporated into assessments conducted by public health departments. We report on a brief scale of public health disaster-related trust, its psychometric properties, and its validity. On the basis of a literature review, our conceptual model of public health disaster-related trust and previously conducted focus groups, we postulated that public health disaster-related trust includes 4 major domains: competency, honesty, fairness, and confidentiality. A random-digit-dialed telephone survey of the Los Angeles county population, conducted in 2004-2005 in 6 languages. Two thousand five hundred eighty-eight adults aged 18 years and older including oversamples of African Americans and Asian Americans. Trust was measured by 4 items scored on a 4-point Likert scale. A summary score from 4 to 16 was constructed. Scores ranged from 4 to 16 and were normally distributed with a mean of 8.5 (SD 2.7). Cronbach α = 0.79. As hypothesized, scores were lower among racial/ethnic minority populations than whites. Also, trust was associated with lower likelihood of following public health recommendations in a hypothetical disaster and lower likelihood of household disaster preparedness. The Public Health Disaster Trust scale may facilitate identifying communities where trust is low and prioritizing them for inclusion in community partnership building efforts under Function 2 of the Centers for Disease Control and Prevention's Public Health Preparedness Capability 1. The

The concept of ego threat in social and personality psychology: is ego threat a viable scientific construct?

PubMed

Leary, Mark R; Terry, Meredith L; Batts Allen, Ashley; Tate, Eleanor B

2009-08-01

Although widely invoked as an explanation for psychological phenomena, ego threat has been conceptualized and induced in a variety of ways. Most contemporary research conceptualizes ego threat as a threat to a person's self-image or self-esteem, but experimental operationalizations of ego threat usually confound threats to self-esteem with threats to public image or decreased control over negative events, leading to an inability to distinguish the effects of threats to people's personal egos from threats to public image or threats to feelings of control. This article reviews research on ego threat, discusses experimental manipulations that confound ego threat with other processes, and makes recommendations regarding the use of ego threat as a construct in personality and social psychology.

The changing nature and scope of public health emergencies in response to annual flu.

PubMed

Hodge, James G

2013-06-01

The rapid spread of influenza during the 2012-13 season brought a series of public health challenges and corresponding response efforts. For decades, responses to annual flu have been undertaken routinely without extensive legal intervention. With the recent declaration of states of public health emergencies in Boston (January 9, 2013) and New York State (January 12, 2013), however, the legal baseline is changing. Propelled by a slate of state and local emergency declarations during the 2009-10 H1N1 pandemic, public officials are beginning to show cause for the issuance of formal emergency declarations in support of flu response efforts. The legal effects of these types of declarations are profound. Public and private actors are given significant, expedited public health powers. Scarce resources like vaccines can be more efficiently allocated. Laws relating to licensure, scope of practice, and liability can be effectively waived. Though originally conceptualized and once reserved for catastrophic, long-term health-related or bioterrorism events, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks. This commentary explores the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public's health.

[Horizon scanning in preparation for future health threats: a pilot exercise conducted by the French Institute for Public Health Surveillance in 2014].

PubMed

Eilstein, Daniel; Xerri, Bertrand; Viso, Anne-Catherine; Therre, Hélène; Gorza, Maud; Fuchs, Doriane; Pozuelos, Jérôme; Ioos, Sophie; Che, Didier; Bertrand, Edwige; El Yamani, Mounia; Empereur-Bissonnet, Pascal; Duport, Nicolas; Desenclos, Jean-Claude

2016-01-01

Background: Health surveillance is a reactive process, with no real hindsight for dealing with signals and alerts. It may fail to detect more radical changes with a major medium-term or long-term impact on public health. To increase proactivity, the French Institute for Public Health Surveillance has opted for a prospective monitoring approach.Methods: Several steps were necessary: 1) Identification of public health determinants. 2) Identification of key variables based on a combination of determinants. Variables were classified into three groups (health event trigger factors, dissemination factors and response factors) and were submitted to future development assumptions. 3) Identification, in each of the three groups, of micro-scenarios derived from variable trends. 4) Identification of macro-scenarios, each built from the three micro-scenarios for each of the three groups. 5) Identification of issues for the future of public health.Results: The exercise identified 22 key variables, 17 micro-scenarios and 5 macro-scenarios. The topics retained relate to issues on social and territorial health inequalities, health burden, individual and collective responsibilities in terms of health, ethical aspects, emerging phenomena, ‘Big data’, data mining, new health technologies, interlocking of analysis scales.Conclusions: The approach presented here guides the programming of activities of a health safety agency, particularly for monitoring and surveillance. By describing possible future scenarios, health surveillance can help decision-makers to influence the context towards one or more favourable futures.

Report: EPA Is Documenting How It Addresses Time-Critical Public Health Risks Under Its Superfund Authority

EPA Pesticide Factsheets

Report #16-P-0059, December 9, 2015. We found that the EPA can provide documentation that imminent and substantial endangerment threats to public health at Superfund time-critical removal sites have been addressed.

Merging Air Quality and Public Health Decision Support Systems

NASA Astrophysics Data System (ADS)

Hudspeth, W. B.; Bales, C. L.

2003-12-01

The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

Molecular detection and point-of-care testing in Ebola virus disease and other threats: a new global public health framework to stop outbreaks.

PubMed

Kost, Gerald J; Ferguson, William; Truong, Anh-Thu; Hoe, Jackie; Prom, Daisy; Banpavichit, Arirat; Kongpila, Surin

2015-01-01

Ultrahigh sensitivity and specificity assays that detect Ebola virus disease or other highly contagious and deadly diseases quickly and successfully upstream in Spatial Care Paths™ can stop outbreaks from escalating into devastating epidemics ravaging communities locally and countries globally. Even had the WHO and CDC responded more quickly and not misjudged the dissemination of Ebola in West Africa and other world regions, mobile rapid diagnostics were, and still are, not readily available for immediate and definitive diagnosis, a stunning strategic flaw that needs correcting worldwide. This article strategizes point-of-care testing for diagnosis, triage, monitoring, recovery and stopping outbreaks in the USA and other countries; reviews Ebola molecular diagnostics, summarizes USA FDA emergency use authorizations and documents why they should not be stop-gaps; and reduces community risk from internal and external infectious disease threats by enabling public health at points of need.

Communicating the threat of emerging infections to the public.

PubMed Central

Freimuth, V.; Linnan, H. W.; Potter, P.

2000-01-01

Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health. PMID:10905966

Do frequent exposures to threats and violence at work affect later workforce participation?

PubMed

Biering, Karin; Andersen, Lars Peter Sønderbo; Hogh, Annie; Andersen, Johan Hviid

2018-05-01

Threats and violence at work are common problems in the human service sector. It can result in physical and psychological health symptoms. The aim of this study was to examine the association between exposure to threats and violence and workforce participation in four human service sectors. 5170 employees answered questionnaires about threats and violence in 2010 and were followed in a register for public transfer incomes for 3.5 years to identify episodes of sick leave, general workforce participation, and permanent health-related benefits. We found associations between exposures to threats and violence at work and workforce participation, though only a few specific types of threats and violence were associated on their own. Self-rated severity of both threatening and violent episodes was associated with overall low workforce participation, new sick leave episodes, and permanent health-related benefits. However, the latter was not statistically significant. The same pattern seems to be present in the relation between the total amount of exposure to threats and violence (threats score and violence score), respectively, and overall low workforce participation and new sick leave episodes. The threats score was also related to permanent health-related benefits. Exposure to threats and violence is associated with temporary and permanent health-related benefits as well as with low workforce participation in general, although some of the associations were not statistically significant.

The Evolution of Public Health Emergency Management as a Field of Practice.

PubMed

Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

2017-09-01

The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.

The Evolution of Public Health Emergency Management as a Field of Practice

PubMed Central

Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

2017-01-01

The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve. PMID:28892444

With the best intentions: lead research and the challenge to public health.

PubMed

Rosner, David; Markowitz, Gerald

2012-11-01

In 2001, Maryland's court of appeals was asked to decide whether researchers at Johns Hopkins University had engaged in unethical research on children. During the 1990s, Johns Hopkins's Kennedy Krieger Institute had studied 108 African American children, aged 6 months to 6 years, to find an inexpensive and "practical" means to ameliorate lead poisoning. We have outlined the arguments in the case and the conundrum faced by public health researchers as they confront new threats to our health from environmental and industrial insults. We examined the case in light of contemporary public health ideology, which prioritizes harm reduction over the historical goals of prevention. As new synthetic toxins-such as bisphenyl A, polychlorinated biphenyls, other chlorinated hydrocarbons, tobacco, vinyl, and asbestos-are discovered to be biologically disruptive and disease producing at low levels, lead provides a window into the troubling dilemmas public health will have to confront in the future.

An integrated process and management tools for ranking multiple emerging threats to animal health.

PubMed

Del Rio Vilas, Victor J; Voller, Fay; Montibeller, Gilberto; Franco, L Alberto; Sribhashyam, Sumitra; Watson, Eamon; Hartley, Matt; Gibbens, Jane C

2013-02-01

The UK's Department for Environment, Food and Rural Affairs supports the use of systematic tools for the prioritisation of known and well defined animal diseases to facilitate long and medium term planning of surveillance and disease control activities. The recognition that emerging events were not covered by the existing disease-specific approaches led to the establishment of the Veterinary Risk Group (VRG), constituted of government officials, and supporting structures such as the Risk Management Cycle and the Emerging Threat Highlight Report (ETHiR), to facilitate the identification, reporting and assessment of emerging threats to UK's animal health. Since its inception in November 2009 to the end of February 2011, the VRG reviewed 111 threats and vulnerabilities (T&V) reported through ETHiR. In July 2010 a decision support system (DSS) based on multi-criteria-decision-analysis (MCDA) improved ETHiR to allow the systematic prioritisation of emerging T&V. The DSS allows the regular ranking of emerging T&V by calculating a set of measurement indices related to the actual impact, possible impact on public perception and level of available capabilities associated with every T&V. The systematic characterisation of the processes leading to the assessment of T&V by the VRG has led to a consistent, auditable and transparent approach to the identification and assessment of emerging risks. The regular use of MCDA to manage a portfolio of emerging risks represents a different and novel application of MCDA in a health related context. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

The Role of Health Educators in Dealing with Biological Threats in the United States

ERIC Educational Resources Information Center

Perez, Miguel A.; Pinzon-Perez, Helda; Sowby, Sherman

2002-01-01

Health educators play a key role in assisting the nation deal with and be prepared for potential biological attacks. This article summarizes information found in the literature about likely bioterrorist threats to the U.S. population and discusses the responsibilities of health educators in regard to these threats. Among the important roles health…

Public health ethics. Public justification and public trust.

PubMed

Childress, J F; Bernheim, R Gaare

2008-02-01

Viewing public health as a political and social undertaking as well as a goal of this activity, the authors develop some key elements in a framework for public health ethics, with particular attention to the formation of public health policies and to decisions by public health officials that are not fully determined by established public policies. They concentrate on ways to approach ethical conflicts about public health interventions. These conflicts arise because, in addition to the value of public health, societies have a wide range of other values that sometimes constrain the selection of means to achieve public health goals. The authors analyze three approaches for resolving these conflicts (absolutist, contextualist, and presumptivist), argue for the superiority of the presumptivist approach, and briefly explicate five conditions for rebutting presumptions in a process of public justification. In a liberal, pluralistic, democratic society, a presumptivist approach that engages the public in the context of a variety of relationships can provide a foundation for public trust, which is essential to public health as a political and social practice as well as to achieving public health goals.

The decision making process on public health measures related to passenger ships: the example of influenza pandemic 2009.

PubMed

Mouchtouri, V A; Bartlett, C L R; Jaremin, Bogdan; Nichols, G; Paux, T; Riemer, T; Black, N; Varela-Martinez, C; Swaan, C M; Schlaich, C; Rachiotis, G; Kremastinou, J; Hadjichristodoulou, C

2010-01-01

Public health measures at sea ports have posed a challenge for public health competent authorities, especially in the context of the influenza pandemic of 2009. This paper discusses the response of authorities to notifications of infectious diseases on passenger ships and the importance of assessing the risks related to cases of influenza. It further provides options for health measures and considerations for decision making during a pandemic such as the influenza pandemic of 2009. Prevention and control of influenza have included action taken by both competent port authorities and ships' crews. Assessing the public health risk of each event reported from ships to competent authorities at ports is important before advice is given on implementation of control measures. Public health risk assessment involves appraisal of threats to passengers and crew on board the ship as well as to the population in the community. Any public health measures taken should be necessary and proportional to the threat. Measures at ports cannot alone be effective in the prevention of the spread of a disease to the community since other means of transport play a major role. Measures taken on board ships can be effective in containing the disease. Consistent policy based on common protocols and carried out by competent authorities at local, national, European, or international levels are essential.

[Health services research for the public health service (PHS) and the public health system].

PubMed

Hollederer, A; Wildner, M

2015-03-01

There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

More on Inoculating Against Reactance to Persuasive Health Messages: The Paradox of Threat.

PubMed

Richards, Adam S; Banas, John A; Magid, Yoav

2017-07-01

This research examined the efficacy of inoculation as a strategy to mitigate psychological reactance based on the level of threat communicated in the forewarning and subsequent persuasive health appeal. Two 2 (inoculation) × 2 (freedom-threatening language) experiments were conducted. The first (N = 181) used elaborated inoculation designed to enhance the threat of impending reactance to a message advocating for responsible alcohol consumption. The second (N = 159) used limited inoculation designed to minimize the threat of impending reactance to a message advocating for responsible soft drink consumption. Results showed that elaborated inoculation increased reactance, whereas limited inoculation decreased reactance but only when the subsequent appeal used less freedom-threatening language. These findings suggest that inoculation has the potential to facilitate or buffer reactance depending on the level of threat communicated in inoculation forewarnings and in subsequent persuasive health appeals.

An Approach to Developing Local Climate Change Environmental Public Health Indicators in a Rural District.

PubMed

Houghton, Adele; Austin, Jessica; Beerman, Abby; Horton, Clayton

2017-01-01

Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network's framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as "high vulnerability." Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment.

A taxonomy of state public health preparedness units: an empirical examination of organizational structure.

