Sample records for yolo county health

  1. Developing the foundation for syndromic surveillance and health information exchange for yolo county, california.

    PubMed

    Chaudhary, Osama

    2012-01-01

    This report delineates Yolo County Health Department's process to ascertain its optimal methods of participation in syndromic surveillance and health information exchange. As a health department serving a county of just 200,000 residents, Yolo County Health Department needed to operate within strict financial constraints. Meaningful Use legislation enabled it to pursue both syndromic surveillance and health information exchange participation whilst complying with its budgetary restrictions. The Health Information Technology for Economic and Clinical Health (HITECH), a segment of the American Recovery and Reinvestment Act of 2009, has incentivized the 'Meaningful Use' of electronic health records (EHRs) by providing incentive reimbursements and non-compliance penalties. The Meaningful Use of EHRs is to take place over 3 Stages: Stage 1 has begun, Stage 2 is imminent, and Stage 3 is currently being discussed. Having been solicited by both health information exchange and syndromic surveillance options which were cost-prohibitive, Yolo County Health Department focused attention on BioSense 2.0, a Meaningul Use-ready and virtually free syndromic surveillance program developed by the Federal Centers for Disease Control and Prevention. In collaboration with Sacramento County Department of Health and Human Services, and with support from several other area counties, Yolo County Health Department submitted a Funding Opportunity application for BioSense 2.0 regional implementation. Through this collaboration, Yolo County Health Department has begun participating in the formative stages of the Sacramento Area Center for Advanced Biosurveillance (SAC-B). Via SAC-B, Yolo County Health Department will be able to participate in syndromic surveillance in the BioSense 2.0 program, and simultaneously expand its electronic health data sharing towards a more comprehensive health information exchange. LASTLY, OVER THE COURSE OF THESE PROJECTS, THREE OTHER METHODS OF PARTICIPATING IN

  2. Yolo County's Accelerated Anaerobic and Aerobic Composting (Full-Scale Controlled Landfill Bioreactor) Project

    NASA Astrophysics Data System (ADS)

    Yazdani, R.; Kieffer, J.; Akau, H.; Augenstein, D.

    2002-12-01

    Sanitary landfilling is the dominant method of solid waste disposal in the United States, accounting for about 217 million tons of waste annually (U.S. EPA, 1997) and has more than doubled since 1960. In spite of increasing rates of reuse and recycling, population and economic growth will continue to render landfilling as an important and necessary component of solid waste management. Yolo County Department of Planning and Public Works, Division of Integrated Waste Management is demonstrating a new landfill technology called Bioreactor Landfill to better manage solid waste. In a Bioreactor Landfill, controlled quantities of liquid (leachate, groundwater, gray-water, etc.) are added and recirculated to increase the moisture content of the waste and improve waste decomposition. As demonstrated in a small-scale demonstration project at the Yolo County Central Landfill in 1995, this process significantly increases the biodegradation rate of waste and thus decreases the waste stabilization and composting time (5 to 10 years) relative to what would occur within a conventional landfill (30 to 50 years or more). When waste decomposes anaerobically (in absence of oxygen), it produces landfill gas (biogas). Biogas is primarily a mixture of methane, a potent greenhouse gas, carbon dioxide, and small amounts of Volatile Organic Compounds (VOC's) which can be recovered for electricity or other uses. Other benefits of a bioreactor landfill composting operation include increased landfill waste settlement which increases in landfill capacity and life, improved leachate chemistry, possible reduction of landfill post-closure management time, opportunity to explore decomposed waste for landfill mining, and abatement of greenhouse gases through highly efficient methane capture over a much shorter period of time than is typical of waste management through conventional landfilling. This project also investigates the aerobic decomposition of waste of 13,000 tons of waste (2.5 acre) for

  3. Controlled Landfill Project in Yolo County, California for Environmental Benefits of Waste Stabilization and Minimization of Greenhouse Gas Emissions

    NASA Astrophysics Data System (ADS)

    Yazdani, R.; Augenstein, D.; Kieffer, J.; Cohen, K.

    2003-12-01

    The Department of Public Works of Yolo County, California, USA has been testing an advanced approach to landfill bioreactors, controlled (or "enhanced") landfilling, at its Yolo County Central Landfill site near Davis, CA, since 1994. Overall objectives have been the management of waste landfilling for: (1) rapid completion of total gas generation; (2) maximum, high-efficiency gas capture; (3) waste volume reduction; and (4) maximum greenhouse gas and carbon sequestration benefits. Methane generation is controlled and enhanced through carefully managed moisture additions, and by taking advantage of landfill temperature elevation. The generated landfill methane, an important greenhouse gas, is recovered with high efficiency through extraction from a porous recovery layer beneath a surface geomembrane cover. Instrumentation included a total of 56 moisture and 15 temperature sensors in the two cells, gas flow monitoring by positive displacement gas meters, and accurate quantification of liquid inputs and outputs. Gas composition, waste volume reduction, base hydrostatic head, and a range of environmental compliance parameters has been monitored since 1995. Partitioning gas tracer tests using the injection of two gases at dilute concentrations in the landfill have also been initiated to compute the fraction of pore space occupied by water between the points of tracer injection and tracer measurement. There has been rapid waste volume reduction in the enhanced cell that corresponds to the solids' reduction to gas. Monitoring is planned for the next several years, until stabilization parameters are determined complete. Encouraging performance is indicated by: (1) sensor data; (2) gas generation results; (3) data from landfill cores; and (4) decomposition-related indicators including rapid volume reduction. When data are synthesized, project results have attractive implications for new approaches to landfill management. Over seven-years, methane recoveries have averaged

  4. 77 FR 23133 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (Yolo-Solano AQMD) portion of the.... * * * * * (381) * * * (i) * * * (I) Yolo-Solano Air Quality Management District. (1) Rule 2.3, ``Ringelmann Chart...

  5. 75 FR 37308 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-29

    ... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State...) * * * (i) * * * (C) Yolo Solano Air Quality Management District (1) Rule 3.21, ``Rice Straw Emission...

  6. 75 FR 25778 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California... Identification of plan. * * * * * (c) * * * (377) * * * (i) * * * (B) Yolo Solano Air Quality Management District...

  7. Estimation of Distributed Groundwater Pumping Rates in Yolo County,CA—Intercomparison of Two Modeling Frameworks

    NASA Astrophysics Data System (ADS)

    Maples, S.; Fogg, G. E.; Harter, T.

    2015-12-01

    Accurate estimation of groundwater (GW) budgets and effective management of agricultural GW pumping remains a challenge in much of California's Central Valley (CV) due to a lack of irrigation well metering. CVHM and C2VSim are two regional-scale integrated hydrologic models that provide estimates of historical and current CV distributed pumping rates. However, both models estimate GW pumping using conceptually different agricultural water models with uncertainties that have not been adequately investigated. Here, we evaluate differences in distributed agricultural GW pumping and recharge estimates related to important differences in the conceptual framework and model assumptions used to simulate surface water (SW) and GW interaction across the root zone. Differences in the magnitude and timing of GW pumping and recharge were evaluated for a subregion (~1000 mi2) coincident with Yolo County, CA, to provide similar initial and boundary conditions for both models. Synthetic, multi-year datasets of land-use, precipitation, evapotranspiration (ET), and SW deliveries were prescribed for each model to provide realistic end-member scenarios for GW-pumping demand and recharge. Results show differences in the magnitude and timing of GW-pumping demand, deep percolation, and recharge. Discrepancies are related, in large part, to model differences in the estimation of ET requirements and representation of soil-moisture conditions. CVHM partitions ET demand, while C2VSim uses a bulk ET rate, resulting in differences in both crop-water and GW-pumping demand. Additionally, CVHM assumes steady-state soil-moisture conditions, and simulates deep percolation as a function of irrigation inefficiencies, while C2VSim simulates deep percolation as a function of transient soil-moisture storage conditions. These findings show that estimates of GW-pumping demand are sensitive to these important conceptual differences, which can impact conjunctive-use water management decisions in the CV.

  8. Floodwater Chemistry in the Yolo Bypass during Winter and Spring 1998

    USGS Publications Warehouse

    Schemel, Laurence E.; Cox, Marisa H.

    2007-01-01

    A preliminary investigation of temporal and spatial variations in floodwater chemistry was conducted during winter and spring 1998 in the Yolo Bypass floodplain of the Sacramento River system. Samples were collected at locations along the eastern margin of the floodplain over the duration of the study and across the floodplain during major periods of inundation. Specific conductance and dissolved organic carbon concentrations along the eastern margin of the Yolo Bypass varied inversely with discharge. The Sacramento River was the greatest source of discharge to the floodplain during major periods of inundation. Increases in specific conductance and dissolved organic carbon were observed along the eastern margin during periods of lower discharge, when local streams accounted for a significant fraction of the total discharge through the Yolo Bypass. Apparent influences of local stream discharges also were observed in surface waters near the western margin of the floodplain during major periods of inundation. Although river and local stream sources of suspended particulate matter appeared important, in-floodplain processes were likely contributors to temporal and spatial variability in concentrations. Values for the C:N ratio of the particulate matter were lowest during periods of decreasing and low discharge through the floodplain, indicating production of phytoplankton in floodplain waters or supply to the floodplain by local stream sources. Phytoplankton discharged from the Yolo Bypass was detected by chlorophyll a monitors downstream in the Sacramento River during this study.

  9. Photographic copy of photograph, Joseph Yolo, photographer, 1936 (original print ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photographic copy of photograph, Joseph Yolo, photographer, 1936 (original print located at U.S. Bureau of Reclamation Upper Columbia Area Office, Yakima, Washington). "WAHT A GOVERNMENT CANAL AND AN ASSURED WATER SUPPLY WILL DO IN A DESERT AREA IS SHOWN IN THIS AIR VIEW OF A SECTION OF THE YAKIMA FEDERAL RECLAMATION PROJECT IN CENTRAL WASHINGTON. THE MAIN CANAL IS SEEN RUNNING DOWN THE MIDDLE OF THE VALLEY WITH PATCHES OF ORCHARDS AND FIELDS ON EITHER SIDE, BUT ABOVE THE CANAL LINE THE SAGE BRUSH DESERT REMAINS, AS CAN BE SEEN ON THE LEFT. THE YAKIMA PROJECT SUPPORTS MORE THAN 110,000 PEOPLE IN A TERRITORY WHICH WAS DESERT 35 YEARS AGO. MANY OF THE ORIGINAL SETTLERS WHO CAME, LIKE THOSE WHO ARE NOW SETTLING ON THE VALE PROJECT, TO BREAK THE RAW DESERT LAND, ARE STILL LIVING ON THESE NEATLY CHECKERBOARDED FARMS" - Kachess Dam, Kachess River, 1.5 miles north of Interstate 90, Easton, Kittitas County, WA

  10. 76 FR 55621 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY: Environmental...-Solano Air Quality Management District portion of the California State Implementation Plan (SIP). This... the following local rule: Yolo-Solano Air Quality Management District Rule 2.41, Expandable...

  11. 75 FR 19923 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State.... ``Improving Air Quality with Economic Incentive Programs,'' EPA- 452/R-01-001, January 2001. B. Does the rule...

  12. 76 FR 55581 - Revision to the California State Implementation Plan; Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... California State Implementation Plan; Yolo-Solano Air Quality Management District AGENCY: Environmental... revision to the Yolo-Solano Air Quality Management District portion of the California State Implementation...-Solano Air Quality Management District (YSAQMD) Rule 2.41, adopted on September 10, 2008, and submitted...

  13. 75 FR 25798 - Revisions to the California State Implementation Plan, Yolo Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0286; FRL-9138-7] Revisions to the California State Implementation Plan, Yolo Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State...

  14. 77 FR 23193 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0180; FRL-9652-3] Revisions to the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District portion of the California State Implementation Plan...

  15. Geochemistry of mercury and other constituents in subsurface sediment—Analyses from 2011 and 2012 coring campaigns, Cache Creek Settling Basin, Yolo County, California

    USGS Publications Warehouse

    Arias, Michelle R.; Alpers, Charles N.; Marvin-DiPasquale, Mark C.; Fuller, Christopher C.; Agee, Jennifer L.; Sneed, Michelle; Morita, Andrew Y.; Salas, Antonia

    2017-10-31

    Cache Creek Settling Basin was constructed in 1937 to trap sediment from Cache Creek before delivery to the Yolo Bypass, a flood conveyance for the Sacramento River system that is tributary to the Sacramento–San Joaquin Delta. Sediment management options being considered by stakeholders in the Cache Creek Settling Basin include sediment excavation; however, that could expose sediments containing elevated mercury concentrations from historical mercury mining in the watershed. In cooperation with the California Department of Water Resources, the U.S. Geological Survey undertook sediment coring campaigns in 2011–12 (1) to describe lateral and vertical distributions of mercury concentrations in deposits of sediment in the Cache Creek Settling Basin and (2) to improve constraint of estimates of the rate of sediment deposition in the basin.Sediment cores were collected in the Cache Creek Settling Basin, Yolo County, California, during October 2011 at 10 locations and during August 2012 at 5 other locations. Total core depths ranged from approximately 4.6 to 13.7 meters (15 to 45 feet), with penetration to about 9.1 meters (30 feet) at most locations. Unsplit cores were logged for two geophysical parameters (gamma bulk density and magnetic susceptibility); then, selected cores were split lengthwise. One half of each core was then photographed and archived, and the other half was subsampled. Initial subsamples from the cores (20-centimeter composite samples from five predetermined depths in each profile) were analyzed for total mercury, methylmercury, total reduced sulfur, iron speciation, organic content (as the percentage of weight loss on ignition), and grain-size distribution. Detailed follow-up subsampling (3-centimeter intervals) was done at six locations along an east-west transect in the southern part of the Cache Creek Settling Basin and at one location in the northern part of the basin for analyses of total mercury; organic content; and cesium-137, which was

  16. Mercury, methylmercury, and other constituents in sediment and water from seasonal and permanent wetlands in the Cache Creek settling basin and Yolo Bypass, Yolo County, California, 2005-06

    USGS Publications Warehouse

    Marvin-DiPasquale, Mark; Alpers, Charles N.; Fleck, Jacob A.

    2009-01-01

    This report presents surface water and surface (top 0-2 cm) sediment geochemical data collected during 2005-2006, as part of a larger study of mercury (Hg) dynamics in seasonal and permanently flooded wetland habitats within the lower Sacramento River basin, Yolo County, California. The study was conducted in two phases. Phase I represented reconnaissance sampling and included three locations within the Cache Creek drainage basin; two within the Cache Creek Nature Preserve (CCNP) and one in the Cache Creek Settling Basin (CCSB) within the creek's main channel near the southeast outlet to the Yolo Bypass. Two additional downstream sites within the Yolo Bypass Wildlife Area (YBWA) were also sampled during Phase I, including one permanently flooded wetland and one seasonally flooded wetland, which had began being flooded only 1–2 days before Phase I sampling.Results from Phase I include: (a) a negative correlation between total mercury (THg) and the percentage of methylmercury (MeHg) in unfiltered surface water; (b) a positive correlation between sediment THg concentration and sediment organic content; (c) surface water and sediment THg concentrations were highest at the CCSB site; (d) sediment inorganic reactive mercury (Hg(II)R) concentration was positively related to sediment oxidation-reduction potential and negatively related to sediment acid volatile sulfur (AVS) concentration; (e) sediment Hg(II)R concentrations were highest at the two YBWA sites; (f) unfiltered surface water MeHg concentration was highest at the seasonal wetland YBWA site, and sediment MeHg was highest at the permanently flooded YBWA site; (g) a 1,000-fold increase in sediment pore water sulfate concentration was observed in the downstream transect from the CCNP to the YBWA; (h) low sediment pore water sulfide concentrations (<1 µmol/L) across all sites; and (i) iron (Fe) speciation data suggest a higher potential for microbial Fe(III)-reduction in the YBWA compared to the CCSB.Phase II

  17. Mercury Cycling in Agricultural and Non-agricultural Wetlands of the Yolo Bypass Wildlife Area, California: Sediment Biogeochemistry

    NASA Astrophysics Data System (ADS)

    Marvin-Dipasquale, M. C.; Windham-Myers, L.; Alpers, C. N.; Agee, J. L.; Cox, M. H.; Kakouros, E.; Wren, S. L.

    2007-12-01

    The Yolo Bypass Wildlife Area (YBWA) is part of the larger Yolo Bypass floodwater protection zone associated with the Sacramento River and the Sacramento-San Joaquin Delta, California. Land use in the YBWA consists of white and wild rice fields, seasonally flooded fallow agricultural fields, and permanently and seasonally flooded non-agricultural wetlands used for resident and migratory waterfowl. A recent assessment of mercury (Hg) and methylmercury (MeHg) loads indicates that the Yolo Bypass is responsible for a high proportion of the aqueous MeHg entering the Delta, and that biota from the Yolo Bypass are considerably elevated in MeHg. The current study examines benthic MeHg production and biogeochemical controls on this process, as a function of YBWA land use, wetland management, and agricultural practices during the 2007 rice growing season (June to October). Preliminary results indicate that in the week following initial flooding of agricultural fields, prior to the establishment of rice plants, the microbial community in the 0-2 cm surface sediment zone exhibited very little potential Hg(II)-methylation activity compared to the permanent wetland habitat (as assessed via the 203Hg(II)- methylation assay). Approximately 1 month after flooding, rice plants were established and the activity of the resident Hg(II)-methylating microbial community had increased substantially in all agricultural fields, although the observed rates of MeHg production were still much lower than those observed in the permanent wetland setting. Ongoing field sampling includes analysis of reactive Hg(II) in sediments and of iron and sulfur redox species in sediments and pore waters.

  18. Yolo Bypass Juvenile Salmon Utilization Study 2016—Summary of acoustically tagged juvenile salmon and study fish release, Sacramento River, California

    USGS Publications Warehouse

    Liedtke, Theresa L.; Hurst, William R.

    2017-09-12

    The Yolo Bypass is a flood control bypass in Sacramento Valley, California. Flood plain habitats may be used for juvenile salmon rearing, however, the potential value of such habitats can be difficult to evaluate because of the intermittent nature of inundation events. The Yolo Bypass Juvenile Salmon Utilization Study (YBUS) used acoustic telemetry to evaluate the movements and survival of juvenile salmon adjacent to and within the Yolo Bypass during the winter of 2016. This report presents numbers, size data, and release data (times, dates, and locations) for the 1,197 acoustically tagged juvenile salmon released for the YBUS from February 21 to March 18, 2016. Detailed descriptions of the surgical implantation of transmitters are also presented. These data are presented to support the collaborative, interagency analysis and reporting of the study findings.

  19. Rapid Target Detection in High Resolution Remote Sensing Images Using Yolo Model

    NASA Astrophysics Data System (ADS)

    Wu, Z.; Chen, X.; Gao, Y.; Li, Y.

    2018-04-01

    Object detection in high resolution remote sensing images is a fundamental and challenging problem in the field of remote sensing imagery analysis for civil and military application due to the complex neighboring environments, which can cause the recognition algorithms to mistake irrelevant ground objects for target objects. Deep Convolution Neural Network(DCNN) is the hotspot in object detection for its powerful ability of feature extraction and has achieved state-of-the-art results in Computer Vision. Common pipeline of object detection based on DCNN consists of region proposal, CNN feature extraction, region classification and post processing. YOLO model frames object detection as a regression problem, using a single CNN predicts bounding boxes and class probabilities in an end-to-end way and make the predict faster. In this paper, a YOLO based model is used for object detection in high resolution sensing images. The experiments on NWPU VHR-10 dataset and our airport/airplane dataset gain from GoogleEarth show that, compare with the common pipeline, the proposed model speeds up the detection process and have good accuracy.

  20. 75 FR 34381 - Final Flood Elevation Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... ground [caret] Elevation in meters (MSL) Modified Mississippi County, Arkansas, and Incorporated Areas... the nearest 0.1 meter. ADDRESSES City of Luxora Maps are available for inspection at 204 North Main... meter. ADDRESSES Unincorporated Areas of Yolo County Maps are available for inspection at the Yolo...

  1. Associations Between County Wealth, Health and Social Services Spending, and Health Outcomes.

    PubMed

    McCullough, J Mac; Leider, Jonathon P

    2017-11-01

    Each year, the County Health Rankings rate the health outcomes of each county in the U.S. A common refrain is that poor counties perform worse than wealthier ones. This article examines that assumption and specifically analyzes characteristics of counties that have performed better in terms of health outcomes than their wealth alone would suggest. Data from the 2013 County Health Rankings were used, as were 2012 financial and demographic information collected by the U.S. Census Bureau. A logistic model was constructed to examine the odds of a county "overperforming" in the rankings relative to community wealth. Analyses were performed in 2016. Communities that were wealthier performed better on the rankings. However, more than 800 of 3,141 counties overperformed by ranking in a better health outcomes quartile than their county's wealth alone would suggest. Regression analyses found that for each additional percentage point of total public spending that was allocated toward community health care and public health, the odds of being an overperformer increased by 3.7%. Community wealth correlates with health, but not always. Population health outcomes in hundreds of counties overperform what would be expected given community wealth alone. These counties tend to invest more in community health care and public health spending and other social services. Although the level of a community's wealth is outside the control of practitioners, shifting the proportion of spending to certain social services may positively impact population health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Mercury cycling in agricultural and non-agricultural wetlands in the Yolo Bypass Wildlife Area, California: bioaccumulation in small fish

    NASA Astrophysics Data System (ADS)

    Ackerman, J. T.; Eagles-Smith, C. A.; Miles, K. A.; Ricca, M. A.

    2007-12-01

    We examined the bioaccumulation of mercury in small fish within white rice, wild rice, and permanent wetland habitats at the Yolo Wildlife Area during the 2007 rice growing season. We introduced 30 mosquito fish in each of four cages placed at the inlet, center, and outlet (two cages) of each wetland in June, immediately after the white rice fields were re-flooded after being seeded. All fish were removed from their cages 60-days after their introduction, with the exception that ten fish from each of the second cages at the outlets were removed 30-days after introduction to assess temporal trends in mercury exposure. Mercury concentrations will be compared between fish that were introduced into cages and reference fish that originated from the same fish stock (Sacramento County Vector Control). We also measured fish length and mass both when they were introduced and collected to 1) control for growth effects on mercury bioaccumulation and 2) examine whether wetland habitat influenced growth rates. Fish are currently being analyzed for mercury and results will be available by the conference.

  3. Simultaneous detection and classification of breast masses in digital mammograms via a deep learning YOLO-based CAD system.

    PubMed

    Al-Masni, Mohammed A; Al-Antari, Mugahed A; Park, Jeong-Min; Gi, Geon; Kim, Tae-Yeon; Rivera, Patricio; Valarezo, Edwin; Choi, Mun-Taek; Han, Seung-Moo; Kim, Tae-Seong

    2018-04-01

    Automatic detection and classification of the masses in mammograms are still a big challenge and play a crucial role to assist radiologists for accurate diagnosis. In this paper, we propose a novel Computer-Aided Diagnosis (CAD) system based on one of the regional deep learning techniques, a ROI-based Convolutional Neural Network (CNN) which is called You Only Look Once (YOLO). Although most previous studies only deal with classification of masses, our proposed YOLO-based CAD system can handle detection and classification simultaneously in one framework. The proposed CAD system contains four main stages: preprocessing of mammograms, feature extraction utilizing deep convolutional networks, mass detection with confidence, and finally mass classification using Fully Connected Neural Networks (FC-NNs). In this study, we utilized original 600 mammograms from Digital Database for Screening Mammography (DDSM) and their augmented mammograms of 2,400 with the information of the masses and their types in training and testing our CAD. The trained YOLO-based CAD system detects the masses and then classifies their types into benign or malignant. Our results with five-fold cross validation tests show that the proposed CAD system detects the mass location with an overall accuracy of 99.7%. The system also distinguishes between benign and malignant lesions with an overall accuracy of 97%. Our proposed system even works on some challenging breast cancer cases where the masses exist over the pectoral muscles or dense regions. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Methylmercury cycling, bioaccumulation, and export from agricultural and non-agricultural wetlands in the Yolo Bypass

    USGS Publications Warehouse

    Windham-Myers, Lisamarie; Marvin-DiPasquale, Mark; Fleck, Jacob; Alpers, Charles N.; Ackerman, Joshua T.; Eagles-Smith, Collin A.; Stricker, Craig; Stephenson, Mark; Feliz, David; Gill, Gary; Bachand, Philip; Brice, Ann; Kulakow, Robin

    2010-01-01

    d) Identification and testing of potential management approaches for reducing MeHg contamination. In addition, the quantitative results reported here assess the effect of current land use practices in the Yolo Bypass MeHg production, bioaccumulation and export, and provide process-based advice towards achieving current goals of the RWQCB-CVR's Sacramento -- San Joaquin Delta Estuary TMDL for Methyl & Total Mercury (Wood et al., 2010b). Further work is necessary to evaluate biotic exposure in the Yolo Bypass Wildlife Area at higher trophic levels (e.g. birds), to quantify winter hydrologic flux of MeHg to the larger Delta ecosystem, and to evaluate rice straw management options to limit labile carbon supplies to surface sediment during winter months. In summary, agricultural management of rice fields -- specifically the periodic flooding and production of easily degraded organic matter -- promotes the production of MeHg beyond rates seen in naturally vegetated wetlands, whether seasonally or permanently flooded., The exported load from MeHg from these agricultural wetlands may be controlled by limiting hydrologic export from fields to enhance on-site MeHg removal processes, but the tradeoff is that this impoundement increases Me Hg exposure to resident organisms.

  5. Measurements of erosion potential using Gust chamber in Yolo Bypass near Sacramento, California

    USGS Publications Warehouse

    Work, Paul A.; Schoellhamer, David H.

    2018-04-27

    This report describes work performed to quantify the erodibility of surface soils in the Yolo Bypass (Bypass) near Sacramento, California, for use in the California Department of Water Resources (DWR) Yolo Bypass D-MCM mercury model. The Bypass, when not serving as a floodway, is heavily utilized for agriculture. During flood events, surface water flows over the soil, resulting in the application of a shear stress to the soil. The shear stress is a function of flow speed and is often assumed to vary as the square of flow speed. Once the shear stress reaches a critical value, erosion commences, and the erosion rate typically increases with applied shear stress. The goal of the work described here was to quantify this process and how it varies throughout the major land uses found in the Yolo Bypass.Each of the major land uses found in the Bypass was targeted for sediment coring and two side-by-side cores, 10 centimeters in diameter, were extracted at each site for testing in a Gust erosion chamber. This device consists of a cylinder with a piston and cap installed to contain a sediment sample and overlying water. In most instances, coring was done with the cylinder, the piston and cap were installed, and testing commenced immediately. The cap at the top of the cylinder contains vanes to induce rotation of the flow and is driven by an electric motor, simulating the bed shear stress experienced by the soil in a flood event. Ambient water is introduced to the cylinder, passes through the device, and carries eroded sediment out of the chamber. The exiting water is tested for turbidity, and water samples obtained to relate turbidity to suspended sediment concentration are used to compute erosion rates for each of the applied shear stresses.The result for each sediment core is (1) definition of the critical shear stress required to initiate sediment erosion and (2) estimation of coefficients required to relate erosion rate to applied shear

  6. County Context and Mental Health Service Utilization by Older Hispanics.

    PubMed

    Kim, Kyeongmo

    2018-04-16

    Although older Hispanics experience high rates of depression, they tend to underuse mental health services. The study examined the association between county characteristics and mental health service use among older Hispanics, controlling for individual characteristics. The study used the 2008-2012 Medical Expenditure Panel Study and linked county-level data from the 2013-2014 Area Health Resources Files and the 2008-2012 Chronic Conditions Data Warehouse, using the Federal Information Processing Standard county code. The sample includes 1,143 community-dwelling Hispanics ages 60 years or older (Level 1) and 156 counties (Level 2) where the sample resides. The single dichotomous measure of mental health service utilization was based on whether or not the respondent met one or more of three conditions: (1) the respondent received care from a mental health professional, (2) received a service including mental health counseling or psychotherapy, or (3) received a service that was related to the International Classification of Diseases. Multilevel logistic regression analysis was used to examine the role of county context. The proportion of older adults and the existence of community mental health centers at the county-level were associated with mental health services use among this population. At the individual-level, education and mental health status were also associated with using mental health services. The county context plays an important role in understanding mental health services use among older Hispanics, indicating the need for intervention strategies at the county level.

  7. California's Yolo Bypass: Evidence that flood control can be compatible with fisheries, wetlands, wildlife, and agriculture

    USGS Publications Warehouse

    Sommer, T.; Harrell, B.; Nobriga, M.; Brown, R.; Moyle, P.B.; Kimmerer, W.; Schemel, Laurence E.

    2001-01-01

    Unlike conventional flood control systems that frequently isolate rivers from ecologically-essential floodplain habitat, California's Yolo Bypass has been engineered to allow Sacramento Valley floodwaters to inundate a broad floodplain. From a flood control standpoint, the 24,000 ha leveed floodplain has been exceptionally successful based on its ability to convey up to 80% of the flow of the Sacramento River basin during high water events. Agricultural lands and seasonal and permanent wetlands within the bypass provide key habitat for waterfowl migrating through the Pacific Flyway. Our field studies demonstrate that the bypass seasonally supports 42 fish species, 15 of which are native. The floodplain appears to be particularly valuable spawning and rearing habitat for the splittail (Pogonichthys macrolepidotus), a federally-listed cyprinid, and for young chinook salmon (Oncorhynchus tshawytscha), which use the Yolo Bypass as a nursery area. The system may also be an important source to the downstream food web of the San Francisco Estuary as a result of enhanced production of phytoplankton and detrital material. These results suggest that alternative flood control systems can be designed without eliminating floodplain function and processes, key goals of the 1996 Draft AFS Floodplain Management Position Statement.

  8. Ranking Community Health Status to Stimulate Discussion of Local Public Health Issues: The Wisconsin County Health Rankings

    PubMed Central

    Peppard, Paul E.; Kindig, David A.; Dranger, Elizabeth; Jovaag, Amanda; Remington, Patrick L.

    2008-01-01

    United Health Foundation’s America’s Health Rankings, which ranks the states from “least healthy” to “healthiest,” receives wide press coverage and promotes discussion of public health issues. The University of Wisconsin Population Health Institute used the United Health Foundation’s model to develop the Wisconsin County Health Rankings (“Health Rankings”) from existing county-level data. The institute first released the rankings in 2004. A survey of the Wisconsin county health officers indicated that they intend to use the rankings for needs assessment, program planning, and discussion with county health boards. The institute implemented many of the health officers’ suggestions for improvement of the rankings in subsequent editions. The methods employed to create the rankings should be applicable in other states. PMID:18172156

  9. "Top Performing" US Hospitals and the Health Status of Counties they Serve.

    PubMed

    Maraccini, Amber M; Yang, Wei; Slonim, Anthony D

    2018-06-01

    This study (a) examined the relationships between "top performing" US hospitals and the health status of counties they serve and (b) compared the health status of "top performing" US hospital counties versus that of remaining US counties. Statistical analyses considered US News and World Report Honor Roll ranking data, as a measure of hospital performance, and County Health Rankings (CHR) data, as a measure of county health status. "Top performing" hospital Honor Roll scores were correlated with measures of Clinical Care (p < 0.001). Counties with "top performing" US hospitals presented greater health status with regard to All Health Outcomes (p < 0.001), Length of Life (p < 0.001), Quality of Life (p < 0.001), All Health Factors (p < 0.001), Health Behaviors (p < 0.001), and Clinical Care (p < 0.001), than compared to remaining US counties. Hospital impact on county health status remains primarily recognized in clinical care and not in overall health. Also, counties that contain a "top performing" US hospital tend to present lower health risks to their citizens than compared to other US counties.

  10. [Health protection and health promotion in formal structures of executive county authorities and executive offices of municipalities having the county status].

    PubMed

    Nosko, Jan; Marcinkiewicz, Andrzej

    2009-01-01

    An analysis of the role of public administration in the Polish health system, essential for the effectiveness of health protection and health promotion, is a very important and urgent task faced by scholars. This issue also concerns the authorities of counties (powiaty) and municipalities having the county status (MHCS), and these structures were chosen as the subject of our study. The aim of the study was to analyze whether health related rules and regulations of these administrative structures comply with the requirements of relevant Polish legislation acts. The survey, performed in 2008, covered all the 378 counties and municipalities having the county status. On the basis of 171 Acts reviewed, a list of 11 groups of obligations and duties assigned to county and municipality units were prepared and used as a research tool. It was found that the provisions of the Health Care Institutions Act of 1991 were most evidently (87%) reflected in the rules and regulations of the studies structures; more than a half (57%) refer to prophylaxis and health promotion, however, the most important Act as far as health protection and health promotion are concerned, i.e., the Act of 2004 was reflected in only 11.6%. Also the presence of some outdated regulations was discovered. The results of the study may indicate that the mechanisms, by which the execution of legal regulations on health protection and health promotion tasks should be supervised, are insufficient.

  11. Disparities in Health Insurance Coverage and Health Status Among Farmworkers, Sonoma County, California, 2013-2014.

    PubMed

    Moore, Kristin L; Mercado, Jenny; Hill, Jana; Katz, Sarah C

    2016-03-31

    The Sonoma County Farmworker Health Survey (FHS) was conducted to describe the health and well-being of adult farmworkers in Sonoma County, California, and to identify preventable health disparities for this population. From September 2013 through January 2014, venue-based and convenience sampling were used to survey 293 farmworkers aged 18 years or older. The questions included self-rated general health, diabetes and hypertension, and body mass index. To identify disparities between surveyed farmworkers and Sonoma County residents overall, age-adjusted prevalence estimates were developed by using indirect standardization to the adult (≥18 years) Sonoma County sample from the California Health Interview Survey for 2011-2012. Surveyed farmworkers were mostly male (91%) and Latino or Hispanic (95%), and 54% had an educational attainment of 8th grade or less. Most (81%) farmworkers reported their families earned less than $30,000 in 2012. After adjusting for age, 30% of farmworkers had US-based health insurance as compared with the 86% of Sonoma County adults in 2011-2012 (P < .001), and 15% of farmworkers reported ever being diagnosed with diabetes after adjusting for age as compared with 5% of Sonoma County adults (P = .002). After adjusting for age, 44% of farmworkers reported poor or fair health in general as compared with 13% of Sonoma County adults (P < .001). We identified significant health disparities between Sonoma County farmworkers and Sonoma County adults overall. Additional research and new health policies are necessary to eliminate these health disparities and to facilitate farmworker access to the health care system.

  12. Radiation in Yolo County

    NASA Astrophysics Data System (ADS)

    Dickie, H.; Colwell, K.

    2013-12-01

    In today's post-nuclear age, there are many man-made sources of radioactivity, in addition to the natural background we expect from cosmic and terrestrial origins. While all atoms possess unstable isotopes, there are few that are abundant enough, energetic enough, and have long enough half-lives to pose a signicant risk of ionizing radiation exposure. We hypothesize a decreasing relative radiation measurement (in detected counts per minute [CPM]) at nine locations that might pose occupational or environmental hazard: 1. A supermarket produce aisle (living tissue has high concentration of 40K) 2. A hospital (medical imaging uses X-rays and radioactive dyes) 3. The electronics section of a superstore (high voltage electronics have the potential to produce ionizing radiation) 4. An electrical transformer (similar reasons) 5. An antique store (some ceramics and glazes use radioisotopes that are now outlawed) 6. A gasoline pump (processing and terrestrial isotope contamination might leave a radioactive residue) 7. A fertilized eld (phosphate rock contains uranium and thorium, in addition to potassium) 8. A house (hopefully mild background, but potential radon contamination) 9. A school (should be radiologically neutral) We tested the hypothesis by measuring 100 minutes of counts on a self-assembled MightyOhmTM Geiger counter at each location. Our results show that contrary to the hypothesized ordering, the house was the most radiologically active. We present possible explanations for the observed radiation levels, as well as possible sources of measurement error, possible consequences of prolonged exposure to the measured levels, and suggestions for decreasing exposure and environmental impact.

  13. Disparities in Health Insurance Coverage and Health Status Among Farmworkers, Sonoma County, California, 2013–2014

    PubMed Central

    Mercado, Jenny; Hill, Jana; Katz, Sarah C.

    2016-01-01

    Introduction The Sonoma County Farmworker Health Survey (FHS) was conducted to describe the health and well-being of adult farmworkers in Sonoma County, California, and to identify preventable health disparities for this population. Methods From September 2013 through January 2014, venue-based and convenience sampling were used to survey 293 farmworkers aged 18 years or older. The questions included self-rated general health, diabetes and hypertension, and body mass index. To identify disparities between surveyed farmworkers and Sonoma County residents overall, age-adjusted prevalence estimates were developed by using indirect standardization to the adult (≥18 years) Sonoma County sample from the California Health Interview Survey for 2011–2012. Results Surveyed farmworkers were mostly male (91%) and Latino or Hispanic (95%), and 54% had an educational attainment of 8th grade or less. Most (81%) farmworkers reported their families earned less than $30,000 in 2012. After adjusting for age, 30% of farmworkers had US-based health insurance as compared with the 86% of Sonoma County adults in 2011–2012 (P < .001), and 15% of farmworkers reported ever being diagnosed with diabetes after adjusting for age as compared with 5% of Sonoma County adults (P = .002). After adjusting for age, 44% of farmworkers reported poor or fair health in general as compared with 13% of Sonoma County adults (P < .001). Conclusion We identified significant health disparities between Sonoma County farmworkers and Sonoma County adults overall. Additional research and new health policies are necessary to eliminate these health disparities and to facilitate farmworker access to the health care system. PMID:27032988

  14. Returns on Investment in California County Departments of Public Health.

    PubMed

    Brown, Timothy T

    2016-08-01

    To estimate the average return on investment for the overall activities of county departments of public health in California. I gathered the elements necessary to estimate the average return on investment for county departments of public health in California during the period 2001 to 2008-2009. These came from peer-reviewed journal articles published as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. I combined these elements by using the standard formula for computing return on investment, and performed a sensitivity analysis. Then I compared the return on investment for county departments of public health with the returns on investment generated for various aspects of medical care. The estimated return on investment from $1 invested in county departments of public health in California ranges from $67.07 to $88.21. The very large estimated return on investment for California county departments of public health relative to the return on investment for selected aspects of medical care suggests that public health is a wise investment.

  15. Returns on Investment in California County Departments of Public Health

    PubMed Central

    2016-01-01

    Objectives. To estimate the average return on investment for the overall activities of county departments of public health in California. Methods. I gathered the elements necessary to estimate the average return on investment for county departments of public health in California during the period 2001 to 2008–2009. These came from peer-reviewed journal articles published as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. I combined these elements by using the standard formula for computing return on investment, and performed a sensitivity analysis. Then I compared the return on investment for county departments of public health with the returns on investment generated for various aspects of medical care. Results. The estimated return on investment from $1 invested in county departments of public health in California ranges from $67.07 to $88.21. Conclusions. The very large estimated return on investment for California county departments of public health relative to the return on investment for selected aspects of medical care suggests that public health is a wise investment. PMID:27310339

  16. Hot Spots and Hot Moments of Methylmercury Production Associated With Agricultural and Non-agricultural Wetlands of the Yolo Bypass Wildlife Area, California

    NASA Astrophysics Data System (ADS)

    Marvin-Dipasquale, M.; Windham-Myers, L.; Agee, J. L.; Kakouros, E.; Cox, M. H.; Fleck, J.; Alpers, C. N.; Stephenson, M.

    2008-12-01

    The Yolo Bypass Wildlife Area (YBWA) is part of the larger Yolo Bypass floodwater protection zone associated with the Sacramento River and the Sacramento-San Joaquin Delta, in California. While mercury contamination is widespread throughout the region due to historic mining practices, the Yolo Bypass is responsible for a high proportion of the aqueous methylmercury (MeHg) entering the Delta, and biota from the Yolo Bypass are particularly elevated in toxic MeHg. Land use in the YBWA includes seasonally flooded agricultural fields (white rice, wild rice, fallow fields), and permanently and seasonally flooded non-agricultural wetlands used for resident and migratory waterfowl. Mercury biogeochemistry was examined in 0-2 cm surface sediment, as a function of habitat type, wetland management, and agricultural practices during the 2007-08 crop year. In permanently flooded wetlands, MeHg concentrations varied within a narrow range (ca. 0.5-1.5 ng/g dry wt) throughout the study period. In contrast, the three types of agricultural fields had higher MeHg concentrations throughout the rice-growing season (June-Sept; ca. 1.5-3.5 ng/g), and exhibited the highest levels (ca. 3.3-6.3 ng/g) in the post-harvest winter period (Dec-Feb). Further, naturally dried sediment, sampled during July '08 from post-harvest drained fallow agricultural fields (prior to reflooding) had MeHg concentrations that were also quite elevated (3.1 +/- 1.5 ng/g). This suggests that the initial elevated concentrations of overlying water MeHg, sometimes measured soon after flooding previously dried fields, may be related to the release of MeHg formed during the previous wet season and trapped in dried sediment, as opposed to being MeHg newly produced by bacteria upon soil rewetting. These results indicate that the 'hot spots and hot moments' associated with MeHg production in this system are linked to hydrologic manipulations (wetting and drying) in the agricultural fields, and that the practice of post

  17. Reinvigorating public health core functions: restructuring Los Angeles county's public health system.

    PubMed

    Fielding, Jonathan E; Luck, Jeff; Tye, Grace

    2003-01-01

    In 1997, the Los Angeles County Department of Health Services launched an effort to revitalize its Public Health Services division. County investments resulted in the creation of 241 new positions, facilitating the establishment of new offices addressing neglected chronic disease prevention, staff development, training, and communication. Service effectiveness and community responsiveness were enhanced by decentralizing leadership through eight Area Health Offices and strengthening partnerships with private health care providers, community-based organizations, and managed care organizations. Infrastructure enhancements included the development of program performance measures, countywide health indicators, a central health assessment and epidemiology office, and a new countywide biennial survey.

  18. California State Implementation Plan; Final Approval of Revision; Yolo-Solano Air Quality Management District; Reasonably Available Control Technology Requirements for 1997 8-hour Ozone NAAQS

    EPA Pesticide Factsheets

    EPA is taking final action to approve a revision to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California SIP concerning YSAQMD regarding RACT)requirements the 1997 8-hour ozone NAAQS and approve negative declarations into SIP.

  19. The convergence of Chinese county government health expenditures: capitation and contribution.

    PubMed

    Zhang, Guoying; Zhang, Luwen; Wu, Shaolong; Xia, Xiaoqiong; Lu, Liming

    2016-08-19

    The disparity between government health expenditures across regions is more severe in developing countries than it is in developed countries. The capitation subsidy method has been proven effective in developed countries in reducing this disparity, but it has not been tested in China, the world's largest developing country. The convergence method of neoclassical economics was adopted to test the convergence of China's regional government health expenditure. Data were obtained from Provinces, Prefectures and Counties Fiscal Statistical Yearbook (2003-2007) edited by the Chinese Ministry of Finance, and published by the Chinese Finance & Economics Publishing House. The existence of σ-convergence and long-term and short-term β-convergence indicated the effectiveness of the capitation subsidy method in the New Rural Cooperative Medical Scheme on narrowing county government health expenditure disparities. The supply-side variables contributed the most to the county government health expenditure convergence, and factors contributing to convergence of county government health expenditures per capita were different in three regions. The narrowing disparity between county government health expenditures across regions supports the effectiveness of the capitation subsidy method adopted by China's New Rural Cooperative Scheme. However, subsidy policy still requires further improvement.

  20. Health Policy Responsiveness: Lessons Learned from Maryland and Prince George's County.

    PubMed

    Sogie-Thomas, Byron; Sankofa, John; Reed, Crystal; Mfume, Kweisi; Doamekpor, Lauren Abla

    2018-04-01

    Effective, timely, and intentional policy efforts can significantly impact and improve the public's health and reduce racial and ethnic health disparities across the nation. Creating and implementing responsive policies at the state and county level is essential to supporting community efforts to improve health behaviors and health outcomes, particularly for communities of color who bear the brunt of disease risk and negative health outcomes. Using policy examples from the State of Maryland and Prince George's County, the largest and wealthiest predominately African-American county in the USA, this case study highlights the importance of state and county policy action when presented with opportunities to affect long-lasting, positive change. We examine each jurisdiction's policy response through the lens of timeliness, intentionality, and effectiveness. At first glance, it would appear that Maryland responded effectively to the rise in tobacco use. Similarly, at face value, it appears that Prince George's County's unchecked rise in obesity rates among African-Americans is an example of nonresponsiveness among local policymakers in the face of an obesity epidemic. However-guided by a more nuanced understanding of "policy responsiveness"-this analysis uncovers a more revealing picture, with important strengths and limitations seen in both policy situations. This analysis raises critical questions about the determinants of jurisdictions' health policy capacity and how policymakers might best be supported in their efforts to build an arsenal of health policies that are timely, effective, and intentional in meeting the needs of vulnerable communities.

  1. County-level job automation risk and health: Evidence from the United States.

    PubMed

    Patel, Pankaj C; Devaraj, Srikant; Hicks, Michael J; Wornell, Emily J

    2018-04-01

    Previous studies have observed a positive association between automation risk and employment loss. Based on the job insecurity-health risk hypothesis, greater exposure to automation risk could also be negatively associated with health outcomes. The main objective of this paper is to investigate the county-level association between prevalence of workers in jobs exposed to automation risk and general, physical, and mental health outcomes. As a preliminary assessment of the job insecurity-health risk hypothesis (automation risk → job insecurity → poorer health), a structural equation model was used based on individual-level data in the two cross-sectional waves (2012 and 2014) of General Social Survey (GSS). Next, using county-level data from County Health Rankings 2017, American Community Survey (ACS) 2015, and Statistics of US Businesses 2014, Two Stage Least Squares (2SLS) regression models were fitted to predict county-level health outcomes. Using the 2012 and 2014 waves of the GSS, employees in occupational classes at higher risk of automation reported more job insecurity, that, in turn, was associated with poorer health. The 2SLS estimates show that a 10% increase in automation risk at county-level is associated with 2.38, 0.8, and 0.6 percentage point lower general, physical, and mental health, respectively. Evidence suggests that exposure to automation risk may be negatively associated with health outcomes, plausibly through perceptions of poorer job security. More research is needed on interventions aimed at mitigating negative influence of automation risk on health. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Assessment of ebola virus disease, health care infrastructure, and preparedness - four counties,Southeastern Liberia, august 2014.

    PubMed

    Forrester, Joseph D; Pillai, Satish K; Beer, Karlyn D; Neatherlin, John; Massaquoi, Moses; Nyenswah, Tolbert G; Montgomery, Joel M; De Cock, Kevin

    2014-10-10

    Ebola virus disease (Ebola) is a multisystem disease caused by a virus of the genus Ebolavirus. In late March 2014, Ebola cases were described in Liberia, with epicenters in Lofa County and later in Montserrado County. While information about case burden and health care infrastructure was available for the two epicenters, little information was available about remote counties in southeastern Liberia. Over 9 days, August 6-14, 2014, Ebola case burden, health care infrastructure, and emergency preparedness were assessed in collaboration with the Liberian Ministry of Health and Social Welfare in four counties in southeastern Liberia: Grand Gedeh, Grand Kru, River Gee, and Maryland. Data were collected by health care facility visits to three of the four county referral hospitals and by unstructured interviews with county and district health officials, hospital administrators, physicians, nurses, physician assistants, and health educators in all four counties. Local burial practices were discussed with county officials, but no direct observation of burial practices was conducted. Basic information about Ebola surveillance and epidemiology, case investigation, contact tracing, case management, and infection control was provided to local officials.

  3. County Variation in Children's and Adolescent's Health Status and School District Performance in California

    PubMed Central

    Jung, Sunyoung

    2008-01-01

    Objectives. We examined the association between county-level estimates of children's health status and school district performance in California. Methods. We used 3 data sources: the California Health Interview Survey, district archives from the California Department of Education, and census-based estimates of county demographic characteristics. We used logistic regression to estimate whether a school district's failure to meet adequate yearly progress goals in 2004 to 2005 was a function of child and adolescent's health status. Models included district- and county-level fixed effects and were adjusted for the clustering of districts within counties. Results. County-level changes in children's and adolescent's health status decreased the likelihood that a school district would fail to meet adequate yearly progress goals during the investigation period. Health status did not moderate the relatively poor performance of predominantly minority districts. Conclusions. We found empirical support that area variation in children's and adolescent's health status exerts a contextual effect on school district performance. Future research should explore the specific mechanisms through which area-level child health influences school and district achievement. PMID:18309137

  4. Health Needs Assessment of Plain Populations in Lancaster County, Pennsylvania.

    PubMed

    Miller, Kirk; Yost, Berwood; Abbott, Christina; Thompson, Scottie; Dlugi, Emily; Adams, Zachary; Schulman, Meryl; Strauss, Nicole

    2017-02-01

    We performed a health needs assessment for three Plain communities in Lancaster County, Pennsylvania from a random sample of households. Compared with the general population of adults, Plain respondents were more likely to be married, to have children, and they had large families; they were more likely to drink well water, to eat fruit and vegetables, to drink raw milk, and to live on a farm. Plain respondents had better physical and mental health and were less likely to have been diagnosed with various medical conditions compared with the general population of adults in Lancaster County but Old Order Mennonite respondents were more likely to have been diagnosed compared with Old Order Amish respondents. Plain respondents usually have a regular doctor and often receive preventive care but Old Order Mennonite respondents were more likely to have a regular doctor, to receive preventive care, to have had their children vaccinated, and to receive routine dental care compared with Old Order Amish respondents. Despite their relative geographic and genetic isolation, and despite the small, relative differences noted, the health of Plain communities in Lancaster County is similar to that of other adults in the County.

  5. The Mecklenburg County Interlocal Agreement: An 18-Year Collaboration Between Medicine and Public Health.

    PubMed

    Piper, Crystal N; Plescia, Marcus; Keener, Stephen R; DeHaven, Mark

    Better integration of public health and medical services has been a long-standing goal in the United States and has been widely discussed in the scientific literature. To identify key lessons and outcomes of the Mecklenburg County Interlocal Agreement, one of the longest running efforts integrating health care delivery and public health services in a major metropolitan area. In-depth key informant interviews and brief questionnaires of leaders involved in the Mecklenburg County Interlocal Agreement. Charlotte-Mecklenburg County, North Carolina. Convenience sample of 15 past and present employees and administrative leaders of the Mecklenburg County Privatization Initiative from the Mecklenburg County Health Department (N = 7) and Carolinas Healthcare System (N = 8). Attitudes reflecting the effects of the Mecklenburg County Privatization Initiative, based on 6 "synergies" for evaluating the effectiveness of health care and public health system collaboration. Mean scores were calculated for 21 questionnaire items, using 5-point Likert scales (1 = no impact; 5 = great impact). Mean scores were calculated by averaging the multiple-item question sets reflecting each of the 6 synergies. Synergy scores ranged from a low of 3.1 (3 items reflecting whether the collaboration "Used clinical practice to identify and address community health problems") to a high of 3.7 (3 items reflecting whether the collaboration "Improved health care by coordinating services for individuals"). The in-depth interviews indicated a clear impact for the 2 synergies linked to individual care. Increased access to care emerged as a strong theme, along with the belief that medical care services were improved and that these improvements persist. The findings of this study provide perspective from an 18-year contractual agreement for a large health care system to operate county public health functions. Implications include the need to incorporate well-defined public health principles in any

  6. Lessons Learned From the Environmental Public Health Tracking Sub-County Data Pilot Project.

    PubMed

    Werner, Angela K; Strosnider, Heather; Kassinger, Craig; Shin, Mikyong

    2017-12-07

    Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network). The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions. This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward. National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.

  7. Timber resource statistics of the Sacramento resource area of California.

    Treesearch

    J.D. Lloyd; Joel Moen; Charles L. Bolsinger

    1986-01-01

    This report is one of five that provide timber resource statistics for 57 of the 58 counties in California (San Francisco is excluded). This report presents statistics from a 1981-84 inventory of the timber resources of Butte, Colusa, El Dorado, Glenn, Lake, Napa, Nevada, Placer, Plumas, Sacramento, Sierra, Sutter, Tehama, Yolo, and Yuba Counties. Tables presented are...

  8. Facilitating the development of a county health coverage plan with data from a community-based health survey.

    PubMed

    Kruger, Daniel J; Hamacher, Linda; Strugar-Fritsch, Donna; Shirey, Lauren; Renda, Emily; Zimmerman, Marc A

    2010-07-01

    Community-Based Participatory Research (CBPR) has the twin goals of generating data and shaping policy decisions, yet examples that combine these goals are scarce in the literature. We describe how a community-based survey was created and used to help develop a county health plan. The Genesee Health Plan (GHP), a community-initiated non-profit organization, provides primary care, prescription drugs, and specialty care to uninsured, low-income adults through a network of independent physicians, clinics, and hospital systems. As part of an advocacy effort, GHP supporters used results from the Speak to Your Health! Community Survey to gain financial and political support for GHP. Our study, which used CBPR principles, was created by the community, local health department, and university partners. As a result, Genesee County became one of the first counties in the United States to make basic health care available to nearly all of its uninsured, low-income adults.

  9. Addressing the social determinants of health through the Alameda County, California, place matters policy initiative.

    PubMed

    Schaff, Katherine; Desautels, Alexandra; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-11-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices.

  10. Understanding of Object Detection Based on CNN Family and YOLO

    NASA Astrophysics Data System (ADS)

    Du, Juan

    2018-04-01

    As a key use of image processing, object detection has boomed along with the unprecedented advancement of Convolutional Neural Network (CNN) and its variants since 2012. When CNN series develops to Faster Region with CNN (R-CNN), the Mean Average Precision (mAP) has reached 76.4, whereas, the Frame Per Second (FPS) of Faster R-CNN remains 5 to 18 which is far slower than the real-time effect. Thus, the most urgent requirement of object detection improvement is to accelerate the speed. Based on the general introduction to the background and the core solution CNN, this paper exhibits one of the best CNN representatives You Only Look Once (YOLO), which breaks through the CNN family’s tradition and innovates a complete new way of solving the object detection with most simple and high efficient way. Its fastest speed has achieved the exciting unparalleled result with FPS 155, and its mAP can also reach up to 78.6, both of which have surpassed the performance of Faster R-CNN greatly. Additionally, compared with the latest most advanced solution, YOLOv2 achieves an excellent tradeoff between speed and accuracy as well as an object detector with strong generalization ability to represent the whole image.

  11. Addressing the Social Determinants of Health through the Alameda County, California, Place Matters Policy Initiative

    PubMed Central

    Schaff, Katherine; Flournoy, Rebecca; Carson, Keith; Drenick, Teresa; Fujii, Darlene; Lee, Anna; Luginbuhl, Jessica; Mena, Mona; Shrago, Amy; Siegel, Anita; Stahl, Robert; Watkins-Tartt, Kimi; Willow, Pam; Witt, Sandra; Woloshin, Diane; Yamashita, Brenda

    2013-01-01

    In Alameda County, California, significant health inequities by race/ethnicity, income, and place persist. Many of the county's low-income residents and residents of color live in communities that have faced historical and current disinvestment through public policies. This disinvestment affects community conditions such as access to economic opportunities, well-maintained and affordable housing, high-quality schools, healthy food, safe parks, and clean water and air. These community conditions greatly affect health. At the invitation of the Joint Center for Political and Economic Studies' national Place Matters initiative, Alameda County Supervisor Keith Carson's Office and the Alameda County Public Health Department launched Alameda County Place Matters, an initiative that addresses community conditions through local policy change. We describe the initiative's creation, activities, policy successes, and best practices. PMID:24179279

  12. Assessing potential spatial accessibility of health services in rural China: a case study of Donghai county

    PubMed Central

    2013-01-01

    Introduction There is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential spatial accessibility of health services in Donghai County. We also give some advice on how to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. Methods The shortest traffic times of from hospitals to villages are calculated with an O-D matrix of GIS extension model. This paper applies an enhanced two-step floating catchment area (E2SFCA) method to study the spatial accessibility of health services and to determine areas with physician shortages in Donghai County. The sensitivity of the E2SFCA for assessing variation in the spatial accessibility of health services is checked using different impedance coefficient valuesa. Geostatistical Analyst model and spatial analyst method is used to analyse the spatial pattern and the edge effect of potential spatial accessibility of health services. Results The results show that 69% of villages have access to lower potential spatial accessibility of health services than the average for Donghai County, and 79% of the village scores are lower than the average for Jiangsu Province. The potential spatial accessibility of health services diminishes greatly from the centre of the county to outlying areas. Using a smaller impedance coefficient leads to greater disparity among the villages. The spatial accessibility of health services is greater along highway in the county. Conclusions Most of villages are in underserved health services areas. An unequal distribution of health service

  13. RESPIRATORY HEALTH OF RURAL AND FARM WOMEN IN THE KEOKUK COUNTY RURAL HEALTH STUDY

    EPA Science Inventory

    RESPIRATORY HEALTH OF RURAL AND FARM WOMEN IN THE KEOKUK COUNTY RURAL HEALTH STUDY
    Allison L. Naleway*, Nancy L. Sprince?, Erik R. Svendsen?, Ann M. Stromquist?, James A. Merchant?
    *Marshfield Medical Research and Education Foundation, Marshfield, WI; ?University of Iowa Co...

  14. Value of training on motivation among health workers in Narok County, Kenya.

    PubMed

    Momanyi, George Osoro; Adoyo, Maureen Atieno; Mwangi, Eunice Muthoni; Mokua, Dennis Okari

    2016-01-01

    Training, as an additive human resources intervention is decisive to organizational performance. Employees require constant update of formal and informal knowledge alongside positive attitudes that have been defined as necessary in motivation leading to effectiveness in performance hence workplace training is tied to achieving organizational aims and objectives. The objective of this study was to determine the influence of training on motivation among health workers in Narok County, Kenya. A cross-sectional study utilizing a self administered questionnaire, targeting 237 health workers and 21 health managers was used. Data analysis was done using SPSS version 21 using descriptive statistics. Factor analysis was done on the training perception in relation to motivation. Majority of the respondents rated their motivation between 7 and 9 in the current health facility (35.4%), Sub-county (33.8%) and County (32.9%) with the median motivation level of 5. Majority of health workers 194 (81.9%) had received a form of training, of whom 191 (98.5%) indicated that on-job training was relevant to their tasks and that it motivated 192 (99.0%) of them to perform better due to coining skills to motivation. Training significantly predicted general motivation (p-value = 0.013), job satisfaction (p-value = .001), intrinsic job satisfaction (p-value = .001) and organisational commitment (p-value <.001). The researchers concluded that there is a relationship between training and motivated health workforce in Narok County and recommended strengthening of current training initiatives by ensuring trainings are more regular and involvement of health workers in discussing their career development prospects.