PubMed

Menachemi, Nir; Yeager, Valerie A; Duncan, W Jack; Katholi, Charles R; Ginter, Peter M

2012-01-01

State public health preparedness units (SPHPUs) were developed in response to federal funding to improve response to disasters: a responsibility that had not traditionally been within the purview of public health. The SPHPUs were created within the existing public health organizational structure, and their placement may have implications for how the unit functions, how communication takes place, and ultimately how well the key responsibilities are performed. This study empirically identifies a taxonomy of similarly structured SPHPUs and examines whether this structure is associated with state geographic, demographic, and threat-vulnerability characteristics. Data representing each SPHPU were extracted from publically available sources, including organizational charts and emergency preparedness plans for 2009. A cross-sectional segmentation analysis was conducted of variables representing structural attributes. Fifty state public health departments. Variables representing "span of control" and "hierarchal levels" were extracted from organizational charts. Structural "complexity" and "centralization" were extracted from state emergency preparedness documents and other secondary sources. On average, 6.6 people report to the same manager as the SPHPU director; 2.1 levels separate the SPHPU director from the state health officer; and a mean of 13.5 agencies collaborate with SPHPU during a disaster. Despite considerable variability in how SPHPUs had been structured, results of the cluster and principal component analysis identified 7 similarly structured groups. Neither the taxonomic groups nor the individual variables representing structure were found to be associated with state characteristics, including threat vulnerabilities. Our finding supports the hypothesis that SPHPUs are seemingly inadvertently (eg, not strategically) organized. This taxonomy provides the basis for which future research can examine how SPHPU structure relates to performance measures and

Building national public health capacity for managing chemical events: A case study of the development of health protection services in the United Kingdom

PubMed Central

Palmer, Stephen; Coleman, Gary

2013-01-01

The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved ‘adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases. PMID:23447032

Building national public health capacity for managing chemical events: a case study of the development of health protection services in the United Kingdom.

PubMed

Palmer, Stephen; Coleman, Gary

2013-05-01

The revised International Health Regulations (2005) require that countries develop plans for chemical threats. In 2012, the World Health Assembly reported that most countries had not yet achieved 'adequate capacity'. We review the evolution of chemical hazards services in the United Kingdom, the result of 15 years of grass-roots pressure and an accumulating weight of chemical incidents that eventually convinced the UK Department of Health of the need for a new national public health function, culminating, in 2003, in the creation of the Chemical Hazards Division of the new Health Protection Agency. Ten years later, public health services are again being radically reorganized with the creation of Public Health England, potentially destabilizing health protection arrangements and creating confusion among roles in managing chemical emergencies. Incorporating health protection into a broader public health organization, however, offers a new opportunity to broaden the scope of health protection services to embrace prevention of non-infectious environmental diseases.

Corporate Funding for Schools of Public Health: Confronting the Ethical and Economic Challenges.

PubMed

Bayer, Ronald; Sampat, Bhaven N

2016-04-01

We discuss the public and private sponsoring of university research and the issues it raises in a context of diminished federal funding. We consider research funding at schools of public health and why these schools have historically had weaker links to industry than have other academic units. We argue that the possibility of enhanced links with industry at schools of public health may raise specific concerns beyond those facing universities generally. Six issues should be considered before entering into these relationships: (1) the effects on research orientation, (2) unacceptability of some funders, (3) potential threats to objectivity and academic freedom, (4) effects on academic standards, (5) the effects on dissemination of knowledge, and (6) reputational risks.

Cyber threats to health information systems: A systematic review.

PubMed

Luna, Raul; Rhine, Emily; Myhra, Matthew; Sullivan, Ross; Kruse, Clemens Scott

2016-01-01

Recent legislation empowering providers to embrace the electronic exchange of health information leaves the healthcare industry increasingly vulnerable to cybercrime. The objective of this systematic review is to identify the biggest threats to healthcare via cybercrime. The rationale behind this systematic review is to provide a framework for future research by identifying themes and trends of cybercrime in the healthcare industry. The authors conducted a systematic search through the CINAHL, Academic Search Complete, PubMed, and ScienceDirect databases to gather literature relative to cyber threats in healthcare. All authors reviewed the articles collected and excluded literature that did not focus on the objective. Researchers selected and examined 19 articles for common themes. The most prevalent cyber-criminal activity in healthcare is identity theft through data breach. Other concepts identified are internal threats, external threats, cyber-squatting, and cyberterrorism. The industry has now come to rely heavily on digital technologies, which increase risks such as denial of service and data breaches. Current healthcare cyber-security systems do not rival the capabilities of cyber criminals. Security of information is a costly resource and therefore many HCOs may hesitate to invest what is required to protect sensitive information.

Meeting the Emerging Public Health Needs of Persons With Blood Disorders

PubMed Central

Parker, Christopher S.; Tsai, James; Siddiqi, Azfar-e-Alam; Atrash, Hani K.; Richardson, Lisa C.

2015-01-01

In its decades-long history, the Division of Blood Disorders (DBD) at CDC has evolved from a patient-focused, services-supporting entity at inception, to one of the world leaders in the practice of public health to improve the lives of people at risk for or affected by nonmalignant blood disorders. The DBD’s earliest public health activities consisted of working with care providers in a network of hemophilia treatment centers to provide AIDS risk reduction services to people with hemophilia. Because this infectious disease threat has been reduced over time as a result of the development of safer treatment products, the DBD—under the auspices of congressional appropriations guidance—has expanded its core activities to encompass blood disorders other than hemophilia, including hemoglobinopathies such as thalassemia and sickle cell disease, and Diamond Blackfan anemia. Simultaneously, in transitioning to a greater public health role, the DBD has expanded its network of partners to new consumer and professional organizations, as well as state and other federal health agencies. The DBD has also developed and maintains many surveillance and registry activities beyond the Universal Data Collection system aimed at providing a better understanding of the health status, health needs, and health-related quality of life of people with nonmalignant blood disorders. The DBD has integrated applicable components of the Essential Services of Public Health successfully to promote and advance the agenda of blood disorders in public health. PMID:25245797

Meeting the emerging public health needs of persons with blood disorders.

PubMed

Parker, Christopher S; Tsai, James; Siddiqi, Azfar-e-Alam; Atrash, Hani K; Richardson, Lisa C

2014-11-01

In its decades-long history, the Division of Blood Disorders (DBD) at CDC has evolved from a patient-focused, services-supporting entity at inception, to one of the world leaders in the practice of public health to improve the lives of people at risk for or affected by nonmalignant blood disorders. The DBD's earliest public health activities consisted of working with care providers in a network of hemophilia treatment centers to provide AIDS risk reduction services to people with hemophilia. Because this infectious disease threat has been reduced over time as a result of the development of safer treatment products, the DBD--under the auspices of congressional appropriations guidance--has expanded its core activities to encompass blood disorders other than hemophilia, including hemoglobinopathies such as thalassemia and sickle cell disease, and Diamond Blackfan anemia. Simultaneously, in transitioning to a greater public health role, the DBD has expanded its network of partners to new consumer and professional organizations, as well as state and other federal health agencies. The DBD has also developed and maintains many surveillance and registry activities beyond the Universal Data Collection system aimed at providing a better understanding of the health status, health needs, and health-related quality of life of people with nonmalignant blood disorders. The DBD has integrated applicable components of the Essential Services of Public Health successfully to promote and advance the agenda of blood disorders in public health. Published by Elsevier Inc.

Correcting for day of the week and public holiday effects: improving a national daily syndromic surveillance service for detecting public health threats.

PubMed

Buckingham-Jeffery, Elizabeth; Morbey, Roger; House, Thomas; Elliot, Alex J; Harcourt, Sally; Smith, Gillian E

2017-05-19

As service provision and patient behaviour varies by day, healthcare data used for public health surveillance can exhibit large day of the week effects. These regular effects are further complicated by the impact of public holidays. Real-time syndromic surveillance requires the daily analysis of a range of healthcare data sources, including family doctor consultations (called general practitioners, or GPs, in the UK). Failure to adjust for such reporting biases during analysis of syndromic GP surveillance data could lead to misinterpretations including false alarms or delays in the detection of outbreaks. The simplest smoothing method to remove a day of the week effect from daily time series data is a 7-day moving average. Public Health England developed the working day moving average in an attempt also to remove public holiday effects from daily GP data. However, neither of these methods adequately account for the combination of day of the week and public holiday effects. The extended working day moving average was developed. This is a further data-driven method for adding a smooth trend curve to a time series graph of daily healthcare data, that aims to take both public holiday and day of the week effects into account. It is based on the assumption that the number of people seeking healthcare services is a combination of illness levels/severity and the ability or desire of patients to seek healthcare each day. The extended working day moving average was compared to the seven-day and working day moving averages through application to data from two syndromic indicators from the GP in-hours syndromic surveillance system managed by Public Health England. The extended working day moving average successfully smoothed the syndromic healthcare data by taking into account the combined day of the week and public holiday effects. In comparison, the seven-day and working day moving averages were unable to account for all these effects, which led to misleading smoothing

With the Best INTENTIONS Lead Research and the Challenge to Public Health

PubMed Central

Markowitz, Gerald

2012-01-01

In 2001, Maryland’s court of appeals was asked to decide whether researchers at Johns Hopkins University had engaged in unethical research on children. During the 1990s, Johns Hopkins’s Kennedy Krieger Institute had studied 108 African American children, aged 6 months to 6 years, to find an inexpensive and “practical” means to ameliorate lead poisoning. We have outlined the arguments in the case and the conundrum faced by public health researchers as they confront new threats to our health from environmental and industrial insults. We examined the case in light of contemporary public health ideology, which prioritizes harm reduction over the historical goals of prevention. As new synthetic toxins—such as bisphenyl A, polychlorinated biphenyls, other chlorinated hydrocarbons, tobacco, vinyl, and asbestos—are discovered to be biologically disruptive and disease producing at low levels, lead provides a window into the troubling dilemmas public health will have to confront in the future. PMID:22994280

The post-2015 landscape: vested interests, corporate social responsibility and public health advocacy.

PubMed

Herrick, Clare

2016-09-01

This paper explores the tensions between UN calls for private sector engagement in the post-2015 landscape and public health opposition to those 'harm industries' that are 'corporate vectors of disease' for the mounting global non-communicable disease burden. The UN's support for public-private partnership has provided industries with 'vested interests' in the propagation of unhealthy behaviours with new opportunities for the strategic alignment of their corporate social responsibility (CSR) endeavours with the post-2015 sustainable development agenda. This has galvanised public health advocates to place pressure on the World Health Organisation to formalise their ambiguous stance towards private sector involvement in public policy formation and the resultant 'conflicts of interest'. This paper critically examines the 'gathering storm' between this 'anti-corporate movement' and the alcohol industry in the increasingly politicised domain of CSR. Drawing on the example of SABMiller's Tavern Intervention Program, the paper argues that CSR represents a profound threat to the sanctity and moral authority of the public health worldview. Questions therefore need to be asked about whether the public health-led path of industry non-association will necessarily result in health improvements or just a further retrenchment of the ideological faultlines explored in the paper. © 2016 Foundation for the Sociology of Health & Illness.

Future of health care delivery in iran, opportunities and threats.

PubMed

Rajabi, F; Esmailzadeh, H; Rostamigooran, N; Majdzadeh, R; Doshmangir, L

2013-01-01

The aim of this study was to determine the impact of important social and technological trends on health care delivery, in the context of developing "Iran's Health System Reform Plan by 2025". A detailed review of the national and international literature was done to identify the main trends affecting health system. To collect the experts' opinions about important trends and their impact on health care delivery, Focus Group Discussions (FGDs) and semi-structured in-depth interviews techniques were used. The study was based on the STEEP model. Final results were approved in an expert's panel session. The important social and technological trends, affecting health system in Iran in the next 15 years are demographic transition, epidemiologic transition, increasing bio-environmental pollution, increasing slums, increasing private sector partnership in health care delivery, moving toward knowledge-based society, development of information and communication technology, increasing use of high technologies in health system, and development of traditional and alternative medicine. The opportunities and threats resulting from the above mentioned trends were also assessed in this study. Increasing healthcare cost due to some trends like demographic and epidemiologic transition and uncontrolled increase in using new technologies in health care is one of the most important threats that the health system will be facing. The opportunities that advancement in technology and moving toward knowledge-based society create are important and should not be ignored.

Understanding Price Elasticities to Inform Public Health Research and Intervention Studies: Key Issues

PubMed Central

Nghiem, Nhung; Genç, Murat; Blakely, Tony

2013-01-01

Pricing policies such as taxes and subsidies are important tools in preventing and controlling a range of threats to public health. This is particularly so in tobacco and alcohol control efforts and efforts to change dietary patterns and physical activity levels as a means of addressing increases in noncommunicable diseases. To understand the potential impact of pricing policies, it is critical to understand the nature of price elasticities for consumer products. For example, price elasticities are key parameters in models of any food tax or subsidy that aims to quantify health impacts and cost-effectiveness. We detail relevant terms and discuss key issues surrounding price elasticities to inform public health research and intervention studies. PMID:24028228

Public health emergencies and the public health/managed care challenge.

PubMed

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Training public health superheroes: five talents for public health leadership.

PubMed

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Applicability of SWOT analysis for measuring quality of public oral health services as perceived by adult patients in Finland. Strengths, weaknesses, opportunities and threats.

PubMed

Toivanen, T; Lahti, S; Leino-Kilpi, H

1999-10-01

To determine the applicability of SWOT analysis for measuring the quality of public oral health services from the adult client's perspective. Data were collected using a structured questionnaire developed in an earlier study. The study group consisted of all adult (over 18 years of age) clients (n = 256) using public municipal oral health services in Kirkkonummi, Finland, during 2 weeks in 1995. Before treatment, patients filled out a questionnaire that measured the importance of their expectations in different aspects of oral care. After the appointment, they filled out a similar questionnaire that measured the enactment of these expectations in the treatment situation. The response rate was 51%. The difference between subjective importance and enactment of expectations was tested by Wilcoxon's signed rank test. Results were interpreted using both a conventional analysis of "expectation enacted or not" and SWOT analysis, which is used in strategic planning to identify areas of strengths (S), weaknesses (W), opportunities (O) and threats (T) in an organisation. In 28 statements out of 35, the two analyses revealed similar interpretations. In most areas the patient-perceived quality of the services was good. Weaknesses were found in the following areas: communicating to patients the causes and risk of developing oral diseases, informing them about different treatment possibilities, and including patients in decision-making when choosing restorative materials. SWOT analysis provided more structured interpretation of the results, and can be more easily transferred to development of services.

Climate change--the greatest public health threat of our time: seeing the wood, not just the trees.

PubMed

McFarlane, Gary J

2010-01-01

If asked to describe the key public health challenges of our time many practitioners might well cite issues such as health inequalities, obesity, smoking and poverty. However, with the greatest of respect to those agendas, they are not, in my view, the greatest priority at present. If we cannot learn to live within sustainable limits and damage beyond repair the essential life support systems that we depend on, they will fail catastrophically with horrific consequences for humanity. All credible, reliable scientific evidence suggests that without profound and significant change that is exactly where we are headed. However, there is time, albeit short, to avoid the very worst consequences of runaway climate change. But to do so requires collective and urgent action now! Public health practitioners have potentially so much to offer towards this effort. We have many of the skills and experience so critically needed to advocate for change--both political and behavioural; we have the ability to design creative, effective, and dynamic interventions to assist and facilitate communities and individuals make the journey; and equally importantly we have huge opportunities to do so. However to do so effectively means that we need to look at the problem through a different lens and make climate change a top public health priority. We need to see beyond many of the institutional and cultural barriers that exist, albeit not through deliberate design, within our organisations which can cause us to be focused on very specific agendas and see the whole wood, rather than individual trees within it. Climate change is not just an "environmental" problem and a priority therefore specifically for that sector. It is already costing lives and is life threatening on a scale that far surpasses current public health concerns and priorities. Equally critically, tackling climate change would and will significantly contribute towards addressing health inequalities. To use two well worn public

From Manaus to Maputo: toward a public health and biodiversity framework.

PubMed

Romanelli, Cristina; Corvalan, Carlos; Cooper, H David; Manga, Lucien; Maiero, Marina; Campbell-Lendrum, Diarmid

2014-09-01

The linkages between human health, biodiversity, ecosystems, and the life-supporting services that they provide are varied and complex. The traditional neglect of this nexus by policy-makers perpetuates threats posed to ecosystems with potentially critical impacts on global health. The Convention on Biological Diversity and the World Health Organization recently co-convened two regional workshops on these intricate but vital linkages. From discussions held with policy-makers and experts in the biodiversity and health sectors, spanning some 50 countries in Africa and the Americas, we derive a broad framework for the development of national and regional public health and biodiversity strategies relevant to strategic planning processes in the emerging post-2015 development context.

Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

PubMed

Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

2018-02-01

With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

National Antimicrobial Resistance Monitoring System: Two Decades of Advancing Public Health Through Integrated Surveillance of Antimicrobial Resistance.

PubMed

Karp, Beth E; Tate, Heather; Plumblee, Jodie R; Dessai, Uday; Whichard, Jean M; Thacker, Eileen L; Hale, Kis Robertson; Wilson, Wanda; Friedman, Cindy R; Griffin, Patricia M; McDermott, Patrick F

2017-10-01

Drug-resistant bacterial infections pose a serious and growing public health threat globally. In this review, we describe the role of the National Antimicrobial Resistance Monitoring System (NARMS) in providing data that help address the resistance problem and show how such a program can have broad positive impacts on public health. NARMS was formed two decades ago to help assess the consequences to human health arising from the use of antimicrobial drugs in food animal production in the United States. A collaboration among the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the United States Department of Agriculture, and state and local health departments, NARMS uses an integrated "One Health" approach to monitor antimicrobial resistance in enteric bacteria from humans, retail meat, and food animals. NARMS has adapted to changing needs and threats by expanding surveillance catchment areas, examining new isolate sources, adding bacteria, adjusting sampling schemes, and modifying antimicrobial agents tested. NARMS data are not only essential for ensuring that antimicrobial drugs approved for food animals are used in ways that are safe for human health but they also help address broader food safety priorities. NARMS surveillance, applied research studies, and outbreak isolate testing provide data on the emergence of drug-resistant enteric bacteria; genetic mechanisms underlying resistance; movement of bacterial populations among humans, food, and food animals; and sources and outcomes of resistant and susceptible infections. These data can be used to guide and evaluate the impact of science-based policies, regulatory actions, antimicrobial stewardship initiatives, and other public health efforts aimed at preserving drug effectiveness, improving patient outcomes, and preventing infections. Many improvements have been made to NARMS over time and the program will continue to adapt to address emerging resistance threats, changes in

Bio-threat preparedness: Need for a paradigm shift.

PubMed

Jindal, A K; Roy, Kaushik

2014-04-01

India of late has been vulnerable to Chemical, Biological, Radiological and Nuclear (CBRN) threat, on account of its unique geographic position. Biological threat is an imminent threat in the hands of a terrorist. The public health system of our country is overburdened due to its present role and bio-attack response is not a priority area. This paper suggests that as the prime focus is on the CR and N threats in the integrated CBRN preparedness strategy and that specialized and technical forces are needed to deal with a bio-threat; hence there is a need for a paradigm shift in policy. The emerging field of bio-threat needs to be delinked from the joint family of 'CBRN', with consequent structural and functional changes. A separate specialized cadre needs to be formed for dealing with bio-threat, created from the pool of doctors and non-medical scientists from the AFMS and the DRDO. Structural changes are needed in the organization, to bring in the resources of NCDC, New Delhi for enhanced disease surveillance capacity and creation of a bio-threat mitigation node in the AFMC, Pune.

An Approach to Developing Local Climate Change Environmental Public Health Indicators in a Rural District

PubMed Central

2017-01-01

Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network's framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as “high vulnerability.” Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment. PMID:28352286

Which US States Pose the Greatest Threats to Military Readiness and Public Health? Public Health Policy Implications for a Cross-sectional Investigation of Cardiorespiratory Fitness, Body Mass Index, and Injuries Among US Army Recruits.

PubMed

Bornstein, Daniel B; Grieve, George L; Clennin, Morgan N; McLain, Alexander C; Whitsel, Laurie P; Beets, Michael W; Hauret, Keith G; Jones, Bruce H; Sarzynski, Mark A

2018-01-09

Many states in the southern region of the United States are recognized for higher rates of obesity, physical inactivity, and chronic disease. These states are therefore recognized for their disproportionate public health burden. The purpose of this study was to investigate state-level distributions of cardiorespiratory fitness, body mass index (BMI), and injuries among US Army recruits in order to determine whether or not certain states may also pose disproportionate threats to military readiness and national security. Sex-specific state-level values for injuries and fitness among 165 584 Army recruits were determined. Next, the relationship between median cardiorespiratory fitness and injury incidence at the state level was examined using Spearman correlations. Finally, multivariable Poisson regression models stratified by sex examined state-level associations between fitness and injury incidence, while controlling for BMI, and other covariates. Cardiorespiratory fitness and training-related injury incidence. A cluster of 10 states from the south and southeastern regions (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas) produced male or female recruits who were significantly less fit and/or more likely to become injured than recruits from other US states. Compared with the "most fit states," the incidence of injuries increased by 22% (95% CI, 17-28; P < .001) and 28% (95% CI, 19-36; P < .001) in male and female recruits from the "least fit states," respectively. The impact of policies, systems, and environments on physical activity behavior, and subsequently fitness and health, has been clearly established. Advocacy efforts aimed at active living policies, systems, and environmental changes to improve population health often fail. However, advocating for active living policies to improve national security may prove more promising, particularly with legislators. Results from this study demonstrate

Use of Comparative Case Study Methodology for US Public Health Policy Analysis: A Review.

PubMed

Dinour, Lauren M; Kwan, Amy; Freudenberg, Nicholas

There is growing recognition that policies influence population health, highlighting the need for evidence to inform future policy development and reform. This review describes how comparative case study methodology has been applied to public health policy research and discusses the methodology's potential to contribute to this evidence. English-language, peer-reviewed articles published between 1995 and 2012 were sought from 4 databases. Articles were included if they described comparative case studies addressing US public health policy. Two researchers independently assessed the 20 articles meeting review criteria. Case-related characteristics and research design tactics utilized to minimize threats to reliability and validity, such as the use of multiple sources of evidence and a case study protocol, were extracted from each article. Although comparative case study methodology has been used to analyze a range of public health policies at all stages and levels, articles reported an average use of only 3.65 (out of 10) research design tactics. By expanding the use of accepted research design tactics, public health policy researchers can contribute to expanding the evidence needed to advance health-promoting policies.

A comprehensive Laboratory Services Survey of State Public Health Laboratories.

PubMed

Inhorn, Stanley L; Wilcke, Burton W; Downes, Frances Pouch; Adjanor, Oluwatosin Omolade; Cada, Ronald; Ford, James R

2006-01-01

In November 2004, the Association of Public Health Laboratories (APHL) conducted a Comprehensive Laboratory Services Survey of State Public Health Laboratories (SPHLs) in order to establish the baseline data necessary for Healthy People 2010 Objective 23-13. This objective aims to measure the increase in the proportion of health agencies that provide or assure access to comprehensive laboratory services to support essential public health services. This assessment addressed only SPHLs and served as a baseline to periodically evaluate the level of improvement in the provision of laboratory services over the decade ending 2010. The 2004 survey used selected questions that were identified as key indicators of provision of comprehensive laboratory services. The survey was developed in consultation with the Centers for Disease Control and Prevention National Center for Health Statistics, based on newly developed data sources. Forty-seven states and one territory responded to the survey. The survey was based on the 11 core functions of SPHLs as previously defined by APHL. The range of performance among individual laboratories for the 11 core functions (subobjectives) reflects the challenging issues that have confronted SPHLs in the first half of this decade. APHL is now working on a coordinated effort with other stakeholders to create seamless state and national systems for the provision of laboratory services in support of public health programs. These services are necessary to help face the threats raised by the specter of terrorism, emerging infections, and natural disasters.

Collaboration Between Public Health and Law Enforcement: New Paradigms and Partnerships for Bioterrorism Planning and Response

PubMed Central

Cohen, Mitchell L.; Friedman, Cindy R.; Scripp, Robert M.; Watz, Craig G.

2002-01-01

The biological attacks with powders containing Bacillus anthracis sent through the mail during September and October 2001 led to unprecedented public health and law enforcement investigations, which involved thousands of investigators from federal, state, and local agencies. Following recognition of the first cases of anthrax in Florida in early October 2001, investigators from Centers for Disease Control and Prevention (CDC) and the Federal Bureau of Investigation (FBI) were mobilized to assist investigators from state and local public health and law enforcement agencies. Although public health and criminal investigations have been conducted in concert in the past, the response to the anthrax attacks required close collaboration because of the immediate and ongoing threat to public safety. We describe the collaborations between CDC and FBI during the investigation of the 2001 anthrax attacks and highlight the challenges and successes of public health and law enforcement collaborations in general. PMID:12396931

National Antimicrobial Resistance Monitoring System: Two Decades of Advancing Public Health Through Integrated Surveillance of Antimicrobial Resistance

PubMed Central

Tate, Heather; Plumblee, Jodie R.; Dessai, Uday; Whichard, Jean M.; Thacker, Eileen L.; Hale, Kis Robertson; Wilson, Wanda; Friedman, Cindy R.; Griffin, Patricia M.; McDermott, Patrick F.

2017-01-01

Abstract Drug-resistant bacterial infections pose a serious and growing public health threat globally. In this review, we describe the role of the National Antimicrobial Resistance Monitoring System (NARMS) in providing data that help address the resistance problem and show how such a program can have broad positive impacts on public health. NARMS was formed two decades ago to help assess the consequences to human health arising from the use of antimicrobial drugs in food animal production in the United States. A collaboration among the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the United States Department of Agriculture, and state and local health departments, NARMS uses an integrated “One Health” approach to monitor antimicrobial resistance in enteric bacteria from humans, retail meat, and food animals. NARMS has adapted to changing needs and threats by expanding surveillance catchment areas, examining new isolate sources, adding bacteria, adjusting sampling schemes, and modifying antimicrobial agents tested. NARMS data are not only essential for ensuring that antimicrobial drugs approved for food animals are used in ways that are safe for human health but they also help address broader food safety priorities. NARMS surveillance, applied research studies, and outbreak isolate testing provide data on the emergence of drug-resistant enteric bacteria; genetic mechanisms underlying resistance; movement of bacterial populations among humans, food, and food animals; and sources and outcomes of resistant and susceptible infections. These data can be used to guide and evaluate the impact of science-based policies, regulatory actions, antimicrobial stewardship initiatives, and other public health efforts aimed at preserving drug effectiveness, improving patient outcomes, and preventing infections. Many improvements have been made to NARMS over time and the program will continue to adapt to address emerging resistance threats

Regional Climate Change and Development of Public Health Decision Aids

NASA Astrophysics Data System (ADS)

Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

2011-12-01

According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

A Conceptualization of Threat Communications and Preventive Health Behavior.

ERIC Educational Resources Information Center

Beck, Kenneth H.; Frankel, Arthur

Making others especially fearful of what can happen if they ignore the advice given in a health-threat warning (fear appeal) encourages their acceptance of the message most of the time, though occasionally this strategy backfires. Current formulations of fear appeals are unable to reconcile these findings satisfactorily. The drive model notion…

Public Health Significance of Neuroticism

PubMed Central

Lahey, Benjamin B.

2009-01-01

The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss. Individuals in the population vary markedly on this trait, ranging from frequent and intense emotional reactions to minor challenges to little emotional reaction even in the face of significant difficulties. Although not widely appreciated, there is growing evidence that neuroticism is a psychological trait of profound public health significance. Neuroticism is a robust correlate and predictor of many different mental and physical disorders, comorbidity among them, and the frequency of mental and general health service use. Indeed, neuroticism apparently is a predictor of the quality and longevity of our lives. Achieving a full understanding of the nature and origins of neuroticism, and the mechanisms through which neuroticism is linked to mental and physical disorders, should be a top priority for research. Knowing why neuroticism predicts such a wide variety of seemingly diverse outcomes should lead to improved understanding of commonalities among those outcomes and improved strategies for preventing them. PMID:19449983

Climate change is likely to worsen the public health threat of diarrheal disease in Botswana.