  15. Value of training on motivation among health workers in Narok County, Kenya

    PubMed Central

    Momanyi, George Osoro; Adoyo, Maureen Atieno; Mwangi, Eunice Muthoni; Mokua, Dennis Okari

    2016-01-01

    Introduction Training, as an additive human resources intervention is decisive to organizational performance. Employees require constant update of formal and informal knowledge alongside positive attitudes that have been defined as necessary in motivation leading to effectiveness in performance hence workplace training is tied to achieving organizational aims and objectives. The objective of this study was to determine the influence of training on motivation among health workers in Narok County, Kenya. Methods A cross-sectional study utilizing a self administered questionnaire, targeting 237 health workers and 21 health managers was used. Data analysis was done using SPSS version 21 using descriptive statistics. Factor analysis was done on the training perception in relation to motivation. Results Majority of the respondents rated their motivation between 7 and 9 in the current health facility (35.4%), Sub-county (33.8%) and County (32.9%) with the median motivation level of 5. Majority of health workers 194 (81.9%) had received a form of training, of whom 191 (98.5%) indicated that on-job training was relevant to their tasks and that it motivated 192 (99.0%) of them to perform better due to coining skills to motivation. Training significantly predicted general motivation (p-value = 0.013), job satisfaction (p-value = .001), intrinsic job satisfaction (p-value = .001) and organisational commitment (p-value <.001). Conclusion The researchers concluded that there is a relationship between training and motivated health workforce in Narok County and recommended strengthening of current training initiatives by ensuring trainings are more regular and involvement of health workers in discussing their career development prospects. PMID:27516826

  16. Influence of urbanization level and gross domestic product of counties in Croatia on access to health care.

    PubMed

    Bagat, Mario; Drakulić, Velibor; Sekelj Kauzlarić, Katarina; Vlahusić, Andro; Bilić, Ivica; Matanić, Dubravka

    2008-06-01

    To examine the association of counties' urbanization level and gross domestic product (GDP) per capita on the access to health care. Counties were divided in two groups according to the urbanization level and GDP per capita in purchasing power standards. The number of physicians per 100,000 inhabitants, the number of physicians in hospitals in four basic specialties, physicians' workload, average duration of working week, the average number of insurants per general practice (GP) team, and the number of inhabitants covered by one internal medicine outpatient clinic were compared between predominantly urban and predominantly rural counties and between richer and poorer counties. Our study included only GP teams and outpatient clinics under the contract with the Croatian Institute for Health Insurance. Data on physicians were collected from the Ministry of Health and Social Welfare, the Croatian Institute for Health Insurance, the Croatian Institute for Public Health, and the Croatian Medical Chamber. Data on the contracts with the Croatian Institute for Health Insurance and health care services provided under these contracts were obtained from the database of the Institute, while population and gross domestic product data were obtained from the Database of the Croatian Institute for Statistics. World Health Organization Health for All Database was used for the international comparison of physician's data. There was no significant difference in the total number of physicians per 100,000 inhabitants between predominantly urban and predominantly rural counties (206.9+/-41.0 vs 175.4+/-30.3; P=0.067, t test) nor between richer and poorer counties (194.5+/-49.8 vs 187.7+/-25.3; P=0.703, t test). However, there were significantly fewer GPs per 100,000 inhabitants in rural than urban counties (49.0+/-5.5 vs 56.7+/-4.6; P=0.003, t test). GPs in rural counties had more insurants than those working in urban counties (1.749.8+/-172.8 vs 1.540.7+/-106.3; P=0.004, t test). The

  17. Health-Related Quality of Life Among Central Appalachian Residents in Mountaintop Mining Counties

    PubMed Central

    Hendryx, Michael

    2011-01-01

    Objectives. We examined the health-related quality of life of residents in mountaintop mining counties of Appalachia using the 2006 national Behavioral Risk Factor Surveillance System. Methods. Dependent variables included self-rated health; the number of poor physical, poor mental, and activity limitation days (in the past 30 days); and the Healthy Days Index. Independent variables included metropolitan status, primary care physician supply, and Behavioral Risk Factor Surveillance System behavioral and demographic variables. We compared dependent variables across 3 categories: mountaintop mining (yes or no), other coal mining (yes or no), and a referent nonmining group. We used SUDAAN MULTILOG and multiple linear regression models with post hoc least squares means to test mountaintop mining effects after adjusting for covariates. Results. Residents of mountaintop mining counties reported significantly more days of poor physical, mental, and activity limitation and poorer self-rated health (P < .01) compared with the other county groupings. Results were generally consistent in separate analyses by gender and age. Conclusions. Mountaintop mining areas are associated with the greatest reductions in health-related quality of life even when compared with counties with other forms of coal mining. PMID:21421943

  18. 76 FR 26981 - Proposed Flood Elevation Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... table provided here represents the flooding sources, location of referenced elevations, effective and.... Specifically, it addresses the following flooding sources: Cache Creek, Cache Creek Left Bank Overflow, and... ``Unincorporated Areas of Yolo County, California'' addressed the flooding source Cache Creek Settling Basin. That...

  19. Rural Health Care Workers and Local Residents Health Status in Yulong County of Yunnan Province China and Hat Yai City of Songkhla Mansion Thailand.

    PubMed

    Fanwei, Q U; Yanling, J; Chongsuvivatwong, V; Liabsuetrakul, T; Yan, L; Le, C; Runsheng, J

    2017-01-01

    To compare health status between Hat Yai city of Songkhla Province in Thailand and Yulong county of Yunnan province in China about rural health care workers and local residents, analyzing of both differences, learning from the advanced experience and practice of Thailand, adjusting policy, especially for the implementation of measures to improve the lack of human resources construction of Yulong County rural health, promote the level of rural health service of Lijiang. A qualitative study consisting of focus group discussions and individual in-depth interviews were conducted in Rural Health Care Workers and Local Residents Health Status in Yulong County of Yunnan Province China and Hat Yai City of Songkhla Mansion Thailand from. Compared to 41(100%) bachelor's degree of medical staffs in Hat Yai, this accounted only 94 (42%) bachelor's degree of medical staffs in Yulong county hospital, and 31 (12%)in townships hospitals. For medical workers in Hat Yai, they have at least one time on-job training per year, but for Yulong county, only 144 (29%)of the medical personnel participated in the training per year. Health expenditures of Yulong county was mainly borne by the local government, and medical insurance coverage rate is 217,107 (99%). Insurance average awareness of Hat Yai is 4449 (66.4%), Yulong County is 62,501 (28.5%), P<0.001, there are statistically significant differences between two cities. Thailand has good experience in training, well-paid, motivating and retaining talent for rural health human resources; multi-pronged, mechanism innovation, establish and perfect the system of human resources for health, is the essential way to solve the problem.

  20. Targeted health department expenditures benefit birth outcomes at the county level.

    PubMed

    Bekemeier, Betty; Yang, Youngran; Dunbar, Matthew D; Pantazis, Athena; Grembowski, David E

    2014-06-01

    Public health leaders lack evidence for making decisions about the optimal allocation of resources across local health department (LHD) services, even as limited funding has forced cuts to public health services while local needs grow. A lack of data has also limited examination of the outcomes of targeted LHD investments in specific service areas. This study used unique, detailed LHD expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes. A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000-2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida. Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three specific examined MCH service areas demonstrating the strongest effects. Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and ensuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

    PubMed

    Gai, Ruoyan Y; Zhou, Chengchao C; Xu, Lingzhong Z; Zhu, Min; Wang, Xingzhou Z; Li, Shixue X; Zheng, Wengui G; Song, Peipei P; Yang, Xuelai L; Fang, Liyi Y; Zhen, Yancheng C; Tang, Wei

    2010-10-01

    This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

  2. Presence of a Community Health Center and Uninsured Emergency Department Visit Rates in Rural Counties

    PubMed Central

    Rust, George; Baltrus, Peter; Ye, Jiali; Daniels, Elvan; Quarshie, Alexander; Boumbulian, Paul; Strothers, Harry

    2009-01-01

    CONTEXT Community health centers (CHCs) provide essential access to a primary care medical home for the uninsured, especially in rural communities with no other primary care safety net. CHCs could potentially reduce uninsured emergency department (ED) visits in rural communities. PURPOSE We compared uninsured ED visit rates between rural counties in Georgia which have a community health center clinic site vs. counties without a CHC presence. METHODS We analyzed data from 100% of ED visits occurring in 117 rural (non-metropolitan statistical area [MSA]) counties in Georgia from 2003-2005. Counties were classified as having a CHC presence if a federally funded (Section 330) community health center had a primary care delivery site in that county throughout the study period. The main outcome measure was uninsured ED visit rates among the uninsured (all-cause ED visits and visits for ambulatory care sensitive conditions). Poisson regression models were used to examine the relationship between ED rates and presence of a CHC. To assure that the effects were unique to the uninsured population, we ran similar analyses on insured ED visits. FINDINGS Counties without a community health center primary care clinic site had 33% higher rates of uninsured all-cause ED visits per 10,000 uninsured population compared with non-CHC counties (rate ratio=1.33, 95% CI=1.11-1.59). Higher ED visit rates remained significant (RR=1.21, 95% CI=1.02-1.42) after adjustment for percent of population below poverty level, percent black, and number of hospitals. Uninsured ED visit rates were also higher for various categories of diagnoses, but remained statistically significant on multivariate analysis only for ambulatory care sensitive conditions (adjusted RR=1.22, 95% CI=1.01-1.47). No such relationship was found for ED visit rates of insured patients (RR=1.06, 95% CI=0.92-1.22). CONCLUSIONS Absence of a community health center is associated with a substantial excess in uninsured ED visits in

  3. County community health associations of net voting shift in the 2016 U.S. presidential election.

    PubMed

    Wasfy, Jason H; Stewart, Charles; Bhambhani, Vijeta

    2017-01-01

    In the U.S. presidential election of 2016, substantial shift in voting patterns occurred relative to previous elections. Although this shift has been associated with both education and race, the extent to which this shift was related to public health status is unclear. To determine the extent to which county community health was associated with changes in voting between the presidential elections of 2016 and 2012. Ecological study with principal component analysis (PCA) using principal axis method to extract the components, then generalized linear regression. General community. All counties in the United States. Physically unhealthy days, mentally unhealthy days, percent food insecure, teen birth rate, primary care physician visit rate, age-adjusted mortality rate, violent crime rate, average health care costs, percent diabetic, and percent overweight or obese. The percentage of Donald Trump votes in 2016 minus percentage of Mitt Romney votes in 2012 ("net voting shift"). Complete public health data was available for 3,009 counties which were included in the analysis. The mean net voting shift was 5.4% (+/- 5.8%). Of these 3,009 counties, 2,641 (87.8%) had positive net voting shift (shifted towards Trump) and 368 counties (12.2%) had negative net voting shift (shifted away from Trump). The first principal component ("unhealthy score") accounted for 68% of the total variance in the data. The unhealthy score included all health variables except primary care physician rate, violent crime rate, and health care costs. The mean unhealthy score for counties was 0.39 (SD 0.16). Higher normalized unhealthy score was associated with positive net voting shift (22.1% shift per unit unhealthy, p < 0.0001). This association was stronger in states that switched Electoral College votes from 2012 to 2016 than in other states (5.9% per unit unhealthy, p <0.0001). Substantial association exists between a shift toward voting for Donald Trump in 2016 relative to Mitt Romney in 2012 and

  4. A county-level cross-sectional analysis of positive deviance to assess multiple population health outcomes in Indiana.

    PubMed

    Hendryx, Michael; Guerra-Reyes, Lucia; Holland, Benjamin D; McGinnis, Michael Dean; Meanwell, Emily; Middlestadt, Susan E; Yoder, Karen M

    2017-10-11

    To test a positive deviance method to identify counties that are performing better than statistical expectations on a set of population health indicators. Quantitative, cross-sectional county-level secondary analysis of risk variables and outcomes in Indiana. Data are analysed using multiple linear regression to identify counties performing better or worse than expected given traditional risk indicators, with a focus on 'positive deviants' or counties performing better than expected. Counties in Indiana (n=92) constitute the unit of analysis. Per cent adult obesity, per cent fair/poor health, low birth weight per cent, per cent with diabetes, years of potential life lost, colorectal cancer incidence rate and circulatory disease mortality rate. County performance that outperforms expectations is for the most part outcome specific. But there are a few counties that performed particularly well across most measures. The positive deviance approach provides a means for state and local public health departments to identify places that show better health outcomes despite demographic, social, economic or behavioural disadvantage. These places may serve as case studies or models for subsequent investigations to uncover best practices in the face of adversity and generalise effective approaches to other areas. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Influence of Urbanization Level and Gross Domestic Product of Counties in Croatia on Access to Health Care

    PubMed Central

    Bagat, Mario; Drakulić, Velibor; Sekelj Kauzlarić, Katarina; Vlahušić, Andro; Bilić, Ivica; Matanić, Dubravka

    2008-01-01

    Aim To examine the association of counties’ urbanization level and gross domestic product (GDP) per capita on the access to health care. Methods Counties were divided in two groups according to the urbanization level and GDP per capita in purchasing power standards. The number of physicians per 100 000 inhabitants, the number of physicians in hospitals in four basic specialties, physicians’ workload, average duration of working week, the average number of insurants per general practice (GP) team, and the number of inhabitants covered by one internal medicine outpatient clinic were compared between predominantly urban and predominantly rural counties, and between richer and poorer counties. Our study included only GP teams and outpatients’ clinics under the contract with the Croatian Institute for Health Insurance. Data on physicians were collected from the Ministry of Health and Social Welfare, the Croatian Institute for Health Insurance, the Croatian Institute for Public Health, and the Croatian Medical Chamber. Data on the contracts with the Croatian Institute for Health Insurance and health care services provided under these contracts were obtained from the database of the Institute, while population and gross domestic product data were obtained from the Database of the Croatian Institute for Statistics. World Health Organization Health for All Database was used for the international comparison of physician’s data. Results There was no significant difference in the total number of physicians per 100 000 inhabitants between predominantly urban and predominantly rural counties (206.9 ± 41.0 vs 175.4 ± 30.3; P = 0.067, t test) nor between richer and poorer counties (194.5 ± 49.8 vs 187.7 ± 25.3; P = 0.703, t test). However, there were significantly fewer GPs per 100 000 inhabitants in rural than urban counties (49.0 ± 5.5 vs 56.7 ± 4.6; P = 0.003, t test). GPs in rural counties had more insurants than those

  6. 78 FR 42018 - Determination of Attainment for the Sacramento Nonattainment Area for the 2006 Fine Particle...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... control agencies in the area: Sacramento Metropolitan Air Quality Management District, Placer County Air Pollution Control District, and Yolo-Solano Air Quality Management District. Based on these reviews, EPA..., 2007) (Miami, Arizona area); and 75 FR 27944 (May 19, 2010) (Coso Junction, California area). Thus EPA...

  7. The Effectiveness of Mentoring for Adolescent Mothers and Their Infants: A Comparative Study between Sister Friend and Cal Learn.

    ERIC Educational Resources Information Center

    Tebb, Kathleen P.

    This study evaluated Sister Friend, a mentoring program in Yolo County, California, serving low-income adolescent mothers and their infants. The primary objective was to determine if participating in the Sister Friend program improved the adolescent mother's parenting class attendance, the home environment, parenting behavior, and child…

  8. Rearrest and linkage to mental health services among clients of the Clark County mental health court program.

    PubMed

    Herinckx, Heidi A; Swart, Sandra C; Ama, Shane M; Dolezal, Cheri D; King, Steve

    2005-07-01

    This study examined rearrest and linkage to mental health services among 368 misdemeanants with severe and persistent mental illness who were served by the Clark County Mental Health Court (MHC). This court, established in April 2000, is based on the concepts of therapeutic jurisprudence. This study addressed the following questions about the effectiveness of the Clark County MHC: Did MHC clients receive more comprehensive mental health services? Did the MHC successfully reduce recidivism? Were there any client or program characteristics associated with recidivism? A secondary analysis of use of mental health services and jail data for the MHC clients enrolled from April 2000 through April 2003 was conducted. The authors used a 12-month pre-post comparison design to determine whether MHC participants experienced reduced rearrest rates for new offenses, reduced probation violations, and increased mental health services 12 months postenrollment in the MHC compared with 12 months preenrollment. The overall crime rate for MHC participants was reduced 4.0 times one year postenrollment in the MHC compared with one year preenrollment. One year postenrollment, 54 percent of participants had no arrests, and probation violations were reduced by 62 percent. The most significant factor in determining the success of MHC participants was graduation status from the MHC, with graduates 3.7 times less likely to reoffend compared with nongraduates. The Clark County MHC successfully reduced rearrest rates for new criminal offenses and probation violations and provided the mental health support services to stabilize mental health consumers in the community.

  9. Association between community health center and rural health clinic presence and county-level hospitalization rates for ambulatory care sensitive conditions: an analysis across eight US states.

    PubMed

    Probst, Janice C; Laditka, James N; Laditka, Sarah B

    2009-07-31

    Federally qualified community health centers (CHCs) and rural health clinics (RHCs) are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS) conditions. We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties). Counties were categorized by facility availability: CHC(s) only, RHC(s) only, both (CHC and RHC), and neither. US Agency for Healthcare Research and Quality definitions were used to identify ACS diagnoses. Discharge rates were based on the individual's county of residence and were obtained by dividing ACS hospitalizations by the relevant county population. We calculated ACS rates separately for children, working age adults, and older individuals, and for uninsured children and working age adults. To ensure stable rates, we excluded counties having fewer than 1,000 residents in the child or working age adult categories, or 500 residents among those 65 and older. Multivariate Poisson analysis was used to calculate adjusted rate ratios. Among working age adults, rate ratio (RR) comparing ACS hospitalization rates for CHC-only counties to those of counties with neither facility was 0.86 (95% Confidence Interval, CI, 0.78-0.95). Among older adults, the rate ratio for CHC-only counties compared to counties with neither facility was 0.84 (CI 0.81-0.87); for counties with both CHC and RHC present, the RR was 0.88 (CI 0.84-0.92). No CHC/RHC effects were found for children. No effects were found on estimated hospitalization rates among uninsured populations. Our results suggest that CHCs and RHCs may play a

  10. Analysis of pesticides in surface water and sediment from Yolo Bypass, California, 2004-2005

    USGS Publications Warehouse

    Smalling, Kelly L.; Orlando, James L.; Kuivila, Kathryn

    2005-01-01

    Inputs to the Yolo Bypass are potential sources of pesticides that could impact critical life stages of native fish. To assess the direct inputs during inundation, pesticide concentrations were analyzed in water, in suspended and bed-sediment samples collected from six source watersheds to the Yolo Bypass, and from three sites within the Bypass in 2004 and 2005. Water samples were collected in February 2004 from the six input sites to the Bypass during the first flood event of the year representing pesticide inputs during high-flow events. Samples were also collected along a transect across the Bypass in early March 2004 and from three sites within the Bypass in the spring of 2004 under low-flow conditions. Low-flow data were used to understand potential pesticide contamination and its effects on native fish if water from these areas were used to flood the Bypass in dry years. To assess loads of pesticides to the Bypass associated with suspended sediments, large-volume water samples were collected during high flows in 2004 and 2005 from three sites, whereas bed sediments were collected from six sites in the fall of 2004 during the dry season. Thirteen current-use pesticides were detected in surface water samples collected during the study. The highest pesticide concentrations detected at the input sites to the Bypass corresponded to the first high-flow event of the year. The highest pesticide concentrations at the two sites sampled within the Bypass during the early spring were detected in mid-April following a major flood event as the water began to subside. The pesticides detected and their concentrations in the surface waters varied by site; however, hexazinone and simazine were detected at all sites and at some of the highest concentrations. Thirteen current-use pesticides and three organochlorine insecticides were detected in bed and suspended sediments collected in 2004 and 2005. The pesticides detected and their concentrations varied by site and sediment

  11. Health reform and primary care capacity: evidence from Houston/Harris County, Texas.

    PubMed

    Begley, Charles; Le, Phuc; Lairson, David; Hanks, Jeanne; Omojasola, Anthony

    2012-02-01

    This study estimated the possible surge in demand for primary care among the low-income population in Houston/Harris County under the Patient Protection and Affordable Care Act, and related it to existing supply by safety-net providers. A model of the demand for primary care visits was developed based on California Health Interview Survey data and applied to the Houston/Harris County population. The current supply of primary care visits by safety-net providers was determined by a local survey. Comparisons indicate that safety-net providers in Houston/Harris County are currently meeting about 30% of the demand for primary care visits by the low-income population, and the rest are either met by private practice physicians or are unmet. Demand for primary care by this population is projected to increase by 30% under health reform leading to a drop in demand met by safety-net providers to less than 25%.

  12. County community health associations of net voting shift in the 2016 U.S. presidential election

    PubMed Central

    Stewart, Charles; Bhambhani, Vijeta

    2017-01-01

    Importance In the U.S. presidential election of 2016, substantial shift in voting patterns occurred relative to previous elections. Although this shift has been associated with both education and race, the extent to which this shift was related to public health status is unclear. Objective To determine the extent to which county community health was associated with changes in voting between the presidential elections of 2016 and 2012. Design Ecological study with principal component analysis (PCA) using principal axis method to extract the components, then generalized linear regression. Setting General community. Participants All counties in the United States. Exposures Physically unhealthy days, mentally unhealthy days, percent food insecure, teen birth rate, primary care physician visit rate, age-adjusted mortality rate, violent crime rate, average health care costs, percent diabetic, and percent overweight or obese. Main outcome The percentage of Donald Trump votes in 2016 minus percentage of Mitt Romney votes in 2012 (“net voting shift”). Results Complete public health data was available for 3,009 counties which were included in the analysis. The mean net voting shift was 5.4% (+/- 5.8%). Of these 3,009 counties, 2,641 (87.8%) had positive net voting shift (shifted towards Trump) and 368 counties (12.2%) had negative net voting shift (shifted away from Trump). The first principal component (“unhealthy score”) accounted for 68% of the total variance in the data. The unhealthy score included all health variables except primary care physician rate, violent crime rate, and health care costs. The mean unhealthy score for counties was 0.39 (SD 0.16). Higher normalized unhealthy score was associated with positive net voting shift (22.1% shift per unit unhealthy, p < 0.0001). This association was stronger in states that switched Electoral College votes from 2012 to 2016 than in other states (5.9% per unit unhealthy, p <0.0001). Conclusions and relevance

  13. Hematology and serum biochemistry values of dusky-footed wood rat (Neotoma fuscipes).

    PubMed

    Weber, David K; Danielson, Kathleen; Wright, Stan; Foley, Janet E

    2002-07-01

    Serum chemistry values and complete blood counts were determined for 36 wild dusky-footed wood rats (Neotoma fuscipes) from Sonoma and western Yolo County, California (USA) in summer 1999 and spring 2001. All wood rats had adequate body condition and were hydrated. Many hematologic and biochemical values were comparable to those for house rat (Rattus rattus). There were differences between wood rats tested immediately after capture (those from Yolo County) and after a week of habituation in the laboratory (Sonoma County). Significant differences were noted in red blood cell counts, hemoglobin, hematocrit, neutrophil:lymphocyte ratio, glucose, alanine transaminase, aspartate aminotransferase, and alkaline phosphatase values. The neutrophil:lymphocyte ratio may have been iatrogenically modified in the wood rats tested immediately after capture by stress-induced neutrophilia and lymphopenia. Eosinophilia may have been associated with parasites such as botflies in four individuals, and hyperglycemia in three individuals could have been associated with stress. The cause of elevated enzymes in the animals tested after laboratory habituation is unclear. The hematologic and biochemical values of these apparently healthy wood rats provide valuable baseline information for use in further medical studies performed with this species.

  14. Voluntary psychiatric emergencies in Los Angeles County after funding of California's Mental Health Services Act.

    PubMed

    Bruckner, Tim A; Yonsu, Kim; Chakravarthy, Bharath; Brown, Timothy Tyler

    2012-08-01

    Since 2006, California's Mental Health Services Act (MHSA) has distributed an estimated $6 billion in new tax revenues to county mental health systems. Although evaluations of MHSA's effectiveness find favorable outcomes among high-risk individuals that represent 6% of all mental health clients, scant research has tested whether MHSA funds improve the overall functioning of the public mental health system. The authors analyzed whether the incidence of voluntary emergency psychiatric visits, a key gauge of the functioning of the mental health system, fell below expected levels after the disbursement of MHSA funds. Los Angeles County, the most populous county in California, was examined. The authors obtained the monthly incidence of emergency psychiatric visits among Medi-Cal patients for 96 months spanning July 2000 to June 2008 (5.9 million overall admissions, of which 47,328 were emergency visits). Time-series methods controlled for temporal patterns in emergency visits as well as other potential confounders (unemployment, for example) that could induce spurious associations. The incidence of voluntary psychiatric emergencies fell below expected levels eight to 12 months after the disbursement of MHSA funds. After one year, emergency visits returned to their long-term mean level. Results remained robust after analyses controlled for outliers and potential confounders. In the short term, an infusion of public funds devoted to mental health services appeared to reduce psychiatric emergency visits. Explanations for the transient nature of the decline in emergency visits in Los Angeles County are discussed.

  15. 27 CFR 9.68 - Merritt Island.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Merritt Island viticultural area is located in Yolo County, California, six miles south of the City of... intersection of Sutter Slough with the Sacramento River. (2) Then west along the course of Sutter Slough for 0... miles to the community of Clarksburg and the intersection of Sacramento River. (4) Then southeasterly...

  16. Unlocking the Latchkey Problem.

    ERIC Educational Resources Information Center

    Press-Dawson, Andee

    1987-01-01

    "Kids-on-Campus" provides before and after school child care services in partnership with seven school districts in Sacramento and Yolo Counties (CA). It is the ideal solution to the latchkey children problem with the program taking responsibility for all the development and administration of in-school child care programs. (MD)

  17. Geotagged US Tweets as Predictors of County-Level Health Outcomes, 2015-2016.

    PubMed

    Nguyen, Quynh C; McCullough, Matt; Meng, Hsien-Wen; Paul, Debjyoti; Li, Dapeng; Kath, Suraj; Loomis, Geoffrey; Nsoesie, Elaine O; Wen, Ming; Smith, Ken R; Li, Feifei

    2017-11-01

    To leverage geotagged Twitter data to create national indicators of the social environment, with small-area indicators of prevalent sentiment and social modeling of health behaviors, and to test associations with county-level health outcomes, while controlling for demographic characteristics. We used Twitter's streaming application programming interface to continuously collect a random 1% subset of publicly available geo-located tweets in the contiguous United States. We collected approximately 80 million geotagged tweets from 603 363 unique Twitter users in a 12-month period (April 2015-March 2016). Across 3135 US counties, Twitter indicators of happiness, food, and physical activity were associated with lower premature mortality, obesity, and physical inactivity. Alcohol-use tweets predicted higher alcohol-use-related mortality. Social media represents a new type of real-time data that may enable public health officials to examine movement of norms, sentiment, and behaviors that may portend emerging issues or outbreaks-thus providing a way to intervene to prevent adverse health events and measure the impact of health interventions.

  18. Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: Why we should measure them all

    PubMed Central

    2014-01-01

    Introduction Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. Methods This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. Results The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. Conclusions It is feasible to extend population health reporting to

  19. Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: why we should measure them all.

    PubMed

    Asada, Yukiko; Whipp, Alyce; Kindig, David; Billard, Beverly; Rudolph, Barbara

    2014-06-13

    Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. It is feasible to extend population health reporting to include reporting of a subpopulation group

  20. 40 CFR 258.41 - Project XL Bioreactor Landfill Projects.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Air Quality Agency for the Buncombe County Solid Waste Management Facility in effect, and shall comply... action. The termination will take effect 60 days from the date of the notice, unless the EPA Regional.... These reporting provisions shall remain in effect for as long as the owner or operator of the Yolo...

  1. 27 CFR 9.68 - Merritt Island.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Merritt Island viticultural area is located in Yolo County, California, six miles south of the City of... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Merritt Island. 9.68... Merritt Island. (a) Name. The name of the viticultural area described in this section is “Merritt Island...

  2. 27 CFR 9.68 - Merritt Island.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Merritt Island viticultural area is located in Yolo County, California, six miles south of the City of... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Merritt Island. 9.68... Merritt Island. (a) Name. The name of the viticultural area described in this section is “Merritt Island...

  3. 27 CFR 9.68 - Merritt Island.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Merritt Island viticultural area is located in Yolo County, California, six miles south of the City of... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Merritt Island. 9.68... Merritt Island. (a) Name. The name of the viticultural area described in this section is “Merritt Island...

  4. 27 CFR 9.68 - Merritt Island.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Merritt Island viticultural area is located in Yolo County, California, six miles south of the City of... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Merritt Island. 9.68... Merritt Island. (a) Name. The name of the viticultural area described in this section is “Merritt Island...

  5. Public health assessment for petitioned public health assessment, Old Douglas County Landfill (a/k/a Douglas County/Cedar Mountain Landfill), Douglasville, Douglas County, Georgia, Region 4: CERCLIS Number GAD984279232. Final report

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

    NONE

    The Old Douglas County Landfill in Douglasville, Georgia, operated from 1973 until 1987 as a municipal waste landfill. Existing landfill records specify that household wastes were received, however, industrial wastes are suspected to have been disposed at this landfill. The Agency for Toxic Substances and Disease Registry (ATSDR) concludes that private well water near the landfill is safe to drink. The surface water from Gothard`s Creek and the settling ponds on the landfill do not have chemicals present at levels of public health concern. The settling ponds on the landfill and parts of Gothard`s Creek contain elevated levels of lead,more » manganese, and iron in the sediment that are not harmfull to humans under typical exposure conditions. The soil located on- and off-site also had elevated levels of lead, manganese, and iron, however, these metals do not pose a threat to human health under typical exposure conditions. Currently, human contact with contaminants in soil, sediment, and surface water associated with Old Douglas County Landfill is not expected to result in adverse health effects. ATSDR determined that the methane monitoring locations and frequency at the landfill are inadequate to fully evaluate conditions at the perimeter of the landfill or near adjacent houses.« less

  6. [Analysis on effect of health promotion project for pupils in Wushan County].

    PubMed

    Lei, Hong-xia; Zhong, Ji-rong

    2010-04-01

    To evaluate the effect of health promotion project ahout hepatitis for pupils, and provide strategies for health promotion. Health promotion program was implemented through health education classes, along with many entertainments and lively activities. 213 teachers, pupils and parents from schools in the county were surveyed. The awareness of them were 100%, and the inoculating rates of hepatitis A vaccine and hepatitis B vaccine were hoth improved to 93%. Health promotion program plays an important role to promote the healthy knowledge of pupils.

  7. Timber resource statistics for the Sacramento resource area of California.

    Treesearch

    Karen L. Waddell; Patricia M. Bassett

    1997-01-01

    This report is a summary of timber resource statistics for the Sacramento Resource Area of California, which includes Butte, Colusa, El Dorado, Glenn, Lake, Napa, Nevada, Placer, Plumas, Sacramento, Sierra, Sutter, Tehama, Yolo, and Yuba Counties. Data were collected as part of a statewide multiresource inventory. The inventory sampled private and public lands except...

  8. Geotagged US Tweets as Predictors of County-Level Health Outcomes, 2015–2016

    PubMed Central

    McCullough, Matt; Meng, Hsien-wen; Paul, Debjyoti; Li, Dapeng; Kath, Suraj; Loomis, Geoffrey; Nsoesie, Elaine O.; Wen, Ming; Smith, Ken R.; Li, Feifei

    2017-01-01

    Objectives. To leverage geotagged Twitter data to create national indicators of the social environment, with small-area indicators of prevalent sentiment and social modeling of health behaviors, and to test associations with county-level health outcomes, while controlling for demographic characteristics. Methods. We used Twitter’s streaming application programming interface to continuously collect a random 1% subset of publicly available geo-located tweets in the contiguous United States. We collected approximately 80 million geotagged tweets from 603 363 unique Twitter users in a 12-month period (April 2015–March 2016). Results. Across 3135 US counties, Twitter indicators of happiness, food, and physical activity were associated with lower premature mortality, obesity, and physical inactivity. Alcohol-use tweets predicted higher alcohol-use–related mortality. Conclusions. Social media represents a new type of real-time data that may enable public health officials to examine movement of norms, sentiment, and behaviors that may portend emerging issues or outbreaks—thus providing a way to intervene to prevent adverse health events and measure the impact of health interventions. PMID:28933925

  9. Cross-Jurisdictional Sharing for Emergency Management-Related Public Health: Exploring the Experiences of Tribes and Counties in California

    PubMed Central

    Wimsatt, Maureen A.

    2017-01-01

    Each American Indian tribe is unique in several ways, including in its relationships with local governments and risk for emergencies. Cross-jurisdictional sharing (CJS) arrangements are encouraged between tribes and counties for emergency management-related population health, but researchers have not yet explored CJS experiences of tribes and counties for emergency management. This investigation used collaboration theory and a CJS spectrum framework to assess the scope and prevalence of tribe–county CJS arrangements for emergency management in California as well as preconditions to CJS. Mixed-methods survey results indicate that tribes and counties have varied CJS arrangements, but many are informal or customary. Preconditions to CJS include tribe–county agreement about having CJS, views of the CJS relationship, barriers to CJS, and jurisdictional strengths and weaknesses in developing CJS arrangements. Areas for public health intervention include funding programs that build tribal capacity in emergency management, reduce cross-jurisdictional disagreement, and promote ongoing tribe–county relationships as a precursor to formal CJS arrangements. Study strengths, limitations, and future directions are also discussed. PMID:28983479

  10. Potential health impacts of heavy-metal exposure at the Tar Creek Superfund site, Ottawa County, Oklahoma.

    PubMed

    Neuberger, John S; Hu, Stephen C; Drake, K David; Jim, Rebecca

    2009-02-01

    The potential impact of exposure to heavy metals and health problems was evaluated at the Tar Creek Superfund site, Ottawa County, Oklahoma, USA. Observed versus expected mortality was calculated for selected conditions in the County and exposed cities. Excess mortality was found for stroke and heart disease when comparing the exposed County to the state but not when comparing the exposed cities to the nonexposed rest of the County. However, sample sizes in the exposed area were small, population emigration has been ongoing, and geographic coding of mortality data was incomplete. In an exposed community, 62.5% of children under the age of 6 years had blood lead levels exceeding 10 microg/dl. The relationships between heavy-metal exposure and children's health and chronic disease in adults are suggestive that a more thorough investigation might be warranted. A number of possible environmental and health studies are suggested, including those focusing on possible central nervous system impacts. Unfortunately, the exposed population is dispersing. One lesson learned at this site is that health studies need to be conducted as soon as possible after an environmental problem is identified to both study the impact of the most acute exposures and to maximize study sample size-including those exposed to higher doses-and minimize the loss of individuals to follow-up.

  11. Disparities in health system input between minority and non-minority counties and their effects on maternal mortality in Sichuan province of western China.

    PubMed

    Ren, Yan; Qian, Ping; Duan, Zhanqi; Zhao, Ziling; Pan, Jay; Yang, Min

    2017-09-29

    The maternal mortality rate (MMR) markedly decreased in China, but there has been a significant imbalance among different geographic regions (east, central and west regions), and the mortality in the western region remains high. This study aims to examine how much disparity in the health system and MMR between ethnic minority and non-minority counties exists in Sichuan province of western China and measures conceivable commitments of the health system determinants of the disparity in MMR. The MMR and health system data of 67 minority and 116 non-minority counties were taken from Sichuan provincial official sources. The 2-level Poisson regression model was used to identify health system determinants. A series of nested models with different health system factors were fitted to decide contribution of each factor to the disparity in MMR. The MMR decreased over the last decade, with the fastest declining rate from 2006 to 2010. The minority counties experienced higher raw MMR in 2002 than non-minority counties (94.4 VS. 58.2), which still remained higher in 2014 (35.7 VS. 14.3), but the disparity of raw MMR between minority and non-minority counties decreased from 36.2 to 21.4. The better socio-economic condition, more health human resources and higher maternal health care services rate were associated with lower MMR. Hospital delivery rate alone explained 74.5% of the difference in MMR between minority and non-minority counties. All health system indicators together explained 97.6% of the ethnic difference in MMR, 59.8% in the change trend, and 66.3% county level variation respectively. Hospital delivery rate mainly determined disparity in MMR between minority and non-minority counties in Sichuan province. Increasing hospital birth rates among ethnic minority counties may narrow the disparity in MMR by more than two-thirds of the current level.

  12. Impermanent politics: the Hillsborough County health care plan and community innovation for the uninsured.

    PubMed

    Brown, Lawrence D

    2006-01-01

    Most communities support their safety-net facilities, but few supply health coverage for uninsured residents. In 1991 Hillsborough County, Florida, created a health care plan that raised the sales tax by a half-cent, used the proceeds to cover about 30,000 uninsured county residents, and assured the public that this would save money. In time, however, various conflicts combined to call into question the plan's ends and means. These challenges reinvigorated advocacy by the plan's supporters, who steered the adoption of changes that seemed to have "institutionalized" it. Community-based reformers might find this local innovation instructive as they ponder how to build enduring programs.

  13. Supportive supervision for medicines management in government health facilities in Kiambu County, Kenya: a health workers' perspective.

    PubMed

    Agoro, Oscar Otieno; Osuga, Ben Onyango; Adoyo, Maureen

    2015-01-01

    Effective supportive supervision is widely recognized as essential for optimal management of medicines in government health facilities and also in contributing towards improved access and utilization of health services. This study sought to examine the extent supportive supervision for medicines management in government health facilities from a health worker perspective. A cross-sectional study was done targeting health workers managing medicines in government health facilities in Kiambu County. One hundred and thirty eight respondents took part in the study which explored the quality of supportive supervision from a health worker's perspective, and also examined the factors influencing their contentment with the level of supervision received. A statistical analysis was done using SPSS 21 and Excel 2013. Supervisory visits from all levels of health management were not regularly done, standard checklists were not routinely used, and action plans irregularly developed and followed up. Only 54 (38.6%) respondents were satisfied with the levels of supportive supervision that they received, with satisfaction significantly differing across the professional cadres, χ (2) (12, n = 138) = 29.762, p = .003; across the different tiers of health facilities, r s (138) = 0.341, p < .001; and with the education levels of the respondents, r s (138) = 0.381, p < .001. The study concluded that supportive supervision for medicines management that government health facilities received was still inadequate, and health workers were dissatisfied with the level of supervision that they received. The study recommends a review of the support supervision policy at the county level to address the unearthed inefficiencies and improve supervision for medicines management in government health facilities.

  14. Health Impact Assessment (HIA) of Proposed Code Changes Regarding Onsite Sewage Disposal Systems in Suffolk County, NY

    EPA Science Inventory

    The U.S. Environmental Protection Agency (EPA) conducted a Health Impact Assessment (HIA) of proposed code changes regarding residential onsite sewage disposal systems (OSDS) in Suffolk County, New York. Of the approximately 569,000 housing units in Suffolk County, 365,000 are no...

  15. How does decentralisation affect health sector planning and financial management? a case study of early effects of devolution in Kilifi County, Kenya.

    PubMed

    Tsofa, Benjamin; Molyneux, Sassy; Gilson, Lucy; Goodman, Catherine

    2017-09-15

    A common challenge for health sector planning and budgeting has been the misalignment between policies, technical planning and budgetary allocation; and inadequate community involvement in priority setting. Health system decentralisation has often been promoted to address health sector planning and budgeting challenges through promoting community participation, accountability, and technical efficiency in resource management. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous devolved county governments, and a substantial transfer of responsibility for healthcare from the central government to these counties. This study analysed the effects of this major political decentralization on health sector planning, budgeting and overall financial management at county level. We used a qualitative, case study design focusing on Kilifi County, and were guided by a conceptual framework which drew on decentralisation and policy analysis theories. Qualitative data were collected through document reviews, key informant interviews, and participant and non-participant observations conducted over an eighteen months' period. We found that the implementation of devolution created an opportunity for local level prioritisation and community involvement in health sector planning and budgeting hence increasing opportunities for equity in local level resource allocation. However, this opportunity was not harnessed due to accelerated transfer of functions to counties before county level capacity had been established to undertake the decentralised functions. We also observed some indication of re-centralisation of financial management from health facility to county level. We conclude by arguing that, to enhance the benefits of decentralised health systems, resource allocation, priority setting and financial management functions between central and decentralised units are guided by considerations around decision space, organisational structure and capacity, and

  16. Health care utilization patterns for young children in rural counties of the I-95 corridor of South Carolina.

    PubMed

    McElligott, James T; Summer, Andrea P

    2013-01-01

    The objective of this study was to assess health care utilization patterns for young children with Medicaid insurance in the rural counties of the I-95 corridor in South Carolina relative to other regions of the state. We hypothesize that young children received less well care and higher levels of tertiary care in the rural counties along the I-95 corridor (I-95) of South Carolina. A Medicaid cohort of children less than 3 years of age was used to compare Early, Periodic, Diagnosis, Screening and Treatment (EPSDT) visits; preventable emergency department (ED) visits; and inpatient visits between I-95, other rural and urban county groupings. The adjusted odds of a child having had 80% of the recommended EPSDT visits were reduced for I-95 compared to other rural counties. The odds of a preventable inpatient or ED visit were increased for all rural counties, with the highest rates in the other rural counties. Children accessed well care less in the I-95 corridor compared to other rural areas of South Carolina. Rural children accessed tertiary care more often than urban children, a finding most prominent outside the I-95 corridor, likely attributable to more available access of tertiary care in rural counties outside the I-95 corridor. © 2012 National Rural Health Association.

  17. Multilevel model to estimate county-level untreated dental caries among US children aged 6-9years using the National Health and Nutrition Examination Survey.

    PubMed

    Lin, Mei; Zhang, Xingyou; Holt, James B; Robison, Valerie; Li, Chien-Hsun; Griffin, Susan O

    2018-06-01

    Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6-9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P=0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P=0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6-9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Published by Elsevier Inc.

  18. Community-wide cardiovascular disease prevention programs and health outcomes in a rural county, 1970-2010.

    PubMed

    Record, N Burgess; Onion, Daniel K; Prior, Roderick E; Dixon, David C; Record, Sandra S; Fowler, Fenwick L; Cayer, Gerald R; Amos, Christopher I; Pearson, Thomas A

    2015-01-13

    Few comprehensive cardiovascular risk reduction programs, particularly those in rural, low-income communities, have sustained community-wide interventions for more than 10 years and demonstrated the effect of risk factor improvements on reductions in morbidity and mortality. To document health outcomes associated with an integrated, comprehensive cardiovascular risk reduction program in Franklin County, Maine, a low-income rural community. Forty-year observational study involving residents of Franklin County, Maine, a rural, low-income population of 22,444 in 1970, that used the preceding decade as a baseline and compared Franklin County with other Maine counties and state averages. Community-wide programs targeting hypertension, cholesterol, and smoking, as well as diet and physical activity, sponsored by multiple community organizations, including the local hospital and clinicians. Resident participation; hypertension and hyperlipidemia detection, treatment, and control; smoking quit rates; hospitalization rates from 1994 through 2006, adjusted for median household income; and mortality rates from 1970 through 2010, adjusted for household income and age. More than 150,000 individual county resident contacts occurred over 40 years. Over time, as cardiovascular risk factor programs were added, relevant health indicators improved. Hypertension control had an absolute increase of 24.7% (95% CI, 21.6%-27.7%) from 18.3% to 43.0%, from 1975 to 1978; later, elevated cholesterol control had an absolute increase of 28.5% (95% CI, 25.3%-31.6%) from 0.4% to 28.9%, from 1986 to 2010. Smoking quit rates improved from 48.5% to 69.5%, better than state averages (observed - expected [O - E], 11.3%; 95% CI, 5.5%-17.7%; P < .001), 1996-2000; these differences later disappeared when Maine's overall quit rate increased. Franklin County hospitalizations per capita were less than expected for the measured period, 1994-2006 (O - E, -17 discharges/1000 residents; 95% CI

  19. Building Community Disaster Resilience: Perspectives From a Large Urban County Department of Public Health

    PubMed Central

    Fielding, Jonathan E.; Chandra, Anita; Williams, Malcolm; Eisenman, David; Wells, Kenneth B.; Law, Grace Y.; Fogleman, Stella; Magaña, Aizita

    2013-01-01

    An emerging approach to public health emergency preparedness and response, community resilience encompasses individual preparedness as well as establishing a supportive social context in communities to withstand and recover from disasters. We examine why building community resilience has become a key component of national policy across multiple federal agencies and discuss the core principles embodied in community resilience theory—specifically, the focus on incorporating equity and social justice considerations in preparedness planning and response. We also examine the challenges of integrating community resilience with traditional public health practices and the importance of developing metrics for evaluation and strategic planning purposes. Using the example of the Los Angeles County Community Disaster Resilience Project, we discuss our experience and perspective from a large urban county to better understand how to implement a community resilience framework in public health practice. PMID:23678937

  20. Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach.

    PubMed

    Choi, HwaJung; Burgard, Sarah; Elo, Irma T; Heisler, Michele

    2015-09-01

    We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n = 34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR = 1.12; 95% CI 1.04-1.19) and were more likely to report diagnosed psychiatric problems (AOR = 1.08; 95% CI 0.99-1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30(th) or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county

  1. Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach

    PubMed Central

    Choi, HwaJung; Burgard, Sarah; Elo, Irma T.; Heisler, Michele

    2015-01-01

    We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n=34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR=1.12; 95% CI 1.04–1.19) and were more likely to report diagnosed psychiatric problems (AOR=1.08; 95% CI 0.99–1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30th or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county residents

  2. Understanding the Gap: Perceived Health Literacy Levels Among Spanish-Speaking Immigrants in Miami-Dade County, 2016.

    PubMed

    Moore, Emily; Cordero, Christina

    2018-06-20

    Health literacy levels among immigrant populations in Miami-Dade County have yet to be examined. This study investigates perceived health literacy ability and measured health literacy scores among Miami-Dade County immigrants. Patients seen in the Refugee Health Assessment Program and Family Planning Program completed a health literacy assessment in November 2016. Participants were immigrants from Spanish-speaking countries who reported living in the U.S. for ≤ 10 years. Logistic regression models were used to determine predictors of agreement. 283 patients responded. No characteristics were significant predictors of agreement; However, we found lower agreement among participants that were 18-24 years old (49%), received medical information from the internet/television (46%), and had lived in the U.S. for only 6-12 months (49%). Our findings suggest that immigrant patients may have limited understanding of their health literacy abilities. Clinicians need to take health literacy levels into account when interacting with patients.

  3. Health providers' perspectives on delivering public health services under the contract service policy in rural China: evidence from Xinjian County.

    PubMed

    Zhou, Huixuan; Zhang, Weijun; Zhang, Shengfa; Wang, Fugang; Zhong, You; Gu, Linni; Qu, Zhiyong; Liang, Xiaoyun; Sa, Zhihong; Wang, Xiaohua; Tian, Donghua

    2015-02-27

    To effectively provide public health care for rural residents, the Ministry of Health formally unveiled the contract service policy in rural China in April 2013. As the counterpart to family medicine in some developed countries, the contract service established a compact between village doctors and local governments and a service agreement between doctors and their patients. This study is a rare attempt to explore the perspectives of health providers on the contract service policy, and investigate the demand side's attitude toward the public health services delivered under the contract policy. This evidence from Xinjian County, Jiangxi Province, the first and most representative pilot site of the contract service, could serve as a reference for policymakers to understand the initial effects of the policy, whereby they can regulate and amend some items before extending it to the whole country. Official documents were collected and semi-structured interviews with human resources and villagers in Xinjian County were conducted in September 2013. A purposive sampling method was used, and eight towns from the total 18 towns in Xinjian County were selected. Ultimately, eight managers (one in each township health center), 20 village doctors from eight clinics, and 11 villagers were interviewed. A thematic approach was used to analyze the data, which reflected the people's experiences brought about by the implementation of the contract service policy. While the contract service actually promoted the supply side to provide more public health services to the villagers and contracted patients felt satisfied with the doctor-patient relationship, most health providers complained about the heavy workload, insufficient remuneration, staff shortage, lack of official identity and ineffective performance appraisal, in addition to contempt from some villagers and supervisors after the implementation of the contract service. Contract service is a crucial step for the government to

  4. Acceptance, Benefits, and Challenges of Public Health-Oriented Pet Business Regulations in King County, Washington.

    PubMed

    Wierenga, Janelle; Thiede, Hanne; Helms, Leah; Hopkins, Sharon

    2016-01-01

    New regulations were implemented in King County, Washington, in 2010 requiring pet businesses to obtain a permit from Public Health-Seattle & King County (Public Health) and undergo annual inspections to provide education and ensure compliance with regulatory standards. The regulations were developed as a tool for zoonotic disease control and prevention education for businesses and their customers, as well as for environmental protection. To assess the acceptance, benefits, and challenges of the new regulations and identify ways for Public Health to improve educational efforts and assist businesses with compliance. Cross-sectional survey. King County, Washington. Pet businesses with Public Health permits in 2013. Self-administered survey responses. The response rate was 40.5%. The majority of respondents provided grooming, pet day care, and kennel/boarding services from small, independent businesses. Sixty-one percent reported Public Health inspections as beneficial, especially concerning disinfection procedures and using an infection control plan. Almost three-fourths of respondents used the Public Health template to develop the infection control plan. Forty-four percent reported using the educational materials provided by Public Health, and 62% used educational materials from other sources. Most respondents reported that they gained benefits from the pet business permit, although fewer agreed that they obtained a good value from the permit and fee. The most common benefits reported were protection of animal and human health and establishing the credibility of the pet business. Major challenges with the implementation of the pet business regulations were not generally reported by respondents. Most respondents reported a collaborative relationship between Public Health and the pet businesses. Improvements in infection control practices and positive responses to the inspections were reported by pet businesses. Survey results were used to improve infection control

  5. Pedestrian detection in video surveillance using fully convolutional YOLO neural network

    NASA Astrophysics Data System (ADS)

    Molchanov, V. V.; Vishnyakov, B. V.; Vizilter, Y. V.; Vishnyakova, O. V.; Knyaz, V. A.

    2017-06-01

    More than 80% of video surveillance systems are used for monitoring people. Old human detection algorithms, based on background and foreground modelling, could not even deal with a group of people, to say nothing of a crowd. Recent robust and highly effective pedestrian detection algorithms are a new milestone of video surveillance systems. Based on modern approaches in deep learning, these algorithms produce very discriminative features that can be used for getting robust inference in real visual scenes. They deal with such tasks as distinguishing different persons in a group, overcome problem with sufficient enclosures of human bodies by the foreground, detect various poses of people. In our work we use a new approach which enables to combine detection and classification tasks into one challenge using convolution neural networks. As a start point we choose YOLO CNN, whose authors propose a very efficient way of combining mentioned above tasks by learning a single neural network. This approach showed competitive results with state-of-the-art models such as FAST R-CNN, significantly overcoming them in speed, which allows us to apply it in real time video surveillance and other video monitoring systems. Despite all advantages it suffers from some known drawbacks, related to the fully-connected layers that obstruct applying the CNN to images with different resolution. Also it limits the ability to distinguish small close human figures in groups which is crucial for our tasks since we work with rather low quality images which often include dense small groups of people. In this work we gradually change network architecture to overcome mentioned above problems, train it on a complex pedestrian dataset and finally get the CNN detecting small pedestrians in real scenes.

  6. Pandemics and health equity: lessons learned from the H1N1 response in Los Angeles County.

    PubMed

    Plough, Alonzo; Bristow, Benjamin; Fielding, Jonathan; Caldwell, Stephanie; Khan, Sinan

    2011-01-01

    Pandemic preparedness and response (as with all public health actions) occur within a social, cultural, and historical context of preexisting health disparities and, in some populations, underlying mistrust in government. Almost 200,000 people received H1N1 vaccine at 109 free, public mass vaccination clinics operated by the Los Angeles County Department of Public Health between October 23, 2009, and December 8, 2009. Wide racial/ethnic disparities in vaccination rates were observed with African Americans having the lowest rate followed by whites. Demographic information, including race/ethnicity, was obtained for 163 087 of the Los Angeles County residents who received vaccine. This information was compared with estimates of the Los Angeles County population distribution by race/ethnicity. Rate ratios of vaccination were as follows: white, reference; African American, 0.5; Asian, 3.2; Hispanic, 1.5; Native American, 1.9; and Pacific Islander, 4.3. Significant political challenges and media coverage focused on equity in vaccination access specifically in the African American population. An important challenge was community-level informal messaging that ran counter to the "official" messages. Finally, we present a partnership strategy, developed in response to the challenges, to improve outreach and build trust and engagement with African Americans in Los Angeles County.

  7. 78 FR 54651 - Sole Source Cooperative Agreement Award to the National Association of County and City Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Sole Source Cooperative Agreement Award to the National...: Notification of a Sole Source Cooperative Agreement Award to the National Association of County and City Health... resilience, and strengthen health care, public health, and emergency management systems. One of the...

  8. The "Health Belief Model" Applied to Two Preventive Health Behaviors Among Women from a Rural Pennsylvania County. AE & RS 115.

    ERIC Educational Resources Information Center

    Hazen, Mary E.

    In order to test the usefulnes of the Health Belief Model (a model designed to measure health practices, attitudes, and knowledge), a survey of Potter County, Pennsylvania was conducted, and 283 responses from adult females without chronic illnesses were analyzed. The dependent variables employed were regulating diet and getting regular exercise.…

  9. Spatial path models with multiple indicators and multiple causes: mental health in US counties.

    PubMed

    Congdon, Peter

    2011-06-01

    This paper considers a structural model for the impact on area mental health outcomes (poor mental health, suicide) of spatially structured latent constructs: deprivation, social capital, social fragmentation and rurality. These constructs are measured by multiple observed effect indicators, with the constructs allowed to be correlated both between and within areas. However, in the scheme developed here, particular latent constructs may also be influenced by known variables, or, via path sequences, by other constructs, possibly nonlinearly. For example, area social capital may be measured by effect indicators (e.g. associational density, charitable activity), but influenced as causes by other constructs (e.g. area deprivation), and by observed features of the socio-ethnic structure of areas. A model incorporating these features is applied to suicide mortality and the prevalence of poor mental health in 3141 US counties, which are related to the latent spatial constructs and to observed variables (e.g. county ethnic mix). Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. The National Environmental Public Health Tracking Network Access to Parks Indicator: A National County-Level Measure of Park Proximity

    PubMed Central

    Ussery, Emily Neusel; Yngve, Leah; Merriam, Dee; Whitfield, Geoffrey; Foster, Stephanie; Wendel, Arthur; Boehmer, Tegan

    2017-01-01

    EXECUTIVE SUMMARY Parks and recreation departments and public health organizations both work to improve the well-being of their communities. Measuring residential proximity to parks could be a specific area of shared interest, given that proximity to parks is needed for walking access, and the use of parks is, in turn, associated with many physical, social, and mental health benefits. The CDC’s publicly available National Environmental Public Health Tracking Network (NEPHTN) Access to Parks Indicator (API) focuses on one major component of access, residential proximity to parks. The API uses a commercial parks database and U.S. Census data to estimate the number and percentage of individuals in the U.S. that live within a half-mile of a park boundary, a measure commonly used to represent park proximity. The API is calculated at the state and county levels and is available for all states and counties in the U.S. Using estimates from the API, we examined the distribution of residential proximity to parks by geography and race/ethnicity. Additionally, we evaluated differences in park proximity by rural/urban status of counties. In 2010, 39% of the total U.S. population lived within a half-mile of a park. This percentage varied widely between states, ranging from 9% in West Virginia to 67% in Hawaii and 88% in the District of Columbia (DC). Park proximity was lowest among non-Hispanic whites (34.2%) and highest among individuals belonging to the non-Hispanic other race category (52.0%). Metropolitan counties had the highest percentage of residents living within a half-mile of a park (43.3%); the percentage was lower in non-metropolitan counties adjacent to a metropolitan county (15.0%) and non-metropolitan counties not adjacent to a metropolitan county (18.5%). Park proximity was higher in metropolitan counties with a larger population size and in non-metropolitan counties with a higher degree of urbanization. The NEPHTN Access to Parks Indicator provides an

  11. The National Environmental Public Health Tracking Network Access to Parks Indicator: A National County-Level Measure of Park Proximity.

    PubMed

    Ussery, Emily Neusel; Yngve, Leah; Merriam, Dee; Whitfield, Geoffrey; Foster, Stephanie; Wendel, Arthur; Boehmer, Tegan

    2016-01-01

    Parks and recreation departments and public health organizations both work to improve the well-being of their communities. Measuring residential proximity to parks could be a specific area of shared interest, given that proximity to parks is needed for walking access, and the use of parks is, in turn, associated with many physical, social, and mental health benefits. The CDC's publicly available National Environmental Public Health Tracking Network (NEPHTN) Access to Parks Indicator (API) focuses on one major component of access, residential proximity to parks. The API uses a commercial parks database and U.S. Census data to estimate the number and percentage of individuals in the U.S. that live within a half-mile of a park boundary, a measure commonly used to represent park proximity. The API is calculated at the state and county levels and is available for all states and counties in the U.S. Using estimates from the API, we examined the distribution of residential proximity to parks by geography and race/ethnicity. Additionally, we evaluated differences in park proximity by rural/urban status of counties. In 2010, 39% of the total U.S. population lived within a half-mile of a park. This percentage varied widely between states, ranging from 9% in West Virginia to 67% in Hawaii and 88% in the District of Columbia (DC). Park proximity was lowest among non-Hispanic whites (34.2%) and highest among individuals belonging to the non-Hispanic other race category (52.0%). Metropolitan counties had the highest percentage of residents living within a half-mile of a park (43.3%); the percentage was lower in non-metropolitan counties adjacent to a metropolitan county (15.0%) and non-metropolitan counties not adjacent to a metropolitan county (18.5%). Park proximity was higher in metropolitan counties with a larger population size and in non-metropolitan counties with a higher degree of urbanization. The NEPHTN Access to Parks Indicator provides an opportunity to understand

  12. Edentulism in high poverty rural counties.

    PubMed

    Mitchell, Jordan; Bennett, Kevin; Brock-Martin, Amy

    2013-01-01

    To examine the differences in oral health status among residents of high-poverty counties, as compared to residents of other rural or urban counties, specifically on the prevalence of edentulism. We used the 2005 Behavioral Risk Factor Surveillance System (BRFSS) and the 2006 Area Resource File (ARF). All analyses were conducted with SAS and SAS-callable SUDAAN, in order to account for weighting and the complex sample design. Characteristics significantly related to edentulism include: geographic location, gender, race, age, health status, employment, insurance, not having a usual source of care, education, marital status, presence of chronic disease, having an English interview, not deferring care due to cost, income, and dentist saturation within the county. Significant associations between high-poverty rural and other rural counties and edentulism were found, and other socioeconomic and health status indicators remain strong predictors of edentulism. © 2012 National Rural Health Association.

  13. [Prediction model of health workforce and beds in county hospitals of Hunan by multiple linear regression].