PubMed

Alexander, Kathleen A; Carzolio, Marcos; Goodin, Douglas; Vance, Eric

2013-03-26

Diarrheal disease is an important health challenge, accounting for the majority of childhood deaths globally. Climate change is expected to increase the global burden of diarrheal disease but little is known regarding climate drivers, particularly in Africa. Using health data from Botswana spanning a 30-year period (1974-2003), we evaluated monthly reports of diarrheal disease among patients presenting to Botswana health facilities and compared this to climatic variables. Diarrheal case incidence presents with a bimodal cyclical pattern with peaks in March (ANOVA p < 0.001) and October (ANOVA p < 0.001) in the wet and dry season, respectively. There is a strong positive autocorrelation (p < 0.001) in the number of reported diarrhea cases at the one-month lag level. Climatic variables (rainfall, minimum temperature, and vapor pressure) predicted seasonal diarrheal with a one-month lag in variables (p < 0.001). Diarrheal case incidence was highest in the dry season after accounting for other variables, exhibiting on average a 20% increase over the yearly mean (p < 0.001). Our analysis suggests that forecasted climate change increases in temperature and decreases in precipitation may increase dry season diarrheal disease incidence with hot, dry conditions starting earlier and lasting longer. Diarrheal disease incidence in the wet season is likely to decline. Our results identify significant health-climate interactions, highlighting the need for an escalated public health focus on controlling diarrheal disease in Botswana. Study findings have application to other arid countries in Africa where diarrheal disease is a persistent public health problem.

Climate Change is Likely to Worsen the Public Health Threat of Diarrheal Disease in Botswana

PubMed Central

Alexander, Kathleen A.; Carzolio, Marcos; Goodin, Douglas; Vance, Eric

2013-01-01

Diarrheal disease is an important health challenge, accounting for the majority of childhood deaths globally. Climate change is expected to increase the global burden of diarrheal disease but little is known regarding climate drivers, particularly in Africa. Using health data from Botswana spanning a 30-year period (1974–2003), we evaluated monthly reports of diarrheal disease among patients presenting to Botswana health facilities and compared this to climatic variables. Diarrheal case incidence presents with a bimodal cyclical pattern with peaks in March (ANOVA p < 0.001) and October (ANOVA p < 0.001) in the wet and dry season, respectively. There is a strong positive autocorrelation (p < 0.001) in the number of reported diarrhea cases at the one-month lag level. Climatic variables (rainfall, minimum temperature, and vapor pressure) predicted seasonal diarrheal with a one-month lag in variables (p < 0.001). Diarrheal case incidence was highest in the dry season after accounting for other variables, exhibiting on average a 20% increase over the yearly mean (p < 0.001). Our analysis suggests that forecasted climate change increases in temperature and decreases in precipitation may increase dry season diarrheal disease incidence with hot, dry conditions starting earlier and lasting longer. Diarrheal disease incidence in the wet season is likely to decline. Our results identify significant health-climate interactions, highlighting the need for an escalated public health focus on controlling diarrheal disease in Botswana. Study findings have application to other arid countries in Africa where diarrheal disease is a persistent public health problem. PMID:23531489

Work-related violence and its association with self-rated general health among public sector employees in Sweden.

PubMed

Vaez, Marjan; Josephson, Malin; Vingård, Eva; Voss, Margaretha

2014-01-01

Work-related violence is one of the most serious threats to employee safety and health. To ascertain the extent of self-reported violence or threats of violence at work in relation to the general health of public sector employees. The study population comprised 9,611 female (83%) and male public employees in Sweden. A questionnaire based on items derived mainly from validated instruments was constructed to cover aspects such as health, lifestyle, and physical and psychosocial work conditions. One in three employees reported work-related violence, with the highest proportions among psychiatric nurses (79%) and psychiatric attendants (75%). Work-related violence more often affected those who were < 45 years old, worked < 40 hours/week, worked nights, or reported poor health. Regardless of gender, age, hours of work, night work, and type of occupation, exposure to work-related violence was associated with less than good general health, and this relationship was strongest for psychiatric nurses (OR=3.19; 95% CI=1.28-7.98), medical doctors/dentists (OR=2.46; 95% CI=1.35-4.49), compulsory school teachers (OR=2.14; 95% CI=1.33-3.45), and other nurses (OR=1.87; 95% CI=1.23-2.84). Work-related violence was frequently reported by employees in the most common public sector occupations, and it was associated with poor health in both genders.

Managing facility risk: external threats and health care organizations.

PubMed

Reid, Daniel J; Reid, William H

2014-01-01

Clinicians and clinical administrators should have a basic understanding of physical and financial risk to mental health facilities related to external physical threat, including actions usually viewed as "terrorism" and much more common sources of violence. This article refers to threats from mentally ill persons and those acting out of bizarre or misguided "revenge," extortionists and other outright criminals, and perpetrators usually identified as domestic or international terrorists. The principles apply both to relatively small and contained acts (such as a patient or ex-patient attacking a staff member) and to much larger events (such as bombings and armed attack), and are relevant to facilities both within and outside the U.S. Patient care and accessibility to mental health services rest not only on clinical skills, but also on a place to practice them and an organized system supported by staff, physical facilities, and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or to serve at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state and national standards for hospital safety, or insurance providers' individual facility requirements. Copyright © 2014 John Wiley & Sons, Ltd.

COST action TD1407: network on technology-critical elements (NOTICE)--from environmental processes to human health threats.

PubMed

Cobelo-García, A; Filella, M; Croot, P; Frazzoli, C; Du Laing, G; Ospina-Alvarez, N; Rauch, S; Salaun, P; Schäfer, J; Zimmermann, S

2015-10-01

The current socio-economic, environmental and public health challenges that countries are facing clearly need common-defined strategies to inform and support our transition to a sustainable economy. Here, the technology-critical elements (which includes Ga, Ge, In, Te, Nb, Ta, Tl, the Platinum Group Elements and most of the rare-earth elements) are of great relevance in the development of emerging key technologies-including renewable energy, energy efficiency, electronics or the aerospace industry. In this context, the increasing use of technology-critical elements (TCEs) and associated environmental impacts (from mining to end-of-life waste products) is not restricted to a national level but covers most likely a global scale. Accordingly, the European COST Action TD1407: Network on Technology-Critical Elements (NOTICE)-from environmental processes to human health threats, has an overall objective for creating a network of scientists and practitioners interested in TCEs, from the evaluation of their environmental processes to understanding potential human health threats, with the aim of defining the current state of knowledge and gaps, proposing priority research lines/activities and acting as a platform for new collaborations and joint research projects. The Action is focused on three major scientific areas: (i) analytical chemistry, (ii) environmental biogeochemistry and (iii) human exposure and (eco)-toxicology.

Public health-specific personal disaster preparedness training: an academic-practice collaboration.

PubMed

Kohn, Sivan; Semon, Natalie; Hedlin, Haley K; Thompson, Carol B; Marum, Felicity; Jenkins, Sebra; Slemp, Catherine C; Barnett, Daniel J

2014-01-01

To measure the following three relevant outcomes of a personal preparedness curriculum for public health workers: 1) the extent of change (increase) in knowledge about personal preparedness activities and knowledge about tools for conducting personal preparedness activities; 2) the extent of change (increase) in preparedness activities performed post-training and/or confidence in conducting these tasks; and 3) an understanding of how to improve levels of personal preparedness using the Extended Parallel Process Model (EPPM) framework. Cross-sectional preinterventional and postinterventional survey using a convenience sample. During 2010, three face-to-face workshops were conducted in three locations in West Virginia. One hundred thirty-one participants (baseline survey); 69 participants (1-year resurvey)-representing West Virginia local health department (LHD) and State Health Department employees. A 3-hour interactive, public health-specific, face-to-face workshop on personal disaster preparedness. Change in 1) knowledge about, and tools for, personal preparedness activities; 2) preparedness activities performed post-training and/or confidence in conducting these activities; and 3) the relationship of EPPM categories to personal preparedness activities. One year postworkshop, 77 percent of respondents reported having personal emergency kits (40 percent at baseline) and 67 percent reported having preparedness plans (38 percent at baseline) suggesting some participants assembled supply kits and plans postworkshop. Within the context of EPPM, respondents in high-threat categories agreed more often than respondents in low-threat categories that severe personal impacts were likely to result from a moderate flood. Compared to respondents categorized as low efficacy, respondents in high-efficacy categories perceived confidence in their knowledge and an impact of their response on their job success at higher rates. Personal disaster preparedness trainings for the LHD

Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article

PubMed Central

HU, Jiaxiang; CHEN, Chao; KUAI, Tingting

2018-01-01

Background: With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. Methods: This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. Results: EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. Conclusion: The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China. PMID:29445625

Reactions to a health threat: dispositional threat orientations and message characteristics.

PubMed

Thompson, Suzanne C; Schlehofer, Michèle M; Gonzalez, Amelia; Denison, Elizabeth

2011-05-01

This study explored the interactive effects of dispositional threat orientation, type of message, and having children on reactions to a message about exposure to bisphenol A (BPA) in plastics. The study used a 2 (message: Fear Arousal or Plain)×2 (parenting status: child or no child)×2 (threat orientation: high or low) mixed factorial design. Adults (N= 200) recruited via the Internet completed measures of threat orientations, reported whether they were a parent, and read either a low or high fear-arousal message about the risks of BPA exposure. They then completed measures of reactions to the message (perceived susceptibility to BPA effects, negative emotions, and behavioural intentions to engage in protection). Depending on threat orientations, the fear arousal version of the message and parenthood had strikingly different effects, ranging from no effect (for those high in a control-based approach) to prompting change (for those low in a control-based approach) to counterproductive (for those high in an optimistic denial approach). These findings suggest that considering individual differences and their interactions with situational factors could improve both the predictive ability of threat protection theories and the delivery of messages intended to change behaviour. ©2010 The British Psychological Society.

Partners in Public Health: Public Health Collaborations With Schools of Pharmacy, 2015.

PubMed

DiPietro Mager, Natalie A; Ochs, Leslie; Ranelli, Paul L; Kahaleh, Abby A; Lahoz, Monina R; Patel, Radha V; Garza, Oscar W; Isaacs, Diana; Clark, Suzanne

To collect data on public health collaborations with schools of pharmacy, we sent a short electronic survey to accredited and preaccredited pharmacy programs in 2015. We categorized public health collaborations as working or partnering with local and/or state public health departments, local and/or state public health organizations, academic schools or programs of public health, and other public health collaborations. Of 134 schools, 65 responded (49% response rate). Forty-six (71%) responding institutions indicated collaborations with local and/or state public health departments, 34 (52%) with schools or programs of public health, and 24 (37%) with local and/or state public health organizations. Common themes of collaborations included educational programs, community outreach, research, and teaching in areas such as tobacco control, emergency preparedness, chronic disease, drug abuse, immunizations, and medication therapy management. Interdisciplinary public health collaborations with schools of pharmacy provide additional resources for ensuring the health of communities and expose student pharmacists to opportunities to use their training and abilities to affect public health. Examples of these partnerships may stimulate additional ideas for possible collaborations between public health organizations and schools of pharmacy.

Wider horizons, wiser choices: horizon scanning for public health protection and improvement.

PubMed

Urquhart, Graham J; Saunders, Patrick

2017-06-01

Systematic continuous thinking about the future helps organizations, professions and communities to both prepare for, and shape, the future. This becomes ever more critical given the accelerating rate at which new data emerge, and in some cases uncertainties around their reliability and interpretation. Businesses with the capability to filter and analyse vast volumes of data to create knowledge and insights requiring action have a competitive advantage. Similarly Government and the public sector, including public health can be more effective and efficient through the early identification of emerging issues (both threats and opportunities). Horizon scanning approaches, and the use of resulting intelligence related to health protection and improvement were reviewed. Public health horizon scanning systems have to date focussed on health technologies and infectious diseases. While these have been successful there is a major gap in terms of non-infectious hazards and health improvement. Any system to meet this need must recognize the changed environment for delivering front line public health services and the critical role of local authorities and the local democratic process. This presents opportunities and challenges and this paper explores those dynamics describing an existing environment and health horizon scanning system which could readily and rapidly be re-engineered to provide a national service. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The global threat of antimicrobial resistance: science for intervention

PubMed Central

Roca, I.; Akova, M.; Baquero, F.; Carlet, J.; Cavaleri, M.; Coenen, S.; Cohen, J.; Findlay, D.; Gyssens, I.; Heure, O.E.; Kahlmeter, G.; Kruse, H.; Laxminarayan, R.; Liébana, E.; López-Cerero, L.; MacGowan, A.; Martins, M.; Rodríguez-Baño, J.; Rolain, J.-M.; Segovia, C.; Sigauque, B.; Taconelli, E.; Wellington, E.; Vila, J.

2015-01-01

In the last decade we have witnessed a dramatic increase in the proportion and absolute number of bacterial pathogens resistant to multiple antibacterial agents. Multidrug-resistant bacteria are currently considered as an emergent global disease and a major public health problem. The B-Debate meeting brought together renowned experts representing the main stakeholders (i.e. policy makers, public health authorities, regulatory agencies, pharmaceutical companies and the scientific community at large) to review the global threat of antibiotic resistance and come up with a coordinated set of strategies to fight antimicrobial resistance in a multifaceted approach. We summarize the views of the B-Debate participants regarding the current situation of antimicrobial resistance in animals and the food chain, within the community and the healthcare setting as well as the role of the environment and the development of novel diagnostic and therapeutic strategies, providing expert recommendations to tackle the global threat of antimicrobial resistance. PMID:26029375

Public health in Canada: Evolution, meaning and a new paradigm for respiratory therapy

PubMed Central

West, Andrew J

2013-01-01

Chronic disease burden in Canada poses an imminent public health threat. The impact of respiratory disease in Canada alone is significant, affecting one in five and leading any other cause of repeat hospitalization in all age groups. Public health action is considered to be an important means of addressing these issues. Historical understanding of health has evolved to support the adoption of paradigms by professions that recognize the limitations of medical intervention in addressing the fundamental basis of disease when compared with the broader public health perspective. Several key historical events have shaped this understanding in the Canadian context including the Lalonde and Epp reports, and public health emergencies such as the severe acute respiratory syndrome outbreak in 2003. The profession of respiratory therapy has historically existed within a medicalized paradigm of practice; however, forces both internal and external to the profession are pressuring it to consider adopting broader social-and population-based approaches. As a rapidly evolving profession, there is a need to explore emerging areas of practice opportunities in the discipline. Investigating alternative knowledge and ideology can ensure that effective strategies for addressing the contemporary respiratory heath needs of Canadians are undertaken. The present article explores the rationale for a public health- and population-based approach to health in general, and its applicability to the respiratory therapist’s role in addressing respiratory health-related issues in Canada. PMID:26078595

Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks.

PubMed

Petkova, Elisaveta P; Ebi, Kristie L; Culp, Derrin; Redlener, Irwin

2015-08-11

The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region's coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region's unique vulnerabilities, and outlines recommendations for improving the region's ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

When does risk perception predict protection motivation for health threats? A person-by-situation analysis.

PubMed

Ferrer, Rebecca A; Klein, William M P; Avishai, Aya; Jones, Katelyn; Villegas, Megan; Sheeran, Paschal

2018-01-01

Although risk perception is a key concept in many health behavior theories, little research has explicitly tested when risk perception predicts motivation to take protective action against a health threat (protection motivation). The present study tackled this question by (a) adopting a multidimensional model of risk perception that comprises deliberative, affective, and experiential components (the TRIRISK model), and (b) taking a person-by-situation approach. We leveraged a highly intensive within-subjects paradigm to test features of the health threat (i.e., perceived severity) and individual differences (e.g., emotion reappraisal) as moderators of the relationship between the three types of risk perception and protection motivation in a within-subjects design. Multi-level modeling of 2968 observations (32 health threats across 94 participants) showed interactions among the TRIRISK components and moderation both by person-level and situational factors. For instance, affective risk perception better predicted protection motivation when deliberative risk perception was high, when the threat was less severe, and among participants who engage less in emotional reappraisal. These findings support the TRIRISK model and offer new insights into when risk perceptions predict protection motivation.

When does risk perception predict protection motivation for health threats? A person-by-situation analysis

PubMed Central

Klein, William M. P.; Avishai, Aya; Jones, Katelyn; Villegas, Megan; Sheeran, Paschal

2018-01-01

Although risk perception is a key concept in many health behavior theories, little research has explicitly tested when risk perception predicts motivation to take protective action against a health threat (protection motivation). The present study tackled this question by (a) adopting a multidimensional model of risk perception that comprises deliberative, affective, and experiential components (the TRIRISK model), and (b) taking a person-by-situation approach. We leveraged a highly intensive within-subjects paradigm to test features of the health threat (i.e., perceived severity) and individual differences (e.g., emotion reappraisal) as moderators of the relationship between the three types of risk perception and protection motivation in a within-subjects design. Multi-level modeling of 2968 observations (32 health threats across 94 participants) showed interactions among the TRIRISK components and moderation both by person-level and situational factors. For instance, affective risk perception better predicted protection motivation when deliberative risk perception was high, when the threat was less severe, and among participants who engage less in emotional reappraisal. These findings support the TRIRISK model and offer new insights into when risk perceptions predict protection motivation. PMID:29494705

Avian influenza virus (H5N1): a threat to human health.

PubMed

Peiris, J S Malik; de Jong, Menno D; Guan, Yi

2007-04-01

Pandemic influenza virus has its origins in avian influenza viruses. The highly pathogenic avian influenza virus subtype H5N1 is already panzootic in poultry, with attendant economic consequences. It continues to cross species barriers to infect humans and other mammals, often with fatal outcomes. Therefore, H5N1 virus has rightly received attention as a potential pandemic threat. However, it is noted that the pandemics of 1957 and 1968 did not arise from highly pathogenic influenza viruses, and the next pandemic may well arise from a low-pathogenicity virus. The rationale for particular concern about an H5N1 pandemic is not its inevitability but its potential severity. An H5N1 pandemic is an event of low probability but one of high human health impact and poses a predicament for public health. Here, we review the ecology and evolution of highly pathogenic avian influenza H5N1 viruses, assess the pandemic risk, and address aspects of human H5N1 disease in relation to its epidemiology, clinical presentation, pathogenesis, diagnosis, and management.

The health information system security threat lifecycle: an informatics theory.

PubMed

Fernando, Juanita I; Dawson, Linda L

2009-12-01

This manuscript describes the health information system security threat lifecycle (HISSTL) theory. The theory is grounded in case study data analyzing clinicians' health information system (HIS) privacy and security (P&S) experiences in the practice context. The 'questerview' technique was applied to this study of 26 clinicians situated in 3 large Australian (across Victoria) teaching hospitals. Questerviews rely on data collection that apply standardized questions and questionnaires during recorded interviews. Analysis (using Nvivo) involved the iterative scrutiny of interview transcripts to identify emergent themes. Issues including poor training, ambiguous legal frameworks containing punitive threats, productivity challenges, usability errors and the limitations of the natural hospital environment emerged from empirical data about the clinicians' HIS P&S practices. The natural hospital environment is defined by the permanence of electronic HISs (e-HISs), shared workspaces, outdated HIT infrastructure, constant interruption, a P&S regulatory environment that is not conducive to optimal training outcomes and budgetary constraints. The evidence also indicated the obtrusiveness, timeliness, and reliability of P&S implementations for clinical work affected participant attitudes to, and use of, e-HISs. The HISSTL emerged from the analysis of study evidence. The theory embodies elements such as the fiscal, regulatory and natural hospital environments which impede P&S implementations in practice settings. These elements conflict with improved patient care outcomes. Efforts by clinicians to avoid conflict and emphasize patient care above P&S tended to manifest as security breaches. These breaches entrench factors beyond clinician control and perpetuate those within clinician control. Security breaches of health information can progress through the HISSTL. Some preliminary suggestions for addressing these issues are proposed. Legislative frameworks that are not related to

Genocide and public health: German doctors and Polish Jews, 1939-41.

PubMed

Browning, Christopher R

1988-01-01

German doctors in the General Government played an important role in providing the medical rationalization for ghettoization and mass murder. Their desire to prevent the spread of disease to Germans led them to favour providing adequate health care for Poles. The same self-interest engendered their persistent advocacy of ghettoization for Jews, who were believed to be natural carriers of spotted fever. When ghetto conditions created a self-fulfilling prophecy of wide-spread disease, the doctors advocated tighter sealing of the ghettos. By late 1941, this self-induced threat to public health made the doctors receptive to a mass murder solution.

Using social network analysis to understand Missouri's system of public health emergency planners.

PubMed

Harris, Jenine K; Clements, Bruce

2007-01-01

Effective response to large-scale public health threats requires well-coordinated efforts among individuals and agencies. While guidance is available to help states put emergency planning programs into place, little has been done to evaluate the human infrastructure that facilitates successful implementation of these programs. This study examined the human infrastructure of the Missouri public health emergency planning system in 2006. The Center for Emergency Response and Terrorism (CERT) at the Missouri Department of Health and Senior Services has responsibility for planning, guiding, and funding statewide emergency response activities. Thirty-two public health emergency planners working primarily in county health departments contract with CERT to support statewide preparedness. We surveyed the planners to determine whom they communicate with, work with, seek expertise from, and exchange guidance with regarding emergency preparedness in Missouri. Most planners communicated regularly with planners in their region but seldom with planners outside their region. Planners also reported working with an average of 12 local entities (e.g., emergency management, hospitals/ clinics). Planners identified the following leaders in Missouri's public health emergency preparedness system: local public health emergency planners, state epidemiologists, the state vaccine and grant coordinator, regional public health emergency planners, State Emergency Management Agency area coordinators, the state Strategic National Stockpile coordinator, and Federal Bureau of Investigation Weapons of Mass Destruction coordinators. Generally, planners listed few federal-level or private-sector individuals in their emergency preparedness networks. While Missouri public health emergency planners maintain large and varied emergency preparedness networks, there are opportunities for strengthening existing ties and seeking additional connections.

Public health in England in 2016-the health of the public and the public health system: a review.

PubMed

Middleton, John

2017-01-01

This article describes the current state of the health of the public in England and the state of the public health professional service and systems. Data sources are wide ranging including the Global Burden of Disease, the Commonwealth Fund and Public Health England reports. There is a high burden of preventable disease and unacceptable inequalities in England. There is considerable expectation that there are gains to be made in preventing ill health and disability and so relieving demand on healthcare. Despite agreement on the need for prevention, the Government has cut public health budgets by a cumulative 10% to 2020. Public health professionals broadly supportive of remaining in the EU face an uphill battle to retain health, workplace and environmental protections following the 'Leave' vote. There is revitalized interest in air pollution. Extreme weather events are testing response and organizational skills of public health professionals and indicating the need for greater advocacy around climate change, biodiversity and protection of ecological systems. Planetary health and ecological public health are ideas whose time has certainly come. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Conceptualizing threats to tobacco control from international economic agreements: the Brazilian experience.

PubMed

Drope, Jeffrey; McGrady, Benn; Bialous, Stella Aguinaga; Lencucha, Raphael; Silva, Vera Luiza da Costa E

2017-10-19

Using the results of dozens of interviews with key actors involved in tobacco control policymaking, we examine these actors' perceptions of threats to tobacco control policy efforts from international economic policies on trade and investment. We also evaluate, from a legal perspective, the genuine threats that exist or potential challenges that economic policies may pose to the Brazilian government's public health efforts. We find that most actors did not perceive these economic policies as a major threat to tobacco control. Objectively, we found that some threats do exist. For example, Brazil's attempt to ban most tobacco additives and flavorings continues to met resistance at the World Trade Organization.

The rush to drill for natural gas: a public health cautionary tale.

PubMed

Finkel, Madelon L; Law, Adam

2011-05-01

Efforts to identify alternative sources of energy have focused on extracting natural gas from vast shale deposits. The Marcellus Shale, located in western New York, Pennsylvania, and Ohio, is estimated to contain enough natural gas to supply the United States for the next 45 years. New drilling technology-horizontal drilling and high-volume hydraulic fracturing of shale (fracking)-has made gas extraction much more economically feasible. However, this technique poses a threat to the environment and to the public's health. There is evidence that many of the chemicals used in fracking can damage the lungs, liver, kidneys, blood, and brain. We discuss the controversial technique of fracking and raise the issue of how to balance the need for energy with the protection of the public's health.

Threats during sex work and association with mental health among young female sex workers in Hong Kong.

PubMed

Mo, Phoenix K H; Mak, Winnie W S; Kwok, Yvonne T Y; Xin, Meiqi; Chan, Charlie W L; Yip, Louise W M

2018-08-01

Young female sex workers (YFSWs) are confronted with significant threats during sex work. The present cross-sectional study examined different levels of threats (i.e., threats to life and health, threats to humanity, threats to control of work and financial security, and the threats to future) experienced by 87 YFSWs (age 16-25) in Hong Kong, and identified their association with mental health (i.e., psychological well-being) together with other factors, including childhood trauma, self-efficacy, hope, and social support. Results showed that the participants encountered a significant number of threats. More than half reported that they had a condom removed by clients during sex (51.7%); or have been humililated by clients (51.7%). Because of sex work, about a quarter (25.3%) have had sexually transmitted disease, and respectively 10.3% and 12.6% have had abortion and unplanned pregnancy. The majority have had friends found out that they engaged in sex work (72.4%). They also showed a high level of worry about the various threats. Multiple linear regression analysis showed that childhood trauma (β = -.26) and worry about threats during sex work (β = -.22) were significantly negative predictors, while self-efficacy (β = .20) and hope (β = .27) were significantly positive predictors of mental health. Future services should improve YFSWs' skills to minimize potential threats during female sex work, address the structural correlates and relieve their worries, and empower them with more hope and self-efficacy in choosing clients.

The Application of the Haddon Matrix to Public Health Readiness and Response Planning

PubMed Central

Barnett, Daniel J.; Balicer, Ran D.; Blodgett, David; Fews, Ayanna L.; Parker, Cindy L.; Links, Jonathan M.

2005-01-01

State and local health departments continue to face unprecedented challenges in preparing for, recognizing, and responding to threats to the public’s health. The attacks of 11 September 2001 and the ensuing anthrax mailings of 2001 highlighted the public health readiness and response hurdles posed by intentionally caused injury and illness. At the same time, recent natural disasters have highlighted the need for comparable public health readiness and response capabilities. Public health readiness and response activities can be conceptualized similarly for intentional attacks, natural disasters, and human-caused accidents. Consistent with this view, the federal government has adopted the all-hazards response model as its fundamental paradigm. Adoption of this paradigm provides powerful improvements in efficiency and efficacy, because it reduces the need to create a complex family of situation-specific preparedness and response activities. However, in practice, public health preparedness requires additional models and tools to provide a framework to better understand and prioritize emergency readiness and response needs, as well as to facilitate solutions; this is particularly true at the local health department level. Here, we propose to extend the use of the Haddon matrix—a conceptual model used for more than two decades in injury prevention and response strategies—for this purpose. PMID:15866764

Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

ERIC Educational Resources Information Center

Hilton, Warren

2013-01-01

This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

Public health human resources: a comparative analysis of policy documents in two Canadian provinces

PubMed Central

2014-01-01

Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be

Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

PubMed

Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

2014-02-24

Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing

Asian tsunami relief: Department of Defense public health response: policy and strategic coordination considerations.