    PubMed

    Ling, Ru; Liu, Jiawang

    2011-12-01

    To construct prediction model for health workforce and hospital beds in county hospitals of Hunan by multiple linear regression. We surveyed 16 counties in Hunan with stratified random sampling according to uniform questionnaires,and multiple linear regression analysis with 20 quotas selected by literature view was done. Independent variables in the multiple linear regression model on medical personnels in county hospitals included the counties' urban residents' income, crude death rate, medical beds, business occupancy, professional equipment value, the number of devices valued above 10 000 yuan, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, and utilization rate of hospital beds. Independent variables in the multiple linear regression model on county hospital beds included the the population of aged 65 and above in the counties, disposable income of urban residents, medical personnel of medical institutions in county area, business occupancy, the total value of professional equipment, fixed assets, long-term debt, medical income, medical expenses, outpatient and emergency visits, hospital visits, actual available bed days, utilization rate of hospital beds, and length of hospitalization. The prediction model shows good explanatory and fitting, and may be used for short- and mid-term forecasting.

  14. A simulation method for combining hydrodynamic data and acoustic tag tracks to predict the entrainment of juvenile salmonids onto the Yolo Bypass under future engineering scenarios

    USGS Publications Warehouse

    Blake, Aaron R.; Stumpner, Paul; Burau, Jon R.

    2017-01-01

    During water year 2016 the U.S. Geological Survey California Water Science Center (USGS) collaborated with the California Department of Water Resources (DWR) to conduct a joint hydrodynamic and fisheries study to acquire data that could be used to evaluate the effects of proposed modifications to the Fremont Weir on outmigrating juvenile Chinook salmon. During this study the USGS surgically implanted acoustic tags in juvenile late fall run Chinook salmon from the Coleman National Fish Hatchery, released the acoustically tagged juvenile salmon into the Sacramento River upstream of the Fremont Weir, and tracked their movements as they emigrated past the western end of the Fremont Weir.The USGS analyzed tracking data from the acoustically tagged juvenile salmon along with detailed hydrodynamic data collected in the Sacramento River during the winter/spring of water year 2016 in the vicinity of the western end of the Fremont Weir to assess the potential for enhancing the entrainment of Sacramento River Chinook salmon onto the Yolo Bypass under six different Fremont Weir modification scenarios. Each modification scenario consists of a notch or multiple notches in the Fremont Weir which are designed to divert a portion of the Sacramento River onto the Yolo Bypass when the Sacramento River is below the crest of the Fremont Weir. The primary goal of this entrainment analysis was to investigate how the location of the notch or notches in each scenario affected the entrainment of juvenile Chinook salmon onto the Yolo Bypass, and to predict the notch location or locations that would result in maximum entrainment under each modification scenario. Stumpner et al.’s (in review) analysis of hydraulic data collected during the 2016 study period showed that backwater effects in the Sacramento River created significant variability in the relationship between Sacramento River stage and the proportion of the Sacramento River flow that we expect to be diverted onto the Yolo Bypass

  15. An Analysis of North Carolina's Rural Health Problems as Perceived by County Rural Development Panels.

    ERIC Educational Resources Information Center

    Hamilton, Vance E., Comp.

    A State Task Force on Rural Health was formed (January 1973) by the State Rural Development Committee to identify and analyze major rural health problems in North Carolina and to recommend alleviation strategies. The Task Force submitted open-ended questionnaires to members of the County Rural Development Panels to secure their perceptions of…

  16. DDT, DDD, and DDE in soil of Xiangfen County, China: Residues, sources, spatial distribution, and health risks.

    PubMed

    Ma, Jin; Pan, Li-Bo; Yang, Xiao-Yang; Liu, Xiao-Ling; Tao, Shi-Yang; Zhao, Long; Qin, Xiao-Peng; Sun, Zai-Jin; Hou, Hong; Zhou, Yong-Zhang

    2016-11-01

    We collected and analyzed 128 surface soil samples from Xiangfen County for dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethane (DDD), and dichlorodiphenyldichloroethylene (DDE). Total DDT concentrations (DDTs; sum of p,p'-DDD, p,p'-DDE, and p,p'-DDT) ranged from ND to 427.81 ng g(-1) (dry weight, dw), with a mean of 40.26 ng g(-1) (dw). Among the three compounds, p,p'-DDD was the most dominant. The DDTs in Xiangfen County soils mainly originated from historical DDT use, but there were also new inputs likely related to dicofol use. The DDTs in Xiangfen County soils were mainly degraded under anaerobic conditions, and direct degradation to DDD was the main degradation route. Regions with relatively high concentrations of DDTs were mainly located in North and South Xiangfen County. In these regions, many soil samples contained p,p'-DDT as the predominant pollutant, suggestive of extensive new inputs of DDT. A health risk assessment revealed that there are no serious long-term health impacts of exposure to DDTs in soil, for adults or children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Does Sodium Knowledge Affect Dietary Choices and Health Behaviors? Results From a Survey of Los Angeles County Residents.

    PubMed

    Dewey, George; Wickramasekaran, Ranjana N; Kuo, Tony; Robles, Brenda

    2017-11-22

    In 2010, the Los Angeles County Department of Public Health launched a local sodium-reduction initiative to address the rising prevalence of high blood pressure (hypertension) and related cardiovascular conditions in the population. To inform this effort, we evaluated self-reported knowledge and health behaviors related to sodium intake among Los Angeles County residents. We administered 3 cross-sectional Internet panel surveys on knowledge about dietary sodium to a sample of Los Angeles County adults, at intervals from December 2014 through August 2016. Multinomial and logistic regression models were constructed to describe associations between sodium knowledge and self-reported health behaviors. A total of 7,067 panel subjects clicked into the online survey, and 2,862 completed the survey (adjusted response rate = 40.5%). Only 102 respondents (3.6%) were able to accurately report the recommended milligrams of sodium that an average adult should consume daily (1,500 mg to 2300 mg). Knowing about daily sodium intake recommendations was associated with increased odds of using Nutrition Facts labels to make food purchase decisions (adjusted odds ratio [AOR], 3.48; 95% confidence interval [CI], 1.59-7.60) and with decreased odds of taking measures to prevent hypertension (AOR, 0.38; 95% CI, 0.19-0.74). Los Angeles County residents had a limited knowledge of recommended daily sodium intake. Efforts to increase understanding of these recommendations may encourage wider engagement in healthy behaviors. Health agencies should integrate sodium reduction messages in their diet and nutrition educational efforts.

  18. Los Angeles County Department of Public Health's Health Hazard Assessment: putting the "health" into hazard assessment.

    PubMed

    Dean, Brandon; Bagwell, Dee Ann; Dora, Vinita; Khan, Sinan; Plough, Alonzo

    2013-01-01

    A ll communities, explicitly or implicitly, assess and prepare for the natural and manmade hazards that they know could impact their community. The commonality of hazard-based threats in most all communities does not usually result in standard or evidence-based preparedness practice and outcomes across those communities. Without specific efforts to build a shared perspective and prioritization, "all-hazards" preparedness can result in a random hodgepodge of priorities and preparedness strategies, resulting in diminished emergency response capabilities. Traditional risk assessments, with a focus on physical infrastructure, do not present the potential health and medical impacts of specific hazards and threats. With the implementation of Centers for Disease Control and Prevention's capability-based planning, there is broad recognition that a health-focused hazard assessment process--that engages the "Whole of Community"--is needed. Los Angeles County's Health Hazard Assessment and Prioritization tool provides a practical and innovative approach to enhance existing planning capacities. Successful utilization of this tool can provide a way for local and state health agencies and officials to more effectively identify the health consequences related to hazard-specific threats and risk, determine priorities, and develop improved and better coordinated agency planning, including community engagement in prioritization.

  19. Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S

    PubMed Central

    Choi, Sunha; Kim, Giyeon

    2016-01-01

    Using the 2004–2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals’ mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults’ immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities. PMID:26910461

  20. Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S.

    PubMed

    Choi, Sunha; Kim, Giyeon; Lee, Sungkyu

    2016-12-01

    Using the 2004-2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals' mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults' immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities.

  1. The Relationship of Individual, Family, and Community Characteristics with Physical Health: An Adult Study in 27 Rural Minnesota Counties

    ERIC Educational Resources Information Center

    Wickrama, K. A. Thulitha; Wickrama, K. A. S.; Romas, John A.

    2005-01-01

    Context and Purpose: This study investigates associations between the proportion of farm families in rural counties and the health of rural individuals, independent of county poverty rate and individual and family socioeconomic factors. This study also examines relationships of these socioeconomic factors and prevalence of specific diseases.…

  2. Proximal and distal determinants of access to health care among Hispanics in El Paso County, Texas.

    PubMed

    Law, Jon; VanDerslice, James

    2011-04-01

    In the United States, having health insurance is an important determinant of health care access and individual health outcomes. Nationwide, a significant proportion of the population does not have health insurance. Hispanics, in particular, are less likely than non-Hispanics to have insurance. A framework was established to examine the relationships between the determinants of insurance coverage and health care affordability in El Paso County, Texas. Data from the 2005 Behavioral Risk Factor Surveillance System were used to examine the relationships described by this framework. The sample included 653 adults, of those 477 self-identified as Hispanic or Latino. In El Paso County, almost half of adult Hispanics lack any type of health insurance coverage, three times the rate of non-Hispanics. Among Hispanics, the lack of health insurance was strongly associated with reduced affordability of health care. Employment status, income, and age were found to have significant associations with insurance coverage and health care affordability. Sex and education level were relevant, yet distal determinants of these outcomes. Ongoing conversations about health care reform should take into account the patterns of coverage within the Hispanic population. Knowing how economic and social factors affect coverage is necessary to inform policy that can effectively alleviate disparities experienced by Hispanics.

  3. Is healthcare caring in Hawai'i? Preliminary results from a health assessment of lesbian, gay, bisexual, transgender, questioning, and intersex people in four counties.

    PubMed

    Stotzer, Rebecca L; Ka'opua, Lana Sue I; Diaz, Tressa P

    2014-06-01

    This paper presents findings from a statewide needs assessment of lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) people in Hawai'i that relate to health status and health-related risk factors such as having health insurance coverage, having a regular doctor, experiencing sexual orientation (SO) or gender identity/expression (GI/E) discrimination in health/mental health care settings, and delaying care due to concerns about SO and GIE discrimination in Hawai'i, Honolulu, Kaua'i, and Maui counties. Results suggest that LGBTQI people in these counties generally rated their self-assessed health as "very good" or "excellent," but had slightly higher rates of smoking and less health insurance coverage than the general population of Hawai'i. Many respondents reported challenges to their health, and negative experiences with healthcare. Unlike prior studies that have shown no difference or a rural disadvantage in care, compared to urban locations, Hawai'i's counties did not have a clear rural disadvantage. Honolulu and Kaua'i Counties demonstrated better health indicators and lower percentages of people who had delayed care due to gender identity concerns. Findings suggest that health/mental health care providers should address potential bias in the workplace to be able to provide more culturally competent practice to LGBTQI people in Hawai'i.

  4. Is Healthcare Caring in Hawai‘i? Preliminary Results from a Health Assessment of Lesbian, Gay, Bisexual, Transgender, Questioning, and Intersex People in Four Counties

    PubMed Central

    Ka‘opua, Lana Sue I; Diaz, Tressa P

    2014-01-01

    This paper presents findings from a statewide needs assessment of lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) people in Hawai‘i that relate to health status and health-related risk factors such as having health insurance coverage, having a regular doctor, experiencing sexual orientation (SO) or gender identity/expression (GI/E) discrimination in health/mental health care settings, and delaying care due to concerns about SO and GIE discrimination in Hawai‘i, Honolulu, Kaua‘i, and Maui counties. Results suggest that LGBTQI people in these counties generally rated their self-assessed health as “very good” or “excellent,” but had slightly higher rates of smoking and less health insurance coverage than the general population of Hawai‘i. Many respondents reported challenges to their health, and negative experiences with healthcare. Unlike prior studies that have shown no difference or a rural disadvantage in care, compared to urban locations, Hawai‘i's counties did not have a clear rural disadvantage. Honolulu and Kaua‘i Counties demonstrated better health indicators and lower percentages of people who had delayed care due to gender identity concerns. Findings suggest that health/mental health care providers should address potential bias in the workplace to be able to provide more culturally competent practice to LGBTQI people in Hawai‘i. PMID:24959391

  5. The reforms of the Chinese health care system: county level changes: the Jiangxi Study.

    PubMed

    Zheng, X; Hillier, S

    1995-10-01

    A survey of the economic performance of county hospitals in middle income counties in Jiangxi province was undertaken in 1989. The survey considered the impact of health policy changes in the P.R.C., especially cost recovery, decentralization, managerial changes and the promotion of traditional medicine. The financial records of county level hospitals and traditional medicine hospitals for the period 1980-89 were examined, as were patient expenditures. Opinions of those responsible for policy execution were surveyed. The data showed that hospitals from which state subsidy had been removed had become dependent on medicine sales and increasing itemization of treatment to recover costs. The insurance status of patients influenced the length of stay and levels of payment. Uninsured peasants had a shorter stay and were charged more for items of treatment. Traditional Medicine hospitals saw more outpatients than County hospitals, but were more likely to have a deficit. They were also very dependent on medicine sales for income. Most officials questioned felt that the changing system caused problems, but at the same time were eager to invest in equipment as a source of revenue.

  6. Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya.

    PubMed

    Njuguna, John; Kamau, Njoroge; Muruka, Charles

    2017-06-21

    Kenya has a high maternal mortality rate. Provision of skilled delivery plays a major role in reducing maternal mortality. Cost is a hindrance to the utilization of skilled delivery. The Government of Kenya introduced a policy of free delivery services in government facilities beginning June 2013. We sought to determine the impact of this intervention on facility based deliveries in Kenya. We compared deliveries and antenatal attendance in 47 county referral hospitals and 30 low cost private hospitals not participating in the free delivery policy for 2013 and 2014 respectively. The data was extracted from the Kenya Health Information System. Multiple regression was done to assess factors influencing increase in number of deliveries among the county referral hospitals. The number of deliveries and antenatal attendance increased by 26.8% and 16.2% in county referral hospitals and decreased by 11.9% and 5.4% respectively in low cost private hospitals. Increase in deliveries among county referral hospitals was influenced by population size of county and type of county referral hospital. Counties with level 5 hospitals recorded more deliveries compared to those with level 4 hospitals. This intervention increased the number of facility based deliveries. Policy makers may consider incorporating low cost private hospitals so as to increase the coverage of this intervention.

  7. Does Sodium Knowledge Affect Dietary Choices and Health Behaviors? Results From a Survey of Los Angeles County Residents

    PubMed Central

    Dewey, George; Wickramasekaran, Ranjana N.; Kuo, Tony

    2017-01-01

    Introduction In 2010, the Los Angeles County Department of Public Health launched a local sodium-reduction initiative to address the rising prevalence of high blood pressure (hypertension) and related cardiovascular conditions in the population. To inform this effort, we evaluated self-reported knowledge and health behaviors related to sodium intake among Los Angeles County residents. Methods We administered 3 cross-sectional Internet panel surveys on knowledge about dietary sodium to a sample of Los Angeles County adults, at intervals from December 2014 through August 2016. Multinomial and logistic regression models were constructed to describe associations between sodium knowledge and self-reported health behaviors. Results A total of 7,067 panel subjects clicked into the online survey, and 2,862 completed the survey (adjusted response rate = 40.5%). Only 102 respondents (3.6%) were able to accurately report the recommended milligrams of sodium that an average adult should consume daily (1,500 mg to 2300 mg). Knowing about daily sodium intake recommendations was associated with increased odds of using Nutrition Facts labels to make food purchase decisions (adjusted odds ratio [AOR], 3.48; 95% confidence interval [CI], 1.59–7.60) and with decreased odds of taking measures to prevent hypertension (AOR, 0.38; 95% CI, 0.19–0.74). Conclusions Los Angeles County residents had a limited knowledge of recommended daily sodium intake. Efforts to increase understanding of these recommendations may encourage wider engagement in healthy behaviors. Health agencies should integrate sodium reduction messages in their diet and nutrition educational efforts. PMID:29166247

  8. Providing engineering services to counties.

    DOT National Transportation Integrated Search

    2008-09-01

    An engineer is required by law to safeguard the health, safety and welfare of the public. The current Kansas : statute state, The Board of County Commissioners of each county shall appoint a licensed professional : engineer, whose title shall be c...

  9. Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013.

    PubMed

    Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

    2016-01-01

    Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person.

  10. Factors associated with adequate weekly reporting for disease surveillance data among health facilities in Nairobi County, Kenya, 2013

    PubMed Central

    Mwatondo, Athman Juma; Ng'ang'a, Zipporah; Maina, Caroline; Makayotto, Lyndah; Mwangi, Moses; Njeru, Ian; Arvelo, Wences

    2016-01-01

    Introduction Kenya adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 to strengthen disease surveillance and epidemic response. However, the goal of weekly surveillance reporting among health facilities has not been achieved. We conducted a cross-sectional study to determine the prevalence of adequate reporting and factors associated with IDSR reporting among health facilities in one Kenyan County. Methods Health facilities (public and private) were enrolled using stratified random sampling from 348 facilities prioritized for routine surveillance reporting. Adequately-reporting facilities were defined as those which submitted >10 weekly reports during a twelve-week period and a poor reporting facilities were those which submitted <10 weekly reports. Multivariate logistic regression with backward selection was used to identify risk factors associated with adequate reporting. Results From September 2 through November 30, 2013, we enrolled 175 health facilities; 130(74%) were private and 45(26%) were public. Of the 175 health facilities, 77 (44%) facilities classified as adequate reporting and 98 (56%) were reporting poorly. Multivariate analysis identified three factors to be independently associated with weekly adequate reporting: having weekly reporting forms at visit (AOR19, 95% CI: 6-65], having posters showing IDSR functions (AOR8, 95% CI: 2-12) and having a designated surveillance focal person (AOR7, 95% CI: 2-20). Conclusion The majority of health facilities in Nairobi County were reporting poorly to IDSR and we recommend that the Ministry of Health provide all health facilities in Nairobi County with weekly reporting tools and offer specific trainings on IDSR which will help designate a focal surveillance person. PMID:27303581

  11. Self-reported physical activity in a rural county: a New York county health census.

    PubMed Central

    Eaton, C B; Nafziger, A N; Strogatz, D S; Pearson, T A

    1994-01-01

    OBJECTIVES. Few studies have described physical activity in rural populations. This study describes the frequency, types, and correlates of physical activity in 29,304 free-living adults in a rural county in New York State. METHODS. Self-reported responses about regular physical activity (maintained long enough to work up a sweat) were analyzed from a private household census of Otsego County with an 86.6% response rate. RESULTS. This survey categorized 46.2% of county residents as sedentary. Walking, the most frequent choice of activity (62% of the women, 36% of the men), increased in frequency with age of respondents whereas cycling, jogging, aerobics, team sports, and swimming (listed in rank order of frequency) generally tended to decrease in frequency with age. Farmers demonstrated an increased amount of "sweat activity" compared with persons in most other occupations. CONCLUSIONS. This descriptive study of physical activity in a rural county shows that sedentary lifestyle is of high prevalence. The high frequency of walking and the gender differences in both the levels and choice of activity suggest that further research and public policy recommendations focus on these issues. PMID:8279607

  12. LightDenseYOLO: A Fast and Accurate Marker Tracker for Autonomous UAV Landing by Visible Light Camera Sensor on Drone.

    PubMed

    Nguyen, Phong Ha; Arsalan, Muhammad; Koo, Ja Hyung; Naqvi, Rizwan Ali; Truong, Noi Quang; Park, Kang Ryoung

    2018-05-24

    Autonomous landing of an unmanned aerial vehicle or a drone is a challenging problem for the robotics research community. Previous researchers have attempted to solve this problem by combining multiple sensors such as global positioning system (GPS) receivers, inertial measurement unit, and multiple camera systems. Although these approaches successfully estimate an unmanned aerial vehicle location during landing, many calibration processes are required to achieve good detection accuracy. In addition, cases where drones operate in heterogeneous areas with no GPS signal should be considered. To overcome these problems, we determined how to safely land a drone in a GPS-denied environment using our remote-marker-based tracking algorithm based on a single visible-light-camera sensor. Instead of using hand-crafted features, our algorithm includes a convolutional neural network named lightDenseYOLO to extract trained features from an input image to predict a marker's location by visible light camera sensor on drone. Experimental results show that our method significantly outperforms state-of-the-art object trackers both using and not using convolutional neural network in terms of both accuracy and processing time.

  13. Influence of Urbanicity and County Characteristics on the ...

    EPA Pesticide Factsheets

    Background: Air pollution epidemiology studies, often conducted in large metropolitan areas due to proximity to regulatory monitors, are limited in their ability to examine potential associations between air pollution exposures and health effects in rural locations. Methods: In a time-stratified case-crossover framework, we examined associations between asthma emergency department (ED) visits in North Carolina (2006-2008) collected by a surveillance system, and short-term ozone exposures using predicted concentrations from the Community Multiscale Air Quality (CMAQ) model. Associations were estimated by county groupings based on four urbanicity classifications (representative of county size and urban proximity) and county health. Results: Ozone was associated with asthma ED visits in all-year and warm season (April-October) analyses [Odds Ratio (OR) =1.019; 95% CI: 0.998, 1.040; OR=1.020; 95% CI: 0.997, 1.044, respectively, for a 20 ppb increase in lag 0-2 days ozone]. The association was strongest in Less Urbanized counties, with no evidence of a positive association in Rural counties. Associations were similar when adjusted for fine particulate matter in copolluant models. Associations were stronger for children (5-17 years of age) compared with other age groups, and for individuals living in counties with poorer health status compared with counties that had the highest health rankings, although estimated associations for these subgroups were imprecise. Conclu

  14. A National Study of the Association between Food Environments and County-Level Health Outcomes

    ERIC Educational Resources Information Center

    Ahern, Melissa; Brown, Cheryl; Dukas, Stephen

    2011-01-01

    Purpose: This national, county-level study examines the relationship between food availability and access, and health outcomes (mortality, diabetes, and obesity rates) in both metro and non-metro areas. Methods: This is a secondary, cross-sectional analysis using Food Environment Atlas and CDC data. Linear regression models estimate relationships…

  15. Long-term effects of health factor modification in Milwaukee County.

    PubMed

    Shi, Lu; van Meijgaard, Jeroen; Fielding, Jonathan E

    2013-01-01

    We use the UCLA Health Forecasting Tool to forecast the 2011-2050 health trends in Milwaukee County. We first simulate a baseline scenario (S-1) that assumes no health behavior change, and compare this with three simulated intervention scenarios: expansion of Quitline reach to enhance smoking cessation (S-2), an increased penetration of diabetes screening (S-3) and construction of additional recreational facilities (S-4). We compared the disease-free life years (DFLY) gained from each intervention scenario by 2050 on a year-by-year and cumulative basis. Simulation results show that increasing access to recreational facilities achieves the greatest gain in DFLYs for every year from 2011 to 2050. By 2050, the cumulative DFLY gain is 22 393, 5956 and 41 396 for S-2, S-3, and S-4, respectively. The cost-effectiveness ratios for Quitline expansion, diabetes screening, and recreational facility construction are $1802, $1285, and $1322, per DFLY gained, respectively.

  16. Hazard-ranking of agricultural pesticides for chronic health effects in Yuma County, Arizona.

    PubMed

    Sugeng, Anastasia J; Beamer, Paloma I; Lutz, Eric A; Rosales, Cecilia B

    2013-10-01

    With thousands of pesticides registered by the United States Environmental Protection Agency, it not feasible to sample for all pesticides applied in agricultural communities. Hazard-ranking pesticides based on use, toxicity, and exposure potential can help prioritize community-specific pesticide hazards. This study applied hazard-ranking schemes for cancer, endocrine disruption, and reproductive/developmental toxicity in Yuma County, Arizona. An existing cancer hazard-ranking scheme was modified, and novel schemes for endocrine disruption and reproductive/developmental toxicity were developed to rank pesticide hazards. The hazard-ranking schemes accounted for pesticide use, toxicity, and exposure potential based on chemical properties of each pesticide. Pesticides were ranked as hazards with respect to each health effect, as well as overall chronic health effects. The highest hazard-ranked pesticides for overall chronic health effects were maneb, metam-sodium, trifluralin, pronamide, and bifenthrin. The relative pesticide rankings were unique for each health effect. The highest hazard-ranked pesticides differed from those most heavily applied, as well as from those previously detected in Yuma homes over a decade ago. The most hazardous pesticides for cancer in Yuma County, Arizona were also different from a previous hazard-ranking applied in California. Hazard-ranking schemes that take into account pesticide use, toxicity, and exposure potential can help prioritize pesticides of greatest health risk in agricultural communities. This study is the first to provide pesticide hazard-rankings for endocrine disruption and reproductive/developmental toxicity based on use, toxicity, and exposure potential. These hazard-ranking schemes can be applied to other agricultural communities for prioritizing community-specific pesticide hazards to target decreasing health risk. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Hazard-Ranking of Agricultural Pesticides for Chronic Health Effects in Yuma County, Arizona

    PubMed Central

    Sugeng, Anastasia J.; Beamer, Paloma I.; Lutz, Eric A.; Rosales, Cecilia B.

    2013-01-01

    With thousands of pesticides registered by the United States Environmental Protection Agency, it not feasible to sample for all pesticides applied in agricultural communities. Hazard-ranking pesticides based on use, toxicity, and exposure potential can help prioritize community-specific pesticide hazards. This study applied hazard-ranking schemes for cancer, endocrine disruption, and reproductive/developmental toxicity in Yuma County, Arizona. An existing cancer hazard-ranking scheme was modified, and novel schemes for endocrine disruption and reproductive/developmental toxicity were developed to rank pesticide hazards. The hazard-ranking schemes accounted for pesticide use, toxicity, and exposure potential based on chemical properties of each pesticide. Pesticides were ranked as hazards with respect to each health effect, as well as overall chronic health effects. The highest hazard-ranked pesticides for overall chronic health effects were maneb, metam sodium, trifluralin, pronamide, and bifenthrin. The relative pesticide rankings were unique for each health effect. The highest hazard-ranked pesticides differed from those most heavily applied, as well as from those previously detected in Yuma homes over a decade ago. The most hazardous pesticides for cancer in Yuma County, Arizona were also different from a previous hazard-ranking applied in California. Hazard-ranking schemes that take into account pesticide use, toxicity, and exposure potential can help prioritize pesticides of greatest health risk in agricultural communities. This study is the first to provide pesticide hazard-rankings for endocrine disruption and reproductive/developmental toxicity based on use, toxicity, and exposure potential. These hazard-ranking schemes can be applied to other agricultural communities for prioritizing community-specific pesticide hazards to target decreasing health risk. PMID:23783270

  18. A comparative analysis of health-related quality of life for residents of U.S. counties with and without coal mining.

    PubMed

    Zullig, Keith J; Hendryx, Michael

    2010-01-01

    We compared health-related quality of life (HRQOL) in mining and non-mining counties in and out of Appalachia using the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Dependent variables included self-rated health, the number of poor physical and mental health days, the number of activity limitation days (in the last 30 days), and the Centers for Disease Control and Prevention Healthy Days Index. Independent variables included the presence of coal mining, Appalachian region residence, metropolitan status, primary care physician supply, and BRFSS behavioral (e.g., smoking, body mass index, and alcohol consumption) and demographic (e.g., age, gender, race, and income) variables. We compared dependent variables across a four-category variable: Appalachia (yes/ no) and coal mining (yes/no). We used SUDAAN Multilog and multiple linear regression models with post-hoc least-squares means to test for Appalachian coal-mining effects after adjusting for covariates. Residents of coal-mining counties inside and outside of Appalachia reported significantly fewer healthy days for both physical and mental health, and poorer self-rated health (p < 0.0005) when compared with referent U.S. non-coal-mining counties, but disparities were greatest for people residing in Appalachian coal-mining areas. Furthermore, results remained consistent in separate analyses by gender and age. Coal-mining areas are characterized by greater socioeconomic disadvantage, riskier health behaviors, and environmental degradation that are associated with reduced HRQOL.

  19. Hurricane exposure and county fetal death rates, utilization of a county environmental quality index for confounding control.

    EPA Science Inventory

    The effects of natural disasters on public health are a rising concern, with increasing severity of disaster events. Many disaster studies utilize county-level analysis, however most do not control for county level environmental factors. Hurricane exposure during pregnancy could ...

  20. Ecosystem Health Assessment at County-Scale Using the Pressure-State-Response Framework on the Loess Plateau, China.

    PubMed

    Liu, Delin; Hao, Shilong

    2016-12-22

    Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County, Loess Plateau, Ningxia Province, China. The basic data used to calculate the values of the assessment indicators include Landsat TM image and socio-economic data, and remote sensing (RS) and the geographic information system (GIS) were used to process image data. The results showed that the ecosystem health conditions of most townships in Yuanzhou County were at the moderately healthy level, three townships were at the healthy level, and only two townships were at the unhelathy level; the areas (percentage) at the unhealthy, moderately healthy and healthy levels were 443.91 km² (12.66%), 2438.75 km² (69.54%) and 624.50 km² (17.81%), respectively. The results could provide useful information for local residents and the government to take measures to improve the health conditions of their township ecosystem.

  1. Ecosystem Health Assessment at County-Scale Using the Pressure-State-Response Framework on the Loess Plateau, China

    PubMed Central

    Liu, Delin; Hao, Shilong

    2016-01-01

    Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County, Loess Plateau, Ningxia Province, China. The basic data used to calculate the values of the assessment indicators include Landsat TM image and socio-economic data, and remote sensing (RS) and the geographic information system (GIS) were used to process image data. The results showed that the ecosystem health conditions of most townships in Yuanzhou County were at the moderately healthy level, three townships were at the healthy level, and only two townships were at the unhelathy level; the areas (percentage) at the unhealthy, moderately healthy and healthy levels were 443.91 km2 (12.66%), 2438.75 km2 (69.54%) and 624.50 km2 (17.81%), respectively. The results could provide useful information for local residents and the government to take measures to improve the health conditions of their township ecosystem. PMID:28025518

  2. Decomposing Mortality Disparities in Urban and Rural U.S. Counties.

    PubMed

    Spencer, Jennifer C; Wheeler, Stephanie B; Rotter, Jason S; Holmes, George M

    2018-05-30

    To understand the role of county characteristics in the growing divide between rural and urban mortality from 1980 to 2010. Age-adjusted mortality rates for all U.S. counties from 1980 to 2010 were obtained from the CDC Compressed Mortality File and combined with county characteristics from the U.S. Census Bureau, the Area Health Resources File, and the Inter-University Consortium for Political and Social research. We used Oaxaca-Blinder decomposition to assess the extent to which rural-urban mortality disparities are explained by observed county characteristics at each decade. Decomposition shows that, at each decade, differences in rural/urban characteristics are sufficient to explain differences in mortality. Furthermore, starting in 1990, rural counties have significantly lower predicted mortality than urban counties when given identical county characteristics. We find changes in the effect of characteristics on mortality, not the characteristics themselves, drive the growing mortality divide. Differences in economic and demographic characteristics between rural and urban counties largely explain the differences in age-adjusted mortality in any given year. Over time, the role these characteristics play in improving mortality has increased differentially for urban counties. As characteristics continue changing in importance as determinants of health, this divide may continue to widen. © Health Research and Educational Trust.

  3. What predicts recovery orientation in county departments of mental health? A pilot study.

    PubMed

    Brown, Timothy T; Mahoney, Christine B; Adams, Neal; Felton, Mistique; Pareja, Candy

    2010-09-01

    In this pilot study we examined the determinants of recovery orientation among employees and influential stakeholders in a sample of 12 county departments of mental health in California. A two-level hierarchical linear model with random intercepts was estimated. Analyses show that recovery orientation has a U-shaped relationship with the age of staff/influential stakeholders and is negatively related to the difference between the desired level of adhocracy and the current level of adhocracy. Recovery orientation is positively related to the education level of staff/influential stakeholders, satisfying transformational leadership outcomes, and larger mental health budgets per capita. Policy implications are discussed.

  4. Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

    PubMed

    Saari, Chelsey K

    The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

  5. The epidemiology of maternal overweight in Dane County, Wisconsin.

    PubMed

    Zeal, Carley; Remington, Patrick; Ndiaye, Mamadou; Stewart, Katharina; Stattelman-Scanlan, Daniel

    2014-02-01

    Research shows that maternal obesity leads not only to adverse pregnancy outcomes but also can act as a predictor of poor health of future generations. The Public Health Madison & Dane County Fetal and Infant Mortality Review Board observed poor health associated with prepregnancy BMI > or = 25, prompting further exploration of this issue in the Dane County, Wisconsin population. This is a descriptive epidemiologic study of the problem of maternal overweight defined as prepregnancy BMI > or = 25 in Dane County. Data were abstracted from the Secure Public Health Electronic Records Environment (SPHERE) on births in Dane County in 2011. Risk ratios were used to determine associations between race, education, parity, gravidity, and place of residence and maternal overweight. A t test was completed to determine differences in mean age of overweight and healthy weight mothers. Approximately half (50.6%) of Dane County mothers in 2011 were overweight or obese prepregnancy. Results showed increased risk of overweight for black mothers and multiparous/multigravidous mothers. There was no difference in mean age of overweight and healthy weight mothers. Overweight rates varied considerably by ZIP code of residence. Rates of maternal overweight vary significantly in Dane County by social and demographic factors. This information can be used to design and target interventions and monitor trends over time.

  6. Counties eliminating racial disparities in colorectal cancer mortality.

    PubMed

    Rust, George; Zhang, Shun; Yu, Zhongyuan; Caplan, Lee; Jain, Sanjay; Ayer, Turgay; McRoy, Luceta; Levine, Robert S

    2016-06-01

    Although colorectal cancer (CRC) mortality rates are declining, racial-ethnic disparities in CRC mortality nationally are widening. Herein, the authors attempted to identify county-level variations in this pattern, and to characterize counties with improving disparity trends. The authors examined 20-year trends in US county-level black-white disparities in CRC age-adjusted mortality rates during the study period between 1989 and 2010. Using a mixed linear model, counties were grouped into mutually exclusive patterns of black-white racial disparity trends in age-adjusted CRC mortality across 20 three-year rolling average data points. County-level characteristics from census data and from the Area Health Resources File were normalized and entered into a principal component analysis. Multinomial logistic regression models were used to test the relation between these factors (clusters of related contextual variables) and the disparity trend pattern group for each county. Counties were grouped into 4 disparity trend pattern groups: 1) persistent disparity (parallel black and white trend lines); 2) diverging (widening disparity); 3) sustained equality; and 4) converging (moving from disparate outcomes toward equality). The initial principal component analysis clustered the 82 independent variables into a smaller number of components, 6 of which explained 47% of the county-level variation in disparity trend patterns. County-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. Counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all. Cancer 2016;122:1735-48. © 2016 American Cancer Society. © 2016 American Cancer Society.

  7. Longitudinal study of rural health workforce in five counties in China: research design and baseline description

    PubMed Central

    2013-01-01

    Background The village doctors have served rural residents for many decades in China, and their role in rural health system has been highly praised in the world; unfortunately, less attention has been paid to the health workforce during the ambitious healthcare reform in recent years. Therefore, we conducted a longitudinal study to explore the current situation and track the future evolution of the rural healthcare workforce. Methods The self-administered structured Village Clinic Questionnaire and Village Doctor Questionnaire, which were modified from the official questionnaires of the Ministry of Health, were constructed after three focus groups, in-depth interviews in Hebei Province, and a pilot survey in Sichuan Province. Using a stratified multistage cluster sampling process, we gathered baseline data for a longitudinal survey of village doctors, village clinics from Changshu County, Liyang County, Yongchuan District, Mianzhu County, and Jingning County in China in 2011. Well-trained interviewers and strict procedures were employed to ensure the quality of this survey. Descriptive and correlation analyses were performed with Stata 12.0. Results After four months of surveying, 1,982 Village Doctor Questionnaires were collected, and the response rate was 88.1%. There were 1,507 (76.0%) male and 475 (24.0%) female doctors, with an average age of 51.3 years. The majority of village doctors (58.5%) practiced both western medicine and Traditional Chinese Medicine, and 91.2% of the doctors received their education below college level. Their practice methods were not correlated with education level (P = 0.43), but closely related to the way they obtained their highest degree (that is, prior to starting work or as on-the-job training) (P < 0.01). The mean income of the village doctors was 1,817 (95% CI 1,733 to 1,900) RMB per month in 2011; only 757 (41.3%) doctors had pensions, and the self-reported expected pension was 1,965 RMB per month. Conclusions Village doctors

  8. Using YOLO based deep learning network for real time detection and localization of lung nodules from low dose CT scans

    NASA Astrophysics Data System (ADS)

    Ramachandran S., Sindhu; George, Jose; Skaria, Shibon; V. V., Varun

    2018-02-01

    Lung cancer is the leading cause of cancer related deaths in the world. The survival rate can be improved if the presence of lung nodules are detected early. This has also led to more focus being given to computer aided detection (CAD) and diagnosis of lung nodules. The arbitrariness of shape, size and texture of lung nodules is a challenge to be faced when developing these detection systems. In the proposed work we use convolutional neural networks to learn the features for nodule detection, replacing the traditional method of handcrafting features like geometric shape or texture. Our network uses the DetectNet architecture based on YOLO (You Only Look Once) to detect the nodules in CT scans of lung. In this architecture, object detection is treated as a regression problem with a single convolutional network simultaneously predicting multiple bounding boxes and class probabilities for those boxes. By performing training using chest CT scans from Lung Image Database Consortium (LIDC), NVIDIA DIGITS and Caffe deep learning framework, we show that nodule detection using this single neural network can result in reasonably low false positive rates with high sensitivity and precision.

  9. DRAFT LANDSAT DATA MOSAIC: MONTGOMERY COUNTY, TEXAS; HARRIS COUNTY, TEXAS; FORT BEND COUNTY, TEXAS; BRAZORIA COUNTY, TEXAS; GALVESTON COUNTY, TEXAS

    EPA Science Inventory

    This is a draft Landsat Data Mosaic, which contains remote sensing information for Montgomery County, Texas Harris County, Texas Fort Bend County, Texas Brazoria County, Texas Galveston County, and Texas Imagery dates on the following dates: October 6, 1999 and September 29, 200...

  10. FULL SCALE BIOREACTOR LANDFILL FOR CARBON SEQUESTRATION AND GREENHOUSE EMISSION CONTROL

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

    Ramin Yazdani; Jeff Kieffer; Heather Akau

    2003-08-01

    The Yolo County Department of Planning and Public Works is constructing a full-scale bioreactor landfill as a part of the Environmental Protection Agency's (EPA) Project XL program to develop innovative approaches for carbon sequestration and greenhouse emission control. The overall objective is to manage landfill solid waste for rapid waste decomposition and maximum landfill gas generation and capture for carbon sequestration and greenhouse emission control. Waste decomposition is accelerated by improving conditions for either the aerobic or anaerobic biological processes and involves circulating controlled quantities of liquid (leachate, groundwater, gray water, etc.), and, in the aerobic process, large volumes ofmore » air. The first phase of the project entails the construction of a 12-acre module that contains a 6-acre anaerobic cell, a 3.5-acre anaerobic cell, and a 2.5-acre aerobic cell at the Yolo County Central Landfill near Davis, California. The cells are highly instrumented to monitor bioreactor performance. Liquid addition has commenced in the 3.5-acre anaerobic cell and the 6-acre anaerobic cell. Construction of the 2.5-acre aerobic cell is nearly complete with only the biofilter remaining and is scheduled to be complete by the end of August 2003. The current project status and preliminary monitoring results are summarized in this report.« less

  11. FULL SCALE BIOREACTOR LANDFILL FOR CARBON SEQUESTRATION AND GREENHOUSE EMISSION CONTROL

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

    Ramin Yazdani; Jeff Kieffer; Heather Akau

    2003-12-01

    The Yolo County Department of Planning and Public Works is constructing a full-scale bioreactor landfill as a part of the Environmental Protection Agency's (EPA) Project XL program to develop innovative approaches for carbon sequestration and greenhouse emission control. The overall objective is to manage landfill solid waste for rapid waste decomposition and maximum landfill gas generation and capture for carbon sequestration and greenhouse emission control. Waste decomposition is accelerated by improving conditions for either the aerobic or anaerobic biological processes and involves circulating controlled quantities of liquid (leachate, groundwater, gray water, etc.), and, in the aerobic process, large volumes ofmore » air. The first phase of the project entails the construction of a 12-acre module that contains a 6-acre anaerobic cell, a 3.5-acre anaerobic cell, and a 2.5-acre aerobic cell at the Yolo County Central Landfill near Davis, California. The cells are highly instrumented to monitor bioreactor performance. Liquid addition has commenced in the 3.5-acre anaerobic cell and the 6-acre anaerobic cell. Construction of the 2.5-acre aerobic cell and biofilter has been completed. The remaining task to be completed is to test the biofilter prior to operation, which is currently anticipated to begin in January 2004. The current project status and preliminary monitoring results are summarized in this report.« less

  12. Urban-rural differences in excess mortality among high-poverty populations: evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health.

    PubMed

    Geronimus, Arline T; Colen, Cynthia G; Shochet, Tara; Ingber, Lori Barer; James, Sherman A

    2006-08-01

    Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.

  13. Implementation of mass media community health education: the Forsyth County Cervical Cancer Prevention Project.

    PubMed

    Dignan, M; Bahnson, J; Sharp, P; Beal, P; Smith, M; Michielutte, R

    1991-09-01

    The Forsyth County Cervical Cancer Prevention Project (FCP) is a community-based health education project funded by the National Cancer Institute. The target population includes around 25 000 black women age 18 and older who reside in Forsyth County, North Carolina. The overall goal of the program is to prevent mortality from cervical cancer by promoting Pap smears and return for follow-up care when needed. Based on the principles of social marketing, a plan to reach the target population with mass media educational messages through electronic and print channels was developed. Guided by marketing objectives, the target population was divided into relatively discrete segments. The segments included church attenders, patients in waiting rooms of public and selected health providers, female students at local colleges, shoppers, viewers of radio and television, newspaper readers, and business owners and managers. Introduction of the program was based on strategies developed for reaching the target population in each segment with television, radio and print mass media messages. Qualitative assessment of the mass media developed by the program indicated that all forms of communication helped to increase awareness of the program.

  14. Use of process evaluation to guide health education in Forsyth County's project to prevent cervical cancer.

    PubMed

    Dignan, M B; Michielutte, R; Sharp, P C; Young, L D; Daniels, L A

    1991-01-01

    The Forsyth County, NC, Cervical Cancer Prevention Project is a 5-year public health education program designed to increase the proportion of black women in the county who are appropriately screened for cervical cancer. In this paper, the authors report on process evaluation--the procedures used to monitor the intervention and to insure that the target population was reached with a high quality, community-based health education program. A system that encompasses documentation of program activities, interviews with women in waiting rooms of primary care providers, semiannual interviews with a panel of approximately 100 women from the target population, and telephone followup with participants in direct education workshops was designed and implemented. Through October 1990, more than 2,100 interviews had been conducted. Data from these activities have facilitated continued development and refinement of educational materials, provided guidance for developing new strategies for reaching the target population, and provided continuous feedback to program managers to allow monitoring the impact of all program activities.

  15. Social health assistance schemes: the case of Medical Financial Assistance for the rural poor in four counties of China

    PubMed Central

    2011-01-01

    Background Economic transition which took place in China over the last three decades, has led to a rapid marketization of the health care sector. Today inequity in health and poverty resulting from major illness has become a serious problem in rural areas of China. Medical Financial Assistance (MFA) is a health assistance scheme that helps rural poor people cope with major illness and alleviate their financial burden from major illness, which will definitely play a significant role in the process of rebuilding Chinese new rural health system. It mainly provides assistance to cover medical expenditure for inpatient services or the treatment of major illnesses, with joint funding from the central and local government. The purpose of this paper is to review the design, funding, implementation and to explore the preliminary effects of four counties' MFA in Hubei and Sichuan province of China. Methods We used an analytical framework built around the main objective of any social assistance scheme. The framework contains six 'targeting' procedural 'steps' which may explain why a specific group does not receive the assistance it ought to receive. More specifically, we explored to what extent the targeting, a key component of social assistance programs, is successful, based on the qualitative and quantitative data collected from four representative counties in central and western China. Results In the study sites, the budget of MFA ranged from 0.8 million Yuan to 1.646 million Yuan in each county and the budget per eligible person ranged from 32.67 Yuan to 149.09 Yuan. The preliminary effects of MFA were quite modest because of the scarcity of funds dedicated to the scheme. The coverage rate of MFA ranged from 17.8% to 24.1% among the four counties. MFA in the four counties used several ways to ration a restricted budget and provided only limited assistance. Substantial problems remained in terms of eligibility and identification of the beneficiaries, utilization and

  16. Health assessment for Tansitor Electronics, Inc. Site, Bennington County, Vermont, Region 1. CERCLIS No. VTD000509174. Preliminary report

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

    Not Available

    1991-03-26

    The Tansitor Electronics, Inc. site, located in Bennington, Bennington County, Vermont, has been proposed by the Environmental Protection Agency for inclusion onto the National Priorities List (NPL). Most of the investigations into site contamination have been coordinated by the Vermont Department of Environmental Conservation. Tansitor Electronics, Inc. operates an electronic capacitor manufacturing facility on a 36-acre parcel located along Route 9 and about 3 miles west of downtown Bennington, Bennington County, Vermont. The site is of potential public health concern because of the risk to human health resulting from possible exposure to hazardous substances at concentrations that may result inmore » adverse health effects. There are no monitoring data or information indicating that appreciable human exposure to site-related contaminants is currently occurring. However, additional monitoring data or information is needed to evaluate the on-site and off-site ground water (shallow aquifer and bedrock aquifer), ambient air, sediment, surface soil, and surface water. The monitoring data or information may form the basis of future ATSDR evaluation of the undefined human exposure pathways and public health implications associated with these pathways. The site is not recommended for follow-up health activities at this time.« less

  17. Media Outlet and Consumer Reactions to Promotional Activities of the Choose Health LA Restaurants Program in Los Angeles County.

    PubMed

    Gase, Lauren N; Montes, Christine; Robles, Brenda; Tyree, Rachel; Kuo, Tony

    2016-01-01

    This study sought to assess promotional activities undertaken to raise public awareness of the Choose Health LA Restaurants program in Los Angeles County, an environmental change strategy that recognizes restaurants for offering reduced-size and healthier menu options. We used multiple methods to assess public awareness of and reactions to the promotional activities, including an assessment of the reach of core promotional activities, a content analysis of earned media, and an Internet panel survey. The study was conducted in Los Angeles County, home to more than 10 million residents. An online survey firm recruited participants for an Internet panel survey; to facilitate generalization of results to the county's population, statistical weights were applied to analyses of the survey data. Promotional activities to raise awareness of the program included community engagement, in-store promotion, and a media campaign. Outcomes included media impressions, the number of people who reported seeing the Choose Health LA Restaurants logo, and a description of the themes present in earned media. Collectively, paid media outlets reported 335 587 229 total impressions. The Internet panel survey showed that 12% of people reported seeing the program logo. Common themes in earned media included the Choose Health LA Restaurants program aims to provide restaurant patrons with more choices, represents a new opportunity for restaurants and public health to work together, will benefit participating restaurants, and will positively impact health. Promotional activities for the Choose Health LA Restaurants program achieved modest reach and positive reactions from media outlets and consumers. The program strategy and lessons learned can help inform present and future efforts to combine environmental and individually focused strategies that target key influences of consumer food selection.

  18. Progress in reducing premature deaths in Wisconsin counties, 2000-2010.

    PubMed

    Nonnweiler, Thomas; Pollock, Elizabeth A; Rudolph, Barbara; Remington, Patrick L

    2013-10-01

    Measuring trends in a county's premature death rate is a straightforward method that can be used to assess a county's progress in improving the health of the population. Age-adjusted premature death rate data from Wisconsin Interactive Statistics on Health for persons less than 75 years of age were collected for the years 2000-2010. Overall 10-year percent change was calculated, compared, and ranked for all Wisconsin counties during this time period. Progress was assessed as excellent (25.0% or greater decline), very good (20.0%-24.9% decline), good (10.0%-19.9% decline), fair (0.0%-9.9% decline), or poor (any increase). Overall, premature death rates in counties declined by 16.8% over the 10-year period 2000-2010 in Wisconsin. Trends varied by county, with 8, 15, 37, 9, and 3 counties having excellent, very good, good, fair, and poor progress, respectively. The most improvement was seen in Kewaunee County (decreasing 38.3%) and the least progress in Lafayette County (increasing 4.8%). Trends in premature death rates were not related to the county's initial death rate, population, rurality, or income. Although premature death rates declined overall in Wisconsin during the 2000s, this progress varied across counties and was not related to baseline mortality rates or other county characteristics.

  19. Surveying Local Health Departments and County Emergency Management Offices on Cooling Centers as a Heat Adaptation Resource in New York State.

    PubMed

    Nayak, Seema G; Lin, Shao; Sheridan, Scott C; Lu, Yi; Graber, Nathan; Primeau, Michael; Rafferty, Claudine Jones; Hwang, Syni-An

    2017-02-01

    Local agencies in New York State (NYS) set up cooling centers to provide relief from summer-time heat especially for people with limited access to air-conditioning. We aimed to determine cooling center locations in NYS, and explore county agencies' involvement in organizing and promoting utilization of cooling centers. We conducted a survey among county health and emergency preparedness offices in NYS (excluding NYC) and explored official county websites. We identified 377 cooling centers, mostly in metropolitan areas of NYS. Although 47 % of counties listed locations online, only 29 % reported locations via survey. Radio (90 %) and internet (84 %) were popular for information dissemination. Air-conditioning was available at all indoor cooling center facilities. Cooling centers in 13 % of the counties were accessible by either public transportation or shuttles arranged by the facility. About 38 % counties do not consider cooling centers important in their region or promote informal cooling centers. More than a third of New York counties had neither cooling centers nor plans to establish a cooling center as extreme heat was not perceived as a threat in their region.

  20. Child Health and Well-Being in Miami-Dade County: 2007 Baseline Survey Results. Final Report

    ERIC Educational Resources Information Center

    Lippman, Laura; Guzman, Lina; Vandivere, Sharon; Atienza, Astrid; Rivers, Andrew

    2007-01-01

    In January through April 2007, the Children's Trust sponsored a population-based survey of parents of children ages birth through 17 in Miami-Dade County to provide a baseline of data on child health and well-being, and to discern unmet needs for services in the Trust's primary impact areas and strategic investments. The survey was conducted by…

  1. Challenges in responding to the ebola epidemic - four rural counties, Liberia, August-November 2014.

    PubMed

    Summers, Aimee; Nyenswah, Tolbert G; Montgomery, Joel M; Neatherlin, John; Tappero, Jordan W; T, Nyenswah; M, Fahnbulleh; M, Massaquoi

    2014-12-19

    The first cases of Ebola virus disease (Ebola) in West Africa were identified in Guinea on March 22, 2014. On March 30, the first Liberian case was identified in Foya Town, Lofa County, near the Guinean border. Because the majority of early cases occurred in Lofa and Montserrado counties, resources were concentrated in these counties during the first several months of the response, and these counties have seen signs of successful disease control. By October 2014, the epidemic had reached all 15 counties of Liberia. During August 27-September 10, 2014, CDC in collaboration with the Liberian Ministry of Health and Social Welfare assessed county Ebola response plans in four rural counties (Grand Cape Mount, Grand Bassa, Rivercess, and Sinoe, to identify county-specific challenges in executing their Ebola response plans, and to provide recommendations and training to enhance control efforts. Assessments were conducted through interviews with county health teams and health care providers and visits to health care facilities. At the time of assessment, county health teams reported lacking adequate training in core Ebola response strategies and reported facing many challenges because of poor transportation and communication networks. Development of communication and transportation network strategies for communities with limited access to roads and limited means of communication in addition to adequate training in Ebola response strategies is critical for successful management of Ebola in remote areas.

  2. Eight Americas: investigating mortality disparities across races, counties, and race-counties in the United States.

    PubMed

    Murray, Christopher J L; Kulkarni, Sandeep C; Michaud, Catherine; Tomijima, Niels; Bulzacchelli, Maria T; Iandiorio, Terrell J; Ezzati, Majid

    2006-09-01

    The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the "eight Americas," to explore the causes of the disparities that can inform specific public health intervention policies and programs. The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15-44 y) and middle-aged (45-59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The

  3. "When a woman is pregnant, her grave is open": health beliefs concerning dietary practices among pregnant Kalenjin women in rural Uasin Gishu County, Kenya.

    PubMed

    Riang'a, Roselyter Monchari; Nangulu, Anne Kisaka; Broerse, Jacqueline E W

    2017-12-16

    Reducing malnutrition remains a major global challenge especially in low- and middle-income countries. Lack of knowledge on the motive of nutritional behaviour could ultimately cripple nutrition intervention outcomes. The purpose of this study was to investigate how health beliefs influence nutritional behaviour intention of the pregnant Kalenjin women of rural Uasin Gishu County in Kenya. The study findings provide useful information for culturally congruent nutrition counselling and intervention. In this qualitative study semi-structured interviews were conducted with 42 pregnant and post-natal (with children less than one year) Kalenjin women in selected rural public health facilities of Uasin Gishu County Kenya. Furthermore, key informant interviews took place with 6 traditional birth attendants who were also pregnancy herbalists, two community health workers and one nursing officer in charge of Maternal and Child Health (MCH) for triangulation and provision of in-depth information. Content analysis of interview transcripts followed a grounded theory (Protection Motivation Theory) approach, using software MAXQDA version 12.1.3. Abstracted labour (big babies and lack of maternal strength), haemorrhage (low blood), or having other diseases and complications (evil or bad food) were the major perceived health threats that influence nutritional behaviour intention of the pregnant Kalenjin women in rural Uasin Gishu County in Kenya. The pregnancy nutritional behaviour and practices of the Kalenjin women in rural Uasin Gishu County act as an adaptive response to the perceived health threats, which seem to be within the agency of pregnant women. As a result, just giving antenatal nutritional counselling without addressing these key health assumptions that underlie a successful pregnancy outcome is unlikely to lead to changes in nutritional behaviour.

  4. System Transformation Under the California Mental Health Services Act: Implementation of Full-Service Partnerships in L.A. County.

    PubMed

    Starks, Sarah L; Arns, Paul G; Padwa, Howard; Friedman, Jack R; Marrow, Jocelyn; Meldrum, Marcia L; Bromley, Elizabeth; Kelly, Erin L; Brekke, John S; Braslow, Joel T

    2017-06-01

    The study evaluated the effect of California's Mental Health Services Act (MHSA) on the structure, volume, location, and patient centeredness of Los Angeles County public mental health services. This prospective mixed-methods study (2006-2013) was based in five Los Angeles County public mental health clinics, all with usual care and three with full-service partnerships (FSPs). FSPs are MHSA-funded programs designed to "do whatever it takes" to provide intensive, recovery-oriented, team-based, integrated services for clients with severe mental illness. FSPs were compared with usual care on outpatient services received (claims data) and on organizational climate, recovery orientation, and provider-client working alliance (surveys and semistructured interviews), with regression adjustment for client and provider characteristics. In the first year after admission, FSP clients (N=174) received significantly more outpatient services than did usual care clients (N=298) (5,238 versus 1,643 minutes, p<.001), and a larger proportion of these services were field based (22% versus 2%, p<.001). Compared with usual care clients, FSP clients reported more recovery-oriented services (p<.001) and a better provider-client working alliance (p=.01). Compared with usual care providers (N=130), FSP providers (N=42) reported more stress (p<.001) and lower morale (p<.001). Los Angeles County's public mental health system was able to transform service delivery in response to well-funded policy mandates. For providers, a structure emphasizing accountability and patient centeredness was associated with greater stress, despite smaller caseloads. For clients, service structure and volume created opportunities to build stronger provider-client relationships and address their needs and goals.

  5. Health Concerns of Northeastern Pennsylvania Residents Living in an Unconventional Oil and Gas Development County.

    PubMed

    McDermott-Levy, Ruth; Garcia, Victoria

    2016-11-01

    This study was conducted to describe the health concerns of residents of an unconventional oil and natural gas development (UOGD) community and identify methods to best disseminate health information to the residents. A qualitative descriptive study of 27 residents of Wyoming County, Pennsylvania, was conducted. Residents described their health concerns in terms of their changing community as a result of UOGD, their feelings of stress and powerlessness related to these changes, and the limited response of their local policymakers and protective agencies. There were indications of misinformation related to routine environmental health and UOGD environmental risks. Web-based educational programs with downloadable printed materials to bridge the knowledge gaps of residents and health professionals are recommended. Recommendations include public health nurses providing education to communities and other health professionals regarding environmental health risks, working with communities to advocate for health-protective regulations, and adopting a community-based participatory approach to meet the needs of community members. © 2016 Wiley Periodicals, Inc.

  6. Suicide Among Military Personnel and Veterans Aged 18-35 Years by County-16 States.

    PubMed

    Logan, Joseph E; Fowler, Katherine A; Patel, Nimeshkumar P; Holland, Kristin M

    2016-11-01

    Suicide among military personnel and young Veterans remains a health concern. This study examined stateside distribution of suicides by U.S. county to help focus prevention efforts. Using 2005-2012 National Violent Death Reporting System data from 16 states (963 counties, or county-equivalent entities), this study mapped the county-level distribution of suicides among current military and Veteran decedents aged 18-35 years. This study also compared incident circumstances of death between decedents in high-density counties (i.e., counties with the highest proportion of deaths) versus those in medium/low-density counties to better understand the precipitators of suicide in counties most affected. Last, this study identified potential military and Veteran Health Administration intervention sites. All analyses were conducted in 2015. Within the National Violent Death Reporting System participating states, an estimated 262 (33%) current military suicides occurred in just ten (1.0%) counties, and 391 (33%) Veteran suicides occurred in 33 (3.4%) counties. Mental health and intimate partner problems were common precipitating circumstances, and some circumstances differed between cases in high- versus those in medium/low-density counties. Multiple potential intervention sites were identified in high-density counties. These findings suggest that military and Veteran suicides are concentrated in a small number of counties. Increased efforts at these locales might be beneficial. Published by Elsevier Inc.

  7. Geographic health inequalities in Norway: a Gini analysis of cross-county differences in mortality from 1980 to 2014.

    PubMed

    Skaftun, Eirin K; Verguet, Stéphane; Norheim, Ole F; Johansson, Kjell A

    2018-05-24

    This study aims at quantifying the level and changes over time of inequality in age-specific mortality and life expectancy between the 19 Norwegian counties from 1980 to 2014. Data on population and mortality by county was obtained from Statistics Norway for 1980-2014. Life expectancy and age-specific mortality rates (0-4, 5-49 and 50-69 age groups) were estimated by year and county. Geographic inequality was described by the absolute Gini index annually. Life expectancy in Norway has increased from 75.6 to 82.0 years, and the risk of death before the age of 70 has decreased from 26 to 14% from 1980 to 2014. The absolute Gini index decreased over the period 1980 to 2014 from 0.43 to 0.32 for life expectancy, from 0.012 to 0.0057 for the age group 50-69 years, from 0.0038 to 0.0022 for the age group 5-49 years, and from 0.0009 to 0.0006 for the age group 0-4 years. It will take between 2 and 32 years (national average 7 years) until the counties catch up with the life expectancy in the best performing county if their annual rates of increase remain unchanged. Using the absolute Gini index as a metric for monitoring changes in geographic inequality over time may be a valuable tool for informing public health policies. The absolute inequality in mortality and life expectancy between Norwegian counties has decreased from 1980 to 2014.