PubMed

Tarantino, Dave

2006-10-01

The Asian tsunami of December 26, 2004, was one of the most devastating natural disasters in modern history. In particular, this disaster created massive, unique, public health threats, necessitating equally massive public health response efforts. The U.S. government (USG), including the Department of Defense (DoD), played a pivotal role in the response. This article examines some of the central policy issues and strategic coordination and planning measures involved in the public health response. The nearly unanimous consensus of international public health experts has been that the potential public health crisis in the aftermath of the Asian tsunami was averted largely because of the coordinated efforts of host nation officials and professionals, international and nongovernmental health organizations, and bilateral donors, especially the USG, including the DoD. The DoD played a central role in public health efforts through coordination and communication assistance, logistical and materiel support, disease surveillance activities, health needs assessments, and the contributions of the USS Mercy hospital ship. The core lessons involve the importance of an early, dedicated, public health response as a component of the overall disaster relief effort, as well as seamless coordination of health sector stakeholders in the USG and with those of the international community and affected host nations, which allows each organization to play to its strengths and to avoid duplication. The Asian tsunami relief effort highlighted the value of civil-military cooperation in disaster relief, particularly in the area of public health. The prominent role of the DoD in tsunami relief efforts, including public health efforts, also yielded beneficial secondary effects by bolstering security cooperation and winning "hearts and minds" in the region.

Responding to Public Health Emergencies on Tribal Lands: Jurisdictional Challenges and Practical Solutions.

PubMed

Barnard, Justin B

2015-01-01

Response to public health emergencies on tribal lands poses a unique challenge for state and tribal public health officials. The complexity and intensely situation-specific nature of federal Indian jurisprudence leaves considerable question as to which government entity, state or tribal, has jurisdiction on tribal lands to undertake basic emergency measures such as closure of public spaces, quarantine, compulsory medical examination, and investigation. That jurisdictional uncertainty, coupled with cultural differences and an often troubled history of tribal-state relations, threatens to significantly impede response to infectious disease outbreaks or other public health emergencies on tribal lands. Given that tribal communities may be disproportionately impacted by public health emergencies, it is critical that tribal, state, and local governments engage with each other in coordinated planning for public health threats. This Article is offered as a catalyst for such planning efforts. The Article identifies some of the most pressing jurisdictional issues that may confront governments responding to a public health emergency on tribal lands, with the aim of highlighting the nature of the problem and the need for action. The Article goes on to examine the most promising means of addressing jurisdictional uncertainty: intergovernmental agreements. Already utilized in many areas of shared interest between tribe and state, intergovernmental agreements offer neighboring state, local, and tribal governments a vehicle for delineating roles and authorities in an emergency, and may lay the groundwork for sharing resources. The Article surveys various representative tribal public health intergovernmental agreements, and concludes with suggestions for tribes and state or local governments looking to craft their own agreements.

An Interim Examination of the US Public Health Response to Ebola.

PubMed

Schemm Dwyer, Katherine; Misner, Heather; Chang, Sara; Fajardo, Neyling

From the summer of 2014 to the spring of 2016, the United States was involved in the Ebola response on both the national and international levels. The United States received 2 imported cases from West Africa and had 2 locally hospital-acquired cases, which spurred a massive and unprecedented public health response. As the domestic response stabilized and the epidemic in West Africa slowed, the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO), through a cooperative agreement with the Centers for Disease Control and Prevention (CDC), led an in-progress review to assess the national public health response to Ebola. The goal was to identify opportunities to improve the Ebola response and best practices to inform future responses. To inform the review, NACCHO and ASTHO relied on feedback collected from several sources, including a stakeholder meeting held in August 2015, a series of key informant interviews, ASTHO's and NACCHO's internal response assessments, and perspectives shared by state and local health department members and workgroups and national partner organizations. ASTHO and NACCHO engaged experts and practitioners in public health, health care, emergency management, laboratory sciences, environmental health, occupational health, homeland security, communications, and public works from US federal, state, and local governments, the nonprofit community, and private industry. This article summarizes feedback and lessons learned as shared by these sources. Additionally, this article presents recommendations for federal, state, local, and nongovernment partners to improve current and future preparedness and response efforts to infectious disease threats.

The measurement of threat orientations.

PubMed

Thompson, Suzanne C; Schlehofer, Michèle M; Bovin, Michelle J

2006-01-01

To develop measures of 3 threat orientations that affect responses to health behavior messages. In Study 1, college students (N = 47) completed items assessing threat orientations and health behaviors. In Study 2, college students and community adults (N = 110) completed the threat orientation items and measures of convergent and discriminant validity. In Study 1, the control-based, denial-based, and heightened-sensitivity-based threat orientation scales demonstrated good internal consistency and correlated with engagement in health behaviors. In Study 2, the convergent and discriminant validity of the 3 measures was established. The 3 scales have good internal reliability and construct validity.

Dental Public Health In Action: Putting Oral Health on the Local Public Health Agenda.

PubMed

Walker, I F; Eapen-Simon, S; Gibson, S

2018-04-18

Oral health is a key public health issue across England. In Wakefield in the north of England, local data suggested the oral health of local children was significantly worse than the national average. This paper describes the work undertaken by Wakefield Council to strategically address this issue. A structured process was adopted. Key lessons include; having senior ownership from the Director of Public Health, partnership working across all key stakeholders, utilising dental public health expertise from Public Health England and the use of extensive engagement with stakeholders. Through this work, oral health is now identified with greater importance in Wakefield as a public health issue. Actions are now strategically co-ordinated across stakeholders to improve oral health in local children. Copyright© 2018 Dennis Barber Ltd.

Tackling emerging fungal threats to animal health, food security and ecosystem resilience.

PubMed

Fisher, Matthew C; Gow, Neil A R; Gurr, Sarah J

2016-12-05

Emerging infections caused by fungi have become a widely recognized global phenomenon. Their notoriety stems from their causing plagues and famines, driving species extinctions, and the difficulty in treating human mycoses alongside the increase of their resistance to antifungal drugs. This special issue comprises a collection of articles resulting from a Royal Society discussion meeting examining why pathogenic fungi are causing more disease now than they did in the past, and how we can tackle this rapidly emerging threat to the health of plants and animals worldwide.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

Public Health Threat of New, Reemerging, and Neglected Zoonoses in the Industrialized World

PubMed Central

Cutler, Sally J.; Fooks, Anthony R.

2010-01-01

Microbiologic infections acquired from animals, known as zoonoses, pose a risk to public health. An estimated 60% of emerging human pathogens are zoonotic. Of these pathogens, >71% have wildlife origins. These pathogens can switch hosts by acquiring new genetic combinations that have altered pathogenic potential or by changes in behavior or socioeconomic, environmental, or ecologic characteristics of the hosts. We discuss causal factors that influence the dynamics associated with emergence or reemergence of zoonoses, particularly in the industrialized world, and highlight selected examples to provide a comprehensive view of their range and diversity. PMID:20031035

Terrorism and emergency preparedness in state and territorial public health departments--United States, 2004.

PubMed

2005-05-13

After the events of September 11, 2001, federal funding for state public health preparedness programs increased from $67 million in fiscal year (FY) 2001 to approximately $1 billion in FY 2002. These funds were intended to support preparedness for and response to terrorism, infectious disease outbreaks, and other public health threats and emergencies. The Council of State and Territorial Epidemiologists (CSTE) assessed the impact of funding on epidemiologic capacity, including terrorism preparedness and response, in state health departments in November 2001 and again in May 2004, after distribution of an additional $1 billion in FY 2003. This report describes the results of those assessments, which indicated that increased funding for terrorism preparedness and emergency response has rapidly increased the number of epidemiologists and increased capacity for preparedness at the state level. However, despite the increase in epidemiologists, state public health officials estimate that 192 additional epidemiologists, an increase of 45.3%, are needed nationwide to fully staff terrorism preparedness programs.

Defining and Developing a Global Public Health Course for Public Health Graduates.

PubMed

Karkee, Rajendra; Comfort, Jude; Alfonso, Helman

2015-01-01

Global public health is increasingly being seen as a speciality field within the university education of public health. However, the exact meaning of global public health is still unclear, resulting in varied curricula and teaching units among universities. The contextual differences between high- and low- and middle-income countries, and the process of globalization need to be taken into account while developing any global public health course. Global public health and public health are not separable and global public health often appears as an extension of public health in the era of globalization and interdependence. Though global public health is readily understood as health of global population, it is mainly practiced as health problems and their solutions set within low- and middle-income countries. Additional specialist competencies relevant to the context of low- and middle-income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalization and its impact on health; disease burden; culture, society, and politics; and management are important.

From public health genomics to precision public health: a 20-year journey.

PubMed

Khoury, Muin J; Bowen, M Scott; Clyne, Mindy; Dotson, W David; Gwinn, Marta L; Green, Ridgely Fisk; Kolor, Katherine; Rodriguez, Juan L; Wulf, Anja; Yu, Wei

2018-06-01

In this paper, we review the evolution of the field of public health genomics in the United States in the past two decades. Public health genomics focuses on effective and responsible translation of genomic science into population health benefits. We discuss the relationship of the field to the core public health functions and essential services, review its evidentiary foundation, and provide examples of current US public health priorities and applications. We cite examples of publications to illustrate how Genetics in Medicine reflected the evolution of the field. We also reflect on how public-health genomics is contributing to the emergence of "precision public health" with near-term opportunities offered by the US Precision Medicine (AllofUs) Initiative.

Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis.

PubMed

Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank

2016-01-01

The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.

Threats to the health care safety net.

PubMed

Taylor, T B

2001-11-01

The American health care safety net is threatened due to inadequate funding in the face of increasing demand for services by virtually every segment of our society. The safety net is vital to public safety because it is the sole provider for first-line emergency care, as well as for routine health care of last resort, through hospital emergency departments (ED), emergency medical services providers (EMS), and public/free clinics. Despite the perceived complexity, the causes and solutions for the current crisis reside in simple economics. During the last two decades health care funding has radically changed, yet the fundamental infrastructure of the safety net has change little. In 1986, the Emergency Medical Treatment and Active Labor Act established federally mandated safety net care that inadvertently encouraged reliance on hospital EDs as the principal safety net resource. At the same time, decreasing health care funding from both private and public sources resulted in declining availability of services necessary to support this shift in demand, including hospital inpatient beds, EDs, EMS providers, on-call specialists, hospital-based nurses, and public hospitals/clinics. The result has been ED/hospital crowding and resource shortages that at times limit the ability to provide even true emergency care and threaten the ability of the traditional safety net to protect public health and safety. This paper explores the composition of the American health care safety net, the root causes for its disintegration, and offers short- and long-term solutions. The solutions discussed include restructuring of disproportionate share funding; presumed (deemed) eligibility for Medicaid eligibility; restructuring of funding for emergency care; health care for foreign nationals; the nursing shortage; utilization of a "health care resources commission"; "episodic (periodic)" health care coverage; best practices and health care services coordination; and government and hospital

Incidence of online health information search: a useful proxy for public health risk perception.

PubMed

Liang, Bo; Scammon, Debra L

2013-06-17

) and public health funds (P=.02)-have significant effects on Web searches for queries related to the flu. After controlling for the number of reported disease cases and Internet access rate by state, we estimate the contribution of social factors to the public health risk perception levels by state (R(2)=23.37%). The interaction effects between flu incidence and social factors for our search terms did not add to the explanatory power of our regression models (R(2)<1%). Our study suggests a practical way to measure the public's health risk perception for certain diseases using online information search volume by state. The social environment influences public risk perception regardless of disease incidence. Thus, monitoring the social variables can be very helpful in being ready to respond to the public's behavior in dealing with public health threats.

Zika Virus: An Emerging Global Health Threat

PubMed Central

Mittal, Rahul; Nguyen, Desiree; Debs, Luca H.; Patel, Amit P.; Liu, George; Jhaveri, Vasanti M.; S. Kay, Sae-In; Mittal, Jeenu; Bandstra, Emmalee S.; Younis, Ramzi T.; Chapagain, Prem; Jayaweera, Dushyantha T.; Liu, Xue Zhong

2017-01-01

Zika virus (ZIKV) is an emerging healthcare threat. The presence of the mosquito Aedes species across South and Central America in combination with complementary climates have incited an epidemic of locally transmitted cases of ZIKV infection in Brazil. As one of the most significant current public health concerns in the Americas, ZIKV epidemic has been a cause of alarm due to its known and unknown complications. At this point, there has been a clear association between ZIKV infection and severe clinical manifestations in both adults and neonates, including but not limited to neurological deficits such as Guillain-Barré syndrome (GBS) and microcephaly, respectively. The gravity of the fetal anomalies linked to ZIKV vertical transmission from the mother has prompted a discussion on whether to include ZIKV as a formal member of the TORCH [Toxoplasma gondii, other, rubella virus, cytomegalovirus (CMV), and herpes] family of pathogens known to breach placental barriers and cause congenital disease in the fetus. The mechanisms of these complex phenotypes have yet to be fully described. As such, diagnostic tools are limited and no effective modalities are available to treat ZIKV. This article will review the recent advancements in understanding the pathogenesis of ZIKV infection as well as diagnostic tests available to detect the infection. Due to the increase in incidence of ZIKV infections, there is an immediate need to develop new diagnostic tools and novel preventive as well as therapeutic modalities based on understanding the molecular mechanisms underlying the disease. PMID:29276699

Public health issues.

PubMed

Ward, R D

1992-04-01

In a recent MSMS survey, MSMS members ranked public health as one the top five issues of major concern to Michigan physicians. Tobacco use, chronic illness, and HIV-infected health care workers comprise some of the major public health issues facing physicians and patients in Michigan. Following is a brief examination of each of these issues. Also included is a brief discussion of medical doctors as public health directors. Should all public health directors be medical doctors? This question is addressed in this cover story.

Health economics in public health.

PubMed

Ammerman, Alice S; Farrelly, Matthew A; Cavallo, David N; Ickes, Scott B; Hoerger, Thomas J

2009-03-01

Economic analysis is an important tool in deciding how to allocate scarce public health resources; however, there is currently a dearth of such analysis by public health researchers. Public health researchers and practitioners were surveyed to determine their current use of health economics and to identify barriers to use as well as potential strategies to decrease those barriers in order to allow them to more effectively incorporate economic analyses into their work. Data collected from five focus groups informed survey development. The survey included a demographic section and 14 multi-part questions. Participants were recruited in 2006 from three national public health organizations through e-mail; 294 academicians, practitioners, and community representatives answered the survey. Survey data were analyzed in 2007. Despite an expressed belief in the importance of health economics, more than half of the respondents reported very little or no current use of health economics in their work. Of those using health economics, cost-benefit and cost-effectiveness analysis and determination of public health costs were cited as the measures used most frequently. The most important barriers were lack of expertise, funding, time, tools, and data, as well as discomfort with economic theory. The resource deemed most important to using health economics was collaboration with economists or those with economic training. Respondents indicated a desire to learn more about health economics and tools for performing economic analysis. Given the importance of incorporating economic analysis into public health interventions, and the desire of survey respondents for more collaboration with health economists, opportunities for such collaborations should be increased.