  8. The public sector nursing workforce in Kenya: a county-level analysis

    PubMed Central

    2014-01-01

    Background Kenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. Methods National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Results Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001). Conclusions An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved. PMID:24467776

  9. The public sector nursing workforce in Kenya: a county-level analysis.

    PubMed

    Wakaba, Mabel; Mbindyo, Patrick; Ochieng, Jacob; Kiriinya, Rose; Todd, Jim; Waudo, Agnes; Noor, Abdisalan; Rakuom, Chris; Rogers, Martha; English, Mike

    2014-01-27

    Kenya's human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001). An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.

  10. The University of Washington's Community-Oriented Public Health Practice program and Public Health-Seattle & King County partnership.

    PubMed

    House, Peter J; Hartfield, Karen; Nicola, Bud; Bogan, Sharon L

    2014-01-01

    The Community-Oriented Public Health Practice (COPHP) program, a 2-year in-residence MPH degree program in the University of Washington School of Public Health, has partnered with Public Health-Seattle & King County (PHSKC) since 2002 to create a mutually beneficial set of programs to improve teaching and address community-based public health problems in a practice setting. The COPHP program uses a problem-based learning approach that puts students in small groups to work on public health problems. Both University of Washington-based and PHSKC-based faculty facilitate the classroom work. In the first year for students, COPHP, in concert with PHSKC, places students in practicum assignments at PHSKC; in the second year, students undertake a master's project (capstone) in a community or public health agency. The capstone project entails taking on a problem in a community-based agency to improve either the health of a population or the capacity of the agency to improve population health. Both the practicum and the capstone projects emphasize applying classroom learning in actual public health practice work for community-based organizations. This partnership brings PHSKC and COPHP together in every aspect of teaching. In essence, PHSKC acts as the "academic health department" for COPHP. There are detailed agreements and contracts that guide all aspects of the partnership. Both the practicum and capstone projects require written contracts. The arrangements for getting non-University of Washington faculty paid for teaching and advising also include formal contracts.

  11. Functional Characteristics of Health Coalitions in Local Public Health Systems: Exploring the Function of County Health Councils in Tennessee.

    PubMed

    Barnes, Priscilla; Erwin, Paul; Moonesinghe, Ramal; Brooks, Ashley; Carlton, Erik L; Behringer, Bruce

    Partnerships are emerging as critically important vehicles for addressing health in local communities. Coalitions involving local health departments can be viewed as the embodiment of a local public health system. Although it is known that these networks are heavily involved in assessment and community planning activities, limited studies have evaluated whether health coalitions are functioning at an optimal capacity. This study assesses the extent to which health coalitions met or exceeded expectations for building functional capacity within their respective networks. An evaluative framework was developed focusing on 8 functional characteristics of coalitions previously identified by Erwin and Mills. Twenty-nine indicators were identified that served as "proxy" measures of functional capacity within health coalitions. Ninety-three County Health Councils (CoHCs) in Tennessee. Diverse member representation; formal rules, roles, and procedures; open, frequent interpersonal communication; task-focused climate; council leadership; resources; active member participation; and external linkages were assessed to determine the level of functionality of CoHCs. Scores across all CoHCs were analyzed using descriptive statistics such as frequency distributions, measures of central tendency, and measures of variability. Data were analyzed using SAS 9.3. Of 68 CoHCs (73% response rate), the total mean score for the level of functional characteristics was 30.5 (median = 30.5; SD = 6.3; range, 18-44). Of the 8 functional characteristics, CoHCs met or exceeded all indicators associated with council leadership, tasked-focused climate, and external linkages. Lowest scores were for having a written communications plan, written priorities or goals, and opportunities for training. This study advances the research on health coalitions by establishing a process for quantifying the functionality of health coalitions. Future studies will be conducted to examine the association between health

  12. Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States

    PubMed Central

    Murray, Christopher J. L; Kulkarni, Sandeep C; Michaud, Catherine; Tomijima, Niels; Bulzacchelli, Maria T; Iandiorio, Terrell J; Ezzati, Majid

    2006-01-01

    Background The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs. Methods and Findings The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15–44 y) and middle-aged (45–59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Conclusions Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans

  13. RACISM IN ORGANIZATIONS: THE CASE OF A COUNTY PUBLIC HEALTH DEPARTMENT.

    PubMed

    Griffith, Derek M; Childs, Erica L; Eng, Eugenia; Jeffries, Vanessa

    2007-01-01

    Racism is part of the foundation of U.S. society and institutions, yet few studies in community psychology or organizational studies have examined how racism affects organizations. This paper proposes a conceptual framework of institutional racism, which describes how, in spite of professional standards and ethics, racism functions within organizations to adversely affect the quality of services, the organizational climate, and staff job satisfaction and morale. Grounded in systems theory and organizational empowerment, the framework is based on data that describe how racism was made manifest in a county public health department. The findings highlight the importance of understanding how organizations are influenced by external forces and can negatively affect clients, communities, and their own staff members.

  14. RACISM IN ORGANIZATIONS: THE CASE OF A COUNTY PUBLIC HEALTH DEPARTMENT

    PubMed Central

    Griffith, Derek M.; Childs, Erica L.; Eng, Eugenia; Jeffries, Vanessa

    2008-01-01

    Racism is part of the foundation of U.S. society and institutions, yet few studies in community psychology or organizational studies have examined how racism affects organizations. This paper proposes a conceptual framework of institutional racism, which describes how, in spite of professional standards and ethics, racism functions within organizations to adversely affect the quality of services, the organizational climate, and staff job satisfaction and morale. Grounded in systems theory and organizational empowerment, the framework is based on data that describe how racism was made manifest in a county public health department. The findings highlight the importance of understanding how organizations are influenced by external forces and can negatively affect clients, communities, and their own staff members. PMID:18852826

  15. Health assessment for Vogel Paint and Wax, Maurice, Sioux County, Iowa, Region 7. CERCLIS No. IAD980630487. Final report

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

    Not Available

    1989-04-29

    The Vogel Paint and Wax National Priority List site is situated in northwest Iowa in Sioux County. Contaminants found at the site consist of heavy metals (particularly cadmium, chromium, lead, and mercury) and volatile organic compounds (benzene, ethylbenzene, methyl ethyl ketone, toluene, and xylene). Two towns, Maurice and Struble, and the Southern Sioux County Rural Water System well field are located within three miles of the site, and two families live within 1600 feet of the waste-disposal site. Environmental pathways include contaminated soil and ground water, as well as potential surface water and air contamination. Although there does not appearmore » to be any immediate public health threat, the site is of potential health concern because of the possibility for further off-site migration of contaminants into the ground water aquifer and for direct on-site contact.« less

  16. Williamsburg County Human Resources Campus (WCHRC): Planning Report.

    ERIC Educational Resources Information Center

    Wynn, Eddie D.; And Others

    Investigating the feasibility of a human resources campus designed to locate all Williamsburg County (a rurally disadvantaged South Carolina county) health and social service agencies in one consolidated area, project objectives were to investigate: agency characteristics; ownership, management, and financing aspects of the campus concept;…

  17. The "sugar pack" health marketing campaign in Los Angeles County, 2011-2012.

    PubMed

    Barragan, Noel C; Noller, Ali J; Robles, Brenda; Gase, Lauren N; Leighs, Michael S; Bogert, Suzanne; Simon, Paul A; Kuo, Tony

    2014-03-01

    As part of a comprehensive approach to combating the obesity epidemic, the Los Angeles County Department of Public Health launched the "Sugar Pack" health marketing campaign in fall 2011. Carried out in three stages, the campaign sought to educate and motivate the public to reduce excess calorie intake from sugar-sweetened beverage consumption. The primary Sugar Pack creative concepts provided consumers with information about the number of sugar packs contained in sugary drinks. Data from formative market research as well as lessons from previous campaigns in other U.S. jurisdictions informed the development of the materials. These materials were disseminated through a multipronged platform that included paid outdoor media on transit and billboards and messaging using social media (i.e., Twitter, Facebook, YouTube, and sendable e-cards). Initial findings from a postcampaign assessment indicate that the Sugar Pack campaign reached broadly into targeted communities, resulting in more than 515 million impressions. Lessons learned from the campaign suggest that employing health marketing to engage the public can lead to increased knowledge, favorable recognition of health messages, and self-reported intention to reduce sugar-sweetened beverage consumption, potentially complementing other obesity prevention strategies in the field.

  18. The Impact of a Community-Based Chronic Disease Prevention Initiative: Evaluation Findings from "Steps to Health King County"

    ERIC Educational Resources Information Center

    Cheadle, Allen; Bourcier, Emily; Krieger, James; Beery, William; Smyser, Michael; Vinh, Diana V.; Lessler, Dan; Alfonsi, Lorrie

    2011-01-01

    "Steps to Health King County" ("Steps KC"; Seattle, Washington) was one of 40 community-level initiatives funded in 2003 as part of the "Steps to a HealthierUS" initiative. "Steps KC" goals included reducing the impact of chronic diseases through a comprehensive, coordinated approach and reducing health…

  19. Hydrogeologic framework of LaSalle County, Illinois

    USGS Publications Warehouse

    Kay, Robert T.; Bailey, Clinton R.

    2016-10-28

    Water-supply needs in LaSalle County in northern Illinois are met by surface water and groundwater. Water-supply needs are expected to increase to serve future residential and mining uses. Available information on water use, geology, surface-water and groundwater hydrology, and water quality provides a hydrogeologic framework for LaSalle County that can be used to help plan the future use of the water resources.The Illinois, Fox, and Vermilion Rivers are the primary surface-water bodies in LaSalle County. These and other surface-water bodies are used for wastewater disposal in the county. The Vermilion River is used as a drinking-water supply in the southern part of the county. Water from the Illinois and Fox Rivers also is used for the generation of electric power.Glacial drift aquifers capable of yielding sufficient water for public supply are expected to be present in the Illinois River Valley in the western part of the county, the Troy Bedrock Valley in the northwestern part of the county, and in the Ticona Bedrock Valley in the south-central part of the county. Glacial drift aquifers capable of yielding sufficient water for residential supply are present in most of the county, although well yield often needs to be improved by using large-diameter wells. Arsenic concentrations above health-based standards have been detected in some wells in this aquifer. These aquifers are a viable source for additional water supply in some areas, but would require further characterization prior to full development.Shallow bedrock deposits comprising the sandstone units of the Ancell Group, the Prairie du Chien Group, dolomite of the Galena and Platteville Groups, and Silurian-aged dolomite are utilized for water supply where these units are at or near the bedrock surface or where overlain by Pennsylvanian-aged deposits. The availability of water from the shallow bedrock deposits depends primarily on the geologic unit analyzed. All these deposits can yield sufficient water for

  20. Mortality, nutrition and health in Lofa County Liberia five years post-conflict.

    PubMed

    Doocy, Shannon; Lewy, Daniela; Guenther, Tanya; Larrance, Ryan

    2010-01-01

    Liberia remains in transition from a state of humanitarian emergency to development, and Lofa County was the epicentre of recent conflict. This study aimed to estimate mortality and malnutrition and evaluate access to health services, water and sanitation. The survey was conducted in April 2009 and employed a 46 cluster×20 design (n=920 households) with probability proportional to size sampling. The crude mortality rate was 24.3/1000/year (CI: 19.0 to 29.6) or 0.67/10,000/day (CI: 0.52 to 0.81). The global acute malnutrition rate was 7.9% (CI: 5.4 to 8.9), and the severe acute malnutrition rate was 4.5% (CI: 2.9 to 6.7). Access to basic health services was relatively good according to a variety of indicators; however, access to sanitation was low, with 39.5% of households reporting access to toilets or latrines. Despite high rates of displacement and infrastructure destruction, population health appears to be relatively stable 5 years post-conflict, though a continued focus on reconstruction and development is needed.

  1. County-level environmental quality and associations with individual - and county-level preterm birth

    EPA Science Inventory

    Human health is influenced by simultaneous exposure to stressors and amenities, but research usually considers single exposures. We constructed a county-level Environmental Quality Index (EQI) using principal components analysis with data from five domains (air, water, land, buil...

  2. LGBT health and vaccinations: Findings from a community health survey of Lexington-Fayette County, Kentucky, USA.

    PubMed

    Jones, Jeff; Poole, Asheley; Lasley-Bibbs, Vivian; Johnson, Mark

    2016-04-07

    Data on adult immunization coverage at the state level and for LGBT Americans in particular are sparse. This study reports the results of a 2012 Lexington-Fayette County, Kentucky, community health assessment's results asking about eight adult vaccinations among 218 lesbian, gay, bisexual, and transgendered (LGBT) respondents. Researchers collected data using an online survey distributed through LGBT social media, posters, and LGBT print media. The LGBT sample largely matches the demographics of the county as a whole except this group reports higher level of education and fewer uninsured individuals. Among LGBT respondents, immunization prevalence reaches 68.0% (annual Influenza), 65.7% (Hepatitis B), 58.8% (Chickenpox/Varicella), 55.9% (Hepatitis A), 41.2% (Smallpox), and 25.8% (Pneumonia). Among respondents who are currently within the recommended 19-26 years age range for the Human Papillomavirus (HPV) vaccine, the LGBT females are less likely to report receiving the vaccine (15.4%) compared to the national coverage percentage of 34.5%. Males, however, are more likely to have received the vaccine (10.3%) than the national percentage of 2.3%. The small number of LGBT seniors in the study report a much higher prevalence of the Shingles (Herpes Zoster) vaccines than for U.S. seniors 60 and older (71.4% compared to 20.1% nationally). LGBT respondents report higher percentages of adult vaccination. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. A Comparative Analysis of the Validity of US State- and County-Level Social Capital Measures and Their Associations with Population Health

    PubMed Central

    Lee, Chul-joo; Kim, Daniel

    2014-01-01

    The goals of this study were to validate a number of available collective social capital measures at the U.S. state and county levels, and to examine the relative extent to which these social capital measures are associated with population health outcomes. Measures of social capital at the U.S. state level included aggregate indices based on the Annenberg National Health Communication Survey (ANHCS) and the Behavioral Risk Factor Surveillance System (BRFSS), Petris Social Capital Index (PSCI), Putnam’s index, and Kim et al.’s scales. County-level measures consisted of Rupasingha et al.’s social capital index (RGFI) and a BRFSS-derived measure. These measures, except for the PSCI, showed evidence of acceptable validity. Moreover, we observed differences across the social capital measures in their associations with population health outcomes. The implications of the findings for future research in this area are discussed. PMID:25574069

  4. Mental Health Outcomes Among Adults in Galveston and Chambers Counties After Hurricane Ike

    PubMed Central

    Ruggiero, Kenneth J.; Gros, Kirstin; McCauley, Jenna L.; Resnick, Heidi S.; Morgan, Mark; Kilpatrick, Dean G.; Muzzy, Wendy; Acierno, Ron

    2014-01-01

    Objective To examine the mental health effects of Hurricane Ike, the third costliest hurricane in US history, which devastated the upper Texas coast in September 2008. Method Structured telephone interviews assessing immediate effects of Hurricane Ike (damage, loss, displacement) and mental health diagnoses were administered via random digit-dial methods to a household probability sample of 255 Hurricane Ike–affected adults in Galveston and Chambers counties. Results Three-fourths of respondents evacuated the area because of Hurricane Ike and nearly 40% were displaced for at least one week. Postdisaster mental health prevalence estimates were 5.9% for posttraumatic stress disorder, 4.5% for major depressive episode, and 9.3% for generalized anxiety disorder. Bivariate analyses suggested that peritraumatic indicators of hurricane exposure severity—such as lack of adequate clean clothing, electricity, food, money, transportation, or water for at least one week—were most consistently associated with mental health problems. Conclusions The significant contribution of factors such as loss of housing, financial means, clothing, food, and water to the development and/or maintenance of negative mental health consequences highlights the importance of systemic postdisaster intervention resources targeted to meet basic needs in the postdisaster period. PMID:22490934

  5. Mental health outcomes among adults in Galveston and Chambers counties after Hurricane Ike.

    PubMed

    Ruggiero, Kenneth J; Gros, Kirstin; McCauley, Jenna L; Resnick, Heidi S; Morgan, Mark; Kilpatrick, Dean G; Muzzy, Wendy; Acierno, Ron

    2012-03-01

      To examine the mental health effects of Hurricane Ike, the third costliest hurricane in US history, which devastated the upper Texas coast in September 2008.   Structured telephone interviews assessing immediate effects of Hurricane Ike (damage, loss, displacement) and mental health diagnoses were administered via random digit-dial methods to a household probability sample of 255 Hurricane Ike-affected adults in Galveston and Chambers counties.   Three-fourths of respondents evacuated the area because of Hurricane Ike and nearly 40% were displaced for at least one week. Postdisaster mental health prevalence estimates were 5.9% for posttraumatic stress disorder, 4.5% for major depressive episode, and 9.3% for generalized anxiety disorder. Bivariate analyses suggested that peritraumatic indicators of hurricane exposure severity-such as lack of adequate clean clothing, electricity, food, money, transportation, or water for at least one week-were most consistently associated with mental health problems.   The significant contribution of factors such as loss of housing, financial means, clothing, food, and water to the development and/or maintenance of negative mental health consequences highlights the importance of systemic postdisaster intervention resources targeted to meet basic needs in the postdisaster period.

  6. A Bone Health Intervention for Chinese Immigrants in Santa Clara County.

    PubMed

    Zou, Joanne; Hampton, Michelle DeCoux; Shade, Kate; Kaku, Leonard

    Among Chinese immigrants, osteoporosis is undertreated, misdiagnosed, and a leading cause of fragility fractures. In orthopaedic surgery departments, prevention education and health behavior change programs are necessary to improve their bone health. The purpose of this study was to examine the effectiveness of an osteoporosis prevention education program on participants' self-efficacy with regard to exercise and nutrition when provided by an orthopaedic surgery team during an annual Chinese Health Fair in Santa Clara County, CA. This pilot study used a single-group pretest and posttest design. Chinese immigrants at risk of osteoporosis were recruited during a 1-day health fair. The Bone Health Intervention (BHI) included orthopaedic surgeon consultation, visual aids including osteoporosis images and bone models, a video that included a discussion on calcium and vitamin D in the Chinese diet and culturally-acceptable exercise, and osteoporosis educational handouts. The Osteoporosis Self-Efficacy Scale (OSES) was utilized to measure participants' confidence in the ability to participate in self-care behaviors related to physical activity and calcium intake before and after the intervention. Paired t tests were used to compare participants' OSES scores pre- and postintervention. There was a significant increase in mean OSES scores postintervention, indicating that the intervention could be an effective method of increasing participants' self-efficacy regarding calcium intake and time spent in exercising. These results indicate that a culturally meaningful education program can potentially reduce fragility fracture risk. Orthopaedic health providers are ideal candidates to deliver preventive care education to improve outcomes for Chinese immigrants.

  7. Ten dimensions of health and their relationships with overall self-reported health and survival in a predominately religiously active elderly population: the cache county memory study.

    PubMed

    Østbye, Truls; Krause, Katrina M; Norton, Maria C; Tschanz, JoAnn; Sanders, Linda; Hayden, Kathleen; Pieper, Carl; Welsh-Bohmer, Kathleen A

    2006-02-01

    To document the extent of healthy aging along 10 different dimensions in a population known for its longevity. A cohort study with baseline measures of overall self-reported health and health along 10 specific dimensions; analyses investigated the 10 dimensions as predictors of self-reported health and 10-year mortality. Cache County, Utah, which is among the areas with the highest conditional life expectancy at age 65 in the United States. Inhabitants of Cache County aged 65 and older (January 1, 1995). Self-reported overall health and 10 specific dimensions of healthy aging: independent living, vision, hearing, activities of daily living, instrumental activities of daily living, absence of physical illness, cognition, healthy mood, social support and participation, and religious participation and spirituality. This elderly population was healthy overall. With few exceptions, 80% to 90% of persons aged 65 to 75 were healthy according to each measure used. Prevalence of excellent and good self-reported health decreased with age, to approximately 60% in those aged 85 and older. Even in the oldest old, the majority of respondents were independent in activities of daily living. Although vision, hearing, and mood were significant predictors of overall self-reported health in the final models, age, sex, and cognition were significant only in the final survival models. This population has a high prevalence of most factors representing healthy aging. The predictors of overall self-reported health are distinct from the predictors of survival in this age group and, being potentially modifiable, are amenable to clinical and public health efforts.

  8. Combining the benefits of decision science and financial analysis in public health management: a county-specific budgeting and planning model.

    PubMed

    Fos, Peter J; Miller, Danny L; Amy, Brian W; Zuniga, Miguel A

    2004-01-01

    State public health agencies are charged with providing and overseeing the management of basic public health services on a population-wide basis. These activities have a re-emphasized focus as a result of the events of September 11, 2001, the subsequent anthrax events, and the continuing importance placed on bioterrorism preparedness, West Nile virus, and emerging infectious diseases (eg, monkeypox, SARS). This has added to the tension that exists in budgeting and planning, given the diverse constituencies that are served in each state. State health agencies must be prepared to allocate finite resources in a more formal manner to be able to provide basic public health services on a routine basis, as well as during outbreaks. This article describes the use of an analytical approach to assist financial analysis that is used for budgeting and planning in a state health agency. The combined benefits of decision science and financial analysis are needed to adequately and appropriately plan and budget to meet the diverse needs of the populations within a state. Health and financial indicators are incorporated into a decision model, based on multicriteria decision theory, that has been employed to acquire information about counties and public health programs areas within a county, that reflect the impact of planning and budgeting efforts. This information can be used to allocate resources, to distribute funds for health care services, and to guide public health finance policy formulation and implementation.

  9. Informing rangeland stewardship with research: lessons learned from Yolo County, California

    Treesearch

    Vance Russell; Chris Rose; Miles DaPrato

    2008-01-01

    Approximately 70 percent of the contiguous United States is in private lands with half of this total in row crop or rangelands. Audubon California’s Landowner Stewardship Program engages with farmers and ranchers on conservation and restoration projects in a manner compatible with existing agricultural operations. To assess the success of these efforts, Audubon,...

  10. Suicides, mental health care and interdisciplinary specialised addiction services in the Agder counties 2004-13.

    PubMed

    Haaland, Vegard Øksendal; Bjørkholt, Marianne; Freuchen, Anne; Ness, Ewa; Walby, Fredrik A

    2017-10-03

    Most of those who commit suicide suffer from one or more mental disorders. We wished to identify the proportion that had been in contact with mental health care or interdisciplinary specialised addiction services during their lifetime and in the year prior to their death, and to describe characteristics of these patients. Information on suicides in the Agder counties in the years 2004–2013 was retrieved from the Cause of Death Registry. Patient records from Sørlandet Hospital were reviewed with the aid of a structured form. Altogether 329 suicides were included in the study. Of these, 66.6 % had at some point in life been in contact with mental health care or interdisciplinary specialised addiction services, 46.2 % during the year preceding their suicide. Altogether 28.6 % were actively undergoing treatment. The proportion who had been in contact in the preceding year tended to be lower among patients younger than 20 when compared to other age groups. Among those who had completed their treatment, there were more patients with adaptation disorder than in the group that remained in treatment; among those who remained in treatment there were more patients with psychotic disorders than among those who had completed their treatment. A higher proportion of those who committed suicide in the Agder counties were in contact with mental health care and interdisciplinary specialised addiction services than what has been found in equivalent international studies. The findings underscore the need to develop effective measures to prevent suicides in these groups of patients.

  11. [Computer usage among primary health care physicians in the Vukovar-Srijem County].

    PubMed

    Iveković, Hrvoje

    2002-01-01

    A survey was carried out, aiming at identification of the current usage of computers among primary health care physicians of the Vukovar-Srijem County. The results indicated poor knowledge and practice concerning the computer usage among examinees: 58% of the responders are not aware of the possibilities of computer usage in a GP office and 82% have not had an opportunity to see the software specialised for usage at GP offices. The results obtained from this survey indicate that none of the examinees use computer during daily routine work at the GP office. Only 26% of the examinees have got a computer, and use it at home, mostly for text processing. The Internet is used actively by 8% of examinees. Lack of education and equipment have been identified as main obstacles in the process of introducing computers to GP offices. Positive attitude towards computer usage has been identified, representing an important stimulus towards a more active role of the health centres management in solving this problem.

  12. A population study of Alzheimer's disease: findings from the Cache County Study on Memory, Health, and Aging.

    PubMed

    Tschanz, Joann T; Treiber, Katherine; Norton, Maria C; Welsh-Bohmer, Kathleen A; Toone, Leslie; Zandi, Peter P; Szekely, Christine A; Lyketsos, Constantine; Breitner, John C S

    2005-01-01

    There are several population-based studies of aging, memory, and dementia being conducted worldwide. Of these, the Cache County Study on Memory, Health and Aging is noteworthy for its large number of "oldest-old" members. This study, which has been following an initial cohort of 5,092 seniors since 1995, has reported among its major findings the role of the Apolipoprotein E gene on modifying the risk for Alzheimer's disease (AD) in males and females and identifying pharmacologic compounds that may act to reduce AD risk. This article summarizes the major findings of the Cache County study to date, describes ongoing investigations, and reports preliminary analyses on the outcome of the oldest-old in this population, the subgroup of participants who were over age 84 at the study's inception.

  13. National Weather Service, Emergency Medical Services, Scripps Institution of Oceanography/UCSD and California EPA Collaboration on Heat Health Impact and Public Notification for San Diego County

    NASA Astrophysics Data System (ADS)

    Tardy, A. O.; Corcus, I.; Guirguis, K.

    2015-12-01

    The National Weather Service (NWS) has issued official heat alerts in the form of either a heat advisory or excessive heat warning product to the public and core partners for many years. This information has traditionally been developed through the use of triggers for heat indices which combine humidity and temperature. The criteria typically used numeric thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality or population acclimation. In 2013, the Scripps Institution of Oceanography, University of California, San Diego in collaboration with the Office of Environmental Health Hazard Assessment, of the California Environmental Protection Agency and the NWS completed a study of heat health impact in California, while the NWS San Diego office began modifying their criteria towards departure from climatological normal with much less dependence on humidity or heat index. The NWS changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system which documents heat health impacts. Results from the UCSD study were finalized and published in 2014; they supported the need for significant modification of the traditional criteria. In order to better understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch, which is charged by the County's Public Health Officer to monitor heat-related illness and injury daily from June through September. The data were combined with UCSD research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, practices and procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services. The end result of the

  14. Recentralization within decentralization: County hospital autonomy under devolution in Kenya

    PubMed Central

    Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

    2017-01-01

    Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

  15. County-level racial prejudice and the black-white gap in infant health outcomes.

    PubMed

    Orchard, Jacob; Price, Joseph

    2017-05-01

    Black mothers are 60 percent more likely than white mothers to have preterm births and twice as likely to have a baby with low birth weight. We examine whether these black-white gaps in birth outcomes are larger in counties with higher levels of racial prejudice. We use data from the restricted-use natality files in the United States, which provide information on birth weight, gestation, and maternal characteristics for over 31 million births from 2002 to 2012, combined with county-level data measures of both explicit and implicit racial prejudice from Project Implicit from over a million individuals who took the Implicit Association Test during this same period. We compare counties that are one standard deviation above the mean (high prejudice) with those that are one standard deviation below the mean (low prejudice) in terms of their average level of racial prejudice. The black-white gap in low birth weight is 14 percent larger in counties with high implicit racial prejudice compared to counties with low prejudice. The black-white gap in preterm births is 29 percent larger in the high prejudice counties. The gaps are even larger when we use explicit measures of racial prejudice with high prejudice counties having a black-white gap that is 22 percent larger for low birth weight and 36 percent larger for preterm births. These relationships do not appear to be biased by the way the prejudice sample is constructed, since the racial gap in birth outcomes is unrelated to other county-level biases such as those based on gender or sexual orientation. The black-white gap in United States' birth outcomes is larger in those counties that have the highest levels of racial prejudice. This is true for both implicit and explicit racial prejudice, though the strength of the relationship is strongest for explicit racial prejudice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Demographic Norms for Metropolitan, Nonmetropolitan and Rural Counties. Mental Health Demographic Profile System Working Paper No. 24, July 1975.

    ERIC Educational Resources Information Center

    Goldsmith, Harold F.; And Others

    Utilizing 1970 census statistics for metropolitan, nonmetropolitan, rural, and "all" counties, this paper presents the selected percentile values for the 130 statistics (social indicators) in the Mental Health Demographic Profile System (the MHDPS is a system which allows the delineation of residential areas with common social rank, life…

  17. Identifying county characteristics associated with resident well-being: A population based study.

    PubMed

    Roy, Brita; Riley, Carley; Herrin, Jeph; Spatz, Erica S; Arora, Anita; Kell, Kenneth P; Welsh, John; Rula, Elizabeth Y; Krumholz, Harlan M

    2018-01-01

    Well-being is a positively-framed, holistic assessment of health and quality of life that is associated with longevity and better health outcomes. We aimed to identify county attributes that are independently associated with a comprehensive, multi-dimensional assessment of individual well-being. We performed a cross-sectional study examining associations between 77 pre-specified county attributes and a multi-dimensional assessment of individual US residents' well-being, captured by the Gallup-Sharecare Well-Being Index. Our cohort included 338,846 survey participants, randomly sampled from 3,118 US counties or county equivalents. We identified twelve county-level factors that were independently associated with individual well-being scores. Together, these twelve factors explained 91% of the variance in individual well-being scores, and they represent four conceptually distinct categories: demographic (% black); social and economic (child poverty, education level [health centers); and physical environment (% commuting by bicycle and by public transit). Twelve factors across social and economic, clinical care, and physical environmental county-level factors explained the majority of variation in resident well-being.

  18. Assessing climate change and health vulnerability at the local level: Travis County, Texas.

    PubMed

    Prudent, Natasha; Houghton, Adele; Luber, George

    2016-10-01

    We created a measure to help comprehend population vulnerability to potential flooding and excessive heat events using health, built environment and social factors. Through principal component analysis (PCA), we created non-weighted sum index scores of literature-reviewed social and built environment characteristics. We created baseline poor health measures using 1999-2005 age-adjusted cardiovascular and combined diabetes and hypertension mortality rates to correspond with social-built environment indices. We mapped US Census block groups by linked age-adjusted mortality and a PCA-created social-built environment index. The goal was to measure flooding and excessive heat event vulnerability as proxies for population vulnerability to climate change for Travis County, Texas. This assessment identified communities where baseline poor health, social marginalisation and built environmental impediments intersected. Such assessments may assist targeted interventions and improve emergency preparedness in identified vulnerable communities, while fostering resilience through the focus of climate change adaptation policies at the local level. No claim to original US government works. Journal compilation © 2016 Overseas Development Institute.

  19. Convolutional Neural Network-Based Embarrassing Situation Detection under Camera for Social Robot in Smart Homes

    PubMed Central

    Sheng, Weihua; Junior, Francisco Erivaldo Fernandes; Li, Shaobo

    2018-01-01

    Recent research has shown that the ubiquitous use of cameras and voice monitoring equipment in a home environment can raise privacy concerns and affect human mental health. This can be a major obstacle to the deployment of smart home systems for elderly or disabled care. This study uses a social robot to detect embarrassing situations. Firstly, we designed an improved neural network structure based on the You Only Look Once (YOLO) model to obtain feature information. By focusing on reducing area redundancy and computation time, we proposed a bounding-box merging algorithm based on region proposal networks (B-RPN), to merge the areas that have similar features and determine the borders of the bounding box. Thereafter, we designed a feature extraction algorithm based on our improved YOLO and B-RPN, called F-YOLO, for our training datasets, and then proposed a real-time object detection algorithm based on F-YOLO (RODA-FY). We implemented RODA-FY and compared models on our MAT social robot. Secondly, we considered six types of situations in smart homes, and developed training and validation datasets, containing 2580 and 360 images, respectively. Meanwhile, we designed three types of experiments with four types of test datasets composed of 960 sample images. Thirdly, we analyzed how a different number of training iterations affects our prediction estimation, and then we explored the relationship between recognition accuracy and learning rates. Our results show that our proposed privacy detection system can recognize designed situations in the smart home with an acceptable recognition accuracy of 94.48%. Finally, we compared the results among RODA-FY, Inception V3, and YOLO, which indicate that our proposed RODA-FY outperforms the other comparison models in recognition accuracy. PMID:29757211

  20. Convolutional Neural Network-Based Embarrassing Situation Detection under Camera for Social Robot in Smart Homes.

    PubMed

    Yang, Guanci; Yang, Jing; Sheng, Weihua; Junior, Francisco Erivaldo Fernandes; Li, Shaobo

    2018-05-12

    Recent research has shown that the ubiquitous use of cameras and voice monitoring equipment in a home environment can raise privacy concerns and affect human mental health. This can be a major obstacle to the deployment of smart home systems for elderly or disabled care. This study uses a social robot to detect embarrassing situations. Firstly, we designed an improved neural network structure based on the You Only Look Once (YOLO) model to obtain feature information. By focusing on reducing area redundancy and computation time, we proposed a bounding-box merging algorithm based on region proposal networks (B-RPN), to merge the areas that have similar features and determine the borders of the bounding box. Thereafter, we designed a feature extraction algorithm based on our improved YOLO and B-RPN, called F-YOLO, for our training datasets, and then proposed a real-time object detection algorithm based on F-YOLO (RODA-FY). We implemented RODA-FY and compared models on our MAT social robot. Secondly, we considered six types of situations in smart homes, and developed training and validation datasets, containing 2580 and 360 images, respectively. Meanwhile, we designed three types of experiments with four types of test datasets composed of 960 sample images. Thirdly, we analyzed how a different number of training iterations affects our prediction estimation, and then we explored the relationship between recognition accuracy and learning rates. Our results show that our proposed privacy detection system can recognize designed situations in the smart home with an acceptable recognition accuracy of 94.48%. Finally, we compared the results among RODA-FY, Inception V3, and YOLO, which indicate that our proposed RODA-FY outperforms the other comparison models in recognition accuracy.

  1. Cost of chronic disease in California: estimates at the county level.

    PubMed

    Brown, Paul M; Gonzalez, Mariaelena; Dhaul, Ritem Sandhu

    2015-01-01

    An estimated 39% of people in California suffer from at least one chronic condition or disease. While the increased coverage provided by the Affordable Care Act will result in greater access to primary health care, coordinated strategies are needed to prevent chronic conditions. To identify cost-effective strategies, local health departments and other agencies need accurate information on the costs of chronic conditions in their region. To present a methodology for estimating the cost of chronic conditions for counties. Estimates of the attributable cost of 6 chronic conditions-arthritis, asthma, cancer, cardiovascular disease, diabetes, and depression-from the Centers for Disease Control and Prevention's Chronic Disease Cost Calculator were combined with prevalence rates from the various sources and census data for California counties to estimate the number of cases and costs of each condition. The estimates were adjusted for differences in prices using Medicare geographical adjusters. An estimated $98 billion is currently spent on treating chronic conditions in California. There is significant variation between counties in the percentage of total health care expenditure due to chronic conditions and county size, ranging from a low 32% to a high of 63%. The variations between counties result from differing rates of chronic conditions across age, ethnicity, and gender. Information on the cost of chronic conditions is important for planning prevention and control efforts. This study demonstrates a method for providing local health departments with estimates of the scope of the problems in their region. Combining the cost estimates with information on current prevention strategies can identify gaps in prevention activities and the prevention measures that promise the greatest return on investment for each county.

  2. Cholera outbreak in Homa Bay County, Kenya, 2015.

    PubMed

    Githuku, Jane Njoki; Boru, Waqo Gufu; Hall, Casey Daniel; Gura, Zeinab; Oyugi, Elvis; Kishimba, Rogath Saika; Semali, Innocent; Farhat, Ghada Nadim; Mattie Park, Meeyoung

    2017-01-01

    Cholera is among the re-emerging diseases in Kenya. Beginning in December 2014, a persistent outbreak occurred involving 29 out of the 47 countries. Homa Bay County in Western Kenya was among the first counties to report cholera cases from January to April 2015. This case study is based on an outbreak investigation conducted by FELTP residents in Homa Bay County in February 2015. It simulates an outbreak investigation including laboratory confirmation, active case finding, descriptive epidemiology and implementation of control measures. This case study is designed for the training of basic level field epidemiology trainees or any other health care workers working in public health-related fields. It can be administered in 2-3 hours. Used as adjunct training material, the case study provides the trainees with competencies in investigating an outbreak in preparation for the actual real-life experience of such outbreaks.

  3. Radon in the ground water of Chester County, Pennsylvania

    USGS Publications Warehouse

    Sloto, Ronald A.; Senior, Lisa A.

    1998-01-01

    IntroductionA study of the occurrence and distribution of dissolved radon in the ground water of Chester County was undertaken by the U.S. Geological Survey (USGS) in cooperation with the Chester County Water Resources Authority and the Chester County Health Depart-ment. The results of this study are published in a technical report by Senior (1998). This fact sheet summarizes the key findings pre-sented in the technical report. Much of the background information on radon was taken from Lindsey and Ator.

  4. Mercury cycling in agricultural and managed wetlands, Yolo Bypass, California: Spatial and seasonal variations in water quality

    USGS Publications Warehouse

    Alpers, Charles N.; Fleck, Jacob A.; Marvin-DiPasquale, Mark C.; Stricker, Craig A.; Stephenson, Mark; Taylor, Howard E.

    2014-01-01

    The seasonal and spatial variability of water quality, including mercury species, was evaluated in agricultural and managed, non-agricultural wetlands in the Yolo Bypass Wildlife Area, an area managed for multiple beneficial uses including bird habitat and rice farming. The study was conducted during an 11-month period (June 2007 to April 2008) that included a summer growing season and flooded conditions during winter. Methylmercury (MeHg) concentrations in surface water varied over a wide range (0.1 to 37 ng L−1 unfiltered; 0.04 to 7.3 ng L−1 filtered). Maximum MeHg values are among the highest ever recorded in wetlands. Highest MeHg concentrations in unfiltered surface water were observed in drainage from wild rice fields during harvest (September 2007), and in white rice fields with decomposing rice straw during regional flooding (February 2008). The ratio of MeHg to total mercury (MeHg/THg) increased about 20-fold in both unfiltered and filtered water during the growing season (June to August 2007) in the white and wild rice fields, and about 5-fold in fallow fields (July to August 2007), while there was little to no change in MeHg/THg in the permanent wetland. Sulfate-bearing fertilizer had no effect on Hg(II) methylation, as sulfate-reducing bacteria were not sulfate limited in these agricultural wetlands. Concentrations of MeHg in filtered and unfiltered water correlated with filtered Fe, filtered Mn, DOC, and two indicators of sulfate reduction: the SO4 2 −/Cl− ratio, and δ34S in aqueous sulfate. These relationships suggest that microbial reduction of SO4 2−, Fe(III), and possibly Mn(IV) may contribute to net Hg(II)-methylation in this setting.

  5. Behavioral and community correlates of adolescent pregnancy and Chlamydia rates in rural counties in Minnesota.

    PubMed

    Kozhimannil, Katy B; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

    2015-06-01

    Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Pregnancy and chlamydia infection rates among 15-19 year-old females were compared across Minnesota's 87 counties, stratified by rural/urban designations. Regression models for rural counties (n = 66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study.

  6. Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US

    PubMed Central

    Stamatakis, Katherine A.; Leatherdale, Scott T.; Marx, Christine; Yan, Yan; Colditz, Graham A.; Brownson, Ross C.

    2013-01-01

    Context The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. Objective This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs. Design Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering. Setting 2,300 local health department jurisdictions defined with respect to county boundaries Participants Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. Main Outcome Measures Likelihood of having obesity prevention activities and association with area-level obesity prevalence Results The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. Conclusions This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance. PMID:22836530

  7. Health hazard evaluation report HETA 97-0115-2718, Northwest Airlines, Wayne County Airport

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

    Roegner, K.C.; Baron, S.

    1998-12-01

    On February 21, 1997, the National Institute for Occupational Safety and Health (NIOSH) received a request from Northwest Airlines (NWA) customer service agents (CSAs) to investigate ongoing health complaints among NWA employees at Wayne County Airport in Detroit, Michigan. Employees expressed concern that certain symptoms such as difficulty breathing, headache, fatigue, nausea, and miscarriages may be related to the indoor environmental quality (IEQ) at the airport. The requesters identified several agents of concern including malodorous sewer gas, carbon monoxide, carbon dioxide, and glycols. In response to the request, NIOSH investigators reviewed the results of previous IEQ investigations conducted at themore » airport and visited the airport on February 9-10, 1998. NIOSH investigators focused on those agents which were of the greatest concern to employees and to which exposure seemed plausible. These included measurements of CO and odors. NIOSH also sought to better understand the types and patterns of symptoms experienced by CSAs.« less

  8. Estimating the potential health impact and costs of implementing a local policy for food procurement to reduce the consumption of sodium in the county of Los Angeles.

    PubMed

    Gase, Lauren N; Kuo, Tony; Dunet, Diane; Schmidt, Steven M; Simon, Paul A; Fielding, Jonathan E

    2011-08-01

    We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629,724 in direct health care costs. Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow.

  9. County-level correlation between adult obesity rates and prevalence of dentists.

    PubMed

    Holzer, Jessica; Canavan, Maureen; Bradley, Elizabeth

    2014-09-01

    Investigators of previous studies regarding the correlation between area-level health care resources and obesity have not examined the association between the prevalence of dentists and rates of adult obesity. The authors conducted a study to address that knowledge gap. Using data compiled in the Robert Wood Johnson County Health Rankings and Roadmaps database, the authors conducted multivariable analyses of the relationship between the prevalence of dentists (from the 2011 Health Resources and Services Administration Area Resource File) and rates of obesity within counties. The authors controlled for prevalence of primary care providers, measures of the built environment (for example, number of recreational facilities per 10,000 population, the percentage of restaurants serving fast food) and county-level sociodemographic and economic factors. When the authors conducted a multivariable analysis adjusted for state-level fixed effects, they found that having one additional dentist per 10,000 population was associated significantly with a 1-percentage point reduction in the rate of obesity (P < .001). This effect was significantly larger in counties in which 25 percent of children or more (versus less than 25 percent of children) lived in poverty and in counties that had more primary care physicians per 10,000 population (P ≤ .009). The association between the prevalence of dentists and obesity, even after adjusting for primary care resources and sociodemographic factors, was evident. Although these data could not be used to assess causality, given the strength of the ecological, cross-sectional association, additional research involving person-level, longitudinal data is warranted. The correlation between the prevalence of dentists and obesity rates highlights the potential for dental professionals, as well as other primary care providers, to provide meaningful health education and support for improved nutritional behaviors, although the increased obesity rates in

  10. Adoption and implementation of a computer-delivered HIV/STD risk-reduction intervention for African American adolescent females seeking services at county health departments: implementation optimization is urgently needed.

    PubMed

    DiClemente, Ralph J; Bradley, Erin; Davis, Teaniese L; Brown, Jennifer L; Ukuku, Mary; Sales, Jessica M; Rose, Eve S; Wingood, Gina M

    2013-06-01

    Although group-delivered HIV/sexually transmitted disease (STD) risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across 8 participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding, and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics.

  11. Adoption and Implementation of a Computer-delivered HIV/STD Risk-Reduction Intervention for African American Adolescent Females Seeking Services at County Health Departments: Implementation Optimization is Urgently Needed

    PubMed Central

    DiClemente, Ralph J.; Bradley, Erin; Davis, Teaniese L.; Brown, Jennifer L.; Ukuku, Mary; Sales, Jessica M.; Rose, Eve S.; Wingood, Gina M.

    2013-01-01

    Although group-delivered HIV/STD risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across eight participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics. PMID:23673891

  12. California's county hospitals and the University of California graduate medical education system. Current issues and future directions.

    PubMed

    Jameson, W J; Pierce, K; Martin, D K

    1998-05-01

    California's county hospitals train 45% of the state's graduate medical residents, including 33% of residents in the University of California system. This paper describes the interrelationships of California's county hospitals and the University of California (UC) graduate medical education (GME) programs, highlighting key challenges facing both systems. The mission of California's county health care systems is to serve all who need health care services regardless of ability to pay. Locating UC GME programs in county hospitals helps serve the public missions of both institutions. Such partnerships enhance the GME experience of UC residents, provide key primary care training opportunities, and ensure continued health care access for indigent and uninsured populations. Only through affiliation with university training programs have county hospitals been able to run the cost-effective, quality programs that constitute an acceptable safety net for the poor. Financial stress, however, has led county hospitals and UC's GME programs to advocate for reform in both GME financing and indigent care funding. County hospitals must participate in constructing strategies for GME reform to assure that GME funding mechanisms provide for equitable compensation of county hospitals' essential role. Joint advocacy will also be essential in achieving significant indigent care policy reform.

  13. The Los Angeles County Community Disaster Resilience Project - a community-level, public health initiative to build community disaster resilience.

    PubMed

    Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

    2014-08-19

    Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest-posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  14. Behavioral and Community Correlates of Adolescent Pregnancy and Chlamydia Rates in Rural Counties in Minnesota1

    PubMed Central

    Kozhimannil, Katy B.; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

    2014-01-01

    Purpose Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Methods Pregnancy and chlamydia infection rates among 15–19 year-old females were compared across Minnesota’s 87 counties, stratified by rural/urban designations. Regression models for rural counties (n=66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Findings Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. Conclusions This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study. PMID:25344773

  15. The effects on population health status of using dedicated property taxes to fund local public health agencies

    PubMed Central

    2011-01-01

    Background In the United States, a dedicated property tax describes the legal authority given to a local jurisdiction to levy and collect a tax for a specific purpose. We investigated for an association of locally dedicated property taxes to fund local public health agencies and improved health status in the eight states designated as the Mississippi Delta Region. Methods We analyzed the difference in health outcomes of counties with and without a dedicated public health tax after adjusting for a set of control variables using regression models for county level data from 720 counties of the Mississippi Delta Region. Results Levying a dedicated public health tax for counties with per capita income above $28,000 is associated with improved health outcomes of those counties when compared to counties without a dedicated property tax for public health. Alternatively, levying a dedicated property tax in counties with lower per capita income is associated with poor health outcomes. Conclusions There are both positive and negative consequences of using dedicated property taxes to fund public health. Policymakers should carefully examine both the positive association of improved health outcomes and negative impact of taxation on poor populations before authorizing the use of dedicated local property tax levies to fund public health agencies. PMID:21672231

  16. The effects on population health status of using dedicated property taxes to fund local public health agencies.

    PubMed

    Honoré, Peggy A; Fos, Peter J; Wang, Xueyuan; Moonesinghe, Ramal

    2011-06-14

    In the United States, a dedicated property tax describes the legal authority given to a local jurisdiction to levy and collect a tax for a specific purpose. We investigated for an association of locally dedicated property taxes to fund local public health agencies and improved health status in the eight states designated as the Mississippi Delta Region. We analyzed the difference in health outcomes of counties with and without a dedicated public health tax after adjusting for a set of control variables using regression models for county level data from 720 counties of the Mississippi Delta Region. Levying a dedicated public health tax for counties with per capita income above $28,000 is associated with improved health outcomes of those counties when compared to counties without a dedicated property tax for public health. Alternatively, levying a dedicated property tax in counties with lower per capita income is associated with poor health outcomes. There are both positive and negative consequences of using dedicated property taxes to fund public health. Policymakers should carefully examine both the positive association of improved health outcomes and negative impact of taxation on poor populations before authorizing the use of dedicated local property tax levies to fund public health agencies.

  17. Perceptions of Global Warming Among the Poorest Counties in the Southeastern United States.

    PubMed

    Kearney, Gregory D; Bell, Ronny A

    2018-03-07

    The geographic position and high level of poverty in the southeastern United States are significant risk factors that contribute to the region's high vulnerability to climate change. The goal of this study was to evaluate beliefs and perceptions of global warming among those living in poverty in the poorest counties in the southeastern United States. Results from this project may be used to support public health efforts to increase climate-related messaging to vulnerable and underserved communities. This was an ecological study that analyzed public opinion poll estimates from previously gathered national level survey data (2016). Responses to 5 questions related to beliefs, attitudes, and perceptions of global warming were evaluated. Counties below the national average poverty level (13.5%) were identified among 11 southeastern US states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Michigan, North Carolina, South Carolina, Tennessee, Virginia). Student t tests were used to compare public perceptions of global warming among the poorest urban and rural counties with national-level public opinion estimates. Overall, counties below the national poverty level in the southeastern US were significantly less likely to believe that global warming was happening compared with national-level estimates. The poorest rural counties were less likely to believe that global warming was happening than the poorest urban counties. Health care providers and public health leaders at regional and local levels are in ideal positions to raise awareness and advocate the health implications of climate change to decision makers for the benefit of helping underserved communities mitigate and adequately adapt to climate-related threats.

  18. Health assessment for Kaiser Steel Corporation Fontana, San Nernadino County, California, Region 9. CERCLIS No. CAD008274938. Preliminary report

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

    Not Available

    1989-10-25

    The Kaiser Steel Corporation (KSC) site was included in the Update 7, proposed National Priorities List (NPL). The site was subsequently dropped from the proposed NPL on October 4, 1989. The site is located near Fontana, California, in San Bernardino County, approximately 45 miles east of Los Angeles. The on-site environmental contamination in groundwater and soil consisted of volatile organic compounds, organic acids, aluminum, barium, iron, lead, manganese, cadmium, and chromium compounds. The site is of potential health concern because of the risk to human health resulting from possible exposure to hazardous substances at concentrations that may result in adversemore » health effects.« less

  19. An Innovative Community-Based Model for Improving Preventive Care in Rural Counties

    PubMed Central

    Scheid, Dewey; Zhao, Daniel; Mishra, Bhawani; Greever-Rice, Tracy

    2017-01-01

    Objectives This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices located in a rural county in Oklahoma. A Wellness Coordinator (WC) working with primary care practices (PCPs), the county health department, the county hospital, and a health information exchange (HIE) organization helped county residents receive evidence-based preventive services. Methods The WC used a community wellness registry connected to electronic medical records via HIE and called patients at the county level based on PCP-prioritized and tailored protocols. The registry flagged patient-level preventive care gaps, tracked outreach efforts, and documented the delivery of preventive services throughout the community. Return on investment (ROI) for prioritized preventive services was estimated in participating organizations. Results Six of the seven primary care practices in the county expressed interest in the project. Three of these practices fully implemented the 1-year outreach program starting in mid-2015. The regional HIE supplied periodic data updates for 9,138 county residents to help the coordinators address care gaps using the community registry. A total of 5,034 outreach calls were made by the WC in the first year and 7,776 prioritized recommendations were offered when care gaps were detected. Of the 5,034 distinct patients who received a call, 1146 (22%) were up-to-date on all prioritized services, while 3,888 (78%) were due for at least one of the selected services. Healthcare organizations in the county significantly improved the delivery of selected preventive services (mean increase: 35% across 10 services; p= 0.004; range: 3% to 215%) and realized a mean ROI of 80% for these services (range: 32% to 122%). The health system that employed the WC earned an estimated revenue of $52,000 realizing a 40% ROI for the coordinator position. Conclusions

  20. Explaining large mortality differences between adjacent counties: a cross-sectional study.

    PubMed

    Schootman, M; Chien, L; Yun, S; Pruitt, S L

    2016-08-02

    Extensive geographic variation in adverse health outcomes exists, but global measures ignore differences between adjacent geographic areas, which often have very different mortality rates. We describe a novel application of advanced spatial analysis to 1) examine the extent of differences in mortality rates between adjacent counties, 2) describe differences in risk factors between adjacent counties, and 3) determine if differences in risk factors account for the differences in mortality rates between adjacent counties. We conducted a cross-sectional study in Missouri, USA with 2005-2009 age-adjusted all-cause mortality rate as the outcome and county-level explanatory variables from a 2007 population-based survey. We used a multi-level Gaussian model and a full Bayesian approach to analyze the difference in risk factors relative to the difference in mortality rates between adjacent counties. The average mean difference in the age-adjusted mortality rate between any two adjacent counties was -3.27 (standard deviation = 95.5) per 100,000 population (maximum = 258.80). Six variables were associated with mortality differences: inability to obtain medical care because of cost (β = 2.6), hospital discharge rate (β = 1.03), prevalence of fair/poor health (β = 2.93), and hypertension (β = 4.75) and poverty prevalence (β = 6.08). Examining differences in mortality rates and associated risk factors between adjacent counties provides additional insight for future interventions to reduce geographic disparities.

  1. "We are toothless and hanging, but optimistic": sub county managers' experiences of rapid devolution in coastal Kenya.

    PubMed

    Nyikuri, Mary M; Tsofa, Benjamin; Okoth, Philip; Barasa, Edwine W; Molyneux, Sassy

    2017-09-15

    In March 2013, Kenya transitioned from a centralized to a devolved system of governance. Within the health sector, this entailed the transfer of service provision functions to 47 newly formed semi-autonomous counties, while policy and regulatory functions were retained at the national level. The devolution process was rapid rather than progressive. We conducted qualitative research within one county to examine the early experiences of devolution in the health sector. We specifically focused on the experience of change from the perspective of sub-county managers, who form the link between county level managers and health facility managers. We collected data by observing a diverse range of management meetings, support supervision visits and outreach activities involving sub-county managers between May 2013 and June 2015, conducting informal interviews wherever we could. Informal observations and interviews were supplemented by fifteen tape recorded in depth interviews with purposively selected sub-county managers from three sub-counties. We found that sub county managers as with many other health system actors were anxious about and ill-prepared for the unexpectedly rapid devolution of health functions to the newly created county government. They experienced loss of autonomy and resources in addition to confused lines of accountability within the health system. However, they harnessed individual, team and stakeholder resources to maintain their jobs, and continued to play a central role in supporting peripheral facility managers to cope with change. Our study illustrates the importance in accelerated devolution contexts for: 1) mid-level managers to adopt new ways of working and engagement with higher and lower levels in the system; 2) clear lines of communication during reforms to these actors and 3) anticipating and managing the effect of change on intangible software issues such as trust and motivation. More broadly, we show the value of examining organisational

  2. Temperature, ozone, and mortality in urban and non-urban counties in the northeastern United States.

    PubMed

    Madrigano, Jaime; Jack, Darby; Anderson, G Brooke; Bell, Michelle L; Kinney, Patrick L

    2015-01-07

    Most health effects studies of ozone and temperature have been performed in urban areas, due to the available monitoring data. We used observed and interpolated data to examine temperature, ozone, and mortality in 91 urban and non-urban counties. Ozone measurements were extracted from the Environmental Protection Agency's Air Quality System. Meteorological data were supplied by the National Center for Atmospheric Research. Observed data were spatially interpolated to county centroids. Daily internal-cause mortality counts were obtained from the National Center for Health Statistics (1988-1999). A two-stage Bayesian hierarchical model was used to estimate each county's increase in mortality risk from temperature and ozone. We examined county-level associations according to population density and compared urban (≥1,000 persons/mile(2)) to non-urban (<1,000 persons/mile(2)) counties. Finally, we examined county-level characteristics that could explain variation in associations by county. A 10 ppb increase in ozone was associated with a 0.45% increase in mortality (95% PI: 0.08, 0.83) in urban counties, while this same increase in ozone was associated with a 0.73% increase (95% PI: 0.19, 1.26) in non-urban counties. An increase in temperature from 70°F to 90°F (21.2°C 32.2°C) was associated with a 8.88% increase in mortality (95% PI: 7.38, 10.41) in urban counties and a 8.08% increase (95% PI: 6.16, 10.05) in non-urban counties. County characteristics, such as population density, percentage of families living in poverty, and percentage of elderly residents, partially explained the variation in county-level associations. While most prior studies of ozone and temperature have been performed in urban areas, the impacts in non-urban areas are significant, and, for ozone, potentially greater. The health risks of increasing temperature and air pollution brought on by climate change are not limited to urban areas.

  3. Ground-water resources data for Baldwin County, Alabama

    USGS Publications Warehouse

    Robinson, James L.; Moreland, Richard S.; Clark, Amy E.

    1996-01-01

    Geologic and hydrologic data for 237 wells were collected, and water-levels in 223 wells in Baldwin and Escambia Counties were measured. Long-term water water-level data, available for many wells, indicate that ground-water levels in most of Baldwin County show no significant trends for the period of record. However, ground-water levels have declined in the general vicinity of Spanish Fort and Daphne, and ground-water levels in the Gulf Shores and Orange Beach areas are less than 5 feet above sea level in places. The quality of ground water generally is good, but problems with iron, sulfur, turbidity, and color occur. The water from most private wells in Baldwin County is used without treatment or filtration. Alabama public- health law requires that water from public-supply wells be chlorinated. Beyond that, the most common treatment of ground water by public-water suppliers in Baldwin County consists of pH adjustment, iron removal, and aeration. The transmissivity of the Miocene-Pliocene aquifer was determined at 10 locations in Baldwin County. Estimates of transmissivity ranged from 700 to 5,400 feet squared per day. In general, aquifer transmissivity was greatest in the southeastern part of the county, and least in the western part of the county near Mobile Bay. A storage coefficient of 1.5 x 10-3 was determined for the Miocene-Pliocene aquifer near Loxley.

  4. Public health assessment for Muskego Sanitary Landfill, Muskego, Waukesha County, Wisconsin, Region 5. Cerclis No. WID000713180. Final report

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

    Not Available

    1994-09-06

    The Muskego Sanitary Landfill site is situated within the City of Muskego, Waukesha County, in the State of Wisconsin. Muskego Sanitary Landfill is a former sand and gravel pit which received unspecified types and amounts of municipal and industrial wastes over a period of approximately 25 years. Muskego Sanitary Landfill site is a public health hazard because in the past some nearby residents probably drank private well water containing site-related contamination. The groundwater around the site might pose a future public health hazard if no further action were taken to clean up the site. Ambient air near Muskego Sanitary Landfillmore » is an indeterminate public health hazard. Wisconsin's Department of Health and Social Services, Division of Health (DOH) recommends the continued monitoring of groundwater in the vicinity of the site.« less

  5. Influence of Urbanicity and County Characteristics on the Association between Ozone and Asthma Emergency Department Visits in North Carolina

    PubMed Central

    Rappold, Ana G.; Davis, J. Allen; Richardson, David B.; Waller, Anna E.; Luben, Thomas J.