The Nation's Top HIV/AIDS Researcher Discusses This Continuing Health Threat

MedlinePlus

Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS The Nation's Top HIV/AIDS Researcher Discusses This Continuing Health Threat Past ... on. For more than 30 years, the NIH's HIV/AIDS research program has been led by Dr. ...

Risk assessment of vector-borne diseases for public health governance.

PubMed

Sedda, L; Morley, D W; Braks, M A H; De Simone, L; Benz, D; Rogers, D J

2014-12-01

In the context of public health, risk governance (or risk analysis) is a framework for the assessment and subsequent management and/or control of the danger posed by an identified disease threat. Generic frameworks in which to carry out risk assessment have been developed by various agencies. These include monitoring, data collection, statistical analysis and dissemination. Due to the inherent complexity of disease systems, however, the generic approach must be modified for individual, disease-specific risk assessment frameworks. The analysis was based on the review of the current risk assessments of vector-borne diseases adopted by the main Public Health organisations (OIE, WHO, ECDC, FAO, CDC etc…). Literature, legislation and statistical assessment of the risk analysis frameworks. This review outlines the need for the development of a general public health risk assessment method for vector-borne diseases, in order to guarantee that sufficient information is gathered to apply robust models of risk assessment. Stochastic (especially spatial) methods, often in Bayesian frameworks are now gaining prominence in standard risk assessment procedures because of their ability to assess accurately model uncertainties. Risk assessment needs to be addressed quantitatively wherever possible, and submitted with its quality assessment in order to enable successful public health measures to be adopted. In terms of current practice, often a series of different models and analyses are applied to the same problem, with results and outcomes that are difficult to compare because of the unknown model and data uncertainties. Therefore, the risk assessment areas in need of further research are identified in this article. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Moving towards a new vision: implementation of a public health policy intervention.

PubMed

Valaitis, Ruta; MacDonald, Marjorie; Kothari, Anita; O'Mara, Linda; Regan, Sandra; Garcia, John; Murray, Nancy; Manson, Heather; Peroff-Johnston, Nancy; Bursey, Gayle; Boyko, Jennifer

2016-05-17

Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public's health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers', managers' and senior managements' perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups) and 2011 (senior management interviews) involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues' empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals; diffusion and dissemination; the outer context

Communication and marketing as climate change-intervention assets a public health perspective.

PubMed

Maibach, Edward W; Roser-Renouf, Connie; Leiserowitz, Anthony

2008-11-01

The understanding that global climate change represents a profound threat to the health and well-being of human and nonhuman species worldwide is growing. This article examines the potential of communication and marketing interventions to influence population behavior in ways consistent with climate change prevention and adaptation objectives. Specifically, using a framework based on an ecologic model of public health, the paper examines: (1) the potential of communication and marketing interventions to influence population behaviors of concern, including support for appropriate public policies; (2) potential target audiences for such programs; and (3) the attributes of effective climate change messages. Communication and marketing interventions appear to have considerable potential to promote important population behavior change objectives, but there is an urgent need for additional translational research to effectively harvest this potential to combat climate change.

The Rush to Drill for Natural Gas: A Public Health Cautionary Tale

PubMed Central

Law, Adam

2011-01-01

Efforts to identify alternative sources of energy have focused on extracting natural gas from vast shale deposits. The Marcellus Shale, located in western New York, Pennsylvania, and Ohio, is estimated to contain enough natural gas to supply the United States for the next 45 years. New drilling technology—horizontal drilling and high-volume hydraulic fracturing of shale (fracking)—has made gas extraction much more economically feasible. However, this technique poses a threat to the environment and to the public's health. There is evidence that many of the chemicals used in fracking can damage the lungs, liver, kidneys, blood, and brain. We discuss the controversial technique of fracking and raise the issue of how to balance the need for energy with the protection of the public's health. PMID:21421959

EPPM and willingness to respond: the role of risk and efficacy communication in strengthening public health emergency response systems.

PubMed

Barnett, Daniel J; Thompson, Carol B; Semon, Natalie L; Errett, Nicole A; Harrison, Krista L; Anderson, Marilyn K; Ferrell, Justin L; Freiheit, Jennifer M; Hudson, Robert; McKee, Mary; Mejia-Echeverry, Alvaro; Spitzer, James; Balicer, Ran D; Links, Jonathan M; Storey, J Douglas

2014-01-01

This study examines the attitudinal impact of an Extended Parallel Process Model (EPPM)-based training curriculum on local public health department (LHD) workers' willingness to respond to representative public health emergency scenarios. Data are from 71 U.S. LHDs in urban and rural settings across nine states. The study explores changes in response willingness and EPPM threat and efficacy appraisals between randomly assigned control versus intervention health departments, at baseline and 1 week post curriculum, through an EPPM-based survey/resurvey design. Levels of response willingness and emergency response-related attitudes/beliefs are measured. Analyses focus on two scenario categories that have appeared on a U.S. government list of scenarios of significant concern: a weather-related emergency and a radiological "dirty" bomb event (U.S. Department of Homeland Security, 2007). The greatest impact from the training intervention on response willingness was observed among LHD workers who had low levels of EPPM-related threat and efficacy perceptions at baseline. Self-efficacy and response efficacy and response willingness increased in intervention LHDs for both scenarios, with greater response willingness increases observed for the radiological "dirty" bomb terrorism scenario. Findings indicate the importance of building efficacy versus enhancing threat perceptions as a path toward greater response willingness, and suggest the potential applicability of such curricular interventions for boosting emergency response willingness among other cadres of health providers.

The course of specialization in public health in Rio de Janeiro, Brazil, from 1926 to 2006: lessons and challenges

PubMed Central

2010-01-01

Background Public health, as a field of knowledge, depends on its professionals. Their education and training, therefore, is considered to be an important factor for the quality of health services. In Brazil, the Course of Specialization in Public Health of the National School of Public Health is one of the oldest in the country. The course has existed for over 80 years, during which it has had an eventful history, with modifications in its organization, interruptions in its delivery, threats to its survival and changes in the institutions hosting it, reflecting the wider transformation in Brazilian society and public life over that period. Methods In this article we analyse this course via its history, disciplines, organization and characteristics of the student body. Results Insights were gained into the advancement of public health in Brazil and the progress of education for professionals in this field was highlighted. The course has formed nearly 2000 specialists in public health. Conclusions An analysis of the course's history provides valuable lessons for other schools of public health trying to train professionals in developing countries. PMID:20205733

Public health ethics: from foundations and frameworks to justice and global public health.

PubMed

Kass, Nancy E

2004-01-01

Ethics dilemmas have been present throughout the history of public health, and bioethics has devoted considerable attention to issues relevant to public health. Only recently, however, has public health ethics emerged as a recognized subfield of bioethics. Public health ethics requires that public health improvement come through just and respectful means. Bioethics in the future not only will take on more issues of public ethics, but will apply it extensive scholarship in distributive justice to questions of global public health.

Antibiotic innovation for future public health needs.

PubMed

Theuretzbacher, U

2017-10-01

The public health threat of antibiotic resistance has gained attention at the highest political levels globally, and recommendations on how to respond are being considered for implementation. Among the recommended responses being explored for their feasibility is the introduction of economic incentives to promote research and development of new antibiotics. There is broad agreement that public investment should stimulate innovation and be linked to policies promoting sustainable and equitable access to antibiotics. Though commonly used, the term 'innovation' is not based on a common understanding. This article aims to initiate discussion on the meaning of 'innovation' in this context. Literature and expert opinion. As the definition of a novel class (novel scaffold, novel pharmacophore), a novel target (novel binding site) and a novel mode of action-the three traditional criteria for 'innovation' in this context-may be confounded by the complexities of antibacterial drug discovery, a biological and outcome-oriented definition of innovation is presented to initiate discussion. Such an expanded definition of innovation in this specific context is based on the overarching requirement that a drug not be affected by cross-resistance to existing drugs in the organisms and indications for which it is intended to be used, and that it have low potential for high-frequency, high-level single-step resistance if intended as a single drug therapy. Policy makers, public health authorities and funders could use such a comprehensive definition of innovation to prioritize where publicly funded incentives should be applied. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

PubMed Central

Kuchibanda, Kizito; Mayo, Aloyce W.

2015-01-01

The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards. PMID:26779565

Health Education in India: A Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis

ERIC Educational Resources Information Center

Sharma, Manoj

2005-01-01

The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the health education profession and discipline in India. Materials from CINAHL, ERIC, MEDLINE, and Internet were collected to conduct the open coding of the SWOT analysis. Strengths of health education in India include an elaborate…

[Burnout : concepts and implications affecting public health].

PubMed

Segura, Omar

2014-01-01

Burnout was originally described as a mental condition characterized by reduced work performance, impotence, frustration and lack of capability to reach objectives or goals while performing a job. For some authors, burnout is a poorly defined mixture of symptoms and signs, while other professionals think of it as a disease and a potential threat to public health. Worldwide, it has been observed that the most afflicted professionals and technicians are those who work providing services or assistance to other people, especially those dedicated to health care. This paper focuses on the idea that burnout should be considered a disease more than a syndrome. On the other hand, definitions of health and disease have changed with time, as well as theoretical and methodological references about burnout. In addition, burnout remains a condition that is being discussed in various scientific areas, with radically opposing positions; these approaches are discussed in this article. After presenting different conceptions regarding burnout, the essay concludes with an exploration of its implications and the identification of possible treatments, especially for health workers, among whom it is more common depending on their predisposing conditions and environments.

Public health and vector-borne diseases - a new concept for risk governance.

PubMed

Schmidt, K; Dressel, K M; Niedrig, M; Mertens, M; Schüle, S A; Groschup, M H

2013-12-01

Public Health is defined as an interdisciplinary multilevel approach that deals with questions of preventing diseases at the population level. In this context, this paper focuses on vector-borne diseases as an important threat with an increasing impact on human and animal health. Emphasis is laid on an integrated health approach ('One-Health' initiative) as it recognizes the interrelated nature of both human and animal health. The importance of vector-borne diseases to new and emerging diseases in Europe was demonstrated, for example, by the recent outbreak of West Nile virus infections in Greece, Northern Italy and Hungary; the spread of Crimean-Congo haemorrhagic fever virus across Turkey, south-western countries of the former USSR and the Balkans; the dramatic increase in hantavirus infections in Germany in 2012; and the dengue virus outbreak in Portugal in the same year. This paper provides a systematic approach for the analysis, assessment and governance of emerging health risks attributed to vector-borne diseases by using a holistic approach developed by the International Risk Governance Council (IRGC), called the 'IRGC Risk Governance Framework'. It can be used by decision-makers and general Public Health authorities in order to evaluate the situation regarding any specific pathogen or Public Health risk and to decide if additional measures should be implemented. © 2013 Blackwell Verlag GmbH.

New technology for early detection of health threats

NASA Astrophysics Data System (ADS)

Southern, Šárka O.; Lilienthal, Gerald W.

2008-04-01

Governmental agencies charged with protecting the health of the population and agriculture have several main strategic objectives including the detection of harmful agents, the identification of vulnerable biological targets, the prediction of health outcomes and the development of countermeasures. New technologies are urgently needed in several critical areas of bio-chemical defense: economical and minimally invasive biosensors for field use in humans and other species important for agriculture and infrastructure, universal analytical platforms for broad-based, early warnings of threats and technologies guiding the development of countermeasures. A new technology called Stress Response Profiling (SRP) was recently developed by the Gaia Medical Institute. SRP provides a universal analytical platform for monitoring health status based on measurements of physiological stress. The platform is implemented through handheld devices that can be used for noninvasive detection of early-stage health problems. This paper summarizes SRP features, advantages and potential benefits for critical areas of homeland defense.

Public health literacy defined.

PubMed

Freedman, Darcy A; Bess, Kimberly D; Tucker, Holly A; Boyd, David L; Tuchman, Arleen M; Wallston, Kenneth A

2009-05-01

Public health literacy is an emerging concept necessary to understand and address the broad array of factors, such as climate change, globalization, and poverty, that influence the public's health. Whereas health literacy has traditionally been operationalized as an individual-level construct, public health literacy takes into account the complex social, ecologic, and systemic forces affecting health and well-being. However, public health literacy has not yet been fully articulated. This paper addresses this gap by outlining a broad, new definition of public health literacy. This definition was developed through an inductive analytic process conducted in 2007 by a multidisciplinary research team, and two expert-panel sessions were convened to assess the consensual validity of the emergent definition. Based on this process, public health literacy is defined as the degree to which individuals and groups can obtain, process, understand, evaluate, and act on information needed to make public health decisions that benefit the community. Three dimensions of public health literacy--conceptual foundations, critical skills, and civic orientation--and related competencies are also proposed. Public health literacy is distinct from individual-level health literacy, and together, the two types of literacy form a more comprehensive model of health literacy. A five-part agenda is offered for future research and action aimed at increasing levels of public health literacy.

A life cycle model of public policy issues in health care: the importance of strategic issues management.

PubMed

Rakich, J S; Feit, M D

2001-01-01

Public policy affects health and social services organizations. Senior management has a responsibility to prevent inappropriate demands of stakeholders from predominating and to influence the outcome of public policy to the benefit of their organization through the strategic issues management process. This article presents a public policy issue life cycle model, life-cycle stages and suggested strategies, paths issues can take in the life cycle, and factors that affect issue paths. An understanding of these dynamics can aid senior managers in shaping and changing public policy issues and lessening external environment threats to their organization.

Avoiding and identifying errors and other threats to the credibility of health economic models.