    2014-01-01

    Background: Air pollution epidemiologic studies, often conducted in large metropolitan areas because of proximity to regulatory monitors, are limited in their ability to examine potential associations between air pollution exposures and health effects in rural locations. Methods: Using a time-stratified case-crossover framework, we examined associations between asthma emergency department (ED) visits in North Carolina (2006–2008), collected by a surveillance system, and short-term ozone (O3) exposures using predicted concentrations from the Community Multiscale Air Quality (CMAQ) model. We estimated associations by county groupings based on four urbanicity classifications (representative of county size and urban proximity) and county health. Results: O3 was associated with asthma ED visits in all-year and warm season (April–October) analyses [odds ratio (OR) = 1.019; 95% CI: 0.998, 1.040; OR = 1.020; 95% CI: 0.997, 1.044, respectively, for a 20-ppb increase in lag 0–2 days O3]. The association was strongest in Less Urbanized counties, with no evidence of a positive association in Rural counties. Associations were similar when adjusted for fine particulate matter in copollutant models. Associations were stronger for children (5–17 years of age) compared with other age groups, and for individuals living in counties identified with poorer health status compared with counties that had the highest health rankings, although estimated associations for these subgroups had larger uncertainty. Conclusions: Associations between short-term O3 exposures and asthma ED visits differed by overall county health and urbanicity, with stronger associations in Less Urbanized counties, and no positive association in Rural counties. Results also suggest that children are at increased risk of O3-related respiratory effects. Citation: Sacks JD, Rappold AG, Davis JA Jr, Richardson DB, Waller AE, Luben TJ. 2014. Influence of urbanicity and county characteristics on the association

  6. Mobilizing mobile medical units for hurricane relief: the United States Public Health Service and Broward County Health Department response to hurricane Wilma, Broward County, Florida.

    PubMed

    Taylor, Melanie M; Stokes, William S; Bajuscak, Ronald; Serdula, Mary; Siegel, Karen L; Griffin, Brian; Keiser, Jeffrey; Agate, Lisa; Kite-Powell, Aaron; Roach, David; Humbert, Nancy; Brusuelas, Kristin; Shekar, Sam S

    2007-01-01

    To describe the outcomes of a collaborative response of federal, state, county, and local agencies in conducting syndromic surveillance and delivering medical care to persons affected by the storm through the use of mobile medical units. Nine mobile medical vans were staffed with medical personnel to deliver care in communities affected by the storm. Individual patient encounter information was collected. A total of 14,033 housing units were approached and checked for occupants. Of residents with whom contact was made, approximately 10 percent required medical assessment in their homes; 3,218 clients were medically evaluated on the mobile medical vans. Sixty-two percent of clients were female. The most common presenting complaints included normal health maintenance (59%), upper respiratory tract illness (10%), and other illness (10%). Injuries occurred in 9 percent. A total of 1,531 doses of medications were dispensed from the mobile medical units during the response. Mobile medical units provided an efficient means to conduct syndromic surveillance and to reach populations in need of medical care who were unable to access fixed local medical facilities.

  7. Estimating the Potential Health Impact and Costs of Implementing a Local Policy for Food Procurement to Reduce the Consumption of Sodium in the County of Los Angeles

    PubMed Central

    Kuo, Tony; Dunet, Diane; Schmidt, Steven M.; Simon, Paul A.; Fielding, Jonathan E.

    2011-01-01

    Objectives. We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. Methods. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions’ potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. Results. Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629 724 in direct health care costs. Conclusions. Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow. PMID:21680933

  8. Building Partnerships: The Opportunities Ahead. The Report of the Panel on the Future Health and Vitality of the County Community Colleges.

    ERIC Educational Resources Information Center

    Shenker, Joseph; And Others

    Drawing from visits to all 19 two-year colleges in New Jersey and meetings with trustees, faculty, administrators, students, and other interested citizens, this report presents a series of recommendations for ensuring the future health and vitality of the state's county community colleges. First, introductory information is presented on the…

  9. Geology, water resources and usable ground-water storage capacity of part of Solano County, California

    USGS Publications Warehouse

    Thomasson, H.G.; Olmsted, F.H.; LeRoux, E.F.

    1960-01-01

    The area described is confined largely to the valley-floor and foothill lands of Solano County, which lies directly between Sacramento, the State capital, and San Francisco. The area is considered in two subareas: The Putah area, which extends from Putah Creek southward to the Montezuma Hills and from the foothills of the Coast Ranges eastward to the west edge of the Yolo Bypass; and the Suisun-Fairfield area, which is to the southwest in the notch in the Coast Ranges through which the waters of the Great Central Valley of California reach San Francisco Bay. There are no known hydrologic interconnections between the two subareas, through either surface streams or underground aquifers. The climate of the area is characterized by warm, rainless summers and by cool winters in which temperatures seldom drop much below freezing. The rainfall ranges from about 17 inches per year along the east side to perhaps 24 inches in the foothills to the west, and irrigation is necessary for all crops except dry-farmed grains, pastures, and some orchards. PUTAH AREA The Putah area occupies the southwestern corner of the Sacramento Valley, a topographic and structural basin underlain by a thick accumulation of sediments eroded from the surrounding hills and mountains by the Sacramento River and its tributaries. The eastern Coast Ranges and foothills lying west of the Sacramento Valley are a generally northward-trending belt of eastward-dipping sedimentary rocks that range in age from Cretaceous to Pleistocene. Successively younger strata are exposed eastward, and the essentially undeformed deposits of late Pleistocene and Recent age that immediately underlie the valley lap onto the tilted sediments of the foothills. Most of the streams of the Putah area rise east of the high ridge of Cretaceous rocks marking the western boundaries of Solano and Yolo Counties, but Putah Creek, the largest stream in the area, rises far west of that ridge and flows across it in a deep, narrow canyon

  10. The Forsyth County Cervical Cancer Prevention Project--I. Cervical cancer screening for black women.

    PubMed

    Dignan, M; Michielutte, R; Wells, H B; Bahnson, J

    1994-12-01

    The Forsyth County Cervical Cancer Prevention Project was a 5 year National Cancer Institute-funded community-based public health education program implemented to address the problem of excess mortality from cervical cancer among black women in Forsyth County, North Carolina. The intervention was a community-based public health education program that included mass media, direct education workshops, and provision of education on cervical cancer and screening to health care providers. The intervention was implemented from November 1988 to September 1991. Evaluation of the community intervention used a quasi-experimental design, with Forsyth County, North Carolina, receiving the program and Durham County, North Carolina, serving as the control. Comparison of pre- and post-intervention telephone survey data revealed that, overall, awareness of cervical cancer and the Pap smear increased. Knowledge, attitudes and behaviors showed little change, considering those interviewed in aggregate. Among women defined as high-risk (elderly, low socioeconomic status, public health clinic patients and/or those who do not receive regular care), a significant trend toward greater participation in screening was detected for the 6 month period following the intervention. These results suggest that awareness of cervical cancer can be increased by public health education, but that the additional attention coming to patients through the actions of health care providers and health care delivery systems may supply the additional input needed to produce behavior change.

  11. The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

    PubMed Central

    Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo

    2014-01-01

    Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR), a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports. PMID:25153472

  12. Case management to reduce risk of cardiovascular disease in a county health care system.

    PubMed

    Ma, Jun; Berra, Kathy; Haskell, William L; Klieman, Linda; Hyde, Shauna; Smith, Mark W; Xiao, Lan; Stafford, Randall S

    2009-11-23

    Case management (CM) is a systematic approach to supplement physician-centered efforts to prevent cardiovascular disease (CVD). Research is limited on its implementation and efficacy in low-income, ethnic minority populations. We conducted a randomized clinical trial to evaluate a nurse- and dietitian-led CM program for reducing major CVD risk factors in low-income, primarily ethnic minority patients in a county health care system, 63.0% of whom had type 2 diabetes mellitus. The primary outcome was the Framingham risk score (FRS). A total of 419 patients at elevated risk of CVD events were randomized and followed up for a mean of 16 months (81.4% retention). The mean FRS was significantly lower for the CM vs usual care group at follow-up (7.80 [95% confidence interval, 7.21-8.38] vs 8.93 [8.36-9.49]; P = .001) after adjusting for baseline FRS. This is equivalent to 5 fewer heart disease events per 1000 individuals per year attributable to the intervention or to 200 individuals receiving the intervention to prevent 1 event per year. The pattern of group differences in the FRS was similar in subgroups defined a priori by sex and ethnicity. The main driver of these differences was lowering the mean (SD) systolic (-4.2 [18.5] vs 2.6 [22.7] mm Hg; P = .003) and diastolic (-6.0 [11.6] vs -3.0 [11.7] mm Hg; P = .02) blood pressures for the CM vs usual care group. Nurse and dietitian CM targeting multifactor risk reduction can lead to modest improvements in CVD risk factors among high-risk patients in low-income, ethnic minority populations receiving care in county health clinics. clinicaltrials.gov Identifier: NCT00128687.

  13. New Mexico: Bernalillo County, Albuquerque (A Former EPA CARE Project)

    EPA Pesticide Factsheets

    The Bernalillo County Office of Environmental Health (BCEH) will help the South Valley neighborhood reduce health risks attributed to benzene and heavy metal exposures by conducting an environmental assessment of gasoline stations and auto dismantlers,

  14. The Alameda County Study: A Systematic, Chronological Review

    ERIC Educational Resources Information Center

    Housman, Jeff; Dorman, Steve

    2005-01-01

    This study is a systematic review of the Alameda County study findings and their importance in establishing a link between lifestyle and health outcomes. A systematic review of literature was performed and data indicating important links between lifestyle and health were synthesized. Although initial studies focused on the associations between…

  15. Availability of more healthful food alternatives in traditional, convenience, and nontraditional types of food stores in two rural Texas counties.

    PubMed

    Bustillos, Brenda; Sharkey, Joseph R; Anding, Jenna; McIntosh, Alex

    2009-05-01

    Limited research has focused on the availability of more healthful food alternatives in traditional food stores (supermarkets and grocery stores) in rural areas. Current market trends suggest that food items may be available for purchase in stores other than traditional food stores. An observational survey was developed and used on-site to document the availability and variety of fruit and vegetables (fresh, canned, and frozen), meats (meat, poultry, fish, and eggs), dairy (milk, yogurt, and cheese), and grains (whole grains and refined grains) in all traditional food stores, convenience stores, and nontraditional food stores (dollar stores and mass merchandisers) in two rural Texas counties. Descriptive statistics and t tests identified that although the widest selection of more healthful food items was available in supermarkets, not all supermarkets carried all items. Grocery stores carried less variety of fresh fruits (8+/-0.7 vs 4.7+/-0.3; P<0.01) and vegetables (10.7+/-0.2 vs 6+/-0; P<0.001) than supermarkets. Fresh fruits and vegetables were not readily available in convenience or nontraditional food stores. Among convenience and nontraditional food stores, "dollar" stores offered the best variety of more healthful canned fruits and vegetables, whole-wheat bread, and whole-grain cereal. Mass merchandisers and dollar stores offered a greater variety of more healthful types of canned tuna and poultry, reduced-fat and skim milk, and low-fat tortillas. In these rural counties, traditional food stores offered greater availability of more healthful food choices across food groups. More healthful food choices in canned fruits and vegetables, canned meat and fish, milk, and grains were also available in dollar stores, mass merchandisers, and convenience stores. Results suggest that a complete understanding of the food environment, especially in rural areas, requires knowledge of the availability and variety of healthful food in all types of stores that are accessible

  16. Socio-economic development and emotion-health connection revisited: a multilevel modeling analysis using data from 162 counties in China.

    PubMed

    Yu, Zonghuo; Wang, Fei

    2016-03-12

    Substantial research has shown that emotions play a critical role in physical health. However, most of these studies were conducted in industrialized countries, and it is still an open question whether the emotion-health connection is a "first-world problem". In the current study, we examined socio-economic development's influence on emotion-health connection by performing multilevel-modeling analysis in a dataset of 33,600 individuals from 162 counties in China. Results showed that both positive emotions and negative emotions predicted level of physical health and regional Gross Domestic Product Per Capita (GDPPC) had some impact on the association between emotion and health through accessibility of medical resources and educational status. But these impacts were suppressed, and the total effects of GDPPC on emotion-health connections were not significant. These results support the universality of emotion-health connection across levels of GDPPC and provide new insight into how socio-economic development might affect these connections.

  17. Description of water-resource-related data compiled for Reno County, south-central Kansas

    USGS Publications Warehouse

    Hansen, C.V.

    1993-01-01

    Water-resource-related data for sites in Reno County, Kansas were compiled in cooperation with the Reno County Health Department as part of the Kansas Department of Health and Environment's Local Environmental Protection Program (LEPP). These data were entered into a relational data-base management system (RDBMS) to facilitate the spatial analysis required to meet the LEPP goals of developing plans for nonpoint-source management and for public- water-supply protection. The data in the RDBMS are organized into digital data sets. The data sets contain the water-resource-related data compiled by the U.S. Geological Survey for 958 wells; by the Kansas Department of Health and Environment for 3,936 wells; by the Kansas Department of Health and Environment for 51 wells, 18 public-water-supply distribution systems, and 7 streams; by the Kansas State Board of Agriculture for 643 wells and 23 streams or surface-water impoundments; and by well-drilling contractors and the Kansas Geological Survey for 96 wells. The data in these five data sets are available from the Reno County Health Department in Hutchinson, Kansas. (USGS)

  18. Crisis & Commitment: 150 Years of Service by Los Angeles County Public Hospitals

    PubMed Central

    Cousineau, Michael R.; Tranquada, Robert E.

    2007-01-01

    The Los Angeles County University of Southern California Medical Center will open soon, replacing the county’s current 74-year-old facility with a modern, although smaller, facility. Los Angeles County has provided hospital care to the indigent since 1858, during which time, the operation of public hospitals has shifted from a state-mandated welfare responsibility to a preeminent part of the county’s public health mission. As this shift occurred, the financing of Los Angeles County hospitals changed from primarily county support to state and federal government sources, particularly Medicaid. The success of the new hospital will depend on whether government leaders at all levels provide the reforms needed to help the county and its partners stabilize its funding base. PMID:17329642

  19. How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project.

    PubMed

    Bromley, Elizabeth; Eisenman, David P; Magana, Aizita; Williams, Malcolm; Kim, Biblia; McCreary, Michael; Chandra, Anita; Wells, Kenneth B

    2017-10-21

    Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups ( n = 5) and interviews ( n = 6 coalition members; n = 16 facilitators) to compare coalitions' strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods.

  20. How Do Communities Use a Participatory Public Health Approach to Build Resilience? The Los Angeles County Community Disaster Resilience Project

    PubMed Central

    Bromley, Elizabeth; Eisenman, David P.; Magana, Aizita; Williams, Malcolm; Kim, Biblia; McCreary, Michael; Chandra, Anita; Wells, Kenneth B.

    2017-01-01

    Community resilience is a key concept in the National Health Security Strategy that emphasizes development of multi-sector partnerships and equity through community engagement. Here, we describe the advancement of CR principles through community participatory methods in the Los Angeles County Community Disaster Resilience (LACCDR) initiative. LACCDR, an initiative led by the Los Angeles County Department of Public Health with academic partners, randomized 16 community coalitions to implement either an Enhanced Standard Preparedness or Community Resilience approach over 24 months. Facilitated by a public health nurse or community educator, coalitions comprised government agencies, community-focused organizations and community members. We used thematic analysis of data from focus groups (n = 5) and interviews (n = 6 coalition members; n = 16 facilitators) to compare coalitions’ strategies for operationalizing community resilience levers of change (engagement, partnership, self-sufficiency, education). We find that strategies that included bidirectional learning helped coalitions understand and adopt resilience principles. Strategies that operationalized community resilience levers in mutually reinforcing ways (e.g., disseminating information while strengthening partnerships) also secured commitment to resilience principles. We review additional challenges and successes in achieving cross-sector collaboration and engaging at-risk groups in the resilience versus preparedness coalitions. The LACCDR example can inform strategies for uptake and implementation of community resilience and uptake of the resilience concept and methods. PMID:29065491

  1. Electronic Health Record (EHR)-Based Community Health Measures: An Exploratory Assessment of Perceived Usefulness by Local Health Departments.

    PubMed

    Comer, Karen F; Gibson, P Joseph; Zou, Jian; Rosenman, Marc; Dixon, Brian E

    2018-05-22

    Given the widespread adoption of electronic health record (EHR) systems in health care organizations, public health agencies are interested in accessing EHR data to improve health assessment and surveillance. Yet there exist few examples in the U.S. of governmental health agencies using EHR data routinely to examine disease prevalence and other measures of community health. The objective of this study was to explore local health department (LHD) professionals' perceptions of the usefulness of EHR-based community health measures, and to examine these perceptions in the context of LHDs' current access and use of sub-county data, data aggregated at geographic levels smaller than county. To explore perceived usefulness, we conducted an online survey of LHD professionals in Indiana. One hundred and thirty-three (133) individuals from thirty-one (31) LHDs participated. The survey asked about usefulness of specific community health measures as well as current access to and uses of sub-county population health data. Descriptive statistics were calculated to examine respondents' perceptions, access, and use. A one-way ANOVA (with pairwise comparisons) test was used to compare average scores by LHD size. Respondents overall indicated moderate agreement on which community health measures might be useful. Perceived usefulness of specific EHR-based community health measures varied by size of respondent's LHD [F(3, 88) = 3.56, p = 0.017]. Over 70% of survey respondents reported using community health data, but of those < 30% indicated they had access to sub-county level data. Respondents generally preferred familiar community health measures versus novel, EHR-based measures that are not in widespread use within health departments. Access to sub-county data is limited but strongly desired. Future research and development is needed as LHD staff gain access to EHR data and apply these data to support the core function of health assessment.

  2. A Comparative Analysis of the Validity of US State- and County-Level Social Capital Measures and Their Associations with Population Health

    ERIC Educational Resources Information Center

    Lee, Chul-Joo; Kim, Daniel

    2013-01-01

    The goals of this study were to validate a number of available collective social capital measures at the US state and county levels, and to examine the relative extent to which these social capital measures are associated with population health outcomes. Measures of social capital at the US state level included aggregate indices based on the…

  3. Impact of Income Inequality on the Nation's Health.

    PubMed

    López, Diego B; Loehrer, Andrew P; Chang, David C

    2016-10-01

    Income inequality in the United States has been increasing in recent decades. It is unclear whether income inequality has an independent effect on health outcomes, or whether it simply correlates with increasing levels of poverty. The goal of this study was to evaluate whether income inequality is significantly associated with US county health care expenditures and health care use. Cross-sectional analysis of county health expenditure data from the Health Resources and Services Administration's Area Resources File, county income inequality measures (Gini coefficient) from the Census' American Community Survey, and estimates of potentially preventable admissions and potentially discretionary procedures from the Nationwide Inpatient Sample (1998 to 2011). Datasets were linked via county Federal Information Processing Standard codes. Multivariable linear and Poisson regression analyses were performed at the county level adjusting for county characteristics. A total of 1,237 counties (of 3,144) were included. Income inequality was associated with higher health care expenditures, with each 1 percentage-point increase in county Gini coefficient associated with a US$40,008 increase in annual county Medicare cost (p = 0.003), and an increase of 174.7 total county Medicare inpatient days per year (p < 0.001). Even after accounting for poverty level and county characteristics, counties with higher inequality had higher potentially preventable admission (eg 4.86 rate ratio for low-birth-weight hospital admissions in the top income inequality quartile compared with bottom quartile; p < 0.001) and a higher incidence of potentially discretionary procedures (eg 1.79 rate ratio for prostatectomy for benign prostatic hyperplasia in the top income inequality quartile compared with bottom quartile; p < 0.001). Income inequality is independently associated with higher health care expenditures and more health care use, with increases in both potentially discretionary procedures and in

  4. System Transformation under the California Mental Health Services Act: Implementation of Full Service Partnerships in Los Angeles County

    PubMed Central

    Starks, Sarah L.; Arns, Paul G.; Padwa, Howard; Friedman, Jack R.; Marrow, Jocelyn; Meldrum, Marcia L.; Bromley, Elizabeth; Kelly, Erin Lee; Brekke, John; Braslow, Joel T.

    2018-01-01

    Objective The objective is to evaluate the effect of California’s Mental Health Services Act on the structure, volume, location, and patient-centeredness of Los Angeles County public mental health services. Methods This prospective mixed-methods study (2006-2013) is based in 5 Los Angeles County public mental health clinics, all with usual care and 3 with Full Service Partnerships (FSP): new MHSA-funded programs designed to “do whatever it takes” to provide intensive, recovery-oriented, team-based, integrated services for clients with severe mental illness. Study participants include treatment providers (42 FSP, 130 usual care) and clients (174 FSP, 298 usual care). FSPs were compared to usual care on outpatient services received (claims data) and organizational climate, recovery orientation, and provider-client working alliance (surveys; semi-structured interviews), with regression adjustment for client and provider characteristics. Results FSP clients received significantly more (5,238 vs. 1,643 minutes, p<.001), and more-frequently field-based (22% vs. 2%, p<.001), outpatient services than usual care clients in the first year post-admission. FSP clients reported more recovery-oriented services (RSA-R 3.8 vs. 3.5, p<.001) and better provider-client working alliance (WAI-S 3.8 vs. 3.6, p=.01). FSP providers reported more stress (55.0 vs. 51.3, p<.001) and lower morale (48.1 vs. 49.6, p<.001). Conclusions Los Angeles County’s public mental health system was able to transform service delivery in response to well-funded policy mandates. For providers, a structure emphasizing accountability and patient-centeredness was associated with greater stress, despite smaller caseloads. For clients, service structure and volume created opportunities to build stronger provider-client relationships and address client needs and goals. PMID:28142386

  5. Environmental Assessment: Johnson County Road F-20 Bypass, Johnson County, Iowa.

    DTIC Science & Technology

    1986-08-01

    D-A184 328 ENVIRONMENTAL ASSESSMENT- JOHNSON COUNTY ROAD F-20 vil BYPASS JOHNSON COUNTY’ IOWA (U) ARMY ENGINEER DISTRICT ROCK ISLAND IL AUG 86...BYPASS JOHNSON COUNTY, IOWA DTIC SELECTEI AUG 24 198D AUGUST 1986 -’"Thn; c>, .. i ’, been p ore i Icr publj rJlxaje aid sale; ii ,,. I distibu on is...2004 19 EPLY TO ATTENTION OP NCRPD-E ENVIRONMENTAL ASSE SSMENT JOHNSON COUNTY ROAD F-20 BYPASS JOHNSON COUNTY, IOWA Acce3siofl For NTIS MR& QUA~rTY

  6. Yucca Mountain: How Do Global and Federal Initiatives Impact Clark County's Nuclear Waste Program?

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

    Navis, I.; McGehee, B.

    2008-07-01

    Since 1987, Clark County has been designated by the U.S. Department of Energy (DOE) as an 'Affected Unit of Local Government' (AULG). The AULG designation is an acknowledgement by the federal government that activities associated with the Yucca Mountain proposal could result in considerable impacts on Clark County residents and the community as a whole. As an AULG, Clark County is authorized to identify 'any potential economic, social, public health and safety, and environmental impacts of a repository', 42 U.S.C. Section 10135(c)(1)(B)(i) under provisions of the Nuclear Waste Policy Act Amendments (NWPAA). Clark County's oversight program contains key elements ofmore » (1) technical and scientific analysis (2) transportation analysis (3) impact assessment and monitoring (4) policy and legislative analysis and monitoring, and (5) public outreach. Clark County has conducted numerous studies of potential impacts, many of which are summarized in Clark County's Impact Assessment Report that was submitted DOE and the President of the United States in February 2002. Given the unprecedented magnitude and duration of DOE's proposal, as well as the many unanswered questions about the transportation routes, number of shipments, and the modal mix that will ultimately be used, impacts to public health and safety and security, as well as socioeconomic impacts, can only be estimated. In order to refine these estimates, Clark County Comprehensive Planning Department's Nuclear Waste Division updates, assesses, and monitors impacts on a regular basis. Clark County's Impact Assessment program covers not only unincorporated Clark County but all five jurisdictions of Las Vegas, North Las Vegas, Henderson, Mesquite, and Boulder City as well as tribal jurisdictions that fall within Clark County's geographic boundary. National and global focus on nuclear power and nuclear waste could have significant impact on the Yucca Mountain Program, and therefore, Clark County's oversight of that

  7. USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

    EPA Pesticide Factsheets

    The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.

  8. Promoting Evidence-Based Decision Making in a Local Health Department, Pueblo City–County, Colorado

    PubMed Central

    Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C.

    2015-01-01

    Background Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Community Context Administrative leaders at the Pueblo City–County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. Methods A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Outcome Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Interpretation Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments. PMID:26111156

  9. A national study of the association between food environments and county-level health outcomes.

    PubMed

    Ahern, Melissa; Brown, Cheryl; Dukas, Stephen

    2011-01-01

    This national, county-level study examines the relationship between food availability and access, and health outcomes (mortality, diabetes, and obesity rates) in both metro and non-metro areas. This is a secondary, cross-sectional analysis using Food Environment Atlas and CDC data. Linear regression models estimate relationships between food availability and access variables (direct-to-consumer farm sales, per capita grocery stores, full-service restaurants, fast food restaurants, and convenience stores) with health outcomes. Controls include smoking, race/ethnicity, gender, age, education, poverty, primary care availability, recreational facility availability, and mobility/distance-from-grocery-store. Non-metro findings: Lower adjusted mortality rates were associated with more per capita full-service restaurants and grocery stores, and greater per capita direct farm sales. Lower adjusted diabetes rates were associated with a lower per capita supply of fast food restaurants and convenience stores, and more per capita full-service restaurants and grocery stores. Lower adjusted obesity rates were associated with more per capita full-service restaurants and grocery stores. Unexpectedly, obesity rates were positively associated with per capita grocery stores and negatively associated with fast food restaurants. Metro findings: More per capita full-service restaurants, grocery stores, and direct farm sales are associated with positive health outcomes; fast food restaurants and convenience stores are associated with negative health outcomes. The food access/availability environment is an important determinant of health outcomes in metro and non-metro areas. Future research should focus on more refined specifications that capture variability across non-metro settings. © 2011 National Rural Health Association.

  10. Promoting Evidence-Based Decision Making in a Local Health Department, Pueblo City-County, Colorado.

    PubMed

    Hardy, Anna K; Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C

    2015-06-25

    Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Administrative leaders at the Pueblo City-County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments.

  11. Effects of Long-Term Dust Exposure on Human Respiratory System Health in Minqin County, China.

    PubMed

    Wang, Jinyu; Li, Sheng; Wang, Shigong; Shang, Kezheng

    2015-01-01

    The aim of this study was to assess the effects of long-term sand dust exposure on human respiratory health. Dust events break out frequently in Minqin County, northwest China, whereas Pingliang City, northwest China, is rarely influenced by dust events. Therefore, Minqin and Pingliang were selected as sand dust exposure region and control area, respectively. The incidence of respiratory system diseases and symptoms was determined through a structured respiratory health questionnaire (ATS-DLD-78-A) and personal interviews. The subjects comprised 728 farmers (Minqin, 424; Pingliang, 304) aged 40 years or older, who had nondocumented occupational history to industrial dust exposure. Prevalences (odds ratio [OR], 95% confidence interval [CI]) of chronic rhinitis, chronic bronchitis, and chronic cough increased 9.6% (3.141, 1.776-5.555), 7.5% (2.468, 1.421-4.286), and 10.2% (1.787, 1.246-2.563) in Minqin comparison with Pingliang, respectively, and the differences were significant (p <.01).

  12. Effects of General Medical Health on Alzheimer Progression: the Cache County Dementia Progression Study

    PubMed Central

    Leoutsakos, Jeannie-Marie S.; Han, Dingfen; Mielke, Michelle M.; Forrester, Sarah N.; Tschanz, JoAnn T.; Corcoran, Chris D.; Green, Robert C.; Norton, Maria C.; Welsh-Bohmer, Kathleen A.; Lyketsos, Constantine G.

    2012-01-01

    Background Several observational studies suggested a link between health status and rate of decline among individuals with Alzheimer’s disease (AD). We sought to quantify the relationship in a population-based study of incident AD, and to compare global comorbidity ratings to counts of comorbid conditions and medications as predictors of AD progression. Methods Design Case-only cohort study arising from population-based longitudinal study of memory and aging. Setting Cache County, Utah Participants 335 individuals with incident AD followed for up to 11 years. Measurements Patient descriptors included sex, age, education, dementia duration at baseline, and APOE genotype. Measures of health status made at each visit included the GMHR (General Medical Health Rating), number of comorbid medical conditions, and number of non-psychiatric medications. Dementia outcomes included the Mini-Mental State Exam (MMSE), Clinical Dementia Rating – sum of boxes (CDR-sb), and the Neuropsychiatric Inventory (NPI). Results Health Status tended to fluctuate over time within individuals. None of the baseline medical variables (GMHR, comorbidities, non-psychiatric medications) were associated with differences in rates of decline in longitudinal linear mixed effects models. Over time, low GMHR ratings, but not comorbidities or medications, were associated with poorer outcomes (MMSE: β=−1.07 p=0.01; CDR-sb: β=1.79 p<0.001; NPI: β=4.57 p=0.01) Conclusions Given that time-varying GMHR, but not baseline GMHR, was associated with the outcomes, there is likely a dynamic relationship between medical and cognitive health. GMHR is a more sensitive measure of health than simple counts of comorbidities or medications. Since health status is a potentially modifiable risk factor, further study is warranted. PMID:22687143

  13. Effects of general medical health on Alzheimer's progression: the Cache County Dementia Progression Study.

    PubMed

    Leoutsakos, Jeannie-Marie S; Han, Dingfen; Mielke, Michelle M; Forrester, Sarah N; Tschanz, JoAnn T; Corcoran, Chris D; Green, Robert C; Norton, Maria C; Welsh-Bohmer, Kathleen A; Lyketsos, Constantine G

    2012-10-01

    Several observational studies have suggested a link between health status and rate of decline among individuals with Alzheimer's disease (AD). We sought to quantify the relationship in a population-based study of incident AD, and to compare global comorbidity ratings to counts of comorbid conditions and medications as predictors of AD progression. This was a case-only cohort study arising from a population-based longitudinal study of memory and aging, in Cache County, Utah. Participants comprised 335 individuals with incident AD followed for up to 11 years. Patient descriptors included sex, age, education, dementia duration at baseline, and APOE genotype. Measures of health status made at each visit included the General Medical Health Rating (GMHR), number of comorbid medical conditions, and number of non-psychiatric medications. Dementia outcomes included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating - sum of boxes (CDR-sb), and the Neuropsychiatric Inventory (NPI). Health status tended to fluctuate over time within individuals. None of the baseline medical variables (GMHR, comorbidities, and non-psychiatric medications) was associated with differences in rates of decline in longitudinal linear mixed effects models. Over time, low GMHR ratings, but not comorbidities or medications, were associated with poorer outcomes (MMSE: β = -1.07 p = 0.01; CDR-sb: β = 1.79 p < 0.001; NPI: β = 4.57 p = 0.01). Given that time-varying GMHR, but not baseline GMHR, was associated with the outcomes, it seems likely that there is a dynamic relationship between medical and cognitive health. GMHR is a more sensitive measure of health than simple counts of comorbidities or medications. Since health status is a potentially modifiable risk factor, further study is warranted.

  14. Interdisciplinary Public Health Intervention in a Multigenerational Tuberculosis (TB) Outbreak in Harris County, Texas: A Case Study with Implications for Disease Control Process Improvement and Transmission Cycle Interruption

    PubMed Central

    Haynie, Aisha; Plasencia, Carlos; Fields, Kimberly; Nesbitt, Elna; Lovings-Clark, Audrey; Scott, Mary; Wiltz-Beckham, Dana; Reed, Brian; Shah, Umair A

    2017-01-01

    Abstract Background Harris County Public Health (HCPH) is the health department for Harris County, Texas jurisdiction. Harris County as a whole is the nation’s third most populous county, with 4.3 million residents, and a TB case rate more than double that of the USA. (7.6 cases per 100,000 pop). A total, 327 individuals were diagnosed with TB in Harris County during 2015, over two-thirds occurring in foreign-born individuals. In 2016, HCPH treated an immigrant female with active TB. Initial contact investigation (CI) yielded five household contacts (HHC). Two tested positive, but refused subsequent clinical evaluation by HCPH. Two months later, HCPH was notified of a HHC hospitalized with TB. After hospital discharge, the sick HHC moved into a motel in attempts to self-isolate, but refused evaluation of additional HHC in the home, and banned home access, precluding adequate CI. After numerous phone calls, visits to motel and home, and multiple rescheduled appointments, legal action appeared inevitable. Days later, HCPH was notified of another HHC diagnosed with active TB. Methods With alarm regarding the family’s adherence to control orders, TB staff implemented an innovative multidisciplinary team-based intervention in hopes of avoiding legal action. A site visit was paid to the motel by a local health authority, two TB staff, a county public investigator, and a refugee clinic outreach worker fluent in the family’s language. Patients were presented with letters requesting immediate cooperation to avoid court filings. Questions were answered, misinformation corrected, and education provided. Results Intermediary on-site intervention using a compassionate, firm multidisciplinary team approach resulted in 16 additional family members tested, yielding an infant with active TB (Case 4) and 8 with TB Infection (TBI). Isolation breaches were also discovered. Most importantly, TB transmission cycle was interrupted. Cultural and economic barriers hindering

  15. Intimate partner violence in pregnancy among antenatal attendees at health facilities in West Pokot county, Kenya.

    PubMed

    Owaka, Isaac Ogweno; Nyanchoka, Margaret Keraka; Atieli, Harryson Etemesi

    2017-01-01

    The objective of this study was to investigate factors contributing to intimate partner violence in pregnancy among antenatal attendees at the health facilities in West Pokot Sub-County. The study was done in West Pokot Sub-County. Using cross sectional study design, a total of 238 antenatal attendees were systematically sampled for the study. Four focused group discussions and 20 key informant interviews were conducted for qualitative data collection. Qualitative data was consolidated into various themes while bivariate and logistic regression analysis was done to determine factors associated with experience of IPV in the index of pregnancy with P ≤ 0.05 being considered significant. The study found prevalence of overall, physical, psychological and sexual IPV in pregnancy to be 66.9%, 29.9%, 55.8% and 39.2% respectively. After adjusting for confounders, Overall IPV in pregnancy was significantly associated with Alcohol intake by partner (OR 2.116, 95% CI 1.950-2.260, P 0.000) and partner's level of education (OR 1.265, 95% CI 1.079-1.487, P 0.031), while psychological and sexual IPV was significantly associated with age of partner (OR 2.292, 95% CI 2.123-2.722, P 0.007) and age of pregnant women (OR 1.174, 95% CI 1.001-1.397 P 0.049) respectively. The care offered to antenatal attendees experiencing IPV was not in line with WHO guidelines and standard on handling gender based violence cases. The study finding indicates that IPV in pregnancy among antenatal attendees in West Pokot is very high. This unearths the gaps on gender based violence interventions in the maternal and child health programs.

  16. Aroostook County Telecommunications Demonstration. Project Period: December 15, 1978-June 15, 1981. Final Report.

    ERIC Educational Resources Information Center

    Medical Care Development, Inc., Augusta, ME.

    The Aroostook County Telecommunications System is a slow-scan television network connecting five health institutions in the county with the Central Maine Interactive Telecommunications System (CMITS). The Aroostook system allows both audio conferencing and still-image videoconferencing among the Aroostook participants, and provides for an…

  17. 40 CFR 52.1638 - Bernalillo County particulate matter (PM10) Group II SIP commitments.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) for Bernalillo County that contained commitments, from the Director of the Albuquerque Environmental... SIPs. The City of Albuquerque and Bernalillo County Air Quality Control Board adopted this SIP revision on November 9, 1988. (b) The Albuquerque Environmental Health Department has committed to comply with...

  18. 40 CFR 52.1638 - Bernalillo County particulate matter (PM10) Group II SIP commitments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) for Bernalillo County that contained commitments, from the Director of the Albuquerque Environmental... SIPs. The City of Albuquerque and Bernalillo County Air Quality Control Board adopted this SIP revision on November 9, 1988. (b) The Albuquerque Environmental Health Department has committed to comply with...

  19. 40 CFR 52.1638 - Bernalillo County particulate matter (PM10) Group II SIP commitments.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) for Bernalillo County that contained commitments, from the Director of the Albuquerque Environmental... SIPs. The City of Albuquerque and Bernalillo County Air Quality Control Board adopted this SIP revision on November 9, 1988. (b) The Albuquerque Environmental Health Department has committed to comply with...

  20. U.S. Geological Survey cooperative water-resources programs in Chester County, Pennsylvania

    USGS Publications Warehouse

    Wood, Charles R.

    1998-01-01

    Since 1969, the U.S. Geological Survey (USGS) has had a cooperative water-resources investigation program with Chester County to measure and describe the water resources of the County. Generally, the USGS provides one-half of the program funding, and local cooperators are required to provide matching funds. Cooperation has been primarily with the Chester County Water Resources Authority (CCWRA), with participation from the Chester County Health Department and funding from the Chester County Board of Commissioners. Municipalities and the Red Clay Valley Association also have provided part of the funding for several projects. This report describes how the long-term partnership between the USGS and Chester County, Pa., provides the County with the information that it needs for sound water-resources management.The CCWRA was created in 1961, primarily for land acquisition and planning for flood-control and water-supply projects. With the backing of the Brandywine Valley Association, the CCWRA started its first cooperative project with the USGS in 1969. It was a study of the water-quality condition of Chester County streams with an emphasis on benthic macroinvertebrates and stream chemistry.The kinds of projects and data collection conducted by the USGS have changed with the needs of Chester County and the mission of the CCWRA. Chester County is experiencing rapid population growth (it had the tenth-highest rate of growth in the nation from 1980 to 1990). This growth places considerable stress on water resources and has caused the CCWRA to broaden its focus from flood control to water-supply planning, water quality, and ground-water and surface-water management. The results of USGS studies are used by the CCWRA and other County agencies, including the Planning Commission, Health Department, and Parks and Recreation Department, for conducting day-to-day activities and planning for future growth. The results also are used by the CCWRA to provide guidance and technical

  1. mHealth Series: mHealth project in Zhao County, rural China – Description of objectives, field site and methods

    PubMed Central

    van Velthoven, Michelle Helena; Li, Ye; Wang, Wei; Du, Xiaozhen; Wu, Qiong; Chen, Li; Majeed, Azeem; Rudan, Igor; Zhang, Yanfeng; Car, Josip

    2013-01-01

    Background We set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies. Field site The field site for this mHealth project was Zhao County, which lies 280 km south of Beijing in Hebei Province, China. Methods We described the methodology of two studies: (i) a mixed methods study exploring factors influencing sample size calculations for mHealth–based health surveys and (ii) a cross–over study determining validity of an mHealth text messaging data collection tool. The first study used mixed methods, both quantitative and qualitative, including: (i) two surveys with caregivers of young children, (ii) interviews with caregivers, village doctors and participants of the cross–over study, and (iii) researchers’ views. We combined data from caregivers, village doctors and researchers to provide an in–depth understanding of factors influencing sample size calculations for mHealth–based health surveys. The second study, a cross–over study, used a randomised cross–over study design to compare the traditional face–to–face survey method to the new text messaging survey method. We assessed data equivalence (intrarater agreement), the amount of information in responses, reasons for giving different responses, the response rate, characteristics of non–responders, and the error rate. Conclusions This paper described the objectives, field site and methods of a large mHealth project part of a collaboration between researchers in China and the UK. The mixed methods study evaluating factors that influence sample size calculations could help future studies with estimating reliable sample sizes. The cross–over study comparing face–to–face and text message survey data collection

  2. Starting school healthy and ready to learn: using social indicators to improve school readiness in Los Angeles County.

    PubMed

    Wold, Cheryl; Nicholas, Will

    2007-10-01

    School readiness is an important public health outcome, determined by a set of interdependent health and developmental trajectories and influenced by a child's family, school, and community environments. The same factors that influence school readiness also influence educational success and health throughout life. A California cigarette tax ballot initiative (Proposition 10) created new resources for children aged 0 to 5 years and their families statewide through county-level First 5 commissions, including First 5 LA in Los Angeles County. An opportunity to define and promote school readiness indicators was facilitated by collaborative relationships with a strong emphasis on data among First 5 LA, the Children's Planning Council, and the Los Angeles County Public Health Department, and other child-serving organizations. A workgroup developed school readiness goals and indicators based on recommendations of the National Education Goals Panel and five key domains of child well-being: 1) good health, 2) safety and survival, 3) economic well-being, 4) social and emotional well-being, and 5) education/workforce readiness. The Los Angeles County Board of Supervisors and First 5 LA Commission adopted the school readiness indicators. First 5 LA incorporated the indicators into the results-based accountability framework for its strategic plan and developed a community-oriented report designed to educate and spur school readiness-oriented action. The Los Angeles County Board of Supervisors approved a countywide consensus-building plan designed to engage key stakeholders in the use of the indicators for planning, evaluation, and community-building activities. School readiness indicators in Los Angeles County represent an important step forward for public health practice, namely, the successful blending of an expanded role for assessment with the ecological model.

  3. A Heat Warning System to Reduce Heat Illness in San Diego County

    NASA Astrophysics Data System (ADS)

    Tardy, A. O.; Corcus, I.; Guirguis, K.; Gershunov, A.; Basu, R.; Stepanski, B.

    2016-12-01

    The National Weather Service (NWS) has issued official heat alerts to the public and decision making partners for many years by developing a single criterion or regional criteria from heat indices which combine temperature and humidity. The criteria have typically relied on fixed thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality, population acclimatization, or impacts on the most vulnerable subgroups. In 2013, the NWS San Diego office began modifying their criteria to account for local climatology with much less dependence on humidity or the heat index. These local changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system (EPIC), which document heat health impacts. The Scripps Institution of Oceanography (SIO) in collaboration with the California Environmental Protection Agency's Office of Environmental Health Hazard Assessment and the NWS completed a study of hospital visits during heat waves in California showing significant health impacts occurred in the past when no regional heat warning was issued. Therefore, the results supported the need for an exploratory project to implement significant modification of the traditional local criteria. To understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch (EMS), which is provided by the County's Public Health Officer to monitor heat-related illness and injury daily during specific heat episodes. The data were combined with SIO research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services (OES). The

  4. Tract- and County-Level Income Inequality and Individual Risk of Obesity in the United States

    PubMed Central

    Fan, Jessie X.; Wen, Ming; Kowaleski-Jones, Lori

    2015-01-01

    Objectives We tested three alternative hypotheses regarding the relationship between income inequality and individual risk of obesity at two geographical scales: U.S. Census tract and county. Methods Income inequality was measured by Gini coefficients, created from the 2000 U.S. Census. Obesity was clinically measured in the 2003–2008 National Health and Nutrition Examination Survey (NHANES). The individual measures and area measures were geo-linked to estimate three sets of multi-level models: tract only, county only, and tract and county simultaneously. Gender was tested as a moderator. Results At both the tract and county levels, higher income inequality was associated with lower individual risk of obesity. The size of the coefficient was larger for county-level Gini than for tract-level Gini; and controlling income inequality at one level did not reduce the impact of income inequality at the other level. Gender was not a significant moderator for the obesity-income inequality association. Conclusions Higher tract and county income inequality was associated with lower individual risk of obesity, indicating that at least at the tract and county levels and in the context of cross-sectional data, the public health goal of reducing the rate of obesity is in line with anti-poverty policies of addressing poverty through mixed-income development where neighborhood income inequality is likely higher than homogeneous neighborhoods. PMID:26680289

  5. Tract- and county-level income inequality and individual risk of obesity in the United States.

    PubMed

    Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

    2016-01-01

    We tested three alternative hypotheses regarding the relationship between income inequality and individual risk of obesity at two geographical scales: U.S. Census tract and county. Income inequality was measured by Gini coefficients, created from the 2000 U.S. Census. Obesity was clinically measured in the 2003-2008 National Health and Nutrition Examination Survey (NHANES). The individual measures and area measures were geo-linked to estimate three sets of multi-level models: tract only, county only, and tract and county simultaneously. Gender was tested as a moderator. At both the tract and county levels, higher income inequality was associated with lower individual risk of obesity. The size of the coefficient was larger for county-level Gini than for tract-level Gini; and controlling income inequality at one level did not reduce the impact of income inequality at the other level. Gender was not a significant moderator for the obesity-income inequality association. Higher tract and county income inequality was associated with lower individual risk of obesity, indicating that at least at the tract and county levels and in the context of cross-sectional data, the public health goal of reducing the rate of obesity is in line with anti-poverty policies of addressing poverty through mixed-income development where neighborhood income inequality is likely higher than homogeneous neighborhoods. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Health assessment for Skinner Landfill, West Chester, Butler County, Ohio, Region 5. CERCLIS No. OHD063963714. Final report

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

    Not Available

    1993-08-10

    The Skinner Landfill is a former landfill in West Chester, Butler County, Ohio. On-site soil, groundwater, and surface water are contaminated with volatile organic compounds (VOCs), semivolatile organic compounds, pesticides, arsenic, and lead. Off-site contamination is minimal. The Skinner Landfill site poses an indeterminate public health hazard. Potential exposure pathways of concern are the ingestion of surface soils containing lead and the ingestion of VOCs in groundwater. Groundwater is a potential exposure pathway because there are uncertainties concerning the potential for contaminated groundwater to move off site.

  7. USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

    EPA Pesticide Factsheets

    This map service displays the results data from the EPA's Environmental Quality Index. The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.

  8. Physical, Mental, and Financial Impacts From Drought in Two California Counties, 2015.

    PubMed

    Barreau, Tracy; Conway, David; Haught, Karen; Jackson, Rebecca; Kreutzer, Richard; Lockman, Andrew; Minnick, Sharon; Roisman, Rachel; Rozell, David; Smorodinsky, Svetlana; Tafoya, Dana; Wilken, Jason A

    2017-05-01

    To evaluate health impacts of drought during the most severe drought in California's recorded history with a rapid assessment method. We conducted Community Assessments for Public Health Emergency Response during October through November 2015 in Tulare County and Mariposa County to evaluate household water access, acute stressors, exacerbations of chronic diseases and behavioral health issues, and financial impacts. We evaluated pairwise associations by logistic regression with pooled data. By assessment area, households reported not having running water (3%-12%); impacts on finances (25%-39%), property (39%-54%), health (10%-20%), and peace of mind (33%-61%); worsening of a chronic disease (16%-46%); acute stress (8%-26%); and considering moving (14%-34%). Impacts on finances or property were each associated with impacts on health and peace of mind, and acute stress. Drought-impacted households might perceive physical and mental health effects and might experience financial or property impacts related to the drought. Public Health Implications. Local jurisdictions should consider implementing drought assistance programs, including behavioral health, and consider rapid assessments to inform public health action.

  9. County and organizational predictors of depression symptoms among low-income nursing assistants in the USA.

    PubMed

    Muntaner, Carles; Li, Yong; Xue, Xiaonan; Thompson, Theresa; Chung, Haejoo; O'Campo, Patricia

    2006-09-01

    Low-wage workers represent an ever-increasing proportion of the US workforce. A wide spectrum of firms demand low-wage workers, yet just 10 industries account for 70% of all low-paying jobs. The bulk of these jobs are in the services and retail sales industries. In health services, 60% of all workers are low-paid, with nursing aides, orderlies, personal attendants, and home care aides earning an average hourly wage of just 7.97 US dollars--a wage that keeps many of these workers hovering near or below the poverty line. Nursing assistants also tend to work in hazardous and grueling conditions. Work conditions are an important determinant of psychological well-being and mental disorders, particularly depression, in the workplace have important consequences for quality of life, worker productivity, and the utilization and cost of health care. In empirical studies of low-wage workers, county-level variables are of theoretical significance. Multilevel studies have recently provided evidence of a link between county-level variables and poor mental health among low-wage workers. To date, however, no studies have simultaneously considered the effect of county-and workplace-level variables. This study uses a repeated measures design and multilevel modeling to simultaneously test the effect of county-, organizational-, workplace-, and individual-level variables on depression symptoms among low-income nursing assistants employed in US nursing homes. We find that age and emotional strain have a statistically significant association with depression symptoms in this population, yet when controlling for county-level variables of poverty, the organizational-level variables used were no longer statistically significant predictors of depression symptoms. This study also contributes to current research methodology in the field of occupational health by using a cross-classified multilevel model to explicitly account for all variations in this three-level data structure, modeling and

  10. Rapid Field Response to a Cluster of Illnesses and Deaths - Sinoe County, Liberia, April-May, 2017.

    PubMed

    Doedeh, John; Frimpong, Joseph Asamoah; Yealue, Kwuakuan D M; Wilson, Himiede W; Konway, Youhn; Wiah, Samson Q; Doedeh, Vivian; Bao, Umaru; Seneh, George; Gorwor, Lawrence; Toe, Sylvester; Ghartey, Emmanuel; Larway, Lawrence; Gweh, Dedesco; Gonotee, Philemon; Paasewe, Thomas; Tamatai, George; Yarkeh, James; Smith, Samuel; Brima-Davis, Annette; Dauda, George; Monger, Thomas; Gornor-Pewu, Leleh W; Lombeh, Siafa; Naiene, Jeremias; Dovillie, Nathaniel; Korvayan, Mark; George, Geraldine; Kerwillain, Garrison; Jetoh, Ralph; Friesen, Suzanne; Kinkade, Carl; Katawera, Victoria; Amo-Addae, Maame; George, Roseline N; Gbanya, Miatta Z; Dokubo, E Kainne

    2017-10-27

    On April 25, 2017, the Sinoe County Health Team (CHT) notified the Liberia Ministry of Health (MoH) and the National Public Health Institute of Liberia of an unknown illness among 14 persons that resulted in eight deaths in Sinoe County. On April 26, the National Rapid Response Team and epidemiologists from CDC, the World Health Organization (WHO) and the African Field Epidemiology Network (AFENET) in Liberia were deployed to support the county-led response. Measures were immediately implemented to identify all cases, ascertain the cause of illness, and control the outbreak. Illness was associated with attendance at a funeral event, and laboratory testing confirmed Neisseria meningitidis in biologic specimens from cases. The 2014-2015 Ebola virus disease (Ebola) outbreak in West Africa devastated Liberia's already fragile health system, and it took many months for the country to mount an effective response to control the outbreak. Substantial efforts have been made to strengthen Liberia's health system to prevent, detect, and respond to health threats. The rapid and efficient field response to this outbreak of N. meningitidis resulted in implementation of appropriate steps to prevent a widespread outbreak and reflects improved public health and outbreak response capacity in Liberia.

  11. Annual economic impacts of seasonal influenza on US counties: Spatial heterogeneity and patterns

    PubMed Central

    2012-01-01

    Economic impacts of seasonal influenza vary across US counties, but little estimation has been conducted at the county level. This research computed annual economic costs of seasonal influenza for 3143 US counties based on Census 2010, identified inherent spatial patterns, and investigated cost-benefits of vaccination strategies. The computing model modified existing methods for national level estimation, and further emphasized spatial variations between counties, in terms of population size, age structure, influenza activity, and income level. Upon such a model, four vaccination strategies that prioritize different types of counties were simulated and their net returns were examined. The results indicate that the annual economic costs of influenza varied from $13.9 thousand to $957.5 million across US counties, with a median of $2.47 million. Prioritizing vaccines to counties with high influenza attack rates produces the lowest influenza cases and highest net returns. This research fills the current knowledge gap by downscaling the estimation to a county level, and adds spatial variability into studies of influenza economics and interventions. Compared to the national estimates, the presented statistics and maps will offer detailed guidance for local health agencies to fight against influenza. PMID:22594494

  12. School-Based Intervention for Nutrition Promotion in Mi Yun County, Beijing, China: Does a Health-Promoting School Approach Improve Parents' Knowledge, Attitudes and Behaviour?

    ERIC Educational Resources Information Center

    Wang, Dongxu; Stewart, Donald; Chang, Chun

    2016-01-01

    Purpose: The purpose of this paper is to assess whether the school-based nutrition programme using the health-promoting school (HPS) framework was effective to improve parents' knowledge, attitudes and behaviour (KAB) in relation to nutrition in rural Mi Yun County, Beijing. Design/methodology/approach: A cluster-randomised intervention trial…

  13. West Virginia Kids Count Data Book: 1993 County Profiles of Child Well-Being.

    ERIC Educational Resources Information Center

    West Virginia Task Force on Children, Youth and Families, Charleston.

    This report provides information on 12 indicators of child and adolescent health, education, and economic status in West Virginia at the state and county level. It includes a state profile, a minority profile, and 55 county profiles. Each of the indicators is discussed on a state-wide basis. The bulk of the report consists of one-page county…

  14. West Virginia Kids Count Data Book: 1994 County Profiles of Child Well-Being.

    ERIC Educational Resources Information Center

    West Virginia Task Force on Children, Youth and Families, Charleston.

    This report provides information on 12 indicators of child and adolescent health, education, and economic status in West Virginia at the state and county level. The report includes a state profile, a minority profile, and 55 county profiles. Each of the indicators is discussed on a state-wide basis. The bulk of the report consists of 1-page county…

  15. Spatiotemporal Discordance in Five Common Measures of Rurality for US Counties and Applications for Health Disparities Research in Older Adults.

    PubMed

    Cohen, Steven A; Kelley, Lauren; Bell, Allison E

    2015-01-01

    Rural populations face numerous barriers to health, including poorer health care infrastructure, access to care, and other sociodemographic factors largely associated with rurality. Multiple measures of rurality used in the biomedical and public health literature can help assess rural-urban health disparities and may impact the observed associations between rurality and health. Furthermore, understanding what makes a place truly "rural" versus "urban" may vary from region to region in the US. The objectives of this study are to compare and contrast five common measures of rurality and determine how well-correlated these measures are at the national, regional, and divisional level, as well as to assess patterns in the correlations between the prevalence of obesity in the population aged 60+ and each of the five measures of rurality at the regional and divisional level. Five measures of rurality were abstracted from the US Census and US Department of Agriculture (USDA) to characterize US counties. Obesity data in the population aged 60+ were abstracted from the Behavioral Risk Factor Surveillance System (BRFSS). Spearman's rank correlations were used to quantify the associations among the five rurality measurements at the national, regional, and divisional level, as defined by the US Census Bureau. Geographic information systems were used to visually illustrate temporal, spatial, and regional variability. Overall, Spearman's rank correlations among the five measures ranged from 0.521 (percent urban-urban influence code) to 0.917 (rural-urban continuum code-urban influence code). Notable discrepancies existed in these associations by Census region and by division. The associations between measures of rurality and obesity in the 60+ population varied by rurality measure used and by region. This study is among the first to systematically assess the spatial, temporal, and regional differences and similarities among five commonly used measures of rurality in the US. There

  16. Sonoma County Office of Education Computer Education Plan. County Level Plans.

    ERIC Educational Resources Information Center

    Malone, Greg

    1986-01-01

    This plan describes the educational computing and computer literacy program to be implemented by the schools in Sonoma County, California. Topics covered include the roles, responsibilities, and procedures of the county-wide computer committee; the goals of computer education in the county schools; the results of a needs assessment study; a 3-year…

  17. Analysis of behavioral risk factor surveillance system data to assess the health of Hispanic Americans with diabetes in El Paso County, Texas.

    PubMed

    Martinez, Nelda C; Bader, Julia

    2007-01-01

    The purpose of this study is to determine and describe the health of Hispanic Americans who live in El Paso County, Texas, along the US-Mexico border, particularly the multidimensional self-management practices of those with diabetes. This study also assesses Hispanic Americans with diabetes consistent with Healthy People 2010 diabetes goals and objectives. Data from the 2002 Paso del Norte Behavioral Risk Factor Surveillance System are used for analysis of behavioral health risk factors associated with diabetes among Hispanic Americans in El Paso County, Texas. One- and two-way frequency tables with logistic regression and tests for comparison of means are used for data analysis. The greatest numbers of Hispanic American residents are younger, with those diagnosed with diabetes aged 45 years and older and with lower level of education, lowest income level, and unable to work. The odds of having diabetes are 4 times greater with increasing age and 6 times greater with lower income level. The type of medical treatment is consistent with the frequency of various diabetes self-management behaviors to optimize health. Hispanic Americans are within the goal for several Healthy People 2010 targets for diabetes. Hispanic Americans along the US-Mexico border remain at risk for development of diabetes, although several self-management behavioral activities are recognized as important for prevention of diabetes to optimize quality of life.

  18. Implementation Study of the Comprehensive Services Program of Palm Beach County, Florida. Final Report

    ERIC Educational Resources Information Center

    Lyons, Sandra; Karlstrom, Mikael; Haywood, Thomas

    2007-01-01

    The Comprehensive Services Program of Palm Beach County, Florida, was an ambitious and innovative effort to improve the school readiness of low-income children in Palm Beach County by identifying needs early and providing early intervention services to support physical, cognitive, and emotional health and development. Services were delivered to…

  19. County-level poverty is equally associated with unmet health care needs in rural and urban settings.

    PubMed

    Peterson, Lars E; Litaker, David G

    2010-01-01

    Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Compare the association between regional poverty with self-reported unmet need, a marker of health care access, by rural/urban setting. Multilevel, cross-sectional analysis of a state-representative sample of 39,953 adults stratified by rural/urban status, linked at the county level to data describing contextual characteristics. Weighted random intercept models examined the independent association of regional poverty with unmet needs, controlling for a range of contextual and individual-level characteristics. The unadjusted association between regional poverty levels and unmet needs was similar in both rural (OR = 1.06 [95% CI, 1.04-1.08]) and urban (OR = 1.03 [1.02-1.05]) settings. Adjusting for other contextual characteristics increased the size of the association in both rural (OR = 1.11 [1.04-1.19]) and urban (OR = 1.11 [1.05-1.18]) settings. Further adjustment for individual characteristics had little additional effect in rural (OR = 1.10 [1.00-1.20]) or urban (OR = 1.11 [1.01-1.22]) settings. To better meet the health care needs of all Americans, health care systems in areas with high regional poverty should acknowledge the relationship between poverty and unmet health care needs. Investments, or other interventions, that reduce regional poverty may be useful strategies for improving health through better access to health care. © 2010 National Rural Health Association.

  20. Health assessment for ALCOA (Vancouver Smelter), Vancouver, Clark County, Washington, Region 10. CERCLIS No. WAD009045279. Final report

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

    Not Available

    1990-05-09

    The ALCOA (also known as Vancouver Smelter) site, located on the northern bank of the Columbia River about 4 miles west of Interstate 5 in Vancouver, Clark County, Washington, has been proposed for the National Priorities List. The site consists of three waste piles containing about 66,000 tons of waste (spent potlinings and alumina insulation) that were deposited on the north bank of the Columbia River by ALCOA between 1973 and 1981. ALCOA has since sold the aluminum smelter to another company, VANALCO. The contaminants detected in the groundwater in the area surrounding the piles include cyanide, fluoride, and trichloroethenemore » (TCE). The ALCOA site is of potential public health concern because humans may be exposed to hazardous substances at concentrations that may result in adverse health effects.« less

  1. County-Level Population Economic Status and Medicare Imaging Resource Consumption.

    PubMed

    Rosenkrantz, Andrew B; Hughes, Danny R; Prabhakar, Anand M; Duszak, Richard

    2017-06-01

    The aim of this study was to assess relationships between county-level variation in Medicare beneficiary imaging resource consumption and measures of population economic status. The 2013 CMS Geographic Variation Public Use File was used to identify county-level per capita Medicare fee-for-service imaging utilization and nationally standardized costs to the Medicare program. The County Health Rankings public data set was used to identify county-level measures of population economic status. Regional variation was assessed, and multivariate regressions were performed. Imaging events per 1,000 Medicare beneficiaries varied 1.8-fold (range, 2,723-4,843) at the state level and 5.3-fold (range, 1,228-6,455) at the county level. Per capita nationally standardized imaging costs to Medicare varied 4.2-fold (range, $84-$353) at the state level and 14.1-fold (range, $33-$471) at the county level. Within individual states, county-level utilization varied on average 2.0-fold (range, 1.1- to 3.1-fold), and costs varied 2.8-fold (range, 1.1- to 6.4-fold). For both large urban populations and small rural states, Medicare imaging resource consumption was heterogeneously variable at the county level. Adjusting for county-level gender, ethnicity, rural status, and population density, countywide unemployment rates showed strong independent positive associations with Medicare imaging events (β = 26.96) and costs (β = 4.37), whereas uninsured rates showed strong independent positive associations with Medicare imaging costs (β = 2.68). Medicare imaging utilization and costs both vary far more at the county than at the state level. Unfavorable measures of county-level population economic status in the non-Medicare population are independently associated with greater Medicare imaging resource consumption. Future efforts to optimize Medicare imaging use should consider the influence of local indigenous socioeconomic factors outside the scope of traditional beneficiary-focused policy

  2. Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

    PubMed

    Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

    2015-01-01

    New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

  3. Nebraska's rural behavioral healthcare workforce distribution and relationship between supply and county characteristics.