PubMed

Tappenden, Paul; Chilcott, James B

2014-10-01

Health economic models have become the primary vehicle for undertaking economic evaluation and are used in various healthcare jurisdictions across the world to inform decisions about the use of new and existing health technologies. Models are required because a single source of evidence, such as a randomised controlled trial, is rarely sufficient to provide all relevant information about the expected costs and health consequences of all competing decision alternatives. Whilst models are used to synthesise all relevant evidence, they also contain assumptions, abstractions and simplifications. By their very nature, all models are therefore 'wrong'. As such, the interpretation of estimates of the cost effectiveness of health technologies requires careful judgements about the degree of confidence that can be placed in the models from which they are drawn. The presence of a single error or inappropriate judgement within a model may lead to inappropriate decisions, an inefficient allocation of healthcare resources and ultimately suboptimal outcomes for patients. This paper sets out a taxonomy of threats to the credibility of health economic models. The taxonomy segregates threats to model credibility into three broad categories: (i) unequivocal errors, (ii) violations, and (iii) matters of judgement; and maps these across the main elements of the model development process. These three categories are defined according to the existence of criteria for judging correctness, the degree of force with which such criteria can be applied, and the means by which these credibility threats can be handled. A range of suggested processes and techniques for avoiding and identifying these threats is put forward with the intention of prospectively improving the credibility of models.

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice.

PubMed

Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-08-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall.

The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

PubMed Central

Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

2015-01-01

The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

The University-Public Health Partnership for Public Health Research Training in Quebec, Canada.

PubMed

Paradis, Gilles; Hamelin, Anne-Marie; Malowany, Maureen; Levy, Joseph; Rossignol, Michel; Bergeron, Pierre; Kishchuk, Natalie

2017-01-01

Enhancing effective preventive interventions to address contemporary public health problems requires improved capacity for applied public health research. A particular need has been recognized for capacity development in population health intervention research to address the complex multidisciplinary challenges of developing, implementing, and evaluating public health practices, intervention programs, and policies. Research training programs need to adapt to these new realities. We have presented an example of a 2003 to 2015 training program in transdisciplinary research on public health interventions that embedded doctoral and postdoctoral trainees in public health organizations in Quebec, Canada. This university-public health partnership for research training is an example of how to link science and practice to meet emerging needs in public health.

[Brazilian bibliographical output on public oral health in public health and dentistry journals].

PubMed

Celeste, Roger Keller; Warmling, Cristine Maria

2014-06-01

The scope of this paper is to describe characteristics of the scientific output in the area of public oral health in journals on public health and dentistry nationwide. The Scopus database of abstracts and quotations was used and eight journals in public health, as well as ten in dentistry, dating from 1947 to 2011 were selected. A research strategy using key words regarding oral health in public health and key words about public health in dentistry was used to locate articles. The themes selected were based on the frequency of key words. Of the total number of articles, 4.7% (n = 642) were found in oral health journals and 6.8% (n = 245) in public health journals. Among the authors who published most, only 12% published in both fields. There was a percentile growth of public oral health publications in dentistry journals, though not in public health journals. In dentistry, only studies indexed as being on the topic of epidemiology showed an increase. In the area of public health, planning was predominant in all the phases studied. Research to evaluate the impact of research and postgraduate policies in scientific production is required.

A new paradigm for quarantine and public health activities at land borders: opportunities and challenges.

PubMed

Waterman, Stephen H; Escobedo, Miguel; Wilson, Todd; Edelson, Paul J; Bethel, Jeffrey W; Fishbein, Daniel B

2009-01-01

The Institute of Medicine (IOM) report Quarantine Stations at Ports of Entry: Protecting the Public's Health focused almost exclusively on U.S. airports and seaports, which served 106 million entries in 2005. IOM concluded that the primary function of these quarantine stations (QSs) should shift from providing inspection to providing strategic national public health leadership. The large expanse of our national borders, large number of crossings, sparse federal resources, and decreased regulation regarding conveyances crossing these borders make land borders more permeable to a variety of threats. To address the health challenges related to land borders, the QSs serving such borders must assume unique roles and partnerships to achieve the strategic leadership and public health research roles envisioned by the IOM. In this article, we examine how the IOM recommendations apply to the QSs that serve the land borders through which more than 319 million travelers, immigrants, and refugees entered the U.S. in 2005.

Lead in ammunition: a persistent threat to health and conservation.

PubMed

Johnson, C K; Kelly, T R; Rideout, B A

2013-12-01

Many scavenging bird populations have experienced abrupt declines across the globe, and intensive recovery activities have been necessary to sustain several species, including the critically endangered California condor (Gymnogyps californianus). Exposure to lead from lead-based ammunition is widespread in condors and lead toxicosis presents an immediate threat to condor recovery, accounting for the highest proportion of adult mortality. Lead contamination of carcasses across the landscape remains a serious threat to the health and sustainability of scavenging birds, and here we summarize recent evidence for exposure to lead-based ammunition and health implications across many species. California condors and other scavenging species are sensitive indicators of the occurrence of lead contaminated carcasses in the environment. Transdisciplinary science-based approaches have been critical to managing lead exposure in California condors and paving the way for use of non-lead ammunition in California. Similar transdisciplinary approaches are now needed to translate the science informing on this issue and establish education and outreach efforts that focus on concerns brought forth by key stakeholders.

The effectiveness of public health interventions to reduce the health impact of climate change: a systematic review of systematic reviews.

PubMed

Bouzid, Maha; Hooper, Lee; Hunter, Paul R

2013-01-01

Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases. For each disease, we performed a systematic search with no restriction on date or language of publication on Medline, Web of Knowledge, Cochrane CENTRAL and SCOPUS up to December 2010 to identify systematic reviews of public health interventions. We retrieved some 3176 records of which 85 full papers were assessed and 33 included in the review. The included papers investigated the effect of public health interventions on various outcome measures. All interventions were GRADE assessed to determine the strength of evidence. In addition we developed a systematic review quality score. The interventions included environmental interventions to control vectors, chemoprophylaxis, immunization, household and community water treatment, greening cities and community advice. For most reviews, GRADE showed low quality of evidence because of poor study design and high heterogeneity. Also for some key areas such as floods, droughts and other weather extremes, there are no adequate systematic reviews of potential public health interventions. In conclusion, we found the evidence base to be mostly weak for environmental interventions that could have the most value in a warmer world. Nevertheless, such interventions should not be dismissed. Future research on public health interventions for climate change adaptation needs to be concerned about quality in study design and should address the gap for floods, droughts and other extreme weather events that pose a risk to health.

The Effectiveness of Public Health Interventions to Reduce the Health Impact of Climate Change: A Systematic Review of Systematic Reviews

PubMed Central

Bouzid, Maha; Hooper, Lee; Hunter, Paul R.

2013-01-01

Background Climate change is likely to be one of the most important threats to public health in the coming years. Yet despite the large number of papers considering the health impact of climate change, few have considered what public health interventions may be of most value in reducing the disease burden. We aimed to evaluate the effectiveness of public health interventions to reduce the disease burden of high priority climate sensitive diseases. Methods and Findings For each disease, we performed a systematic search with no restriction on date or language of publication on Medline, Web of Knowledge, Cochrane CENTRAL and SCOPUS up to December 2010 to identify systematic reviews of public health interventions. We retrieved some 3176 records of which 85 full papers were assessed and 33 included in the review. The included papers investigated the effect of public health interventions on various outcome measures. All interventions were GRADE assessed to determine the strength of evidence. In addition we developed a systematic review quality score. The interventions included environmental interventions to control vectors, chemoprophylaxis, immunization, household and community water treatment, greening cities and community advice. For most reviews, GRADE showed low quality of evidence because of poor study design and high heterogeneity. Also for some key areas such as floods, droughts and other weather extremes, there are no adequate systematic reviews of potential public health interventions. Conclusion In conclusion, we found the evidence base to be mostly weak for environmental interventions that could have the most value in a warmer world. Nevertheless, such interventions should not be dismissed. Future research on public health interventions for climate change adaptation needs to be concerned about quality in study design and should address the gap for floods, droughts and other extreme weather events that pose a risk to health. PMID:23634220

Opportunities for Public Relations Research in Public Health.

ERIC Educational Resources Information Center

Wise, Kurt

2001-01-01

Considers how communication researchers have developed a solid body of knowledge in the health field but know little about the activities of public relations practitioners in public health bodies. Suggests that public relations scholarship and practice have much to offer the field of public health in helping public health bodies meet their…

Informational privacy and the public's health: the Model State Public Health Privacy Act.

PubMed

Gostin, L O; Hodge, J G; Valdiserri, R O

2001-09-01

Protecting public health requires the acquisition, use, and storage of extensive health-related information about individuals. The electronic accumulation and exchange of personal data promises significant public health benefits but also threatens individual privacy; breaches of privacy can lead to individual discrimination in employment, insurance, and government programs. Individuals concerned about privacy invasions may avoid clinical or public health tests, treatments, or research. Although individual privacy protections are critical, comprehensive federal privacy protections do not adequately protect public health data, and existing state privacy laws are inconsistent and fragmented. The Model State Public Health Privacy Act provides strong privacy safeguards for public health data while preserving the ability of state and local public health departments to act for the common good.

A novel public health threat - high lead solder in stainless steel rainwater tanks in Tasmania.

PubMed

Lodo, Kerryn; Dalgleish, Cameron; Patel, Mahomed; Veitch, Mark

2018-02-01

We identified two water tanks in Tasmania with water lead concentrations exceeding the Australian Drinking Water Guidelines (ADWG) limit; they had been constructed with stainless steel and high-lead solder from a single manufacturer. An investigation was initiated to identify all tanks constructed by this manufacturer and prevent further exposure to contaminated water. To identify water tanks we used sales accounts, blood and water lead results from laboratories, and media. We analysed blood and water lead concentration results from laboratories and conducted a nested cohort study of blood lead concentrations in children aged <18 years. We identifed 144 tanks constructed from stainless steel and high lead solder. Median water lead concentrations were significantly higher in the stainless steel tanks (121µg/L) than in the galvanised tanks (1µg/L). Blood lead concentrations ranged from 1 to 26µg/dL (median 5µg/dL); of these, 77% (n=50) were below the then-recommended health-related concentration of 10µg/dL. Concentrations in the 15 people (23%) above this limit ranged from 10-26µg/dL, with a median of 14µg/dL. The median blood lead concentration in the nested cohort of children was initially 8.5µg/dL, dropping to 4.5µg/dL after follow-up. Lead concentrations in the water tanks constructed from stainless steel and high-lead solder were up to 200 times above the recommended ADWG limits. Implications for public health: This investigation highlights the public health risk posed by use of non-compliant materials in constructing water tanks. © 2017 Department of Health and Human Services Tasmania.

Applying social science and public health methods to community-based pandemic planning.

PubMed

Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

2010-11-01

Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

Training Public Health Advisors.

PubMed

Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L

2015-01-01

Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

Solutions to the new threats to academic freedom?

PubMed

Tooley, Michael

2014-05-01

In my commentary on Francesca Minerva's article 'New Threats to Academic Freedom', I agree with her contention that the existence of the Internet has given rise to new and very serious threats to academic freedom. I think that it is crucial that we confront those threats, and find ways to eliminate them, which I believe can be done. The threats in question involve both authors and editors. In the case of authors, I argue that the best solution is not anonymous publication, but publication using pseudonyms, and I describe how that would work. In the case of editors, my proposal is a website that a number of journals would have access to, where papers that editors judge to be clearly worthy of publication, but whose publication seems likely to set off a firestorm of public and media protest, could be published without any indication of the journal that had accepted the paper for publication. © 2014 John Wiley & Sons Ltd.

50 CFR 21.52 - Public health control order for resident Canada geese.

Code of Federal Regulations, 2010 CFR

2010-10-01

... to human health. (c) What is a direct threat to human health? A direct threat to human health is one... use must comply with any labeling restrictions. (iv) Persons using shotguns must use nontoxic shot, as...

50 CFR 21.52 - Public health control order for resident Canada geese.

Code of Federal Regulations, 2012 CFR

2012-10-01

... to human health. (c) What is a direct threat to human health? A direct threat to human health is one... use must comply with any labeling restrictions. (iv) Persons using shotguns must use nontoxic shot, as...

50 CFR 21.52 - Public health control order for resident Canada geese.

Code of Federal Regulations, 2014 CFR

2014-10-01

... to human health. (c) What is a direct threat to human health? A direct threat to human health is one... use must comply with any labeling restrictions. (iv) Persons using shotguns must use nontoxic shot, as...

50 CFR 21.52 - Public health control order for resident Canada geese.

Code of Federal Regulations, 2013 CFR

2013-10-01

... to human health. (c) What is a direct threat to human health? A direct threat to human health is one... use must comply with any labeling restrictions. (iv) Persons using shotguns must use nontoxic shot, as...

[Bioterrorism--a public and health threat].

PubMed

Jezek, Z

2000-11-01

In recent years the fear of bioterrorism, of secret modernization and dissemination of biological weapons is increasing. Facts detected recently in Iran, Japan and the former Soviet Union provide evidence that there are countries and dissident groups which have access to modern technology of cultivation of dangerous pathogens as well as motivation for their use in acts of terrorism or war. The menace of biological terrorism is nowadays, as compared with the past, much greater. The most feared candidates as regards production of biological weapons are the pathogens of smallpox, anthrax and plague. The author discusses the serious character of possible events associated with terrorist dissemination of these pathogens. It is much esier to produce and use biological weapons than to create effective systems of defence against them. The menace of bioterrorism and bioweapons must not be exaggerated nor underestimated. The possible terrorist use of bioweapons is real. At present even the most advanced industrial countries cannot quarantee effective protection of their populations. Fortunately they are however aware of their present vulnerability. Our society is not equipped to cope with bioterrorism. Preparation and reinforcement of the health services, in particular of sections specialized in the control of infectious diseases is an effective step to divert the sequelae and suffering associated with terrorist use of biological agents. It is essential to be prepared. This calls for time and funds which unfortunately are not plentiful.

Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis

PubMed Central

Buttigieg, Sandra C.; Schuetz, Marcus; Bezzina, Frank

2016-01-01

The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state’s health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta. PMID:27683658

[Terrorism, public health and health services].

PubMed

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Issues and Trends in Higher Education Health