    PubMed

    Nguyen, Anh T; Trout, Kate E; Chen, Li-Wu; Madison, Lynda; Watkins, Katherine L; Watanabe-Galloway, Shinobu

    2016-01-01

    Specific attention is needed to improve mental health outcomes in rural communities. Rural communities continue to have higher unmet mental health needs than their urban counterparts. Quantifying workforce supply and shortages can aid in identifying areas in need of the recruitment, training, licensure, and retention of behavioral health professionals. However, workforce analyses have presented a challenge as comprehensive workforce data are limited. This study examines the geographic distribution of behavioral healthcare professionals and the relationship between supply and county characteristics in Nebraska in 2012. Practice location data for behavioral healthcare professionals were obtained from the 2012 University of Nebraska Medical Center's Health Profession Tracking Service Survey. Behavioral healthcare professionals included were psychiatric prescribers, independent behavioral professionals, mental health practitioners, and addiction counselors. The rural and urban distribution of professionals was examined using descriptive statistics. The relationships between county-level provider-to-population ratios and county characteristics were examined using multivariate Poisson regression analyses. In 2012, there were 2468 behavioral health professionals actively practicing in Nebraska. The majority (71.2%) of all behavioral professionals in Nebraska were actively practicing in metropolitan areas as compared to 27.3% in rural and 1.5% in frontier areas. For all categories of professions, excluding physician assistants, Nebraska's urban areas had the highest ratios of provider to 100 000 population as compared to rural and frontier areas in Nebraska. The total supply of behavioral health professionals was positively associated with metropolitan areas and the percentage of populations in poverty. The total supply of behavioral health professionals was negatively associated with the percentage of children under 18 years of age and the percentage of elderly aged 65

  4. An Innovative Project Breaks Down Barriers to Oral Health Care for Vulnerable Young Children in Los Angeles County.

    PubMed

    Crall, James J; Illum, Jackie; Martinez, Ana; Pourat, Nadereh

    2016-06-01

    Despite the high rate of untreated tooth decay, many young children in California under six years of age have never been to a dentist. Numerous and complex barriers to access to oral health care for young children exist, and a multifaceted approach is required to improve receipt of preventive and treatment services that could improve the oral health of this population. This policy brief describes the UCLA-First 5 LA 21st Century Dental Homes Project, which was designed to improve oral health care for young children in 12 Federally Qualified Health Center (FQHC) clinic sites with co-located dental and primary care services and its accessibility in their service areas throughout Los Angeles County. The project funded infrastructure and staffing, provided technical assistance to improve operations, trained clinical personnel to provide oral health care to young children, implemented a quality improvement learning collaborative, trained parents and child care providers in oral hygiene and healthy habits, and disseminated information to promote effective policies. Early data on the project indicated twofold increases in delivery of both diagnostics and treatment visits for young children, and a threefold increase in preventive services for young children during the program.

  5. Public health assessment addendum for Letterkenny Army Depot, USA Letterkenny Southeast Area, Chambersburg, Franklin County, Pennsylvania, Region 3. CERCLIS No. PA6213820503 and USA Letterkenny, Property Disposal Office Area, Chambersburg, Franklin County, Pennsylvania. CERCLIS No. PA2210090054. Final report

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

    Not Available

    1993-05-25

    The Letterkenny Army Depot (Letterkenny) is five miles north of Chambersburg, in Franklin County, Pennsylvania. The US Army Depot consists of two National Priorities List (NPL) sites: USA Letterkenny Southeast Area (hereafter referred to as the SE Area) and USA Letterkenny - Property Disposal Office Area (hereafter referred to as the PDO Area). A public health assessment of those combined sites was released by the Agency for Toxic Substances and Disease Registry on September 30, 1988 (Appendix 1). The previous public health assessment combined discussion of both NPL sites due to similar contaminants and pathways. Since the release of themore » previous public health assessment, new environmental, community health concerns, and health outcome data have become available, warranting this addendum.« less

  6. Data for Community Health Assessment in Rural Colorado: A Comparison of Electronic Health Records to Public Health Surveys to Describe Childhood Obesity.

    PubMed

    Gutilla, Margaret J; Davidson, Arthur J; Daley, Matthew F; Anderson, G Brooke; Marshall, Julie A; Magzamen, Sheryl

    Community-level data are necessary to inform community health assessments and to plan for appropriate interventions. However, data derived from public health surveys may be limited or unavailable in rural locations. We compared 2 sources of data for community health assessment in rural Colorado, electronic health records (EHRs) and routine public health surveys. Comparison of cross-sectional measures of childhood/youth obesity prevalence and data quality. Two rural Colorado counties, La Plata and Prowers. The EHR cohort comprised patients 2 to 19 years of age who underwent a visit with the largest health care provider in each county. These data included sex, age, weight, height, race, ethnicity, and insurance status. Public health survey data were obtained from 2 surveys, the Colorado Child Health Survey (2-14 years of age) and the Healthy Kids Colorado Survey (15-19 years of age) and included caregiver and self-reported height and weight estimates. We calculated body mass index percentile for each patient and survey respondent and determined overweight/obesity prevalence by county. We evaluated data source quality indicators according to a rubric developed for this analysis. The EHR sample captured approximately 35% (n = 3965) and 70% (n = 2219) of all children living in La Plata and Prowers Counties, respectively. The EHR prevalence estimates of overweight/obesity were greater in precision than survey data in both counties among children 2 to 14 years of age. In addition, the EHR data were more timely and geographically representative than survey data and provided directly measured height and weight. Conversely, survey data were easier to access and more demographically representative of the overall population. Electronic health records describing the prevalence of obesity among children/youth living in rural Colorado may complement public health survey data for community health assessment and health improvement planning.

  7. Assessment of household preparedness through training exercises--two metropolitan counties, Tennessee, 2011.

    PubMed

    2012-09-14

    Public health emergency preparedness involves improving both workforce and household capacity to manage disasters. To improve preparedness at both levels, the Tennessee Department of Health (TDH) formed a Rapid Assessment of Populations Impacted by Disasters (RAPID) team. In 2011, the team used Community Assessment for Public Health Emergency Response (CASPER) two-stage cluster sampling methodology to measure household preparedness for disasters or emergencies in two metropolitan counties. In the two counties, 23% and 31% of households reported being "well-prepared" to handle disasters or emergencies, 43% and 44% reported being "somewhat prepared," and 25% and 20% reported being "not at all prepared." As a result of this experience, RAPID teams were able to improve their methods, streamline processes, and create a better community assessment toolkit. To increase preparedness at both the community and workforce levels, public health departments should assess community preparedness to inform the planning process and provide field training and exercise opportunities for public health workers.

  8. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action

    PubMed Central

    Olmedo, Luis; Bejarano, Ester; Lugo, Humberto; Murillo, Eduardo; Seto, Edmund; Wong, Michelle; King, Galatea; Wilkie, Alexa; Meltzer, Dan; Carvlin, Graeme; Jerrett, Michael; Northcross, Amanda

    2017-01-01

    Summary: The Imperial County Community Air Monitoring Network (the Network) is a collaborative group of community, academic, nongovernmental, and government partners designed to fill the need for more detailed data on particulate matter in an area that often exceeds air quality standards. The Network employs a community-based environmental monitoring process in which the community and researchers have specific, well-defined roles as part of an equitable partnership that also includes shared decision-making to determine study direction, plan research protocols, and conduct project activities. The Network is currently producing real-time particulate matter data from 40 low-cost sensors throughout Imperial County, one of the largest community-based air networks in the United States. Establishment of a community-led air network involves engaging community members to be citizen-scientists in the monitoring, siting, and data collection process. Attention to technical issues regarding instrument calibration and validation and electronic transfer and storage of data is also essential. Finally, continued community health improvements will be predicated on facilitating community ownership and sustainability of the network after research funds have been expended. https://doi.org/10.1289/EHP1772 PMID:28886604

  9. Arsenic in ground water in Tuscola County, Michigan

    USGS Publications Warehouse

    Haack, Sheridan K.; Rachol, Cynthia M.

    2000-01-01

    Previous studies of ground-water resources in Michigan by the Michigan Department of Community Health (MDCH), the Michigan Department of Environmental Quality (MDEQ), and the U.S. Geological Survey (USGS) indicate that in several counties in the southeastern part of the State the concentrations of arsenic in ground water may exceed the U.S. Environmental Protection Agency (USEPA) maximum contaminant level (MCL) of 50 micrograms per liter [µg/L]. This MCL was established in 1986. The Safe Drinking Water Act, as amended in 1996, requires USEPA to revise this standard in 2000. In June 2000, the USEPA proposed a revised MCL of 5 µg/L. In 1996, the USGS, in cooperation with the MDEQ and the Health Departments of Genesee, Huron, Lapeer, Livingston, Oakland, Sanilac, Shiawassee, Tuscola and Washtenaw counties, began a study of the factors controlling arsenic occurrence and concentrations in ground water in southeastern Michigan. This study is one of four USGS Drinking Water Initiative projects throughout the United States.

  10. Left behind: widening disparities for males and females in US county life expectancy, 1985–2010

    PubMed Central

    2013-01-01

    Background The United States spends more than any other country on health care. The poor relative performance of the US compared to other high-income countries has attracted attention and raised questions about the performance of the US health system. An important dimension to poor national performance is the large disparities in life expectancy. Methods We applied a mixed effects Poisson statistical model and Gaussian Process Regression to estimate age-specific mortality rates for US counties from 1985 to 2010. We generated uncertainty distributions for life expectancy at each age using standard simulation methods. Results Female life expectancy in the United States increased from 78.0 years in 1985 to 80.9 years in 2010, while male life expectancy increased from 71.0 years in 1985 to 76.3 years in 2010. The gap between female and male life expectancy in the United States was 7.0 years in 1985, narrowing to 4.6 years in 2010. For males at the county level, the highest life expectancy steadily increased from 75.5 in 1985 to 81.7 in 2010, while the lowest life expectancy remained under 65. For females at the county level, the highest life expectancy increased from 81.1 to 85.0, and the lowest life expectancy remained around 73. For male life expectancy at the county level, there have been three phases in the evolution of inequality: a period of rising inequality from 1985 to 1993, a period of stable inequality from 1993 to 2002, and rising inequality from 2002 to 2010. For females, in contrast, inequality has steadily increased during the 25-year period. Compared to only 154 counties where male life expectancy remained stagnant or declined, 1,405 out of 3,143 counties (45%) have seen no significant change or a significant decline in female life expectancy from 1985 to 2010. In all time periods, the lowest county-level life expectancies are seen in the South, the Mississippi basin, West Virginia, Kentucky, and selected counties with large Native American populations

  11. Physical, Mental, and Financial Impacts From Drought in Two California Counties, 2015

    PubMed Central

    Barreau, Tracy; Conway, David; Haught, Karen; Jackson, Rebecca; Kreutzer, Richard; Lockman, Andrew; Minnick, Sharon; Roisman, Rachel; Rozell, David; Smorodinsky, Svetlana; Tafoya, Dana

    2017-01-01

    Objectives. To evaluate health impacts of drought during the most severe drought in California’s recorded history with a rapid assessment method. Methods. We conducted Community Assessments for Public Health Emergency Response during October through November 2015 in Tulare County and Mariposa County to evaluate household water access, acute stressors, exacerbations of chronic diseases and behavioral health issues, and financial impacts. We evaluated pairwise associations by logistic regression with pooled data. Results. By assessment area, households reported not having running water (3%–12%); impacts on finances (25%–39%), property (39%–54%), health (10%–20%), and peace of mind (33%–61%); worsening of a chronic disease (16%–46%); acute stress (8%–26%); and considering moving (14%–34%). Impacts on finances or property were each associated with impacts on health and peace of mind, and acute stress. Conclusions. Drought-impacted households might perceive physical and mental health effects and might experience financial or property impacts related to the drought. Public Health Implications. Local jurisdictions should consider implementing drought assistance programs, including behavioral health, and consider rapid assessments to inform public health action. PMID:28323464

  12. Mean Cancer Mortality Rates in Low Versus High Elevation Counties in Texas

    PubMed Central

    Hart, John

    2010-01-01

    There is controversy as to whether low levels of radiation (i.e., < 5 rem) pose a health risk. This brief inquiry compares archived cancer mortality data in counties having relatively low (0–250 feet above sea level), medium (500–1000 feet above sea level), and high (3000+ feet above sea level) elevations also having corresponding greater natural background levels of radiation respectively. Cancer mortality was found to be lowest in the high elevation counties (mean = 58.2) followed by low elevation counties (67.5) and then medium elevation counties (70.4). Statistically significant differences were found between low –high elevations (p = 0.003), and medium – high elevations (p = 0.010), but not between low and medium elevations (p = 0.5). More rigorous research, with an accounting of confounding variables, is indicated. PMID:21191484

  13. Community Perspectives on Cultural Considerations for Breast and Cervical Cancer Education among Marshallese Women in Orange County, California

    PubMed Central

    Briand, Greta; Peters, Ruth

    2017-01-01

    The Marshallese community of Orange County California is a part of a highly mobile population that migrates between Hawai‘i, Arkansas, Washington, and California. In Orange County, the Marshallese community is primarily centered on faith-based organization in the city of Costa Mesa. Culture and language strengthen the bonds between different Marshallese communities across the U.S., and churches serve as conduits for communication between groups. Culture also places an important role in guiding behavior pertaining to health and social interaction. For instance, as in many other cultures, Marshallese men and women do not speak to each other about health, particularly reproductive health, in an open social setting. In Orange County, one female Marshallese health educator promotes breast and cervical cancer screening by talking informally with women, usually in faith-based settings and in-home visits. This community commentary describes the key cultural considerations and strategies used by the health educator to reach and educate the community. PMID:29805327

  14. 75 FR 25308 - Environmental Impact Statement: Winnebago County, IL and Rock County, WI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Environmental Impact Statement: Winnebago County, IL and Rock County, WI AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice... Nye School Road northwest of Beloit, Rock County, Wisconsin to the interchange of Rockton Road and I...

  15. Associations between county and municipality zoning ordinances and access to fruit and vegetable outlets in rural North Carolina, 2012.

    PubMed

    Mayo, Mariel Leah; Pitts, Stephanie B Jilcott; Chriqui, Jamie F

    2013-12-05

    Zoning ordinances and land-use plans may influence the community food environment by determining placement and access to food outlets, which subsequently support or hinder residents' attempts to eat healthfully. The objective of this study was to examine associations between healthful food zoning scores as derived from information on local zoning ordinances, county demographics, and residents' access to fruit and vegetable outlets in rural northeastern North Carolina. From November 2012 through March 2013, county and municipality zoning ordinances were identified and double-coded by using the Bridging the Gap food code/policy audit form. A healthful food zoning score was derived by assigning points for the allowed use of fruit and vegetable outlets. Pearson coefficients were calculated to examine correlations between the healthful food zoning score, county demographics, and the number of fruit and vegetable outlets. In March and April 2013, qualitative interviews were conducted among county and municipal staff members knowledgeable about local zoning and planning to ascertain implementation and enforcement of zoning to support fruit and vegetable outlets. We found a strong positive correlation between healthful food zoning scores and the number of fruit and vegetable outlets in 13 northeastern North Carolina counties (r = 0.66, P = .01). Major themes in implementation and enforcement of zoning to support fruit and vegetable outlets included strict enforcement versus lack of enforcement of zoning regulations. Increasing the range of permitted uses in zoning districts to include fruit and vegetable outlets may increase access to healthful fruit and vegetable outlets in rural communities.

  16. Associations Between County and Municipality Zoning Ordinances and Access to Fruit And Vegetable Outlets in Rural North Carolina, 2012

    PubMed Central

    Mayo, Mariel Leah; Chriqui, Jamie F.

    2013-01-01

    Introduction Zoning ordinances and land-use plans may influence the community food environment by determining placement and access to food outlets, which subsequently support or hinder residents’ attempts to eat healthfully. The objective of this study was to examine associations between healthful food zoning scores as derived from information on local zoning ordinances, county demographics, and residents’ access to fruit and vegetable outlets in rural northeastern North Carolina. Methods From November 2012 through March 2013, county and municipality zoning ordinances were identified and double-coded by using the Bridging the Gap food code/policy audit form. A healthful food zoning score was derived by assigning points for the allowed use of fruit and vegetable outlets. Pearson coefficients were calculated to examine correlations between the healthful food zoning score, county demographics, and the number of fruit and vegetable outlets. In March and April 2013, qualitative interviews were conducted among county and municipal staff members knowledgeable about local zoning and planning to ascertain implementation and enforcement of zoning to support fruit and vegetable outlets. Results We found a strong positive correlation between healthful food zoning scores and the number of fruit and vegetable outlets in 13 northeastern North Carolina counties (r = 0.66, P = .01). Major themes in implementation and enforcement of zoning to support fruit and vegetable outlets included strict enforcement versus lack of enforcement of zoning regulations. Conclusion Increasing the range of permitted uses in zoning districts to include fruit and vegetable outlets may increase access to healthful fruit and vegetable outlets in rural communities. PMID:24309091

  17. County Government in Georgia [And] Teacher's Manual for County Government in Georgia.

    ERIC Educational Resources Information Center

    Hepburn, Mary A.

    The student textbook and the teacher's manual focus on the services, organization, and funding of county government in Georgia. Designed to be used over a three to six week period, the textbook is arranged into six chapters. Chapter one discusses county government, its services, and its structure. Chapter two focuses on county officials and their…

  18. US County-Level Trends in Mortality Rates for Major Causes of Death, 1980-2014.

    PubMed

    Dwyer-Lindgren, Laura; Bertozzi-Villa, Amelia; Stubbs, Rebecca W; Morozoff, Chloe; Kutz, Michael J; Huynh, Chantal; Barber, Ryan M; Shackelford, Katya A; Mackenbach, Johan P; van Lenthe, Frank J; Flaxman, Abraham D; Naghavi, Mohsen; Mokdad, Ali H; Murray, Christopher J L

    2016-12-13

    County-level patterns in mortality rates by cause have not been systematically described but are potentially useful for public health officials, clinicians, and researchers seeking to improve health and reduce geographic disparities. To demonstrate the use of a novel method for county-level estimation and to estimate annual mortality rates by US county for 21 mutually exclusive causes of death from 1980 through 2014. Redistribution methods for garbage codes (implausible or insufficiently specific cause of death codes) and small area estimation methods (statistical methods for estimating rates in small subpopulations) were applied to death registration data from the National Vital Statistics System to estimate annual county-level mortality rates for 21 causes of death. These estimates were raked (scaled along multiple dimensions) to ensure consistency between causes and with existing national-level estimates. Geographic patterns in the age-standardized mortality rates in 2014 and in the change in the age-standardized mortality rates between 1980 and 2014 for the 10 highest-burden causes were determined. County of residence. Cause-specific age-standardized mortality rates. A total of 80 412 524 deaths were recorded from January 1, 1980, through December 31, 2014, in the United States. Of these, 19.4 million deaths were assigned garbage codes. Mortality rates were analyzed for 3110 counties or groups of counties. Large between-county disparities were evident for every cause, with the gap in age-standardized mortality rates between counties in the 90th and 10th percentiles varying from 14.0 deaths per 100 000 population (cirrhosis and chronic liver diseases) to 147.0 deaths per 100 000 population (cardiovascular diseases). Geographic regions with elevated mortality rates differed among causes: for example, cardiovascular disease mortality tended to be highest along the southern half of the Mississippi River, while mortality rates from self-harm and

  19. [Effects of land use structure change on regional ecological health--taking Shapingba County as an example].

    PubMed

    Wang, Cheng; Wei, Chaofu; Gao, Ming; Luo, Guanglian; Jiang, Wei

    2005-12-01

    Land resource is the carrier for the exchange of matter, energy and information flows, while the change velocity and the intensity of land use has strong effects on the ecological processes such as matter circulation, energy flow, and biologic diversity. Land use structure change will alter the type, area, and spatial distribution of ecosystem, and in the meantime, result in the changes of regional ecological health. Employing the principles and methods of landscape ecology, and through endowing relative ecological value to land use type, this paper analyzed the charaeteristics of recent 10 years land use change in Shapingba County of Chongqing, and discussed the effects of land use change on regional ecological health, aimed to provide scientific references for land use planning and sustainable land resource utilization. The results indicated that transformation often occurred among different land use types, and the land use structure in each transformation phase differed quite obviously. Under different land use structure, there was a great disparity in relative ecological value of sub-ecosystems, which played various roles in regional ecological health. In general, the regional relative ecological value embodied both increase and decrease. In the future, the relative ecological value of sub-ecosystem would represent three tendencies, i.e., increase first and decrease then, continuous decrease, and continuous increase. The situation of regional ecological health would gradually become better.

  20. County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: How does place affect use?

    PubMed Central

    Chi, Donald L.; Leroux, Brian

    2013-01-01

    Little is known about how place affects childrens’ access to dental care. We analyzed data for 25,908 Iowa Medicaid-enrolled children with chronic conditions to identify the county-level determinants of dental utilization. Our analyses suggest that higher levels of poverty and designation as a dental health professional shortage area at the county-level are associated with lower probability of child-level dental use. There are significant interactions between child-level race/ethnicity and county-level poverty as well as between child-level disability and county-level unemployment. We present a new descriptive model on dental utilization that emphasizes county-level factors as well as interactions between county-level and child-level factors. PMID:22981229

  1. Dementia caregivers’ coping strategies and their relationship to health and well-being: The Cache County Study

    PubMed Central

    Snyder, Christine M.; Fauth, Elizabeth; Wanzek, Joseph; Piercy, Kathleen W.; Norton, Maria C.; Corcoran, Chris; Rabins, Peter V.; Lyketsos, Constantine G.; Tschanz, JoAnn T.

    2016-01-01

    Objectives Prior research identifies that psychological outcomes among dementia caregivers are associated with their use of coping strategies. Few studies have tested the association of coping and health longitudinally. Method This study examined factors associated with the use of coping strategies over time and their associations with physical and mental health outcomes in a population-based sample of 226 dementia caregivers in Cache County, Utah. Caregivers annually completed the Ways of Coping Checklist-Revised, the Beck Anxiety Inventory, and a health interview. Care-recipient cognitive and functional abilities were obtained using the Mini-Mental State Exam and the Clinical Dementia Rating. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory. Results Caregivers most frequently identified providing care as a problem (37.6%). Linear mixed models of caregiver coping strategies found that the use of most strategies were stable except for increasing Avoidance among adult child caregivers (β = 0.14, p = 0.048). On average, increased Wishful Thinking (β = 2.48, p < 0.001) or Blames Self (β = 1.06, p = 0.002) was associated with higher anxiety scores. Increased use of Blames Others among males (interaction, β = 0.28, p = 0.02) and greater use of Wishful Thinking among younger caregivers (interaction, β = −0.01, p = 0.01) was associated with more health conditions in the caregiver. Coping strategies were not associated with caregivers’ change in anxiety or number of health conditions over time. Conclusion Our results emphasize the importance of caregiver coping strategies on caregiver health and well-being and may identify subgroups of persons at risk for worse outcomes. PMID:25093439

  2. Health assessment for Master Disposal Service Landfill, Waukesha County, Brookfield, Wisconsin, Region 5. CERCLIS No. WID980820070. Preliminary report

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

    Not Available

    1988-12-10

    The Master Disposal Service Landfill is listed on the National Priorities List. The site is located on the western edge of Brookfield in Waukesha County, Wisconsin. From 1962 to 1982, Master Disposal Service, Inc. operated a 40-acre landfill and filled a 26-acre wetland area by accepting in excess of 1.5 million gallons of industrial wastes. The wastes included solvents, paint products, adhesives, oils, and foundry wastes. State sampling established that ground water near the site is contaminated by chromium, lead, phenols, and PCBs. Based on the available information, the site is considered to be of potential public health concern becausemore » of the risk to human health caused by the possibility of exposure to hazardous substances via contaminated ground water, surface water, soil and air.« less

  3. Groundwater-Quality Assessment, Pike County, Pennsylvania, 2007

    USGS Publications Warehouse

    Senior, Lisa A.

    2009-01-01

    constituents introduced by human activities that pose a health risk or otherwise were of concern in groundwater in the county. The analyses included major ions, nutrients, selected trace metals, volatile organic compounds (VOCs), selected organic wastewater compounds, gross alpha-particle and gross beta-particle activity, uranium, and radon-222. Analyses of the 20 samples were primarily for dissolved constituents, but six samples were analyzed for both dissolved and total metals. Results of the 2007 sampling indicated few water-quality problems, although concentrations of some constituents indicated influence of human activities on groundwater. No constituent analyzed exceeded any primary drinking-water standard or maximum contaminant level (MCL) established by the U.S. Environmental Protection Agency. Radon-222 levels were greater than, or equal to, the proposed MCL of 300 picocuries per liter (pCi/L) in water from 15 (75 percent) of the 20 wells. Radon-222 levels did not exceed the alternative MCL of 4,000 pCi/L in any groundwater sample. Radon-222 is naturally occurring, and the greatest concentrations (up to 2,650 pCi/L) were in water samples from wells in members of the Catskill Formation, a fractured-rock aquifer. The dissolved arsenic concentration of 3.9 micrograms per liter (ug/L) in one sample was greater than the health-advisory (HA) level of 2 ug/L but less than the MCL of 10 ug/L. Recommended or secondary maximum contaminant levels (SMCLs) were exceeded for pH, dissolved iron, and dissolved manganese. In six samples analyzed for dissolved and total concentrations of selected metals, total concentrations commonly were much greater than dissolved concentrations of iron, and to a lesser degree, for arsenic, lead, copper, and manganese. Concentrations of iron above the SMCL of 300 ug/L may be more widespread in the county for particulate iron than for dissolved iron. The total arsenic concentration in one of the six samples was greater than the HA level of

  4. Factors influencing deliveries at health facilities in a rural Maasai Community in Magadi sub-County, Kenya.

    PubMed

    Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David

    2018-01-03

    In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and

  5. An overview of mental health care system in Kilifi, Kenya: results from an initial assessment using the World Health Organization's Assessment Instrument for Mental Health Systems.

    PubMed

    Bitta, Mary A; Kariuki, Symon M; Chengo, Eddie; Newton, Charles R J C

    2017-01-01

    Little is known about the state of mental health systems in Kenya. In 2010, Kenya promulgated a new constitution, which devolved national government and the national health system to 47 counties including Kilifi County. There is need to provide evidence from mental health systems research to identify priority areas in Kilifi's mental health system for informing county health sector decision making. We conducted an initial assessment of state of mental health systems in Kilifi County and documented resources, policy and legislation and spectrum of mental, neurological and substance use disorders. This was a pilot study that used the brief version of the World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 to collect data. Data collection was based on the year 2014. Kilifi county has two public psychiatric outpatient units that are part of general hospitals. There is no standalone mental hospital in Kilifi. There are no inpatients or community based facilities for people with mental health problems. Although the psychiatric facilities in Kilifi have an essential drugs list, supply of drugs is erratic with frequent shortages. There is no psychiatrist or psychologist in Kilifi with only two psychiatric nurses for a population of approximately 1.2 million people. Schizophrenia was the commonest reason for visiting outpatient facilities (47.1%) while suicidal ideation was the least common (0.4%). Kenya's mental health policy, which is being used by Kilifi County, is outdated and does not cater for the current mental health needs of Kilifi. There is no specific legislation to protect the rights of people with mental health problems. No budget exists specifically for mental health care. There have been no efforts to integrate mental health care into primary care in Kilifi, and there is no empirical research work to evaluate its feasibility. There is an urgent need to increase resources allocated for mental health in particular

  6. Linking diurnal trends in methylmercury concentration and organic matter photo-reactivity in wetlands of the Yolo Bypass, California

    NASA Astrophysics Data System (ADS)

    Fleck, J. A.; Downing, B. D.; Saraceno, J.; Gill, G.; Stephenson, M.; Bergamaschi, B. A.

    2008-12-01

    Aqueous concentrations of methylmercury (MeHg) are known to vary temporally and spatially due to multiple concurrent production and loss mechanisms, and due to variations in the hydrologic connectivity between the methylating substrate (most commonly the benthos) and the overlying water compartments. Diurnal trends in MeHg production, bacterial demethylation, photo-demethylation, diffusion and advection transport processes have been identified and investigated; however, the magnitude and relative importance of each process in mediating overlying water MeHg concentrations, is not well known in natural wetland systems. Temporal variations in aqueous MeHg concentrations may impact the biological accumulation of MeHg into the base of the aquatic food chain, and may challenge regulatory efforts designed to mitigate MeHg exports from point and non-point sources. To identify the possible "hot moments" during the diurnal cycle, surface water MeHg concentrations were monitored in two agricultural wetland settings (wild rice and white rice fields) over a 24- hour period within the Yolo Bypass Wildlife Area, California using a combination of in situ optical sensors and traditional surface-water grab samples. In the wild rice field, MeHg concentrations doubled from 1 ng/L to 2 ng/L over the nighttime hours and returned to 1 ng/L during the daylight hours, whereas the white rice field showed no significant variation in MeHg concentration (0.73 +/- 0.08 ng/L) throughout the diurnal cycle. Similar trends were observed when MeHg data was expressed as a percentage of total Hg, with both wetland habitats exhibiting similar levels (20% MeHg) following the nighttime period and the wild rice field declining to 10% in the early evening. Field parameters measured in situ (including: solar radiation, pH, dissolved oxygen, and temperature) exhibited large diurnal trends in both wetlands, whereas optical proxies for dissolved organic matter (DOM) composition mirrored the fluctuations in Me

  7. Does More Public Health Spending Buy Better Health?

    PubMed Central

    Sung, Jaesang; Honore, Peggy

    2015-01-01

    Background: In this article, we attempt to address a persistent question in the health policy literature: Does more public health spending buy better health? This is a difficult question to answer due to unobserved differences in public health across regions as well as the potential for an endogenous relationship between public health spending and public health outcomes. Methods: We take advantage of the unique way in which public health is funded in Georgia to avoid this endogeneity problem, using a twelve year panel dataset of Georgia county public health expenditures and outcomes in order to address the “unobservables” problem. Results: We find that increases in public health spending lead to increases in mortality by several different causes, including early deaths and heart disease deaths. We also find that increases in such spending leads to increases in morbidity from heart disease. Conclusions: Our results suggest that more public health funding may not always lead to improvements in health outcomes at the county level. PMID:28462255

  8. Health Hazard Evaluation Report HETA 84-046-1584, Hennepin County Medical Center, Minneapolis, Minnesota. [Ethylene oxide and waste anesthetic gases

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

    Daniels, W.J.; Orris, P.

    1985-04-01

    Personal and area air samples were analyzed for ethylene oxide and waste anesthetic gases at Hennepin County Medical Center, Minneapolis, Minnesota in February, April, and July, 1984. The survey was requested by the center to evaluate health problems among employees. Medical questionnaires were administered and interviews were conducted with 59 employees in the instrument and operating room areas of the ear, nose, and throat, and surgery clinics. Ethylene-oxide was not detected during operation of the sterilizer. Nitrous-oxide concentrations of 66 to 138ppm were detected during surgical procedures. The authors conclude that a health hazard due to exposure to waste anestheticmore » gases exists at the center. Recommendations include evaluating the ventilation system and conducting additional monitoring for waste anesthetic gases.« less

  9. An Exploratory Study of the Comprehension, Retention and Action of the Denton County Older Population in Regards to Disaster Preparedness Education

    ERIC Educational Resources Information Center

    Knight, Rebekah P.

    2012-01-01

    The purpose of this exploratory study was to operationalize the responses from a sample of the community dwelling older population from Denton County, Texas on disaster preparedness education given by Denton County Health Department (DCHD) personnel. The goals and objectives were drawn from the Texas Public Health and Medical Emergency Management…

  10. Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study

    PubMed Central

    Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Takahashi, Risa; Montalbetti, Francesca; Segafredo, Giulia; Betrán, Ana Pilar

    2016-01-01

    Background South Sudan has one of the world’s poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County. Methods Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis. Results The barriers to institutional childbirth were categorised under four main themes: 1) Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2) Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3) Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4) Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission. Conclusions Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested. PMID:27977745

  11. Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.

    PubMed

    Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Takahashi, Risa; Montalbetti, Francesca; Segafredo, Giulia; Betrán, Ana Pilar

    2016-01-01

    South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County. Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis. The barriers to institutional childbirth were categorised under four main themes: 1) Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2) Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3) Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4) Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission. Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested.

  12. The Evolution of an Innovative Community-Engaged Health Navigator Program to Address Social Determinants of Health.

    PubMed

    Page-Reeves, Janet; Moffett, Maurice L; Steimel, Leah; Smith, Daryl T

    Health navigators and other types of community health workers (CHWs) have become recognized as essential components of quality care, and key for addressing health disparities owing to the complex health care services landscape presents almost insurmountable challenges for vulnerable individuals. Bernalillo County, New Mexico, has high rates of uninsurance, poverty, and food insecurity. The design of the Pathways to a Healthy Bernalillo County Program (BP) has evolved innovations that are unique in terms of program stability and security, expansive reach, and community capacity across six domains: sustainable public mechanism for program funding, involvement of community organizations in designing the program, expanded focus to address the broader social determinants of health with targeted outreach, an integrated, community-based implementation structure, an outcomes-based payment structure, and using an adaptive program design that actively incorporates navigators in the process. In 2008, the Pathways to a Healthy Bernalillo County Program (BP), located in the Albuquerque metropolitan area in central New Mexico, was established to provide navigation and support for the most vulnerable county residents. BP is funded through a 1% carve out of county mill levy funds. The pathways model is an outcome-based approach for health and social services coordination that uses culturally competent CHW as "navigators" trained to connect at-risk individuals to needed health and social services. One of the important innovations of the pathways approach is a shift in focus from merely providing discrete services to confirming healthy outcomes for the individual patient.

  13. Association Between Alcohol Outlets and HIV Prevalence in U.S. Counties.

    PubMed

    Rossheim, Matthew E; Thombs, Dennis L; Suzuki, Sumihiro

    2016-11-01

    The current study examines associations between on- and off-premise alcohol retail outlets and HIV prevalence in counties across the United States during a 3-year period. Health department and U.S. Census Bureau surveillance data were analyzed from 1,523 counties in 47 states, representing more than 86% of the U.S. population. Multilevel Poisson regression models were used to examine the association between the number of on- and off-premise alcohol outlets in a county and HIV prevalence in the same county, adjusting for the between-year correlation of HIV prevalence within each county. When we adjusted for potential confounders, number of on-premise alcohol outlets within a county was positively associated with HIV prevalence, whereas off-premise alcohol outlets were negatively associated with HIV prevalence. The relations observed in this study are consistent with the niche theory of assortative drinking, which maintains that drinkers who are prone to risk taking may be attracted to alcohol outlets where they can expand their social networks to include similarly high-risk individuals who engage in both heavy drinking and sexual risk taking. This is the largest study conducted to date to examine the association between alcohol retail outlet types and HIV prevalence. Natural experiments are needed to examine specific policy changes that reduce outlet density and its association with HIV incidence.

  14. Physical access to health facilities and contraceptive use in Kenya: evidence from the 2008-2009 Kenya Demographic and Health Survey.

    PubMed

    Ettarh, Remare R; Kyobutungi, Catherine

    2012-09-01

    The objective of the study was to determine the spatial variation in modern contraceptive use and unmet need for family planning across the counties of Kenya and to examine whether the spatial patterns were associated with inequalities in physical access to health facilities. Data were obtained from the 2008-2009 Kenya Demographic and Health Survey and linked to the location of health facilities in the country. Multivariate logistic regression was used to examine the influence of distance to the nearest health facility and health facility density, in addition to other covariates, on modern contraceptive use and unmet need. Overall, the prevalence of modern contraceptive use and unmet need among women aged 15-49 in Kenya was 42.1% and 19.7% respectively. Among the respondents who lived more than 5 km from the nearest health facility modern contraceptive use was significantly less likely compared to women resident 5 km or less from the nearest health facility. Women from counties with higher health facility density were 53% more likely to use modern contraceptives compared to women in counties with low health facility density. Distance and health facility density in the county were not significantly associated with unmet need. Physical access to health facilities is an important determinant of modern contraceptive use and unmet need in Kenya. Strategies should be developed in underserved counties to mitigate the challenge of distance to health facilities, such as delivering services by outreach and mobile facilities.

  15. Occupational safety and health status of medical laboratories in Kajiado County, Kenya.

    PubMed

    Tait, Fridah Ntinyari; Mburu, Charles; Gikunju, Joseph

    2018-01-01

    Despite the increasing interest in Occupational Safety and Health (OSH), seldom studies are available on OSH in medical laboratories from developing countries in general although a high number of injuries occur without proper documentation. It is estimated that every day 6,300 people die as a result of occupational accidents or work-related diseases resulting in over 2.3 million deaths per year. Medical laboratories handle a wide range of materials, potentially dangerous pathogenic agents and exposes health workers to numerous potential hazards. This study evaluated the status of OSH in medical laboratories in Kajiado County, Kenya. The objectives included establishment of biological, chemical and physical hazards; reviewing medical laboratories control measures; and enumerating factors hindering implementation of good practices in OSH. This was a cross-sectional descriptive study research design. Observation check lists, interview schedules and structured questionnaires were used. The study was carried out in 108 medical laboratories among 204 sampled respondents. Data was analysed using statistical package for social science (SPSS) 20 software. The commonest type of hazards in medical laboratories include; bacteria (80%) for Biological hazards; handling un-labelled and un-marked chemicals (38.2%) for chemical hazards; and laboratory equipment's dangerously placed (49.5%) for Physical hazards. According to Pearson's Product Moment Correlation analysis, not-wearing personal protective equipment's was statistically associated with exposure to hazards. Individual control measures were statistically significant at 0.01 significance level. Only 65.1% of the factors influencing implementation of OSH in medical laboratories were identified. Training has the highest contribution to good OSH practices.

  16. Perceptions of adolescents, parents, and school personnel from a predominantly Cuban American community regarding dating and teen dating violence prevention.

    PubMed

    Gonzalez-Guarda, Rosa M; Cummings, Amanda M; Pino, Karen; Malhotra, Krithika; Becerra, Maria M; Lopez, Jessica E

    2014-04-01

    The purpose of this study was to explore perceptions of dating relationships and teen dating violence prevention within a predominantly Cuban American community in Miami-Dade County. Eight focus groups (n = 74 participants) with adolescents of Hispanic origin (n = 29), their parents (n = 29), and school personnel (n = 16) were conducted and analyzed using content analysis. Four themes characterized the nature and context of dating relationships among adolescents of Hispanic origin: YOLO -You Only Live Once, cultural unity but social division, dating is not going out, and the social environment challenges healthy relationships. The information generated from this study can be used to develop culturally tailored teen dating violence prevention programs targeting youth of Hispanic origin. © 2014 Wiley Periodicals, Inc.

  17. Clark county monitoring program

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

    Conway, Sheila; Auger, Jeremy; Navies, Irene

    2007-07-01

    Available in abstract form only. Full text of publication follows: Since 1988, Clark County has been one of the counties designated by the United States Department of Energy (DOE) as an 'Affected Unit of Local Government' (AULG). The AULG designation is an acknowledgement by the federal government that could be negatively impacted to a considerable degree by activities associated with the Yucca Mountain High Level Nuclear Waste Repository. These negative effects would have an impact on residents as individuals and the community as a whole. As an AULG, Clark County is authorized to identify 'any potential economic, social, public healthmore » and safety, and environmental impacts' of the potential repository (42 USC Section 10135(C)(1)(B)(1)). Toward this end, Clark County has conducted numerous studies of potential impacts, many of which are summarized in the Clark County's Impact Assessment Report that was submitted by the DOE and the president of the United States in February 2002. Given the unprecedented magnitude and duration of the DoE's proposal, as well as the many unanswered questions about the number of shipments and the modal mix, the estimate of impacts described in these studies are preliminary. In order to refine these estimates, Clark County Comprehensive Planning Department's Nuclear Waste Division is continuing to assess potential impacts. In addition, the County has implemented a Monitoring Program designed to capture changes to the social, environmental, and economic well-being of its residents resulting from the Yucca Mountain project and other significant events within the County. The Monitoring Program acts as an 'early warning system' that allows Clark County decision makers to proactive respond to impacts from the Yucca Mountain Project. (authors)« less

  18. Public Health Nursing Staff Health Education Attitudes.

    ERIC Educational Resources Information Center

    Collins, Terence R.; And Others

    Health education attitudes toward prevention, detection, and treatment of selected chronic diseases and conditions confronting public health nursing staffs were investigated at a Florida Department of Health and Rehabilitative Services District, which is composed of 16 county public health units (CPHU). Findings were used to determine type of…

  19. County portraits of Washington State.

    Treesearch

    Wendy J. McGinnis; Richard H. Phillips; Terry L. Raettig; Kent P. Connaughton

    1997-01-01

    This publication provides a general picture of the population, economy, and natural resources of the counties in Washington State. The intent of this report is to provide insight to changes in a county over the last 10 to 20 years, to compare county trends to statewide trends (and state trends to national trends), and to provide information on all the counties in a...

  20. Store type and demographic influence on the availability and price of healthful foods, Leon County, Florida, 2008.

    PubMed

    Leone, Angela F; Rigby, Samantha; Betterley, Connie; Park, Sohyun; Kurtz, Hilda; Johnson, Mary Ann; Lee, Jung Sun

    2011-11-01

    The availability of healthful foods varies by neighborhood. We examined the availability and price of more healthful foods by store type, neighborhood income level, and racial composition in a community with high rates of diet-related illness and death. We used the modified Nutrition Environment Measures Survey in Stores to conduct this cross-sectional study in 2008. We surveyed 73 stores (29% supermarkets, 11% grocery stores, and 60% convenience stores) in Leon County, Florida. We analyzed the price and availability of foods defined by the 2005 Dietary Guidelines for Americans as "food groups to encourage." We used descriptive statistics, t tests, analysis of variance, and χ(2) tests in the analysis. Measures of availability for all more healthful foods differed by store type (P < .001). Overall, supermarkets provided the lowest price for most fresh fruits and vegetables, low-fat milk, and whole-wheat bread. Availability of 10 of the 20 fruits and vegetables surveyed, shelf space devoted to low-fat milk, and varieties of whole-wheat bread differed by neighborhood income level (P < .05), but no trends were seen for the availability or price of more healthful foods by neighborhood racial composition. Store type affects the availability and price of more healthful foods. In particular, people without access to supermarkets may have limited ability to purchase healthful foods. Nutrition environment studies such as this one can be used to encourage improvements in neighborhoods that lack adequate access to affordable, healthful food, such as advocating for large retail stores, farmer's markets, and community gardens in disadvantaged neighborhoods.

  1. Tobacco control and direct democracy in Dade County, Florida: future implications for health advocates.

    PubMed

    Givel, M S; Glantz, S A

    2000-01-01

    In 1979 and 1980 in Dade County, Florida, a small grassroots advocacy group, Group Against Smoking Pollution (GASP), attempted to enact a clean indoor air ordinance through the initiative process. The tobacco industry's successful efforts to defeat the initiatives were expensive high-tech media-centered campaigns. Even though GASP's electoral resources were extremely limited for both initiatives, GASP utilized similar media-centered tactics. This approach attempted to defeat the tobacco industry in its own venue, in spite of the tobacco industry's vastly greater resources. Nevertheless, the industry defeated these ordinances by narrow margins because of broad voter support for the initiatives before the industry started its campaigns. Health advocates will never have the resources to match the tobacco industry in expensive high-tech media-centered initiative campaigns. Rather, their power lies in the general popularity of tobacco control legislation and their ability to mobilize broad grassroots efforts combined with an adequately funded media campaign.

  2. Health Education Needs: A Survey of Rural Adults in Northumberland County, Pennsylvania, 1975. An Interim Report. Rural Health Staff Papers - Paper Number 6.

    ERIC Educational Resources Information Center

    Leadley, Samuel M.

    In June 1975, 53 men and 56 women living on commercial farms in Northumberland County, Pennsylvania were interviewed regarding their behaviors, beliefs, and attitudes related to preventing cancer and coronary heart disease. Respondents represented about 23% of all adults living on commercial farms in the county. A commercial farm was defined as…

  3. 76 FR 30152 - East Calloway County Middle School Mercury Spill Site, Murray, Calloway County, KY; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... Middle School Mercury Spill Site, Murray, Calloway County, KY; Notice of Settlement AGENCY: Environmental... Calloway County Middle School Mercury Spill Site located in Murray, Calloway County, Kentucky for... County [[Page 30153

  4. Self-rated health and mortality in different occupational classes and income groups in Nord-Trøndelag County, Norway.

    PubMed

    Holseter, Christoffer; Dalen, Joakim Døving; Krokstad, Steinar; Eikemo, Terje Andreas

    2015-03-10

    People with a lower socioeconomic position have a higher the prevalence of most self-rated health problems. In this article we ask whether this may be attributed to self-rated health not reflecting actual health, understood as mortality, in different socioeconomic groups. For the study we used data from the Nord-Trøndelag Health Study 1984-86 (HUNT1), in which the county's entire adult population aged 20 years and above were invited to participate. The association between self-rated health and mortality in different occupational classes and income groups was analysed. The analysis corrected for age, chronic disease, functional impairment and lifestyle factors. The association between self-rated health and mortality was of the same order of magnitude for the occupational classes and income groups, but persons without work/income and with poor self-rated health stood out. Compared with persons in the highest socioeconomic class, unemployed men had a hazard ratio for death that was three times higher in the follow-up period. For women with no income, the ratio was twice as high. INTERPRETATION Self-rated health and mortality largely conform to the different socioeconomic strata. This supports the perception that socioeconomic differences in health are a reality and represent a significant challenge nationally. Our results also increase the credibility of findings from other studies that use self-reported health in surveys to measure differences and identify the mechanisms that create them.

  5. Health Education Needs: A Survey of Rural Adults in Juniata County, Pennsylvania, 1975. An Interim Report. Rural Health Staff Papers - Paper Number 4.

    ERIC Educational Resources Information Center

    Leadley, Samuel M.

    In June 1975, 62 men and 64 women living on commercial farms in Juniata County, Pennsylvania were interviewed regarding their behaviors, beliefs, and attitudes related to preventing cancer and coronary heart disease. Respondents represented about 22% of all adults living on commercial farms in the county. A commercial farm was defined as one that…

  6. Health Education Needs: A Survey of Rural Adults in Fulton County, Pennsylvania, 1975. An Interim Report. Rural Health Staff Papers - Paper Number 5.

    ERIC Educational Resources Information Center

    Leadley, Samuel M.

    In June 1975, 47 men and 43 women living on commercial farms in Fulton County, Pennsylvania were interviewed regarding their behaviors, beliefs, and attitudes related to preventing cancer and coronary heart disease. Respondents represented about 39% of all adults living on commercial farms in the county. A commercial farm was defined as one that…

  7. The Economic Impact of Schenectady County Community College on Schenectady County, 1981-82.

    ERIC Educational Resources Information Center

    Chestnut, Erma Ruth

    This report on the economic impact of Schenectady County Community College (SCCC) uses a modification of the Caffrey and Isaacs model to assess SCCC-related local business volume, SCCC costs and benefits to the Schenectady County government, and the likely impact on the county if SCCC did not exist. Part I provides background to the study,…

  8. Modeling Area-Level Health Rankings.

    PubMed

    Courtemanche, Charles; Soneji, Samir; Tchernis, Rusty

    2015-10-01

    Rank county health using a Bayesian factor analysis model. Secondary county data from the National Center for Health Statistics (through 2007) and Behavioral Risk Factor Surveillance System (through 2009). Our model builds on the existing county health rankings (CHRs) by using data-derived weights to compute ranks from mortality and morbidity variables, and by quantifying uncertainty based on population, spatial correlation, and missing data. We apply our model to Wisconsin, which has comprehensive data, and Texas, which has substantial missing information. The data were downloaded from www.countyhealthrankings.org. Our estimated rankings are more similar to the CHRs for Wisconsin than Texas, as the data-derived factor weights are closer to the assigned weights for Wisconsin. The correlations between the CHRs and our ranks are 0.89 for Wisconsin and 0.65 for Texas. Uncertainty is especially severe for Texas given the state's substantial missing data. The reliability of comprehensive CHRs varies from state to state. We advise focusing on the counties that remain among the least healthy after incorporating alternate weighting methods and accounting for uncertainty. Our results also highlight the need for broader geographic coverage in health data. © Health Research and Educational Trust.

  9. Priority setting for health in the context of devolution in Kenya: implications for health equity and community-based primary care

    PubMed Central

    McCollum, Rosalind; Theobald, Sally; Otiso, Lilian; Martineau, Tim; Karuga, Robinson; Barasa, Edwine; Molyneux, Sassy; Taegtmeyer, Miriam

    2018-01-01

    Abstract Devolution changes the locus of power within a country from central to sub-national levels. In 2013, Kenya devolved health and other services from central government to 47 new sub-national governments (known as counties). This transition seeks to strengthen democracy and accountability, increase community participation, improve efficiency and reduce inequities. With changing responsibilities and power following devolution reforms, comes the need for priority-setting at the new county level. Priority-setting arises as a consequence of the needs and demand for healthcare resources exceeding the resources available, resulting in the need for some means of choosing between competing demands. We sought to explore the impact of devolution on priority-setting for health equity and community health services. We conducted key informant and in-depth interviews with health policymakers, health providers and politicians from 10 counties (n = 269 individuals) and 14 focus group discussions with community members based in 2 counties (n = 146 individuals). Qualitative data were analysed using the framework approach. We found Kenya’s devolution reforms were driven by the need to demonstrate responsiveness to county contexts, with positive ramifications for health equity in previously neglected counties. The rapidity of the process, however, combined with limited technical capacity and guidance has meant that decision-making and prioritization have been captured and distorted for political and power interests. Less visible community health services that focus on health promotion, disease prevention and referral have been neglected within the prioritization process in favour of more tangible curative health services. The rapid transition in power carries a degree of risk of not meeting stated objectives. As Kenya moves forward, decision-makers need to address the community health gap and lay down institutional structures, processes and norms which promote health

  10. Social Determinants of HIV Disparities in the Southern United States and in Counties with Historically Black Colleges and Universities (HBCUs), 2013-2014.

    PubMed

    Sutton, Madeline Y; Gray, Simone C; Elmore, Kim; Gaul, Zaneta

    2017-01-01

    HIV infection disproportionately affects Blacks in the southern United States (U.S.), a region where legal policies that may unintentionally impede earlier HIV detection and treatment are prevalent. Historically Black Colleges and Universities (HBCUs) have historically facilitated social change in communities of color and have been underexplored as partners for HIV prevention. We describe geographic and social determinants of health (SDH) in the southern U.S. to inform potential HBCU-public health partnerships that might improve HIV health equity. We evaluated the relationship between county-level HIV prevalences (2013), HBCU geographic coordinates, and SDH variables in the southern counties with HBCUs. U.S. Census-derived SDH variables included race/ethnicity (i.e., Black, White, Hispanic), unemployment, female head of household, poverty, percent owner-occupied housing units, urbanicity, and primary care provider rates. Associations were assessed using bivariate and multivariable linear regression. Of 104 HBCUs in the contiguous U.S., 100 (96%) were located in 69 southern counties with average Black populations of 40% and an average HIV prevalence of 615. 5 per 100,000, over two times the national rate (295.1 per 100,000). In bivariable analyses, higher HIV rates in these counties were associated with higher percent Black population, unemployment, female head of household, poverty, fewer owner-occupied housing units, and greater urbanicity (p < 0.05). In multivariable analyses, counties with higher HIV rates had higher percentages of Blacks, greater urbanicity, fewer owner-occupied housing units, and more female heads of households (p < 0.05). The southern U.S. is disproportionately affected by HIV, and many HBCUs are located in affected southern counties. HBCUs may be important public health partners for helping to develop structural interventions that strengthen HIV policies in support of health equity in these southern, mostly urban counties.

  11. Morris County Improvement Authority, Morris County, New Jersey Renewable Energy Initiative

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

    Bonanni, John

    2013-05-01

    The Morris County Improvement Authority (Authority), a public body corporate and politic of the State of New Jersey and created and controlled by the County, at the direction of the County and through the Program guaranteed by the County, financed 3.2 MW of solar projects (Solar Projects) at fifteen (15) sites for seven (7) local government units (Local Units) in and including the County. The Program uses a Power Purchase Agreement (PPA) structure, where the Solar Developer constructs, operates and maintains all of the Solar Projects, for the benefit of the Local Units and the Authority, for the maximum Statemore » law allowable PPA period of fifteen (15) years. Although all fifteen (15) sites were funded by the Authority, only the Mennen Arena site was considered for the purposes of the required local match funding for this grant. Specifically at the Mennen Arena site, the Authority financed 1.6 MW of solar panels. On October 18, 2013, the DOE Grant was drawn down following completion of the necessary application documents and final execution of an agreement memorializing the contemplated transaction by the Local Units, the County, The Authority and the solar developer. The proceeds of the DOE Grant were then applied to reduce the PPA price to all Local Units across the program and increase the savings from approximately 1/3 to almost half off the existing and forecasted utility pricing over the fifteen (15) year term, without adversely affecting all of the other benefits. With the application of the rate buy down, the price of electricity purchased under the PPA dropped from 10.9 to 7.7 cents/kWh. This made acquisition of renewable energy much more affordable for the Local Units, and it enhanced the success of the program, which will encourage other counties and local units to develop similar programs.« less

  12. Consortium building among local health departments in northwest Illinois.

    PubMed Central

    Orthoefer, J; Bain, D; Empereur, R; Nesbit, T A

    1988-01-01

    The 1947 report by Haven Emerson envisioned the widespread delivery of local public health services through organizational patterns that substituted multi-county or regional agencies for locally controlled departments. The 1971 study by Vlado Getting supported the Emerson report and suggested alternative methods to provide public health services via multi-county area health service agencies for rural areas of Illinois. The number of local agencies in the State has doubled since the mid-1960s, yet a majority of rural counties have maintained a single-county health agency rather than forming multi-county arrangements. In effect, potential economies of scale have been forfeited. In northwest Illinois, however, eight local health departments, covering both rural and urban areas, have formed a multi-county consortium to identify and meet several overlapping program needs. This Region I consortium, with a population base of 590,000, was created as a result of the 1981 Omnibus Budget Reduction Act. Through the block grants created by the act, funds became available for preventive health and health promotion activities in fiscal year 1982. Once in place, the consortium provided a cost effective means to manage the Women, Infants, and Children Supplemental Feeding Program (WIC) and some elements of family planning programs in Region I. The consortium approach offers numerous opportunities for future growth and regionalization of services. PMID:3140277

  13. Transforming the Cross Cultural Collaborative of Pierce County Through Assessment Capacity Building

    PubMed Central

    Garza, Mary A.; Abatemarco, Diane J.; Gizzi, Cindan; Abegglen, Lynn M.; Johnson-Conley, Christina

    2010-01-01

    Background Underserved populations are underrepresented in public health initiatives such as tobacco control and in cancer clinical trials. Community involvement is crucial to interventions aimed at reducing health disparities, and local health departments increasingly are called upon to provide both leadership and funding. The Tacoma Pierce County Health Department (TPCHD), in conjunction with 13 key community-based organizations and healthcare systems, formed the Cross Cultural Collaborative of Pierce County (CCC) that successfully employs needs-assessment and evaluation techniques to identify community health initiatives. Methods Community leaders from six underserved populations of the CCC were trained in needs-assessments techniques. Assessments measured effectiveness of the collaborative process and community health initiatives by using key informant (n = 18) and group interviews (n = 3). Results The CCC, facilitated by its partnership with the TPCHD, built capacity and competence across community groups to successfully obtain two funded public health initiatives for six priority populations. Members expressed overall satisfaction with the training, organizational structure, and leadership. The CCC’s diversity, cultural competency, and sharing of resources were viewed both as a strength and a decision-making challenge. Conclusion Public health department leadership, collaboration, and evidence-based assessment and evaluation were key to demonstrating effectiveness of the interventions, ensuring the CCC’s sustainability. PMID:19077598

  14. Health Education Needs: A Survey of Rural Adults in Butler County, Pennsylvania, 1975. An Interim Report. Rural Health Staff Papers - Paper Number 7.

    ERIC Educational Resources Information Center

    Leadley, Samuel M.; Taranto, Angelo A.

    In July and August 1975, 17 men and 63 women living in rural areas in Butler County, Pennsylvania were interviewed as to their behaviors, beliefs, and attitudes related to preventing cancer and coronary heart disease. Respondents represented about 12% of all adults living on commercial farms and 5% of all rural nonfarm adults in the county. A…

  15. Swing voting in the 2016 presidential election in counties where midlife mortality has been rising in white non-Hispanic Americans.

    PubMed

    Bilal, Usama; Knapp, Emily A; Cooper, Richard S

    2018-01-01

    Understanding the effects of widespread disruption of the social fabric on public health outcomes can provide insight into the forces that drive major political realignment. Our objective was to estimate the association between increases in mortality in middle-aged non-Hispanic white adults from 1999 to 2005 to 2009-2015, health inequalities in life expectancy by income, and the surge in support for the Republican Party in pivotal US counties in the 2016 presidential election. We conducted a longitudinal ecological study in 2764 US counties from 1999 to 2016. Increases in mortality were measured using age-specific (45-54 years of age) all-cause mortality from 1999 to 2005 to 2009-2015 at the county level. Support for the Republican Party was measured as the party's vote share in the presidential election in 2016 adjusted for results in 2008 and 2012. We found a significant up-turn in mortality from 1999 to 2005 to 2009-2015 in counties where the Democratic Party won twice (2008 and 2012) but where the Republican Party won in 2016 (+10.7/100,000), as compared to those in which the Democratic Party won in 2016 (-15.7/100,000). An increase in mortality of 15.2/100,000 was associated with a significant (p < 0.001) 1% vote swing from the 2008-2012 average to 2016. We also found that counties with wider health inequalities in life expectancy were more likely to vote Republican in 2016, regardless of the previous voting patterns. Counties with worsening premature mortality in the last 15 years and wider health inequalities shifted votes toward the Republican Party presidential candidate. Further understanding of causes of unanticipated deterioration in health in the general population can inform social policy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Local Public Health Systems and the Incidence of Sexually Transmitted Diseases

    PubMed Central

    Chen, Jie; Owusu-Edusei, Kwame; Suh, Allen; Bekemeier, Betty

    2012-01-01

    Objectives. We examined the associations of local public health system organization and local health department resources with county-level sexually transmitted disease (STD) incidence rates in large US health jurisdictions. Methods. We linked annual county STD incidence data (2005–2008) to local health department director responses (n = 211) to the 2006 wave of the National Longitudinal Study of Local Public Health Systems, the 2005 national Local Health Department Profile Survey, and the Area Resource File. We used nested mixed effects regression models to assess the relative contribution of local public health system organization, local health department financial and resource factors, and sociodemographic factors known to be associated with STD incidence to county-level (n = 307) STD incidence. Results. Jurisdictions with local governing boards had significantly lower county-level STD incidence. Local public health systems with comprehensive services where local health departments shoulder much of the effort had higher county-level STD rates than did conventional systems. Conclusions. More integration of system partners in local public health system activities, through governance and interorganizational arrangements, may reduce the incidence and burden of STDs. PMID:22813090

  17. The association between county political inclination and obesity: Results from the 2012 presidential election in the United States.

    PubMed

    Shin, Michael E; McCarthy, William J

    2013-11-01

    We examined whether stable, county-level, voter preferences were significantly associated with county-level obesity prevalence using data from the 2012 US Presidential election. County voting preference for the 2012 Republican Party presidential candidate was used as a proxy for voter endorsement of personal responsibility approaches to reducing population obesity risk versus approaches featuring government-sponsored, multi-sectoral efforts like those recommended by the Centers for Disease Control Centers for Disease Control (CDC, 2009). Cartographic visualization and spatial analysis were used to evaluate the geographic clustering of obesity prevalence rates by county, and county-level support for the Republican Party candidate in the 2012 U.S. presidential election. The spatial analysis informed the spatial econometric approach employed to model the relationship between political preferences and other covariates with obesity prevalence. After controlling for poverty rate, percent African American and Latino populations, educational attainment, and spatial autocorrelation in the error term, we found that higher county-level obesity prevalence rates were associated with higher levels of support for the 2012 Republican Party presidential candidate. Future public health efforts to understand and reduce obesity risk may benefit from increased surveillance of this and similar linkages between political preferences and health risks. © 2013.

  18. Urologist Density and County-Level Urologic Cancer Mortality

    PubMed Central

    Odisho, Anobel Y.; Cooperberg, Matthew R.; Fradet, Vincent; Ahmad, Ardalan E.; Carroll, Peter R.

    2010-01-01

    Purpose The surgical work force distribution at the county level varies widely across the United States, and the impact of differential access on cancer outcomes is unclear. We used urologists as a test case because they are the first care providers for urologic cancers, can easily be identified from available data sources, and are unevenly distributed throughout the country. The goal of this study was to determine the effect of increasing urologist density on local prostate, bladder, and kidney cancer mortality. Patients and Methods Using county-level data from the Area Resource File, US Census, National Cancer Institute, and Centers for Disease Control, regression models were built for prostate, bladder, and kidney cancer mortality, controlling for categorized urologist density, county demographics, socioeconomic factors, and preexisting health care infrastructure. Results For each of the three cancers, there was a statistically significant cancer-specific mortality reduction associated with counties that had more than zero urologists (16% to 22% reduction for prostate cancer, 17% to 20% reduction for bladder cancer, and 8% to 14% reduction for kidney cancer with increasing urologist density) relative to zero urologists. However, increasing density greater than two urologists per 100,000 people had no statistically significant impact on mortality for any of the tumors studied. Conclusion The presence of a urologist is associated with lower mortality for urologic cancers in that county, but increasing urologist density does not yield further improvements. Therefore, a nuanced and geographically aware policy toward the size and distribution of the future work force is most likely to provide the greatest population-level improvement in cancer mortality outcomes. PMID:20406931

  19. Public health assessment for C and R Battery Inc. , Richmond, Chesterfield County, Virginia, Region 3. Cerclis No. VAD049957913. Final report

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

    Not Available

    The C R Battery Company, Inc. property, a former battery recycling facility, is a National Priorities List (NPL) site situated in Chesterfield County, approximately 6 miles southeast of Richmond, Virginia. The contaminants found on the site at concentrations considered to be of concern include antimony, arsenic, cadmium, and lead. Potential exposure pathways include inhalation of contaminated dust, and the ingestion of contaminated groundwater. The site is an indeterminate public health hazard. However, data are not available for all environmental media to which humans may be exposed.

  20. Public water supplies in Gloucester County, New Jersey

    USGS Publications Warehouse

    Hardt, William F.

    1963-01-01

    Gloucester County is in the southwestern part of New Jersey, below Camden, and is a part of the Lower Delaware River Valley. This area is attracting new industry and has shown a population increase of about 47 percent from 1950 to 1960, mostly urban. With the economic growth of the county, the availability and quality of water become increasingly important.The county is in the Coastal Plain of New Jersey. It is underlain by unconsolidated sands and clays of Quaternary, Tertiary, and Cretaceous age. The Raritan and Magothy Formations constitute the most important aquifers and yield more than 95 percent of the water pumped by the public water systems in the county. These formations are capable of yielding 1,400 gpm (gallons per minute) or more to large diameter wells. High yielding wells generally can be drilled anywhere in the county, although the formations are deeper toward the Atlantic Ocean. The Cohansey Sand, second most important aquifer, yields up to 800 gpm or more from large diameter wells. This aquifer is present only in the sparsely populated southeastern half of the county. The Wenonah Formation and Mount Laurel Sand are capable of yielding 100 to 200 gpm in certain areas.The overall chemical quality of the naturally occurring ground water is good. The water generally meets the U.S. Public Health Service's (1962) suggested limit for dissolved solids; however, in some areas, the water carries objectionable amounts of iron and nitrate in solution and has a low pH. Contamination of ground water by salt-water encroachment or by pollution from industrial activity or organic waste in densely populated areas should be prevented. The quality rather than the quantity of water may be the important factor in future ground-water developments.The 21 public water systems in Gloucester County pumped about 1.3 billion gallons of water during 1948 and some 2.7 billion gallons during 1959. This is slightly more than a hundred percent increase in pumpage in 12 year s. The

  1. Ground-water resources and geology of Waukesha County, Wisconsin

    USGS Publications Warehouse

    Gonthier, Joseph B.

    1975-01-01

    Good-quality water is available from the sand-and-gravel, Niagara, and sandstone aquifers in Waukesha County, Wis. As much as 15 gallons per minute (0.95 litres per second) can be obtained from wells almost everywhere in the county. Several hundred gallons per minute are available from aquifers in the glacial drift that fill bedrock valleys to thicknesses of 300 feet (91 metres) or more. Estimated well yields from much of the surficial outwash in western Waukesha County exceed 500 gallons per minute (31 litres per second). Estimated well yields from most of the Niagara aquifer, a dolomite as much as 325 feet (99 metres) thick in the eastern two-thirds of the county, exceed 50 gallons per minute (3.2 litres per second). The sandstone aquifer underlies the entire county and ranges in thickness from about 400 feet (120 metres) in the northwest corner to about 2,400 feet (730 metres) in the southeast corner. This aquifer yields more than 1,000 gallons per minute (63 litres per second) to wells over most of the county and is the principal source for municipal and subdivision water. Ground water in Waukesha County is of good quality and is suitable for most uses. Most of the water is a calcium magnesium bicarbonate type, is very hard [more than 180 mg/l (milligrams per litre) hardness], and requires softening for some uses. The ground water locally contains iron and manganese concentrations that exceed the limits (0.3 and 0.05 mg/l, respectively) recommended by the U.S. Public Health Service (1962, p. 7). Water high in sulfate and dissolved solids (saline water) is present locally in the Niagara and sandstone aquifers. Water from one well contained excessive nitrate (more than 45 mg/l). With one exception, wells sampled at irregular intervals indicated no significant changes in their chemical characteristics with time. About 24.3 million gallons per day (1.06 cubic metres per second) of ground water was pumped in the county in 1970. Sixty-two percent was withdrawn from

  2. Health assessment for Norman Poer Farm National Priorities List (NPL) Site, Hancock County, Indiana, Region 5. CERCLIS No. IND980684583. Final report

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

    Not Available

    The Norman Poer Farm National Priorities List site is situated in Hancock County, Indiana. Offgrade solvents and paint resin materials were stored on-site in 263 fifty-five gallon drums. The U.S. Environmental Protection Agency removed all the drums and the top six to eight inches of soil at the three drum storage areas in 1983. The Remedial Investigation (RI) conducted after the emergency removal did not show any contamination of the environment on-site or off-site. Based on the available information, the site is considered to be of no public health concern because of the absence of exposure to hazardous substances. Nomore » health study follow-up is indicated at this time.« less

  3. HOME ENVIRONMENT AND CHILDHOOD ASTHMA IN A RURAL IOWA COUNTY

    EPA Science Inventory

    HOME ENVIRONMENT AND CHILDHOOD ASTHMA IN A RURAL IOWA COUNTY
    Erik R. Svendsen*?, Stephen J. Reynolds*?, James A. Merchant*, Allison L. Naleway*?, Ann M. Stromquist*, Peter S. Thorne*.
    *University of Iowa College of Public Health, Iowa City, IA ?Current: USEPA RTP, NC ?Curre...

  4. Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas
- Behavioral Risk Factor Surveillance System, United States, 2012.

    PubMed

    Chowdhury, Pranesh P; Mawokomatanda, Tebitha; Xu, Fang; Gamble, Sonya; Flegel, David; Pierannunzi, Carol; Garvin, William; Town, Machell

    2016-04-29

    Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S. Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level. January-December 2012. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. This report presents results for all 50 states, the District of Columbia, participating U.S. territories that include the Commonwealth of Puerto Rico (Puerto Rico) and Guam, 187 Metropolitan/Micropolitan Statistical Areas (MMSAs), and 210 counties (n = 475,687 survey respondents) for the year 2012. In 2012, the estimated prevalence of health-risk behaviors, chronic diseases or conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of the abstract lists a summary of results by selected BRFSS measures. Each set of proportions refers to the range of

  5. Social Determinants of HIV Disparities in the Southern United States and in Counties with Historically Black Colleges and Universities (HBCUs), 2013–2014

    PubMed Central

    Sutton, Madeline Y.; Gray, Simone C.; Elmore, Kim; Gaul, Zaneta

    2017-01-01

    HIV infection disproportionately affects Blacks in the southern United States (U.S.), a region where legal policies that may unintentionally impede earlier HIV detection and treatment are prevalent. Historically Black Colleges and Universities (HBCUs) have historically facilitated social change in communities of color and have been underexplored as partners for HIV prevention. We describe geographic and social determinants of health (SDH) in the southern U.S. to inform potential HBCU-public health partnerships that might improve HIV health equity. We evaluated the relationship between county-level HIV prevalences (2013), HBCU geographic coordinates, and SDH variables in the southern counties with HBCUs. U.S. Census-derived SDH variables included race/ethnicity (i.e., Black, White, Hispanic), unemployment, female head of household, poverty, percent owner-occupied housing units, urbanicity, and primary care provider rates. Associations were assessed using bivariate and multivariable linear regression. Of 104 HBCUs in the contiguous U.S., 100 (96%) were located in 69 southern counties with average Black populations of 40% and an average HIV prevalence of 615. 5 per 100,000, over two times the national rate (295.1 per 100,000). In bivariable analyses, higher HIV rates in these counties were associated with higher percent Black population, unemployment, female head of household, poverty, fewer owner-occupied housing units, and greater urbanicity (p < 0.05). In multivariable analyses, counties with higher HIV rates had higher percentages of Blacks, greater urbanicity, fewer owner-occupied housing units, and more female heads of households (p < 0.05). The southern U.S. is disproportionately affected by HIV, and many HBCUs are located in affected southern counties. HBCUs may be important public health partners for helping to develop structural interventions that strengthen HIV policies in support of health equity in these southern, mostly urban counties. PMID:28107532

  6. A Mixed-Methods Evaluation of the Choose Less, Weigh Less Portion Size Health Marketing Campaign in Los Angeles County.

    PubMed

    Gase, Lauren N; Barragan, Noel C; Robles, Brenda; Leighs, Michael; Kuo, Tony

    2015-01-01

    To assess the impact of the Choose Less, Weigh Less portion size health marketing campaign. A mixed-methods, cross-sectional evaluation. A quantitative Internet panel survey was administered through an online sampling vendor and qualitative interviews were conducted by street intercept. The panel survey included 796 participants, weighted to represent Los Angeles County. Street intercept interviews were conducted with 50 other participants. The Choose Less, Weigh Less campaign included print media on transit shelters, bus and rail cars, and billboards; radio and online advertising; and Web site content and social media outreach. The panel survey measured self-reported campaign exposure and outcomes, including knowledge of recommended daily calorie limits, attitudes toward portion sizes, and intent to reduce calories and portion size. Intercept interviews assessed campaign appeal, clarity, and utility. Weighted survey data were analyzed using logistic regression to assess the association between campaign exposure and outcomes. Interview data were analyzed for themes. The campaign reached 19.7% of the Los Angeles County population. Significant differences were seen for 2 of the 10 outcomes assessed. Participants who saw the campaign were more likely than those who did not to report fast-food portion sizes as being too large (adjusted odds ratio [Adj. OR]: 1.89; 95% confidence interval [CI]: 1.16, 3.07) and intention to choose a smaller portion (Adj. OR: 1.99; 95% CI: 1.20, 3.31). Qualitative data revealed three themes about appeal, clarity, and utility. Health marketing efforts targeting portion size can have relatively broad reach and limited but positive impacts on consumer attitudes and intent to select smaller portions.

  7. Public health assessment for Commencement Bay, South Tacoma Field, Tacoma, Pierce County, Washington, Region 10. Cerclis No. WAD980724173 (A/K/A Commencement Bay, South Tacoma Channel, Tacoma, Pierce County, Washington, Region 10. Cerclis No. WAD980726301). Final report

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

    NONE

    The Commencement Bay, South Tacoma Field site occupies 260 acres of land located in the southwestern section of the city of Tacoma in Pierce County, Washington. The South Tacoma Field site poses a public health hazard to trespassers who repeatedly ingest contaminated surface soils, surface water, and sediment during recreational activities at the site. Exposure to the contaminants arsenic, copper, lead, manganese, as well as polychlorinated biphenyl and polycyclic aromatic hydrocarbon compounds may have occurred in the past, may be presently occurring, and may occur in the future, which could result in noncarcinogenic and carcinogenic health effects. Potentially, the sitemore » can pose a public health hazard through exposure to groundwater and subsurface soil contaminants that could cause adverse health effects. Additionally, should contruction/excavation uncover contaminated subsurface soils, workers as well as recreationalists/trespassers may be exposed.« less

  8. Community health education improves child health care in Rural Western China.

    PubMed

    Liang, Weifeng; Xing, Yuan; Pang, Miaomiao; Wang, Duolao; Yan, Hong

    2018-04-10

    Rural infant growth failure has been highlighted as a priority for action in China's national nutrition and child development policies. The aim of this paper was to evaluate the effect of community-based intervention project on child feeding, child health care and child growth. From 2001 to 2005, UNICEF and China's Ministry of Health worked together to develop holistic strategies for child health care. All the interventions were implemented through the three-tier (county-township-village) rural health care network.In this study, 34 counties were included in both surveys in 2001 and 2005. Among these 34 counties, nine were subjected to the intervention and 25 counties were used as controls. In nine intervention counties, leaflets containing information of supplemental feeding of infants and young children were printed and distributed to women during hospital delivery or visit to newborn by village doctors. Two cross-sectional surveys were both conducted from July to early September in 2001 and 2005. We calculated Z-scores of height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ), with the new WHO growth standard. HAZ < - 2 was defined as stunting, WAZ < - 2 was defined as underweight, and WHZ < - 2 was defined as wasting. Following the four-year study period, the parents in the intervention group showed significantly better infant and young child feeding practices and behaviors of child care than did their control group counterparts. In addition, all three anthropometric indicators in 2005 in the intervention group were better than in the control, with stunting 4.9% lower (p < 0.001), underweight 2.2% lower (p < 0.001), and wasting 1.0% lower (p < 0.05). We concluded that the health care education intervention embed in government had the potential to be successfully promoted in rural western China.

  9. Health assessment for Salem Acres, Essex County, Salem, Massachusetts, Region 1. CERCLIS No. MAD980525240. Preliminary report

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

    Not Available

    The Salem Acres, Incorporated site is a 235 acre parcel located in Salem, Essex County, Massachusetts. There are pits at the site which have apparently been filled with sewage sludge and tannery wastes. Organic compounds and metals have been found in the sludge in the pits, generally in the high parts-per-million range in very limited testing. Compounds detected in sludge included PCB-1254, lead, chromium, and mercury. Soil samples in the area did not show evident contamination. Off-site surface water had elevated levels of lead; two measurements were 64 ug/l and 89 ug/l, approximately. An oil sheen in surface water andmore » vegetation typical of polluted areas indicated water quality degradation. The site is considered to be of potential public health concern because of the risk to human health caused by the possibility of exposure to hazardous substances via continued direct exposure to soils, sediments and sludge residues in marginal areas of the site, and any consumption of any fish from the streams draining the site.« less

  10. Access to Primary Care in US Counties Is Associated with Lower Obesity Rates.

    PubMed

    Gaglioti, Anne H; Petterson, Stephen; Bazemore, Andrew; Phillips, Robert

    2016-01-01

    Obesity causes substantial morbidity and mortality in the United States. Evidence shows that primary care physician (PCP) supply correlates positively with improved health, but its association with obesity in the United States as not been adequately characterized. Our purpose was to characterize the association between PCP supply in US counties and adult obesity. We performed a multivariate logistic regression analysis to examine the relationship between county-level PCP supply and individual obesity status. We controlled for individual variables, including sex, race, marital status, income, and insurance status, and county-level variables, including rurality and poverty. Higher county-level PCP supply was associated with lower adult obesity after controlling for common confounders. Individuals living in counties with the most robust PCP supply were about 20% less likely to be obese (P ≤ .01) than those living in counties with the lowest PCP supply. While the observed association between the supply of PCPs and lower rates of obesity may not be causal, the association warrants further investigation. This may have important implications for restructuring the physician workforce in the context of the current PCP shortage and implementation of the Affordable Care Act and the patient-centered medical home. © Copyright 2016 by the American Board of Family Medicine.

  11. Comparison of ArcGIS and SAS Geostatistical Analyst to Estimate Population-Weighted Monthly Temperature for US Counties.

    PubMed

    Xiaopeng, Q I; Liang, Wei; Barker, Laurie; Lekiachvili, Akaki; Xingyou, Zhang

    Temperature changes are known to have significant impacts on human health. Accurate estimates of population-weighted average monthly air temperature for US counties are needed to evaluate temperature's association with health behaviours and disease, which are sampled or reported at the county level and measured on a monthly-or 30-day-basis. Most reported temperature estimates were calculated using ArcGIS, relatively few used SAS. We compared the performance of geostatistical models to estimate population-weighted average temperature in each month for counties in 48 states using ArcGIS v9.3 and SAS v 9.2 on a CITGO platform. Monthly average temperature for Jan-Dec 2007 and elevation from 5435 weather stations were used to estimate the temperature at county population centroids. County estimates were produced with elevation as a covariate. Performance of models was assessed by comparing adjusted R 2 , mean squared error, root mean squared error, and processing time. Prediction accuracy for split validation was above 90% for 11 months in ArcGIS and all 12 months in SAS. Cokriging in SAS achieved higher prediction accuracy and lower estimation bias as compared to cokriging in ArcGIS. County-level estimates produced by both packages were positively correlated (adjusted R 2 range=0.95 to 0.99); accuracy and precision improved with elevation as a covariate. Both methods from ArcGIS and SAS are reliable for U.S. county-level temperature estimates; However, ArcGIS's merits in spatial data pre-processing and processing time may be important considerations for software selection, especially for multi-year or multi-state projects.

  12. Hydrology of Polk County, Florida

    USGS Publications Warehouse

    Spechler, Rick M.; Kroening, Sharon E.

    2007-01-01

    Local water managers usually rely on information produced at the State and regional scale to make water-resource management decisions. Current assessments of hydrologic and water-quality conditions in Polk County, Florida, commonly end at the boundaries of two water management districts (South Florida Water Management District and the Southwest Florida Water Management District), which makes it difficult for managers to determine conditions throughout the county. The last comprehensive water-resources assessment of Polk County was published almost 40 years ago. To address the need for current countywide information, the U.S. Geological Survey began a 3?-year study in 2002 to update information about hydrologic and water-quality conditions in Polk County and identify changes that have occurred. Ground-water use in Polk County has decreased substantially since 1965. In 1965, total ground-water withdrawals in the county were about 350 million gallons per day. In 2002, withdrawals totaled about 285 million gallons per day, of which nearly 95 percent was from the Floridan aquifer system. Water-conservation practices mainly related to the phosphate-mining industry as well as the decrease in the number of mines in operation in Polk County have reduced total water use by about 65 million gallons per day since 1965. Polk County is underlain by three principal hydrogeologic units. The uppermost water-bearing unit is the surficial aquifer system, which is unconfined and composed primarily of clastic deposits. The surficial aquifer system is underlain by the intermediate confining unit, which grades into the intermediate aquifer system and consists of up to two water-bearing zones composed of interbedded clastic and carbonate rocks. The lowermost hydrogeologic unit is the Floridan aquifer system. The Floridan aquifer system, a thick sequence of permeable limestone and dolostone, consists of the Upper Floridan aquifer, a middle semiconfining unit, a middle confining unit, and

  13. Potential Impacts of Climate Change on Sediment - Water Exchange of Mercury in a Managed Flood Conveyance System

    NASA Astrophysics Data System (ADS)

    Heim, W. A.; Stephenson, M.; Negrey, J.; Gill, G. A.; Coale, K. H.; DiGiorgio, C.; Harris, R. C.

    2016-12-01

    Yolo Bypass is the largest flood bypass in the Sacramento Valley, California. During high flow flood events water is diverted into the Yolo Bypass from the Sacramento River to control river stage and protect the cities of Sacramento, West Sacramento, and Davis from flooding. Climate change projections for the Yolo Bypass indicate the risk of flooding will increase. An increase in flooding would result in increased connectivity of the flood plain with downstream habitats as well as provide conditions favorable for in situ production of methylmercury (MeHg). Conversion of inorganic mercury (Hg) to the more toxic organic form MeHg in freshwater systems is generally accepted to be mediated by bacteria activity. There are a number of environmental variables (organic carbon, sulfate, oxygen) and conditions (temperature, porosity, soil type) that could influence the net production of MeHg and its ultimate release into the water column. This study investigated sediment-water exchange of both Hg and MeHg from the following habitat types in the Yolo Bypass: wild rice, white rice, seasonal wetlands, irrigated pasture, non-irrigated pasture, fallow land, farm land, freshwater tidal wetland, and agricultural drain. Two methods were used to determine sediment-water exchange of inorganic and organic mercury; first a direct assessment using incubated cores and second, modeling the sediment-water exchange from measurements of interstitial pore water concentration gradients. Results indicate habitat type, land use, and flooding influence Hg and MeHg fluxes. If flooding frequency increases in the Yolo Bypass mercury fluxes are expected to increase resulting in an increase in Hg load to downstream habitats and an increase in biotic exposure to MeHg in the system. A next step will be to utilize data generated from this study in the Dynamic Mercury Cycling Model (D-MCM) which will be used to improve our understanding of factors controlling production and transport of Hg and MeHg in the

  14. Effectiveness of Kenya's Community Health Strategy in delivering community-based maternal and newborn health care in Busia County, Kenya: non-randomized pre-test post test study

    PubMed Central

    Wangalwa, Gilbert; Cudjoe, Bennett; Wamalwa, David; Machira, Yvonne; Ofware, Peter; Ndirangu, Meshack; Ilako, Festus

    2012-01-01

    Background Maternal mortality ratio and neonatal mortality rate trends in Kenya have remained unacceptably high in a decade. In 2007, the Ministry of Public Health and Sanitation adopted a community health strategy to reverse the poor health outcomes in order to meet Millennium Development Goals 4 and 5. It aims at strengthening community participation and its ability to take action towards health. The study aimed at evaluating the effectiveness of the strategy in improving maternal and neonatal health outcomes in Kenya. Methods Between 2008 and 2010, the African Medical and Research Foundation implemented a community-based maternal and newborn care intervention package in Busia County using the community health strategy approach. An interventional, non-randomized pre-test post test study design was used to evaluate change in essential maternal and neonatal care practices among mothers with children aged 0 - 23 months. Results There was statistically significant (p < 0.05) increase in attendance of at least four antenatal care visits (39% to 62%), deliveries by skilled birth attendants (31% to 57%), receiving intermittent preventive treatment (23% to 57%), testing for HIV during pregnancy (73% to 90%) and exclusive breastfeeding (20% to 52%). Conclusion The significant increase in essential maternal and neonatal care practices demonstrates that, community health strategy is an appropriate platform to deliver community based interventions. The findings will be used by actors in the child survival community to improve current approaches, policies and practice in maternal and neonatal care. PMID:23467438

  15. Effectiveness of Kenya's Community Health Strategy in delivering community-based maternal and newborn health care in Busia County, Kenya: non-randomized pre-test post test study.

    PubMed

    Wangalwa, Gilbert; Cudjoe, Bennett; Wamalwa, David; Machira, Yvonne; Ofware, Peter; Ndirangu, Meshack; Ilako, Festus

    2012-01-01

    Maternal mortality ratio and neonatal mortality rate trends in Kenya have remained unacceptably high in a decade. In 2007, the Ministry of Public Health and Sanitation adopted a community health strategy to reverse the poor health outcomes in order to meet Millennium Development Goals 4 and 5. It aims at strengthening community participation and its ability to take action towards health. The study aimed at evaluating the effectiveness of the strategy in improving maternal and neonatal health outcomes in Kenya. Between 2008 and 2010, the African Medical and Research Foundation implemented a community-based maternal and newborn care intervention package in Busia County using the community health strategy approach. An interventional, non-randomized pre-test post test study design was used to evaluate change in essential maternal and neonatal care practices among mothers with children aged 0 - 23 months. There was statistically significant (p < 0.05) increase in attendance of at least four antenatal care visits (39% to 62%), deliveries by skilled birth attendants (31% to 57%), receiving intermittent preventive treatment (23% to 57%), testing for HIV during pregnancy (73% to 90%) and exclusive breastfeeding (20% to 52%). The significant increase in essential maternal and neonatal care practices demonstrates that, community health strategy is an appropriate platform to deliver community based interventions. The findings will be used by actors in the child survival community to improve current approaches, policies and practice in maternal and neonatal care.

  16. Association Between County-Level Characteristics and Eye Care Use by US Adults in 22 States After Accounting for Individual-Level Characteristics Using a Conceptual Framework.

    PubMed

    Chou, Chiu-Fang; Beckles, Gloria L; Cheng, Yiling J; Saaddine, Jinan B

    2016-10-01

    Individual-level characteristics are associated with eye care use. The influence of contextual factors on vision and eye health, as well as health behavior, is unknown. To examine the association between county-level characteristics and eye care use after accounting for individual-level characteristics using a conceptual framework. This investigation was a cross-sectional study of respondents 40 years and older participating in the Behavioral Risk Factor Surveillance System surveys between 2006 and 2010 from 22 states that used the Visual Impairment and Access to Eye Care module. Multilevel regressions were used to examine the association between county-level characteristics and eye care use after adjusting for individual-level characteristics (age, sex, race/ethnicity, educational attainment, annual household income, employment status, health care insurance coverage, eye care insurance coverage, personal established physician, poor vision or eye health, and diabetes status). Data analysis was performed from March 23, 2014, to June 7, 2016. Eye care visit and receipt of a dilated eye examination in the past year. Among 117 295 respondents who resided in 828 counties, individual-level data were obtained from the Behavioral Risk Factor Surveillance System surveys. All county-level variables were aggregated at the county level from the Behavioral Risk Factor Surveillance System surveys except for a high geographic density of eye care professionals, which was obtained from the 2010 Area Health Resource File. After controlling for individual-level characteristics, the odds of reporting an eye care visit in the past year were significantly higher among people living in counties with high percentages of black individuals (adjusted odds ratio [aOR], 1.12; 95% CI, 1.01-1.24; P = .04) or low-income households (aOR, 1.12; 95% CI, 1.00-1.25; P = .045) or with a high density of eye care professionals (aOR, 1.18; 95% CI, 1.07-1.29; P < .001) than among those living

  17. Future-oriented tweets predict lower county-level HIV prevalence in the United States.

    PubMed

    Ireland, Molly E; Schwartz, H Andrew; Chen, Qijia; Ungar, Lyle H; Albarracín, Dolores

    2015-12-01

    Future orientation promotes health and well-being at the individual level. Computerized text analysis of a dataset encompassing billions of words used across the United States on Twitter tested whether community-level rates of future-oriented messages correlated with lower human immunodeficiency virus (HIV) rates and moderated the association between behavioral risk indicators and HIV. Over 150 million tweets mapped to U.S. counties were analyzed using 2 methods of text analysis. First, county-level HIV rates (cases per 100,000) were regressed on aggregate usage of future-oriented language (e.g., will, gonna). A second data-driven method regressed HIV rates on individual words and phrases. Results showed that counties with higher rates of future tense on Twitter had fewer HIV cases, independent of strong structural predictors of HIV such as population density. Future-oriented messages also appeared to buffer health risk: Sexually transmitted infection rates and references to risky behavior on Twitter were associated with higher HIV prevalence in all counties except those with high rates of future orientation. Data-driven analyses likewise showed that words and phrases referencing the future (e.g., tomorrow, would be) correlated with lower HIV prevalence. Integrating big data approaches to text analysis and epidemiology with psychological theory may provide an inexpensive, real-time method of anticipating outbreaks of HIV and etiologically similar diseases. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  18. Future-Oriented Tweets Predict Lower County-Level HIV Prevalence in the United States

    PubMed Central

    Ireland, Molly E.; Schwartz, Hansen A.; Chen, Qijia; Ungar, Lyle; Albarracín, Dolores

    2016-01-01

    Objective Future orientation promotes health and well-being at the individual level. Computerized text analysis of a dataset encompassing billions of words used across the United States on Twitter tested whether community-level rates of future-oriented messages correlated with lower HIV rates and moderated the association between behavioral risk indicators and HIV. Method Over 150 million Tweets mapped to US counties were analyzed using two methods of text analysis. First, county-level HIV rates (cases per 100,000) were regressed on aggregate usage of future-oriented language (e.g., will, gonna). A second data-driven method regressed HIV rates on individual words and phrases. Results Results showed that counties with higher rates of future tense on Twitter had fewer HIV cases, independent of strong structural predictors of HIV such as population density. Future-oriented messages also appeared to buffer health risk: Sexually transmitted infection rates and references to risky behavior on Twitter were associated with higher HIV prevalence in all counties except those with high rates of future orientation. Data-driven analyses likewise showed that words and phrases referencing the future (e.g., tomorrow, would be) correlated with lower HIV prevalence. Conclusion Integrating big data approaches to text analysis and epidemiology with psychological theory may provide an inexpensive, real-time method of anticipating outbreaks of HIV and etiologically similar diseases. PMID:26651466

  19. Somerset County Renewable Energy Initiative

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

    Katula, Denise

    2014-05-07

    The County of Somerset, New Jersey, through the Somerset County Improvement Authority (SCIA), applied Federal funding through the U.S. Department of Energy to will apply project funds to buy-down the capital costs of equipment associated with the installation of solar photovoltaic (PV) systems at two sites owned by the County. This Renewable Energy Initiative allows the County to take advantage of clean renewable energy, without any adverse debt impacts, and at a price that results in operating budget savings beyond what is presently available in the marketplace. This project addressed the objectives of the Office of Energy Efficiency and Renewablemore » Energy by making the acquisition of renewable energy more affordable for the County, thereby, encouraging other counties and local units to develop similar programs and increase the deployment of solar energy technologies. The two sites that were funded by the DOE grant are part of a much larger, ambitious, and unique renewable energy project, described in the next section.« less

  20. Successful practices in title III implementation. Chemical Emergency Preparedness and Prevention Technical Assistance Bulletin. Cameron County, Texas; Bucks County, Pennsylvania; Harford County, Maryland; Dallas County, Texas. Series 6, Number 7

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

    Not Available

    This is another in a series of bulletins EPA is issuing to provide examples of implementation programs and strategies of the Emergency Planning and Community Right-to-Know Act of 1986, known as Title III, that are innovative or have proven effective. The purpose of these bulletins is to share information on successful practices with Local Emergency Planning Committees (LEPCs), State Emergency Response Commissions (SERCs), fire departments, and other Title III implementing agencies throughout the country in the hope that such information will prove useful to other SERCs and LEPCs as their programs develop and evolve. The bulletin discusses Title III implementationmore » for Cameron County in Texas, Bucks County in Pennsylvania, Harford County in Maryland, and Dallas County in Texas.« less

  1. Minority politics in the house of medicine: the physicians forum and the New York County Medical Society, 1938-1965.

    PubMed

    Brickman, J P

    1999-01-01

    The late 1930s challenged laissez-faire medicine. Recognition of serious inadequacies in the distribution of medical services stirred activists who questioned fee-for-service delivery and posited a national health program, including health insurance. The AMA and its components--state and county medical societies--counterattacked, mobilizing money and their powerful political arsenal to fight government intrusion in private medicine. The Physicians Forum, initially under the leadership of Ernst P. Boas, emerged as a formidable element within the New York County Medical Society (the largest component of the AMA). The Forum provoked discussion of medical indigence and economics, upsetting the Society leadership with independent candidate slates and telling the public that doctors spoke with more than one voice. For 25 years, the Physicians Forum altered the dynamics of the Medical Society of the County of New York. While the Forum effort to institutionalize minority opinion in the councils of medicine failed, the interchange between County regulars and Forum insurgents broadened the medical reform agenda and moved the County Society in directions that historically it had avoided. Although medical economics formed an unbridgeable chasm between County regulars and rebels, Forum members demonstrated that medicine was not monolithic, that "majority opinion [was not] ... unanimous opinion," and that doctors must speak to issues of medical and social policy.

  2. Implementation of a hypertension control program in the County of North Karelia, Finland

    PubMed Central

    Nissinen, Aulikki; Tuomilehto, Jaako; Elo, Jyrki; Salonen, Jukka T.; Puska, Pekka

    1981-01-01

    A hypertension control program was established as part of the more comprehensive North Karelia Project. This project was started in 1972 in response to a petition from the population of North Karelia, a county in Finland, asking for national assistance to reduce the exceptionally high cardiovascular disease mortality and morbidity in the area. The North Karelia Project was carried out from 1972 to 1977. The hypertension control program was implemented mainly in local health centers by physicians and public health nurses, who followed guidelines issued by the project staff and worked under its supervision. Although the target population for the North Karelia Project was the entire population of North Karelia, the project focused on middle-aged men. The hypertension subprogram was introduced in steps. Its objectives included the training of health personnel, establishment of an information system in the county to educate people about hypertension, and organization of the detection, treatment, and followup of hypertensives. A hypertension dispensary was established in each of the 12 health centers in the county. Continuous training of the local public health nurses and physicians faciliated integration of the hypertension program into the operations of the health centers. A central hypertension register and the hypertension control clinics at the health centers were the essential tools in the systematic followup of hypertensives. Some 17,000 hypertensives were on the register by the end of the 5-year project. The main aim in providing health education about hypertension, as well as in treating hypertension itself, was to prevent severe cardiovascular diseases as a whole. Therefore the hypertension control program was integrated into the comprehensive cardiovascular disease control program, and hypertensives received advice concerning smoking and dietary changes as well as about high blood pressure. A survey of health care personnel in North Karelia and in a reference

  3. Heart Disease Death Rates in Low Versus High Land Elevation Counties in the U.S.

    PubMed

    Hart, John

    2015-01-01

    Previous research on land elevation and cancer death rates in the U.S. revealed lower cancer death rates in higher elevations. The present study further tests the possible effect of land elevation on a diffident health outcome, namely, heart disease death rates. U.S. counties not overlapping in their land elevations according to their lowest and highest elevation points were identified. Using an ecological design, heart disease death rates for two races (black and white) corresponding to lower elevation counties were compared to heart disease death rates in higher land elevation counties using the two-sample t-test and effect size statistics. Death rates in higher land elevation counties for both races were lower compared to the death rates in lower land elevation counties (p < 0.001) with large effect sizes (of > 0.70). Since this is an observational study, no causal inference is claimed, and further research is indicated to verify these findings.

  4. Heart Disease Death Rates in Low Versus High Land Elevation Counties in the U.S

    PubMed Central

    2015-01-01

    Previous research on land elevation and cancer death rates in the U.S. revealed lower cancer death rates in higher elevations. The present study further tests the possible effect of land elevation on a diffident health outcome, namely, heart disease death rates. U.S. counties not overlapping in their land elevations according to their lowest and highest elevation points were identified. Using an ecological design, heart disease death rates for two races (black and white) corresponding to lower elevation counties were compared to heart disease death rates in higher land elevation counties using the two-sample t-test and effect size statistics. Death rates in higher land elevation counties for both races were lower compared to the death rates in lower land elevation counties (p < 0.001) with large effect sizes (of > 0.70). Since this is an observational study, no causal inference is claimed, and further research is indicated to verify these findings. PMID:26674102

  5. Factors influencing patient safety in Sweden: perceptions of patient safety officers in the county councils

    PubMed Central

    2013-01-01

    Background National, regional and local activities to improve patient safety in Sweden have increased over the last decade. There are high ambitions for improved patient safety in Sweden. This study surveyed health care professionals who held key positions in their county council’s patient safety work to investigate their perceptions of the conditions for this work, factors they believe have been most important in reaching the current level of patient safety and factors they believe would be most important for achieving improved patient safety in the future. Methods The study population consisted of 218 health care professionals holding strategic positions in patient safety work in Swedish county councils. Using a questionnaire, the following topics were analysed in this study: profession/occupation; number of years involved in a designated task on patient safety issues; knowledge/overview of the county council’s patient safety work; ability to influence this work; conditions for this work; and the importance of various factors for current and future levels of patient safety. Results The response rate to the questionnaire was 79%. The conditions that had the highest number of responses in complete agreement were “patients’ involvement is important for patient safety” and “patient safety work has good support from the county council’s management”. Factors that were considered most important for achieving the current level of patient safety were root cause and risk analyses, incident reporting and the Swedish Patient Safety Law. An organizational culture that encourages reporting and avoids blame was considered most important for improved patient safety in the future, closely followed by improved communication between health care practitioners and patients. Conclusion Health care professionals with important positions in the Swedish county councils’ patient safety work believe that conditions for this work are somewhat constrained. They attribute

  6. Fuelwood use in U.S. counties

    Treesearch

    Kenneth E. Skog; Robert S. Manthy

    1989-01-01

    This study explains and determines fuelwood consumption at the county level based on county economic and demographic conditions, and identifies U.S. counties where potential fuelwood use problems and benefits are greatest. The percentage of wood-burning households in a county is estimated and multiplied by estimated average wood consumed per wood-burning household in...

  7. Examination of the relative importance of hospital employment in non-metropolitan counties using location quotients.

    PubMed

    Smith, Jon L

    2013-01-01

    The US Health Care and Social Services sector (North American Industrial Classification System 'sector 62') has become an extremely important component of the nation's economy, employing approximately 18 million workers and generating almost $753 billion in annual payrolls. At the county level, the health care and social services sector is typically the largest or second largest employer. Hospital employment is often the largest component of the sector's total employment. Hospital employment is particularly important to non-metropolitan or rural communities. A high quality healthcare sector serves to promote economic development and attract new businesses and to provide stability in economic downturns. The purpose of this study was to examine the intensity of hospital employment in rural counties relative to the nation as a whole using location quotients and to draw conclusions regarding how potential changes in Medicare and Medicaid might affect rural populations. Estimates for county-level hospital employment are not commonly available. Estimates of county-level hospital employment were therefore generated for all counties in the USA the Census Bureau's County Business Pattern Data for 2010. These estimates were used to generate location quotients for each county which were combined with demographic data to generate a profile of factors that are related to the magnitude of location quotients. The results were then used to draw inferences regarding the possible impact of the Patient Protection and Affordable Care Act 2010 (ACA) and the possible imposition of aspects of the Budget Control Act 2011 (BCA). Although a very high percentage of rural counties contain medically underserved areas, an examination of location quotients indicates that the percentage of the county workforce employed by hospitals in the most rural counties tends to be higher than for the nation as a whole, a counterintuitive finding. Further, when location quotients are regressed upon data

  8. 2. HEALTH CENTER OFFICE SOUTH BACK AND EAST SIDE, FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. HEALTH CENTER OFFICE SOUTH BACK AND EAST SIDE, FROM PASSAGE BEHIND COURTHOUSE, CAMERA FACING NORTHWEST. - Lancaster County Center, Health Center Office, 4845 Cedar Avenue, Lancaster, Los Angeles County, CA

  9. Assessment of biological conditions at selected stream sites in Johnson County, Kansas, and Cass and Jackson Counties, Missouri, 2003 and 2004

    USGS Publications Warehouse

    Poulton, Barry C.; Rasmussen, Teresa J.; Lee, Casey J.

    2007-01-01

    Macroinvertebrate samples were collected at 15 stream sites representing 11 different watersheds in Johnson County, Kansas, in 2003 and 2004 to assess biological conditions in streams and relations to environmental variables. Published data from an additional seven stream sites, one in Johnson County, Kansas, and six others in adjacent Cass and Jackson Counties in Missouri also were evaluated. Multimetric scores, which integrated a combination of measures that describe various aspects of biological community abundance and diversity, were used to evaluate and compare the biological health of streams. In addition, for 15 of 16 Johnson County stream sites, environmental data (streamflow, precipitation, and land use) and water- and sediment-quality data (primarily nutrients, indicator bacteria, and organic wastewater compounds) were used in statistical analyses to evaluate relations between macroinvertebrate metrics and variables that may affect them. The information is useful for defining current conditions, evaluating conditions relative to State aquatic-life support and total maximum daily load requirements, evaluating effects of urbanization, developing effective water-quality management plans, and documenting changes in biological condition and water quality.Biological conditions in selected Johnson County streams generally reflected a gradient in the degree of human disturbances upstream from the sites, including percentage of urban and agricultural land use as well as the presence, absence, and proximity of wastewater treatment discharges. In this report, the term gradient is used to describe a continuum in the conditions (biological, environmental, or land use) observed at the study sites. Upstream Blue River sites, downstream from primarily agricultural land use, consistently scored among the sites least impacted by human disturbance, and in some metrics these sites scored higher than the State reference site (Captain Creek). The term impact, as used in this

  10. 77 FR 14032 - John H. Chafee Coastal Barrier Resources System; Lee County, FL, and Newport County, RI...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-08

    ..., FXHC11240900000T5, 123] John H. Chafee Coastal Barrier Resources System; Lee County, FL, and Newport County, RI... Lee County, Florida. The second map, dated September 30, 2009, is for four CBRS units located in... by Lee County, and 1 restaurant. The Service's assessment of 2011 aerial imagery estimates that the...

  11. Acute Health Effects Among Military Personnel Participating in the Cleanup of the Hebei Spirit Oil Spill, 2007, in Taean County, Korea

    PubMed Central

    Gwack, Jin; Lee, Ju Hyung; Kang, Young Ah; Chang, Kyu-jin; Lee, Moo Sik; Hong, Jee Young

    2012-01-01

    Objectives This study was conducted to investigate acute health effects and its related factors among military personnel participating in the cleanup of the 2007 Hebei Spirit oil spill accident in Taean county, Korea. Methods We collected data on acute symptoms during the cleanup and their predictors using a self-administered questionnaire to 2624 military personnel. Selfreported symptoms included six neurologic symptoms, five respiratory symptoms, two dermatologic symptoms, three ophthalmic symptoms, and three general symptoms. Independent variables were demographic factors (gender, age, education level, and rank), health behavioral factors (smoking history and usage of the personal protective equipment such as masks and gloves), and occupational history such as where and for how long individuals participated in cleanup. Results The duration of work days was significantly associated with 17 acute symptoms except for itchiness and red skin.Working in Taean county also increased the risk of most acute symptoms except headache and back pain. In regard to personal protective equipment, wearing masks was mainly related to the development of respiratory symptoms such as sore throat and wearing other protective equipment was related to the development of sore throat, back pain, headache, and cough. Military personnel younger than 25 years reported 4.66 times more hot flushing and 5.39 times more itchiness than those older than 25 years. Conclusion It should be emphasized that for early-stage cleanup the number of workers should be minimized, sufficient personal protective equipment with approved quality for blocking noxious gas should be supplied, and systematic health care for the workers should be provided. Health effects could be diminished by providing adequate education regarding the appropriate use of protective equipment, especially to nonprofessionals such as residents and volunteers. To make disaster response expeditious, a national and regional preparedness

  12. How Are Kentucky's Children Stacking Up? A County by County Analysis.

    ERIC Educational Resources Information Center

    Chandler, Betsy

    In a county by county analysis, this report assesses the quality of life for Kentucky's children. Researchers developed a child quotient (CQ) based on 18 indicators: per capita income, children in poverty, women receiving inadequate prenatal care, infant deaths, teens giving birth, substandard dwellings, children in foster care, per-pupil…

  13. Mansonia titillans: New Resident Species or Infrequent Visitor in Chatham County, Georgia, and Beaufort County, South Carolina, USA.

    PubMed

    Moulis, Robert A; Peaty, Laura F A W; Heusel, Jeffrey L; Lewandowski, Henry B; Harrison, Bruce A; Kelly, Rosmarie; Hager, Elizabeth J

    2015-06-01

    In September, October, and November 2014, adult Mansonia titillans were collected at 4 separate sites near Savannah in Chatham County, Georgia, and 1 site in Muscogee County, GA, during routine mosquito surveillance. Although previously recorded from Beaufort County, SC, and several inland southern Georgia counties, recent reports of this species from coastal Georgia or South Carolina are lacking. These newly captured Ma. titillans specimens represent the first documented records for Muscogee County and Chatham County, GA, and may indicate a recent northern expansion or reintroduction of this species along the Georgia and South Carolina coast.

  14. Biological conditions in streams of Johnson County, Kansas, and nearby Missouri, 2003 and 2004

    USGS Publications Warehouse

    Poulton, Barry C.; Rasmussen, Teresa J.; Lee, Casey J.

    2007-01-01

    Johnson County is one of the fastest growing and most populated counties in Kansas. Urban development affects streams by altering stream hydrology, geomorphology, water chemistry, and habitat, which then can lead to adverse effects on fish and macroinvertebrate communities. In addition, increasing sources of contaminants in urbanizing streams results in public-health concerns associated with exposure to and consumption of contaminated water. Biological assessments, or surveys of organisms living in aquatic environments, are crucial components of water-quality programs because they provide an indication of how well water bodies support aquatic life. This fact sheet describes current biological conditions of Johnson County streams and characterizes stream biology relative to urban development. Biological conditions were evaluated by collecting macroinvertebrate samples from 15 stream sites in Johnson County, Kansas, in 2003 and 2004 (fig. 1). Data from seven additional sites, collected as part of a separate study with similar objectives in Kansas and Missouri (Wilkison and others, 2005), were evaluated to provide a more comprehensive assessment of watersheds that cross State boundaries. Land-use and water- and streambed-sediment-quality data also were used to evaluate factors that may affect macroinvertebrate communities. Metrics are indices used to measure, or evaluate, macroinvertebrate response to various factors such as human disturbance. Multimetric scores, which integrated 10 different metrics that measure various aspects of macroinvertebrate communities, including organism diversity, composition, tolerance, and feeding characteristics, were used to evaluate and compare biological health of Johnson County streams. This information is useful to city and county officials for defining current biological conditions, evaluating conditions relative to State biological criteria, evaluating effects of urbanization, developing effective water-quality management plans

  15. Geographic distribution of insufficient sleep across the United States: a county-level hotspot analysis.

    PubMed

    Grandner, Michael A; Smith, Tony E; Jackson, Nicholas; Jackson, Tara; Burgard, Sarah; Branas, Charles

    2015-09-01

    Insufficient sleep is associated with cardiometabolic risk and neurocognitive impairment. Determinants of insufficient sleep include many social and environmental factors. Assessment of geographic hot/coldspots may uncover novel risk groups and/or targets for public health intervention. The aim of this study was to discern geographic patterns in the first data set to include county-level sleep data. The 2009 Behavioral Risk Factor Surveillance System was used. Insufficient sleep was assessed with a survey item and dichotomized. Data from n = 2231 counties were available. Tests for significant spatial concentrations of high/low levels of insufficient sleep (hotspots/coldspots) used the Getis-Ord G* statistic of local spatial concentration, chosen due to the nature of missing data. Eighty-four counties were hotspots, with high levels of insufficient sleep ( P < .01), and 45 were coldspots, with low insufficient sleep ( P < .01). Hotspots were found in Alabama (1 county), Arkansas (1), Georgia (1), Illinois (1), Kentucky (25), Louisiana (1), Missouri (4), Ohio (7), Tennessee (12), Texas (9), Virginia (6), and West Virginia (16). Coldspots were found in Alabama (1 county), Georgia (2), Illinois (6), Iowa (6), Michigan (2), Minnesota (1), North Carolina (1), Texas (7), Virginia (12), and Wisconsin (6). Several contiguous hotspots and coldspots were evident. Notably, the 17 counties with the highest levels of insufficient sleep were found in a contiguous set at the intersection of Kentucky, Tennessee, Virginia, and West Virginia (all P < .0002). Geographic distribution of insufficient sleep in the United States is uneven. Some areas (most notably parts of Appalachia) experience disproportionately high amounts of insufficient sleep and may be targets of intervention. Further investigation of determinants of geographic variability needs to be explored, which would enhance the utility of these data for development of public health campaigns.

  16. Assessment of Grassland Health Based on Spatial Information Technology in Changji Autonomous Prefecture, Xinjiang

    NASA Astrophysics Data System (ADS)

    Du, M. J.; Zheng, J. H.; Mu, C.

    2018-04-01

    Based on the "pressure-state-response" (PSR) model, comprehensively applied GIS and RS techniques, 20 evaluation indicators were selected based on pressure, state and response, the entropy weight method was used to determine the weight of each index and build a grassland health evaluation system in Changji Prefecture, Xinjiang. Based on this, evaluation and dynamic analysis of grassland health in Changji Prefecture from 2000 to 2016, using GIS/RS technology, the trend of grassland health status in Changji is analyzed and studied. The results show that: 1) Grassland with low health leveld, lower health level, sub-health level, health level and high health level accounts for 1.46 %,27.67 %,38.35 %,29.21 % and 3.31 % of the total area of Changji. Qitai County, Hutubi County, and Manas County are lower health levels, Jimsar County, Changji City, and Mulei County are at a relatively high level, and Fukang City has a healthy level of health. 2) The level of grassland health in Changji County decreased slightly during the 17 years, accounting for 38.42 % of the total area. The area of 23,87 % showed a stable trend, and the improved area accounted for 37.31 % of the vertical surface area.

  17. Unconsolidated Aquifers in Tompkins County, New York

    USGS Publications Warehouse

    Miller, Todd S.

    2000-01-01

    Unconsolidated aquifers consisting of saturated sand and gravel are capable of supplying large quantities of good-quality water to wells in Tompkins County, but little published geohydrologic inform ation on such aquifers is available. In 1986, the U.S.Geological Survey (USGS) began collecting geohydrologic information and well data to construct an aquifer map showing the extent of unconsolidated aquifers in Tompkins county. Data sources included (1) water-well drillers. logs; (2) highway and other construction test-boring logs; (3) well data gathered by the Tompkins County Department of Health, (4) test-well logs from geohydrologic consultants that conducted projects for site-specific studies, and (5) well data that had been collected during past investigations by the USGS and entered into the National Water Information System (NWIS) database. In 1999, the USGS, in cooperation with the Tompkins County Department of Planning, compiled these data to construct this map. More than 600 well records were entered into the NWIS database in 1999 to supplement the 350 well records already in the database; this provided a total of 950 well records. The data were digitized and imported into a geographic information system (GIS) coverage so that well locations could be plotted on a map, and well data could be tabulated in a digital data base through ARC/INFO software. Data on the surficial geology were used with geohydrologic data from well records and previous studies to delineate the extent of aquifers on this map. This map depicts (1) the extent of unconsolidated aquifers in Tompkins County, and (2) locations of wells whose records were entered into the USGS NWIS database and made into a GIS digital coverage. The hydrologic information presented here is generalized and is not intended for detailed site evaluations. Precise locations of geohydrologic-unit boundaries, and a description of the hydrologic conditions within the units, would require additional detailed, site

  18. Cluster of Ebola Virus Disease, Bong and Montserrado Counties, Liberia.

    PubMed

    Nyenswah, Tolbert G; Fallah, Mosaka; Calvert, Geoffrey M; Duwor, Stanley; Hamilton, E Dutch; Mokashi, Vishwesh; Arzoaquoi, Sampson; Dweh, Emmanuel; Burbach, Ryan; Dlouhy, Diane; Oeltmann, John E; Moonan, Patrick K

    2015-07-01

    Lack of trust in government-supported services after the death of a health care worker with symptoms of Ebola resulted in ongoing Ebola transmission in 2 Liberia counties. Ebola transmission was facilitated by attempts to avoid cremation of the deceased patient and delays in identifying and monitoring contacts.

  19. Need for Subsidized Family Planning Services: United States, Each State and County, 1968.

    ERIC Educational Resources Information Center

    Planned Parenthood--World Population, New York, NY.

    To provide federal, state, and local health agencies with information needed to achieve the national objectives of improving health, assisting families to escape poverty, and providing parents with freedom of choice in determining the number and spacing of their children, information was collected from 3,072 United States counties. Data from a…

  20. Water-Quality Data, Huron County, Michigan 2004

    DTIC Science & Technology

    2005-01-01

    ecoregion VII, EPA 822-B-00-018: U.S. Environ - mental Protection Agency, 93 p. U.S. Environmental Protection Agency, Water Quality Crite- ria: U.S...U.S. Environmental Protection Agency, 2000a, and American Public Health Association, 1998, as well as the standard field procedures documented by the... environmental samples (Bird and others, 2001). Figure 1. Map showing surface-water and ground-water sampling locations in Huron County, Michigan KINDE ELKTON

  1. Environmental health monograph

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

    Not Available

    1974-05-01

    Current environmental programs intended to reduce or mediate environmental health hazards in Berkeley, Charleston, and Dorchester Counties, South Carolina, are described. The following areas are considered: air pollution, noise abatement, pesticide control, accident prevention, food and milk sanitation, occupational health housing, water supply, sewerage, industrial waste, solid waste disposal, and vector control. The lack of adequate technically trained manpower or funds to implement minimum codes currently in force in the Trident Region is noted. The wide range of public and private agencies concerned with environmental health issues creates complexities in dealing with these issues. Conflicting codes and standards exist atmore » various government levels. The Trident Health District Office Air Pollution Control Program provides the following: ambient air quality surveillance; review of plans and specifications for proposed air pollution control facilities and equipment; and air monitoring. A list of safety - related courses offered by the Greater Charleston Safety Council is provided. A lack of readily available statistics concerning the various kinds of accidents and the frequency of their occurrence is noted. Concern is also expressed over the lack of personnel to inspect the growing food service industry. Local activities in the area of occupational health are reported to be less than minimal. The Charleston County Health Department has recently introduced a rural sanitation program. The county also issues permits for septic tank installation. The Regional Planning Council for the area aids municipalities and counties in planning for and implementing supply control and solid waste management in compliance with Federal and State laws. Mosquito abatement, rabies control, and rodent control activities in the area are described. Portions of this document are not fully legible. (GRA)« less

  2. 75 FR 26709 - Clarke County Water Supply Project, Clarke County, IA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... Project, Clarke County, IA AGENCY: Natural Resources Conservation Service. ACTION: Notice of intent to... Conservationist for Planning, 210 Walnut Street, Room 693, Des Moines, IA 50309-2180, telephone: 515-284- 4769... available at the Iowa NRCS Web site at http://www.ia.nrcs.usda.gov . A map of the Clarke County Water Supply...

  3. The timber resources of Humboldt County, California.

    Treesearch

    Daniel D. Oswald

    1968-01-01

    This report presents the first complete inventory of Humboldt County's timber resources. Past Forest Survey inventories have included Humboldt County, but they were not designed to obtain volume estimates for an individual county. Humboldt County is part of a survey unit which also includes Del Norte County. There are eight such inventory units in California; and...

  4. Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals.

    PubMed

    Wang, Xuan; Luo, Hongye; Qin, Xianjin; Feng, Jun; Gao, Hongda; Feng, Qiming

    2016-08-23

    As the core of the county-level Maternal and Child Health Hospitals (MCHH) in rural areas of China, the service efficiency affects the fairness and availability of healthcare services. This study aims to identify the determinants of hospital efficiency and explore how to improve the performance of MCHH in terms of productivity and efficiency. Data was collected from a sample of 32 county-level MCHHs of Guangxi in 2014. Firstly, we specified and measured the indicators of the inputs and outputs which represent hospital resources expended and its profiles respectively. Then we estimated the efficiency scores using Data Envelopment Analysis (DEA) for each hospital. Efficiency scores were decomposed into technical, scale and congestion components, and the potential output increases and/or input reductions were also estimated in this model, which would make relatively inefficient hospitals more efficient. In the second stage, the estimated efficiency scores are regressed against hospital external and internal environment factors using a Tobit model. We used DEAP (V2.1) and R for data analysis. The average scores of technical efficiency, net technical efficiency (managerial efficiency) and scale efficiency of the hospitals were 0.875, 0.922 and 0.945, respectively. Half of the hospitals were efficient, and 9.4 % and 40.6 % were weakly efficient and inefficient, respectively. Among the low-productiveness hospitals, 61.1 % came from poor counties (Poor counties in this article are in the list of key poverty-stricken counties at the national level, published by The State Council Leading Group Office of Poverty Alleviation and Development, 2012). The total input indicated that redundant medical resources in poverty areas were significantly higher than those in non-poverty areas. The Tobit regression model showed that the technical efficiency was proportional to the total annual incomes, the number of discharge patients, and the number of outpatient and emergency visits

  5. Population substructure in Cache County, Utah: the Cache County study

    PubMed Central

    2014-01-01

    Background Population stratification is a key concern for genetic association analyses. In addition, extreme homogeneity of ethnic origins of a population can make it difficult to interpret how genetic associations in that population may translate into other populations. Here we have evaluated the genetic substructure of samples from the Cache County study relative to the HapMap Reference populations and data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Results Our findings show that the Cache County study is similar in ethnic diversity to the self-reported "Whites" in the ADNI sample and less homogenous than the HapMap CEU population. Conclusions We conclude that the Cache County study is genetically representative of the general European American population in the USA and is an appropriate population for conducting broadly applicable genetic studies. PMID:25078123

  6. Comparison of ArcGIS and SAS Geostatistical Analyst to Estimate Population-Weighted Monthly Temperature for US Counties

    PubMed Central

    Xiaopeng, QI; Liang, WEI; BARKER, Laurie; LEKIACHVILI, Akaki; Xingyou, ZHANG

    2015-01-01

    Temperature changes are known to have significant impacts on human health. Accurate estimates of population-weighted average monthly air temperature for US counties are needed to evaluate temperature’s association with health behaviours and disease, which are sampled or reported at the county level and measured on a monthly—or 30-day—basis. Most reported temperature estimates were calculated using ArcGIS, relatively few used SAS. We compared the performance of geostatistical models to estimate population-weighted average temperature in each month for counties in 48 states using ArcGIS v9.3 and SAS v 9.2 on a CITGO platform. Monthly average temperature for Jan-Dec 2007 and elevation from 5435 weather stations were used to estimate the temperature at county population centroids. County estimates were produced with elevation as a covariate. Performance of models was assessed by comparing adjusted R2, mean squared error, root mean squared error, and processing time. Prediction accuracy for split validation was above 90% for 11 months in ArcGIS and all 12 months in SAS. Cokriging in SAS achieved higher prediction accuracy and lower estimation bias as compared to cokriging in ArcGIS. County-level estimates produced by both packages were positively correlated (adjusted R2 range=0.95 to 0.99); accuracy and precision improved with elevation as a covariate. Both methods from ArcGIS and SAS are reliable for U.S. county-level temperature estimates; However, ArcGIS’s merits in spatial data pre-processing and processing time may be important considerations for software selection, especially for multi-year or multi-state projects. PMID:26167169

  7. Cal MediConnect Enrollment: Why Are Dual-Eligible Consumers in Los Angeles County Opting Out?

    PubMed

    McBride, Kate; Reynoso, Ana; Alunan, Tiffany; Gutierrez, Brenda; Bacong, Adrien; Moon, Marge; Bacigalupo, Anastasia; Benjamin, A E; Wallace, Steven P.; Kietzman, Kathryn G

    2017-09-01

    Los Angeles County has the state’s lowest rate of consumer enrollment in Cal MediConnect, a program that is responsible for the delivery and coordination of medical, behavioral health, and long-term services and support benefits for individuals who are dually eligible for Medicare and Medi-Cal. This policy brief examines the factors that influence consumer decisions and may contribute to low enrollment rates. Influential factors include consumer knowledge of health care options, perception of choice, and disruption of existing care. Differences in decision making by age, complexity of health care needs, race/ethnicity, immigration status, and primary language are also noted. Policy recommendations include engaging consumers in the planning and dissemination of information about their health care options, optimizing consumer choice and implementing the least disruptive pathway to enrollment, and recognizing and responding to the great diversity of dual-eligible consumers in Los Angeles County.

  8. Influence of Peer Pressure on Secondary School Students Drop out in Rongo Sub-County, Migori County, Kenya

    ERIC Educational Resources Information Center

    Omollo, Atieno Evaline; Yambo, Onyango J. M.

    2017-01-01

    The purpose of this study was to establish the influence of peer pressure on secondary school students' drop out in Rongo Sub-County, Migori County, Kenya. The statement of the problem showed that the sub-county had a dropout rate of 43 percent as compared to the neighboring sub counties like Uriri, Awendo, Nyatike, Kuria and Migori which had 25,…

  9. Chester County ground-water atlas, Chester County, Pennsylvania

    USGS Publications Warehouse

    Ludlow, Russell A.; Loper, Connie A.

    2004-01-01

    Chester County encompasses 760 square miles in southeastern Pennsylvania. Groundwater-quality studies have been conducted in the county over several decades to address specific hydrologic issues. This report compiles and describes water-quality data collected during studies conducted mostly after 1990 and summarizes the data in a county-wide perspective.In this report, water-quality constituents are described in regard to what they are, why the constituents are important, and where constituent concentrations vary relative to geology or land use. Water-quality constituents are grouped into logical units to aid presentation: water-quality constituents measured in the field (pH, alkalinity, specific conductance, and dissolved oxygen), common ions, metals, radionuclides, bacteria, nutrients, pesticides, and volatile organic compounds. Water-quality constituents measured in the field, common ions (except chloride), metals, and radionuclides are discussed relative to geology. Bacteria, nutrients, pesticides, and volatile organic compounds are discussed relative to land use. If the U.S. Environmental Protection Agency (USEPA) or Chester County Health Department has drinking water standards for a constituent, the standards are included. Tables and maps are included to assist Chester County residents in understanding the water-quality constituents and their distribution in the county.Ground water in Chester County generally is of good quality and is mostly acidic except in the carbonate rocks and serpentinite, where it is neutral to strongly basic. Calcium carbonate and magnesium carbonate are major constituents of these rocks. Both compounds have high solubility, and, as such, both are major contributors to elevated pH, alkalinity, specific conductance, and the common ions. Elevated pH and alkalinity in carbonate rocks and serpentinite can indicate a potential for scaling in water heaters and household plumbing. Low pH and low alkalinity in the schist, quartzite, and

  10. 75 FR 13297 - Southeastern Lincoln County Habitat Conservation Plan, Lincoln County, NV

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-19

    ... development), flood control activities (within the City of Caliente), maintenance of Lincoln County roads and... library locations: (1) Clark County Library, 1401 E. Flamingo Road, Las Vegas, NV 89119; (702) 507-3400...- administered land. Proposed covered activities include: (1) Planned land development and maintenance activities...

  11. West Virginia Kids Count Data Book: 1995 County Profiles of Child Well-Being.

    ERIC Educational Resources Information Center

    West Virginia Task Force on Children, Youth and Families, Charleston.

    This Kids Count report presents data measuring the health and the economic, educational, and social well-being of children in West Virginia at the state and county levels. It measures 12 indicators of child and adolescent health, education, and economic status, but focuses on the following 10 indicators, called "Family Supports for At-Risk…

  12. Peer power: how Dare County, North Carolina, is addressing chronic disease through innovative programming.

    PubMed

    Thomas, Anne B; Ward, Ellie

    2006-01-01

    Peer Power is an innovative school-based program that trains high school students as health educators and mentors for middle school students. The program was designed to produce positive health behavior changes in youth and reduce long-term incidence of chronic diseases of the heart and lung. This program, developed at the Management Academy for Public Health, has been successful in receiving grant funds and has demonstrated positive behavioral changes in youth in the areas of physical activity, nutrition, and tobacco use. Peer Power has far exceeded the anticipated outcomes and proven to be a catalyst for improved health behaviors throughout the community. Positive unintended consequences of Peer Power include the development of an effective social marketing campaign, reduction in tobacco sales to minors, and an increase in smoke-free restaurants in Dare County. Benefits received by Management Academy participants are evident through improved business and administrative skills at the Dare County Department of Public Health, the number of new and innovative programs that have succeeded in securing grant funds, and the sustainability of the programs developed.

  13. Relationship between Job Satisfaction of County Extension Staff and the Level of Emotional Intelligence of County Extension Directors

    ERIC Educational Resources Information Center

    Villard, Judith A.; Earnest, Garee W.

    2006-01-01

    This descriptive-correlational study used a census of Ohio State University Extension county directors and a random sample of county staff throughout the State of Ohio. Data were collected utilizing Bar-On's Emotional Intelligence Quotient instrument (county directors) and Warner's job satisfaction instrument (county staff). The study examined the…

  14. Using health-facility data to assess subnational coverage of maternal and child health indicators, Kenya.

    PubMed

    Maina, Isabella; Wanjala, Pepela; Soti, David; Kipruto, Hillary; Droti, Benson; Boerma, Ties

    2017-10-01

    To develop a systematic approach to obtain the best possible national and subnational statistics for maternal and child health coverage indicators from routine health-facility data. Our approach aimed to obtain improved numerators and denominators for calculating coverage at the subnational level from health-facility data. This involved assessing data quality and determining adjustment factors for incomplete reporting by facilities, then estimating local target populations based on interventions with near-universal coverage (first antenatal visit and first dose of pentavalent vaccine). We applied the method to Kenya at the county level, where routine electronic reporting by facilities is in place via the district health information software system. Reporting completeness for facility data were well above 80% in all 47 counties and the consistency of data over time was good. Coverage of the first dose of pentavalent vaccine, adjusted for facility reporting completeness, was used to obtain estimates of the county target populations for maternal and child health indicators. The country and national statistics for the four-year period 2012/13 to 2015/16 showed good consistency with results of the 2014 Kenya demographic and health survey. Our results indicated a stagnation of immunization coverage in almost all counties, a rapid increase of facility-based deliveries and caesarean sections and limited progress in antenatal care coverage. While surveys will continue to be necessary to provide population-based data, web-based information systems for health facility reporting provide an opportunity for more frequent, local monitoring of progress, in maternal and child health.

  15. Mental health professional shortage areas in rural Appalachia.

    PubMed

    Hendryx, Michael

    2008-01-01

    Research on health disparities in Appalachia has rarely compared Appalachia to other geographic areas in such a way as to isolate possible Appalachian effects. This study tests hypotheses that nonmetropolitan Appalachia will have higher levels of mental health professional shortage areas than other nonmetropolitan areas of the same states, but that these disparities will dissipate when accounting for social and economic differences. The study analyzed secondary data for nonmetropolitan counties (N = 618) in the 13 Appalachian states. Appalachian counties were identified from the Appalachian Regional Commission designations. Mental health professional shortages were identified from Health Resources and Services Administration data. Area Resource File data were used to measure county-level income, education, uninsurance, unemployment, race/ethnicity percentages, and urban influence codes. Logistic regression models tested whether Appalachia was significantly associated with shortage areas, and whether the Appalachian effect persisted after accounting for social and economic covariates. Seventy percent of Appalachian nonmetropolitan counties were mental health professional shortage areas, significantly higher than non-Appalachian, nonmetropolitan counties in the same states. The Appalachian effect did not persist after controlling for the full set of other variables; education and race/ethnicity emerged as significant predictors. Appalachia location is associated with mental health professional shortages, but this effect is driven by underlying social differences, in particular by lower education. This method of identifying Appalachia for comparative purposes may be applied to many other health services research questions and to other defined geographic regions.

  16. Water resources of Sweetwater County, Wyoming

    USGS Publications Warehouse

    Mason, Jon P.; Miller, Kirk A.

    2004-01-01

    Sweetwater County is located in the southwestern part of Wyoming and is the largest county in the State. A study to quantify the availability and describe the chemical quality of surface-water and ground-water resources in Sweetwater County was conducted by the U.S. Geological Survey in cooperation with the Wyoming State Engineers Office. Most of the county has an arid climate. For this reason a large amount of the flow in perennial streams within the county is derived from outside the county. Likewise, much of the ground-water recharge to aquifers within the county is from flows into the county, and occurs slowly. Surface-water data were not collected as part of the study. Evaluations of streamflow and stream-water quality were limited to analyses of historical data and descriptions of previous investigations. Forty-six new ground-water-quality samples were collected as part of the study and the results from an additional 782 historical ground-water-quality samples were reviewed. Available hydrogeologic characteristics for various aquifers throughout the county also are described. Flow characteristics of streams in Sweetwater County vary substantially depending on regional and local basin characteristics and anthropogenic factors. Because precipitation amounts in the county are small, most streams in the county are ephemeral, flowing only as a result of regional or local rainfall or snowmelt runoff. Flows in perennial streams in the county generally are a result of snowmelt runoff in the mountainous headwater areas to the north, west, and south of the county. Flow characteristics of most perennial streams are altered substantially by diversions and regulation. Water-quality characteristics of selected streams in and near Sweetwater County during water years 1974 through 1983 were variable. Concentrations of dissolved constituents, suspended sediment, and bacteria generally were smallest at sites on the Green River because of resistant geologic units, increased

  17. Assessing The Value Of 40 Years Of Local Public Expenditures On Health.

    PubMed

    Leider, Jonathon P; Alfonso, Natalia; Resnick, Beth; Brady, Eoghan; McCullough, J Mac; Bishai, David

    2018-04-01

    The US public and private sectors now spend more than $3 trillion on health each year. While critical studies have examined the relationship between public spending on health and health outcomes, relatively little is known about the impact of broader public-sector spending on health. Using county-level public finance data for the period 1972-2012, we estimated the impact of local public hospital spending and nonhospital health spending on all-cause mortality in the county. Overall, a 10 percent increase in nonhospital health spending was associated with a 0.006 percent decrease in all-cause mortality one year after the initial spending. This effect was larger and significant in counties with greater proportions of racial/ethnic minorities. Our results indicate that county nonhospital health spending has health benefits that can help reduce costs and improve health outcomes in localities across the nation, though greater focus on population-oriented services may be warranted.

  18. HIV intertest interval among MSM in King County, Washington.

    PubMed

    Katz, David A; Dombrowski, Julia C; Swanson, Fred; Buskin, Susan E; Golden, Matthew R; Stekler, Joanne D

    2013-02-01

    The authors examined temporal trends and correlates of HIV testing frequency among men who have sex with men (MSM) in King County, Washington. The authors evaluated data from MSM testing for HIV at the Public Health-Seattle & King County (PHSKC) STD Clinic and Gay City Health Project (GCHP) and testing history data from MSM in PHSKC HIV surveillance. The intertest interval (ITI) was defined as the number of days between the last negative HIV test and the current testing visit or first positive test. Correlates of the log(10)-transformed ITI were determined using generalised estimating equations linear regression. Between 2003 and 2010, the median ITI among MSM seeking HIV testing at the STD Clinic and GCHP were 215 (IQR: 124-409) and 257 (IQR: 148-503) days, respectively. In multivariate analyses, younger age, having only male partners and reporting ≥10 male sex partners in the last year were associated with shorter ITIs at both testing sites (p<0.05). Among GCHP attendees, having a regular healthcare provider, seeking a test as part of a regular schedule and inhaled nitrite use in the last year were also associated with shorter ITIs (p<0.001). Compared with MSM testing HIV negative, MSM newly diagnosed with HIV had longer ITIs at the STD Clinic (median of 278 vs 213 days, p=0.01) and GCHP (median 359 vs 255 days, p=0.02). Although MSM in King County appear to be testing at frequent intervals, further efforts are needed to reduce the time that HIV-infected persons are unaware of their status.

  19. Nursing during World War II: Finnmark County, Northern Norway.

    PubMed

    Immonen, Ingrid

    2013-01-01

    This study is part the project "Nursing in Borderland - Finnmark 1939-1950" within nursing history that sheds light on nursing and health care during World War II in Finnmark County, Northern Norway. The study focuses on challenges in nursing care that arose during the war because of war activities in the Barents area. This article focuses on challenges caused by shortage of supplies. The aim of the project is to widen the understanding of development within health care and living conditions in the area. This is a historical study using narratives, government documents and literature. Interviews with nurses and persons active in health care during World War II constitute the main data of the research. Thematic issues that arise from interviews are analysed. Primary and secondary written sources are used in analysing the topics. Because of war activities, deportation and burning of the county, archives were partly destroyed. Central archives can contribute with annual reports, whereas local archives are fragmentary. There are a number of reports written soon after the War, as well as a number of biographical books of newer date. CHALLENGES CAUSED BY WAR, WHICH APPEAR IN THE INTERVIEWS, ARE: 1) shortage of supplies, 2) increased workload, 3) multicultural society, 4) ethical dilemmas, 5) deportation of the population. In this paper, focus is on challenges caused by shortage of supplies. Both institutions, personnel and patients were marked by the war. This has to be taken in consideration in health care today.

  20. Trends and Patterns of Differences in Infectious Disease Mortality Among US Counties, 1980-2014.

    PubMed

    El Bcheraoui, Charbel; Mokdad, Ali H; Dwyer-Lindgren, Laura; Bertozzi-Villa, Amelia; Stubbs, Rebecca W; Morozoff, Chloe; Shirude, Shreya; Naghavi, Mohsen; Murray, Christopher J L

    2018-03-27

    Infectious diseases are mostly preventable but still pose a public health threat in the United States, where estimates of infectious diseases mortality are not available at the county level. To estimate age-standardized mortality rates and trends by county from 1980 to 2014 from lower respiratory infections, diarrheal diseases, HIV/AIDS, meningitis, hepatitis, and tuberculosis. This study used deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the US Census Bureau, NCHS, and the Human Mortality Database. Validated small-area estimation models were applied to these data to estimate county-level infectious disease mortality rates. County of residence. Age-standardized mortality rates of lower respiratory infections, diarrheal diseases, HIV/AIDS, meningitis, hepatitis, and tuberculosis by county, year, and sex. Between 1980 and 2014, there were 4 081 546 deaths due to infectious diseases recorded in the United States. In 2014, a total of 113 650 (95% uncertainty interval [UI], 108 764-117 942) deaths or a rate of 34.10 (95% UI, 32.63-35.38) deaths per 100 000 persons were due to infectious diseases in the United States compared to a total of 72 220 (95% UI, 69 887-74 712) deaths or a rate of 41.95 (95% UI, 40.52-43.42) deaths per 100 000 persons in 1980, an overall decrease of 18.73% (95% UI, 14.95%-23.33%). Lower respiratory infections were the leading cause of infectious diseases mortality in 2014 accounting for 26.87 (95% UI, 25.79-28.05) deaths per 100 000 persons (78.80% of total infectious diseases deaths). There were substantial differences among counties in death rates from all infectious diseases. Lower respiratory infection had the largest absolute mortality inequality among counties (difference between the 10th and 90th percentile of the distribution, 24.5 deaths per 100 000 persons). However, HIV/AIDS had the highest relative mortality inequality between counties (10.0 as the

  1. Examining the relationship between the food environment and adult diabetes prevalence by county economic and racial composition: an ecological study.

    PubMed

    Haynes-Maslow, Lindsey; Leone, Lucia A

    2017-08-09

    Inequitable access to healthy food may contribute to health disparities. This study examines the relationship between the prevalence of adult diabetes and food access in the U.S. by county economic/racial composition. An ecological study from 2012 was used to estimate the relationship between diabetes and retail food outlet access. County diabetes prevalence was measured based on individual responses to the Behavioral Risk Factor Surveillance Survey question, "Have you ever been told by a doctor that you have diabetes?" If the answer was "yes" individuals were classified as having diabetes. Retail food outlets included grocery stores, supercenters, farmer's markets, full-service restaurants, fast food restaurants and convenience stores. Counties were categorized as "high-poverty" or "low-poverty". Counties were categorized as low (< 4.6%), medium (4.6%-31.0%), and high (> 31.0%) percent minority residents. Multiple linear regression models estimated the association between retail food outlets and diabetes, controlling for confounders, and testing for interactions between retail food outlets and county racial composition. Regression models were conditioned on county economic composition. Data were analyzed in 2016. Density of retail foods outlets varied greatly by county economic and racial composition; counties with medium-minority populations had the least access to grocery stores and the highest access to fast food restaurants and convenience stores. Low poverty/low-minority population counties had the greatest access to farmer's markets and grocery stores. For low poverty/low-minority counties, grocery stores were associated with decreased of diabetes prevalence. Supercenters were associated with an increase in diabetes prevalence for high-poverty/low-minority counties. Only low poverty/medium-minority counties had a statistically significant relationship between farmer's markets and diabetes prevalence. Fast food restaurants were found to be positively

  2. Carbon monoxide poisoning--Weld County, Colorado, 1993.

    PubMed

    1994-10-28

    In March 1993, the Colorado Department of Public Health and Environment (CDPHE) was notified that six family members residing in a home in Weld County had suffered carbon monoxide (CO) poisoning; five of the persons died. An investigation indicated that the source of CO had been a van parked in the garage of the home; the van had been left running, and the exhaust fumes leaked into the home. This report summarizes the investigation of this incident.

  3. Human papillomavirus vaccine awareness, uptake, and parental and health care provider communication among 11- to 18-year-old adolescents in a rural Appalachian Ohio county in the United States.

    PubMed

    Bhatta, Madhav P; Phillips, Lynette

    2015-01-01

    This study examined human papillomavirus (HPV) vaccine awareness and uptake, and communication with a parent and/or a health care provider among 11- to 18-year-old male and female adolescents in an Appalachian Ohio county. Five questions regarding the HPV vaccine were added to the 2012 Youth Risk Behavior Surveillance System (YRBSS) surveys administered to middle and high school students in the county. The YRBSS surveys are school-based, anonymous, and voluntary. The questions added were about vaccine awareness and uptake, and communication with a parent or health care provider about the vaccine. Of the 1,299 participants, 51.9% were male and 90.3% were white. Overall, 49.2%, 23.5%, 19.2%, and 24.6%, respectively, reported vaccine awareness, uptake of at least 1 dose of the HPV vaccine, communication with a parent, and communication with a health care provider. Females and adolescents ≥ 15 years were significantly more likely to report awareness, uptake, and parental and provider communication than males and adolescents ≤ 14 years. Adolescents receiving any dose of the vaccine were significantly more likely to have had a parent (OR: 3.74; 95% CI: 2.30-6.06) or a health care provider (OR: 10.91; 95% CI: 6.42-18.6) discuss the vaccine than those who had not received any dose. Despite the strong link between parental and health care provider communication and HPV vaccine uptake, the levels of communication remain low in this Appalachian population. These findings suggest the need for public health education programs targeting the health care providers, the parents, and the adolescents to improve awareness, knowledge, and HPV vaccine uptake. © 2014 National Rural Health Association.

  4. Surface-Water and Ground-Water Resources of Kendall County, Illinois

    USGS Publications Warehouse

    Kay, Robert T.; Mills, Patrick C.; Hogan, Jennifer L.; Arnold, Terri L.

    2005-01-01

    Group, the Galena-Platteville dolomite, the Maquoketa Group, and the Silurian dolomite where these units are at the bedrock surface. The availability of water from the shallow bedrock aquifer depends primarily on the geologic unit utilized. The Silurian dolomite, Galena-Platteville dolomite, and Ancell Group can yield sufficient water for residential and municipal supply in at least some parts of the county. The Cambrian-Ordovician aquifer system is composed of the most widespread, productive aquifers in northern Illinois and is used for water supply by a number of municipalities and industrial facilities. Water levels in the aquifer system have declined by as much as 600 feet in Kendall County and the aquifer frequently contains concentrations of radium above established health guidelines.

  5. Can Twitter be used to predict county excessive alcohol consumption rates?

    PubMed Central

    Ashford, Robert D.; Hemmons, Jessie; Summers, Dan; Hamilton, Casey

    2018-01-01

    Objectives The current study analyzes a large set of Twitter data from 1,384 US counties to determine whether excessive alcohol consumption rates can be predicted by the words being posted from each county. Methods Data from over 138 million county-level tweets were analyzed using predictive modeling, differential language analysis, and mediating language analysis. Results Twitter language data captures cross-sectional patterns of excessive alcohol consumption beyond that of sociodemographic factors (e.g. age, gender, race, income, education), and can be used to accurately predict rates of excessive alcohol consumption. Additionally, mediation analysis found that Twitter topics (e.g. ‘ready gettin leave’) can explain much of the variance associated between socioeconomics and excessive alcohol consumption. Conclusions Twitter data can be used to predict public health concerns such as excessive drinking. Using mediation analysis in conjunction with predictive modeling allows for a high portion of the variance associated with socioeconomic status to be explained. PMID:29617408

  6. Dietary folate, vitamin B-12, vitamin B-6 and incident Alzheimer's disease: the cache county memory, health and aging study.

    PubMed

    Nelson, C; Wengreen, H J; Munger, R G; Corcoran, C D

    2009-12-01

    To examine associations between dietary and supplemental folate, vitamin B-12 and vitamin B-6 and incident Alzheimer's disease (AD) among elderly men and women. Data collected were from participants of the Cache County Memory, Health and Aging Study, a longitudinal study of 5092 men and women 65 years and older who were residents of Cache County, Utah in 1995. Multistage clinical assessment procedures were used to identify incident cases of AD. Dietary data were collected using a 142-item food frequency questionnaire. Cox Proportional Hazards (CPH) modeling was used to determine hazard ratios across quintiles of micronutrient intake. 202 participants were diagnosed with incident AD during follow-up (1995-2004). In multivariable CPH models that controlled for the effects of gender, age, education, and other covariates there were no observed differences in risk of AD or dementia by increasing quintiles of total intake of folate, vitamin B-12, or vitamin B-6. Similarly, there were no observed differences in risk of AD by regular use of either folate or B6 supplements. Dietary intake of B-vitamins from food and supplemental sources appears unrelated to incidence of dementia and AD. Further studies examining associations between dietary intakes of B-vitamins, biomarkers of B-vitamin status and cognitive endpoints are warranted.

  7. HUMAN INFECTION WITH NONTUBERCULOUS MYCOBACTERIA SPP. IN KING COUNTY, WASHINGTON, 1999-2002

    EPA Science Inventory

    Human infection with nontuberculous Mycobacteria spp. in King County, Washington, 1999 - 2002
    E Hilborn, T Covert, M Yakrus, G Stelma, M Schmitt
    1) US Environmental Protection Agency, Office of Research and Development, National Health and Environmental Research Laboratory,...

  8. Monitoring health systems readiness and inpatient malaria case-management at Kenyan county hospitals.

    PubMed

    Zurovac, Dejan; Machini, Beatrice; Kiptui, Rebecca; Memusi, Dorothy; Amboko, Beatrice; Kigen, Samuel; Njiri, Patricia; Waqo, Ejersa

    2018-05-29

    Change of severe malaria treatment policy from quinine to artesunate, a major malaria control advance in Africa, is compromised by scarce data to monitor policy translation into practice. In Kenya, hospital surveys were implemented to monitor health systems readiness and inpatient malaria case-management. All 47 county referral hospitals were surveyed in February and October 2016. Data collection included hospital assessments, interviews with inpatient health workers and retrospective review of patients' admission files. Analysis included 185 and 182 health workers, and 1162 and 1224 patients admitted with suspected malaria, respectively, in all 47 hospitals. Cluster-adjusted comparisons of the performance indicators with exploratory stratifications were performed. Malaria microscopy was universal during both surveys. Artesunate availability increased (63.8-85.1%), while retrospective stock-outs declined (46.8-19.2%). No significant changes were observed in the coverage of artesunate trained (42.2% vs 40.7%) and supervised health workers (8.7% vs 12.8%). The knowledge about treatment policy improved (73.5-85.7%; p = 0.002) while correct artesunate dosing knowledge increased for patients < 20 kg (42.7-64.6%; p < 0.001) and > 20 kg (70.3-80.8%; p = 0.052). Most patients were tested on admission (88.6% vs 92.1%; p = 0.080) while repeated malaria testing was low (5.2% vs 8.1%; p = 0.034). Artesunate treatment for confirmed severe malaria patients significantly increased (69.9-78.7%; p = 0.030). No changes were observed in artemether-lumefantrine treatment for non-severe test positive patients (8.0% vs 8.8%; p = 0.796). Among test negative patients, increased adherence to test results was observed for non-severe (68.6-78.0%; p = 0.063) but not for severe patients (59.1-62.1%; p = 0.673). Overall quality of malaria case-management improved (48.6-56.3%; p = 0.004), both for children (54.1-61.5%; p = 0.019) and adults

  9. EPA Grant will help Berkshire County Residents with Energy Efficiency and Air Quality

    EPA Pesticide Factsheets

    A project that works to reduce respiratory health problems for residents in northern Berkshire County of Massachusetts through energy efficiency improvements, has received $25,000 from a US Environmental Protection Agency program that addresses environment

  10. Health Equity and the Fallacy of Treating Causes of Population Health as if They Sum to 100.

    PubMed

    Krieger, Nancy

    2017-04-01

    Numerous examples exist in population health of work that erroneously forces the causes of health to sum to 100%. This is surprising. Clear refutations of this error extend back 80 years. Because public health analysis, action, and allocation of resources are ill served by faulty methods, I consider why this error persists. I first review several high-profile examples, including Doll and Peto's 1981 opus on the causes of cancer and its current interpretations; a 2015 high-publicity article in Science claiming that two thirds of cancer is attributable to chance; and the influential Web site "County Health Rankings & Roadmaps: Building a Culture of Health, County by County," whose model sums causes of health to equal 100%: physical environment (10%), social and economic factors (40%), clinical care (20%), and health behaviors (30%). Critical analysis of these works and earlier historical debates reveals that underlying the error of forcing causes of health to sum to 100% is the still dominant but deeply flawed view that causation can be parsed as nature versus nurture. Better approaches exist for tallying risk and monitoring efforts to reach health equity.

  11. Health Equity and the Fallacy of Treating Causes of Population Health as if They Sum to 100%

    PubMed Central

    2017-01-01

    Numerous examples exist in population health of work that erroneously forces the causes of health to sum to 100%. This is surprising. Clear refutations of this error extend back 80 years. Because public health analysis, action, and allocation of resources are ill served by faulty methods, I consider why this error persists. I first review several high-profile examples, including Doll and Peto’s 1981 opus on the causes of cancer and its current interpretations; a 2015 high-publicity article in Science claiming that two thirds of cancer is attributable to chance; and the influential Web site “County Health Rankings & Roadmaps: Building a Culture of Health, County by County,” whose model sums causes of health to equal 100%: physical environment (10%), social and economic factors (40%), clinical care (20%), and health behaviors (30%). Critical analysis of these works and earlier historical debates reveals that underlying the error of forcing causes of health to sum to 100% is the still dominant but deeply flawed view that causation can be parsed as nature versus nurture. Better approaches exist for tallying risk and monitoring efforts to reach health equity. PMID:28272952

  12. Investigation of Pertussis Cases in a Texas County, 2008-2012.

    PubMed

    Staudt, Amanda; Mangla, Anil T; Alamgir, Hasanat

    2015-07-01

    Within the past 25 years, there has been a dramatic increase in the incidence of pertussis cases in the United States. As such, this investigation reports on the high-risk groups and describes risk factors of pertussis cases in a large Texas county. This study was a cross-sectional analysis of data collected by health department employees using the Texas Department of State Health Service's Pertussis Case Track Record, which is the standard investigation form for collecting vital information on pertussis cases. We extracted and analyzed county-level data for a 5-year period (2008-2012). The study population at risk included all current residents in this county, and cases included all who were clinically diagnosed as having confirmed or probable pertussis cases that were reported to the health department according to the Centers for Disease Control and Prevention case definition. The vaccination status of a case was defined as fully vaccinated, partially vaccinated, or not vaccinated. A total of 198 probable and confirmed pertussis cases were included in this analysis. Most of the cases were infants younger than 1 year old (n = 107). The largest category of cases was not vaccinated and of the rest, 32.8% were partially vaccinated, 17.2% had unknown vaccination status, and 13.1% were fully vaccinated. Only 48 (24.2%) sources of exposure were identified and they included fathers (14.6%), sisters (14.6%), brothers (14.6%), other children (14.6%), and mothers (12.5%). Many sources of exposure (n = 26, 54.1%) were unaware of their vaccination history. Hispanics accounted for 84.5% of cases in the younger than 1 year old group and 88.9% of cases were in the 1 to 2 years old group. With respect to race/ethnicity and vaccination status of the cases, 39.46% of Hispanics, 32% of whites, and 50% of blacks were reported to be unvaccinated. Increasing pertussis vaccination coverage among children, as well as providing booster shots to adults with special attention on the

  13. Digital computer processing of LANDSAT data for North Alabama. [Linestone County, Madison County, Jackson County, Marshall County, and DeKalb County

    NASA Technical Reports Server (NTRS)

    Bond, A. D.; Atkinson, R. J.; Lybanon, M.; Ramapriyan, H. K.

    1977-01-01

    Computer processing procedures and programs applied to Multispectral Scanner data from LANDSAT are described. The output product produced is a level 1 land use map in conformance with a Universal Transverse Mercator projection. The region studied was a five-county area in north Alabama.

  14. Evidence for a decrease in transmission of Ebola virus--Lofa County, Liberia, June 8-November 1, 2014.

    PubMed

    Sharma, Aditya; Heijenberg, Nico; Peter, Clement; Bolongei, Josephus; Reeder, Bruce; Alpha, Tamba; Sterk, Esther; Robert, Hugues; Kurth, Andreas; Cannas, Angela; Bocquin, Anne; Strecker, Thomas; Logue, Christopher; Di Caro, Antonino; Pottage, Thomas; Yue, Constanze; Stoecker, Kilian; Wölfel, Roman; Gabriel, Martin; Günther, Stephan; Damon, Inger

    2014-11-21

    Lofa County has one of the highest cumulative incidences of Ebola virus disease (Ebola) in Liberia. Recent situation reports from the Liberian Ministry of Health and Social Welfare (MoHSW) have indicated a decrease in new cases of Ebola in Lofa County. In October 2014, the Liberian MoHSW requested the assistance of CDC to further characterize recent trends in Ebola in Lofa County. Data collected during June 8-November 1, 2014 from three sources were analyzed: 1) aggregate data for newly reported cases, 2) case-based data for persons admitted to the dedicated Ebola treatment unit (ETU) for the county, and 3) test results for community decedents evaluated for Ebola. Trends from all three sources suggest that transmission of Ebola virus decreased as early as August 17, 2014, following rapid scale-up of response activities in Lofa County after a resurgence of Ebola in early June 2014. The comprehensive response strategy developed with participation from the local population in Lofa County might serve as a model to implement in other affected areas to accelerate control of Ebola.

  15. County Community Development Studies. No. 2: Extensions Library on Tape, Sarasota County.

    ERIC Educational Resources Information Center

    Rozar, Luther L.; And Others

    A study was conducted in Sarasota County, Florida, to determine the feasibility of implementing a County Extension Service library on telecassette tape that could be dialed by phone callers. The system would allow office callers access to two-to-three-minute tape recordings containing information on many common problems. A survey instrument…

  16. Albemarle County road orders, 1783-1816.

    DOT National Transportation Integrated Search

    1975-01-01

    During the early stages of the pilot study of Albemarle County it was necessary to examine and extract all the road orders for the counties from which Albemarle was formed, as well as the orders for Albemarle when it still contained the counties of A...

  17. Agreement between the County of Sullivan and Sullivan County Community College and the Professional Staff Association of Sullivan County Community College, September 1, 1987-August 31, 1990.

    ERIC Educational Resources Information Center

    Sullivan County Community Coll., Loch Sheldrake, NY.

    This collective bargaining agreement between the County of Sullivan and Sullivan County Community College and the Professional Staff Association of Sullivan County Community College establishes conditions of employment for academic teaching, non-teaching, and support staff. The articles in the agreement set forth provisions related to: (1)…

  18. Changing the paradigm: planning for ambulatory care expansion in Los Angeles County using a community-based and evidence-based model.

    PubMed

    Fielding, J E; Lamirault, I; Nolan, B; Bobrowsky, J

    2000-07-01

    In 1998, Los Angeles County's Department of Health Services (DHS) embarked on a planning process to expand ambulatory care services for the county's 2.7 million uninsured and otherwise medically indigent residents. This planning process was novel in two ways. First, it used a quantitative, needs-based approach for resource allocation to ensure an equitable distribution of safety-net ambulatory care services across the county. Second, it used a new community-based planning paradigm that took into consideration the specific needs of each of the county's eight geographic service planning areas. Together, the evidence-based approach to planning and the community-based decision-making will ensure that DHS can more equitably provide for the needs of Los Angeles County's medically indigent residents.

  19. Coping with Resource Management Challenges in Mumias Sub-County, Kakamega County, Kenya

    ERIC Educational Resources Information Center

    Anyango, Onginjo Rose; Orodho, John Aluko

    2016-01-01

    The gist of the study was to examine the main coping strategies used to manage resources in public secondary schools in Mumias Sub-County, Kakamega County, Kenya. The study was premised on Hunts (2007) theory on project management. A descriptive survey design was adopted. A combination of purposive and simple random sampling techniques were used…

  20. Public Health Surveillance Strategies for Mass Gatherings: Super Bowl XLIX and Related Events, Maricopa County, Arizona, 2015.

    PubMed

    Ayala, Aurimar; Berisha, Vjollca; Goodin, Kate; Pogreba-Brown, Kristen; Levy, Craig; McKinney, Benita; Koski, Lia; Imholte, Sara

    2016-01-01

    Super Bowl XLIX took place on February 1, 2015, in Glendale, Arizona. In preparation for this event and associated activities, the Maricopa County Department of Public Health (MCDPH) developed methods for enhanced surveillance, situational awareness, and early detection of public health emergencies. Surveillance strategies implemented from January 22 to February 6, 2015, included enhanced surveillance alerts; animal disease surveillance; review of NFL clinic visits; syndromic surveillance for emergency room visits, urgent care facilities, and hotels; real-time onsite syndromic surveillance; all-hazards mortality surveillance; emergency medical services surveillance, review of poison control center reports; media surveillance; and aberration detection algorithms for notifiable diseases. Surveillance results included increased influenzalike illness activity reported from urgent care centers and a few influenza cases reported in the NFL clinic. A cyanide single event exposure was investigated and determined not to be a public health threat. Real-time field syndromic surveillance documented minor injuries at all events and sporadic cases of gastrointestinal and neurological (mostly headaches) disease. Animal surveillance reports included a cat suspected of carrying plague and tularemia and an investigation of highly pathogenic avian influenza in a backyard chicken flock. Laboratory results in both instances were negative. Aberration detection and syndromic surveillance detected an increase in measles reports associated with a Disneyland exposure, and syndromic surveillance was used successfully during this investigation. Coordinated enhanced epidemiologic surveillance during Super Bowl XLIX increased the response capacity and preparedness of MCDPH to make informed decisions and take public health actions in a timely manner during these mass gathering events.

  1. Overweight and obesity among low-income women in rural West Virginia and urban Los Angeles County.

    PubMed

    Robles, Brenda; Frost, Stephanie; Moore, Lucas; Harris, Carole V; Bradlyn, Andrew S; Kuo, Tony

    2014-10-01

    We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult women recruited from public-sector clinics serving low-income populations. All participants answered survey questions regarding socio-demographics and diets. In both jurisdictions, we assessed obesity using objectively measured height and weight (calculated BMI). As part of each community case study, we performed multivariable regression analyses to describe the relationships between overweight and obesity and selected covariates (e.g., dietary behaviors). Overweight and obesity were prevalent among low-income women from WV (73%, combined) and LA County (67%, combined). In both communities, race and ethnicity appeared to predict the two conditions; however, the associations were not robust. In LA County, for example, African American and Hispanic women were 1.4 times (95% CI=1.12, 1.81) more likely than white women to be overweight and obese. Collectively, these subpopulation health data served as an important guide for further planning of obesity prevention efforts in both communities. These efforts became a part of the subsequent Community Transformation Grants portfolio. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Current status of Enterobius vermicularis infection in primary schoolchildren in Miaoli County and Taichung County, Taiwan.

    PubMed

    Wang, Cheng-Chieh; Lee, Yuan-Fang; Chang, Chih-Cheng; Lee, Nie-Sue; Chen, Po-Yen; Huang, Fang-Liang; Liou, Nuo-Wei

    2009-10-01

    No epidemiological survey of the prevalence of Enterobius vermicularis infection in Miaoli County and Taichung County has been conducted. This epidemiological survey was performed to describe the profile of E. vermicularis infection in schoolchildren in Miaoli County and Taichung County. The first part of this study was conducted between November 2005 and February 2006 in Miaoli County. 44,071 primary schoolchildren from 18 districts were examined by 2 consecutive-day adhesive cellophane perianal swabs to estimate the infection rate. The second part was performed between October 2006 and January 2007 in Taichung County. 24,382 primary schoolchildren from 14 districts were examined. In Miaoli County, the infection rate was 2.39% (1054/44,071). The infection rate was highest in the Taian (6.69%; 20/299), Shytarn (4.49%; 11/245), and Dahu townships (3.6%; 40/1111). In Taichung County, the infection rate was 2.95% (720/24,382). The infection rate was highest in the Da-an (5.46%; 26/476) and Heping townships (4.48%; 9/201). The infection rate for a family with > or =3 children was significantly higher than that for a family with < or =2 children (p = 0.007). The frequency of washing linen and cleaning bedclothes significantly affected the infection rate of enterobiasis (p < 0.01). The efficacy rate for mebendazole was 96%, with no difference between 1 and 2 doses. The number of children per family and the frequency of washing linen and cleaning bedclothes were the most important factors for transmission of pinworm infection among the groups surveyed.

  3. Water resources of Duval County, Florida

    USGS Publications Warehouse

    Phelps, G.G.

    1994-01-01

    The report describes the hydrology and water resources of Duval County, the development of its water supplies, and water use within the county. Also included are descriptions of various natural features of the county (such as topography and geology), an explanation of the hydrologic cycle, and an interpretation of the relationship between them. Ground-water and surface-water resources and principal water-quality features within the county are also discussed. The report is intended to provide the general public with an overview of the water resources Of Duval County, and to increase public awareness of water issues. Information is presented in nontechnical language to enable the general reader to understand facts about water as a part of nature, and the problems associated with its development and use.

  4. Building a Model System of Developmental Services in Orange County

    ERIC Educational Resources Information Center

    Halfon, Neal; Russ, Shirley; Regalado, Michael

    2004-01-01

    In 1998, California voters passed Proposition 10, the California Children and Families First Act, which provides for an excise tax on tobacco products to fund parent education, health and child care programs that promote early childhood development for 0-5s. Since the adoption of its first Strategic Plan (2000), the Orange County First 5…

  5. Orange County Photovoltaic Project & Educational COmponent

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

    Parker, Renee

    the Orange County Climate Change Education Center: The Climate Change Education Center, originally located within the Orange County Convention Center, served as a central place to inform and educate commercial and residential sectors of environmental, health, and economic benefits of renewable energy, energy efficiency, and greenhouse gas emission reductions. Grant funds were used to pay for the rent required to maintain a lease at the Convention Center, conduct five educational workshops, and for planned upgrades to the Center displays highlighting a number of energy efficiency and renewable energy projects implemented at the Orange County Convention Center and Downtown Orange County. An initial design concept for an upgraded Climate Change Education Center and educational displays was proposed. However, after the Convention Center determined the space occupied by the Climate Change Education Center; a feasibility study for relocation to the proposed area was conducted in October 2013. In December 2013, it was determined that the desired location of the for the Climate Change Education Center at the Orange County Extension Education Center provided too many construction challenges for relocation with too many building retrofits and access problems, including lack of access for loading and unloading exhibits as well as roof drainage relocations and sewer service connection issues. Another suitable location for relocating the Climate Change Education Center could not be located so the project was terminated. The Climate Change Education Center is no longer in existence in Orange County and has been eliminated. Grant funds were used to pay for marketing services for a state wide marketing program including solar & other renewable energy technologies for rebranding and developing marketing materials including web site design and updating. A website was maintained and updated the www.PowerUpGreenEnergy.com website (no longer in service). Sustainability Training for the

  6. Water-resources data network evaluation for Monterey County, California; Phase 2, northern and coastal areas of Monterey County

    USGS Publications Warehouse

    Templin, W.E.; Smith, P.E.; DeBortoli, M.L.; Schluter, R.C.

    1995-01-01

    Control and Water Conservation District maintained three networks in the study areas to measure ground-water levels: (1) the summer network, (2) the monthly network, and (3) the annual autumn network. The California American Water Company also did some ground-water-level monitoring in these areas. Well coverage for ground-water monitoring was dense in the seawater-intrusion area north of Moss Landing (possibly because of multiple overlying aquifers), but sparse in other parts of the study areas. During the study, 44 sections were identified as not monitored for ground-water levels. In an ideal ground-water-level network, wells would be evenly spaced, except where local conditions or correlations of wells make monitoring unnecessary. A total of 384 wells that monitor ground-water levels and/or ground-water quality were identified during this study. The Monterey County Flood Control and Water Conservation District sampled ground-water quality monthly during the irrigation season to monitor seawater intrusion. Once each year (during the summer), the wells in this network were monitored for chlorides, specific conductance, and nitrates. Additional samples were collected from each well once every 5 years for complete mineral analysis. The California Department of Health Services, the California American Water Company, the U.S. Army Health Service at Ford Ord, and the Monterey Peninsula Water Management District also monitored ground-water quality in wells in the study areas. Well coverage for the ground-water- quality networks was dense in the seawater- intrusion area north of Moss Landing, but sparse in the rest of the study areas. During this study, 54 sections were identified as not monitored for water quality.

  7. Health assessment for Harvey and Knott Drum National Priorities List (NPL) Site, New Castle County, Delaware, Region 3. CERCLIS No. DED980713093. Final report

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

    Not Available

    The Harvey Knott Drum National Priorities List site, located near Kirkwood in New Castle County, Delaware, is an inactive landfill that had received sanitary, municipal and industrial wastes. Contaminants released from the site include heavy metals and organic compounds and have entered groundwater, soils, sediments, and surface waters. The principal concern is that contaminated groundwater may migrate to off-site domestic, public, and agricultural water supply wells. Also, contaminants in off-site surface water and sediments pose some concern for recreational use and consumption of fish. Off-site contaminated soils near the west property line may be a threat to persons that trespassmore » into that area. The site is of potential health concern because of the risk to human health resulting from possible exposure to hazardous substances at concentrations that may result in adverse health effects.« less

  8. Somerset County Flood Information System

    USGS Publications Warehouse

    Hoppe, Heidi L.

    2007-01-01

    The timely warning of a flood is crucial to the protection of lives and property. One has only to recall the floods of August 2, 1973, September 16 and 17, 1999, and April 16, 2007, in Somerset County, New Jersey, in which lives were lost and major property damage occurred, to realize how costly, especially in terms of human life, an unexpected flood can be. Accurate forecasts and warnings cannot be made, however, without detailed information about precipitation and streamflow in the drainage basin. Since the mid 1960's, the National Weather Service (NWS) has been able to forecast flooding on larger streams in Somerset County, such as the Raritan and Millstone Rivers. Flooding on smaller streams in urban areas was more difficult to predict. In response to this problem the NWS, in cooperation with the Green Brook Flood Control Commission, installed a precipitation gage in North Plainfield, and two flash-flood alarms, one on Green Brook at Seeley Mills and one on Stony Brook at Watchung, in the early 1970's. In 1978, New Jersey's first countywide flood-warning system was installed by the U.S. Geological Survey (USGS) in Somerset County. This system consisted of a network of eight stage and discharge gages equipped with precipitation gages linked by telephone telemetry and eight auxiliary precipitation gages. The gages were installed throughout the county to collect precipitation and runoff data that could be used to improve flood-monitoring capabilities and flood-frequency estimates. Recognizing the need for more detailed hydrologic information for Somerset County, the USGS, in cooperation with Somerset County, designed and installed the Somerset County Flood Information System (SCFIS) in 1990. This system is part of a statewide network of stream gages, precipitation gages, weather stations, and tide gages that collect data in real time. The data provided by the SCFIS improve the flood forecasting ability of the NWS and aid Somerset County and municipal agencies in

  9. 77 FR 73005 - Revisions to the California State Implementation Plan, Imperial County, Placer County, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ...EPA is proposing to approve revisions to the Imperial County Air Pollution Control District (ICAPCD), Placer County Air Pollution Control District (PCAPCD) and Ventura County Air Pollution Control District (PCAPCD) portions of the California State Implementation Plan (SIP). Under authority of the Clean Air Act as amended in 1990 (CAA or the Act), we are proposing to approve local rules that address emission statements for ICAPCD and PCAPCD and definitions for VCAPCD.

  10. The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

    PubMed

    Linnen, Daniel T; Kornak, John; Stephens, Caroline

    2018-03-28

    Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p < 0.001). For hospitals in small metro counties, the odds of having such a rating were 3.7 times greater (95% confidence interval = 0.7-23.4, p = 0.12), although not statistically significant. Few ratings were provided for rural counties, and analysis of rural counties was underpowered. Hospitals in medium-sized metro counties are associated with unfavorable Medicare mortality ratings, but current methods to assign mortality ratings may hinder fair comparisons. Patient transfers from rural locations to regional medical centers may contribute to these results, a potential factor that future research should examine.

  11. Public health assessment for Lone Star Army Ammunition Plant, Texarkana, Bowie County, Texas, Region 6, CERCLIS number TX7213821831. Final report

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

    NONE

    Lone Star Army Ammunition Plant (Lone Star) is a 15,546-acre government-owned contractor-operated industrial facility 12 miles west of Texarkana, Texas in Bowie County. Lone Star is near the communities of Hooks and Leary to the north, and Redwater and Maud to the south. The Old Demolition Area (ODA), a 19-acre section of land on the Lone Star facility used for the disposal of explosives by detonation, was placed on the National Priorities List (NPL) on July 22, 1987. The Texas Department of Health (TDH) and the Agency for Toxic Substances and Disease Registry (ATSDR) evaluated the environmental information available formore » the site and identified several exposure situations for evaluation. These exposure situations include possible contact with site contaminants in sediment, soil, ordnance debris, surface water, and groundwater. Based on available data the authors have concluded that overall there are no public health hazards related to environmental contamination at the ODA. In the future, the conclusion category for the whole site could change if additional information indicates that a public health hazard exists.« less

  12. [Role of socio-economy and management in sustainable transmission control of schistosomiasis in Taoyuan County, Hunan Province, China].

    PubMed

    Luo, Zhi-Hong; Li, Sheng-Ming; Zhou, Xiao-Nong; Yi, Ping; Ren, Guang-Hui; Franziska, Bieri; Zhao, Zheng-Yuan; Hou, Xun-Ya; Ren, Mao-Yuan; Li, Yi-Yi; Dong, Ru-Lan; Zeng, Jin-Yuan; She, Shu-Ping

    2013-02-01

    To clarify the role of socio-economy and management in the sustainable schistosomiasis-control in Taoyuan County, an endemic area in hilly region, Hunan Province, China. From 1996 to 2011, the data of socio-economy, the management of schistosomiasis control organizations, environment, and the changes in schistosomiasis prevalence were collected in Taoyuan County where schistosomiasis transmission had been controlled since 2008. A sampling survey of schistosomiasis prevalence of human and bovine was performed in 2011 to verify the current status of schistosomiasis transmission. All the data were analyzed statistically to evaluate the role of socio-economy and management in the sustainable schistosomiasis control. During the period from 1998 to 2012, the socio-economy including the residents' productive mode and daily life in Taoyuan County improved dramatically, but the recurrence risk of schistosomiasis endemic still existed due to the retuning of out-going workers and the migrating population. Moreover, the introduction of exotic species of plants and animals may increase the risk. The low running cost of schistosomiasis control organization as well as the efficient and adequate resource allocation in the county was in line with the national requirement to strengthen the rural grass-roots public health system. The harmonious development of socio-economy and the scientific and efficient health system in Taoyuan County are the key factors for the sustainable transmission control of schistosomiasis.

  13. Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China.

    PubMed

    Pan, Yao; Chen, Shanquan; Chen, Manli; Zhang, Pei; Long, Qian; Xiang, Li; Lucas, Henry

    2016-01-27

    Health inequity is an important issue all around the world. The Chinese basic medical security system comprises three major insurance schemes, namely the Urban Employee Basic Medical Insurance (UEBMI), the Urban Resident Basic Medical Insurance (URBMI), and the New Cooperative Medical Scheme (NCMS). Little research has been conducted to look into the disparity in payments among the health insurance schemes in China. In this study, we aimed to evaluate the disparity in reimbursements for tuberculosis (TB) care among the abovementioned health insurance schemes. This study uses a World Health Organization (WHO) framework to analyze the disparities and equity relating to the three dimensions of health insurance: population coverage, the range of services covered, and the extent to which costs are covered. Each of the health insurance scheme's policies were categorized and analyzed. An analysis of the claims database of all hospitalizations reimbursed from 2010 to 2012 in three counties of Yichang city (YC), which included 1506 discharges, was conducted to identify the differences in reimbursement rates and out-of-pocket (OOP) expenses among the health insurance schemes. Tuberculosis patients had various inpatient expenses depending on which scheme they were covered by (TB patients covered by the NCMS have less inpatient expenses than those who were covered by the URBMI, who have less inpatient expenses than those covered by the UEBMI). We found a significant horizontal inequity of healthcare utilization among the lower socioeconomic groups. In terms of financial inequity, TB patients who earned less paid more. The NCMS provides modest financial protection, based on income. Overall, TB patients from lower socioeconomic groups were the most vulnerable. There are large disparities in reimbursement for TB care among the three health insurance schemes and this, in turn, hampers TB control. Reducing the gap in health outcomes between the three health insurance schemes in

  14. Indicators for Environment Health Risk Assessment in the Jiangsu Province of China

    PubMed Central

    Zhang, Shujie; Wei, Zhengzheng; Liu, Wenliang; Yao, Ling; Suo, Wenyu; Xing, Jingjing; Huang, Bingzhao; Jin, Di; Wang, Jiansheng

    2015-01-01

    According to the framework of “Pressure-State-Response”, this study established an indicator system which can reflect comprehensive risk of environment and health for an area at large scale. This indicator system includes 17 specific indicators covering social and economic development, pollution emission intensity, air pollution exposure, population vulnerability, living standards, medical and public health, culture and education. A corresponding weight was given to each indicator through Analytical Hierarchy Process (AHP) method. Comprehensive risk assessment of the environment and health of 58 counties was conducted in the Jiangsu province, China, and the assessment result was divided into four types according to risk level. Higher-risk counties are all located in the economically developed southern region of Jiangsu province and relatively high-risk counties are located along the Yangtze River and Xuzhou County and its surrounding areas. The spatial distribution of relatively low-risk counties is dispersive, and lower-risk counties mainly located in the middle region where the economy is somewhat weaker in the province. The assessment results provide reasonable and scientific basis for Jiangsu province Government in formulating environment and health policy. Moreover, it also provides a method reference for the comprehensive risk assessment of environment and health within a large area (provinces, regions and countries). PMID:26371016

  15. Indicators for Environment Health Risk Assessment in the Jiangsu Province of China.

    PubMed

    Zhang, Shujie; Wei, Zhengzheng; Liu, Wenliang; Yao, Ling; Suo, Wenyu; Xing, Jingjing; Huang, Bingzhao; Jin, Di; Wang, Jiansheng

    2015-09-07

    According to the framework of "Pressure-State-Response", this study established an indicator system which can reflect comprehensive risk of environment and health for an area at large scale. This indicator system includes 17 specific indicators covering social and economic development, pollution emission intensity, air pollution exposure, population vulnerability, living standards, medical and public health, culture and education. A corresponding weight was given to each indicator through Analytical Hierarchy Process (AHP) method. Comprehensive risk assessment of the environment and health of 58 counties was conducted in the Jiangsu province, China, and the assessment result was divided into four types according to risk level. Higher-risk counties are all located in the economically developed southern region of Jiangsu province and relatively high-risk counties are located along the Yangtze River and Xuzhou County and its surrounding areas. The spatial distribution of relatively low-risk counties is dispersive, and lower-risk counties mainly located in the middle region where the economy is somewhat weaker in the province. The assessment results provide reasonable and scientific basis for Jiangsu province Government in formulating environment and health policy. Moreover, it also provides a method reference for the comprehensive risk assessment of environment and health within a large area (provinces, regions and countries).

  16. HIV Intertest Interval among MSM in King County, Washington

    PubMed Central

    Katz, David A.; Dombrowski, Julia C.; Swanson, Fred; Buskin, Susan; Golden, Matthew R.; Stekler, Joanne D.

    2012-01-01

    OBJECTIVES We examined temporal trends and correlates of HIV testing frequency among men who have sex with men (MSM) in King County, WA. METHODS We evaluated data from MSM testing for HIV at the Public Health - Seattle & King County (PHSKC) STD Clinic and Gay City Health Project (GCHP) and testing history data from MSM in PHSKC HIV surveillance. The intertest interval (ITI) was defined as the number of days between the last negative HIV test and the current testing visit or first positive test. Correlates of the log10-transformed ITI were determined using GEE linear regression. RESULTS Between 2003 and 2010, the median ITI among MSM seeking HIV testing at the STD Clinic and GCHP were 215 (IQR: 124–409) and 257 (IQR: 148–503) days, respectively. In multivariate analyses, younger age, having only male partners, and reporting ≥10 male sex partners in the last year were associated with shorter ITIs at both testing sites (p<0.05). Among GCHP attendees, having a regular healthcare provider, seeking a test as part of a regular schedule, and inhaled nitrite use in the last year were also associated with shorter ITIs (p<0.001). Compared to MSM testing HIV-negative, MSM newly diagnosed with HIV had longer ITIs at the STD Clinic (median of 213 versus 278 days; p=0.01) and GCHP (median 255 versus 359 days; p=0.02). CONCLUSIONS Although MSM in King County appear to be testing at frequent intervals, further efforts are needed to reduce the time that HIV-infected persons are unaware of their status. PMID:22563016

  17. Nursing during World War II: Finnmark County, Northern Norway

    PubMed Central

    Immonen, Ingrid

    2013-01-01

    Introduction This study is part the project “Nursing in Borderland – Finnmark 1939–1950” within nursing history that sheds light on nursing and health care during World War II in Finnmark County, Northern Norway. The study focuses on challenges in nursing care that arose during the war because of war activities in the Barents area. This article focuses on challenges caused by shortage of supplies. The aim of the project is to widen the understanding of development within health care and living conditions in the area. Study design This is a historical study using narratives, government documents and literature. Methods Interviews with nurses and persons active in health care during World War II constitute the main data of the research. Thematic issues that arise from interviews are analysed. Primary and secondary written sources are used in analysing the topics. Because of war activities, deportation and burning of the county, archives were partly destroyed. Central archives can contribute with annual reports, whereas local archives are fragmentary. There are a number of reports written soon after the War, as well as a number of biographical books of newer date. Results Challenges caused by war, which appear in the interviews, are: 1) shortage of supplies, 2) increased workload, 3) multicultural society, 4) ethical dilemmas, 5) deportation of the population. In this paper, focus is on challenges caused by shortage of supplies. Conclusions Both institutions, personnel and patients were marked by the war. This has to be taken in consideration in health care today. PMID:23630668

  18. Low-Wage Counties Face Locational Disadvantages.

    ERIC Educational Resources Information Center

    Gibbs, Robert; Cromartie, John B.

    2000-01-01

    Small populations and remoteness are the most salient features of low-wage counties. These locational attributes coincide with fewer high-wage jobs, yet low wages within industries define low-wage counties more than industry composition. Although adults in low-wage counties have less education and labor force participation overall, the role played…

  19. Individual and county level predictors of asthma related emergency department visits among children on Medicaid: A multilevel approach.

    PubMed

    Baltrus, Peter; Xu, Junjun; Immergluck, Lilly; Gaglioti, Anne; Adesokan, Adeola; Rust, George

    2017-01-02

    Disparities in asthma outcomes are well documented in the United States. Interventions to promote equity in asthma outcomes could target factors at the individual and community levels. The objective of this analysis was to understand the effect of individual (race, gender, age, and preventive inhaler use) and county-level factors (demographic, socioeconomic, health care, air-quality) on asthma emergency department (ED) visits among Medicaid-enrolled children. This was a retrospective cohort study of Medicaid-enrolled children with asthma in 29 states in 2009. Multilevel regression models of asthma ED visits were constructed utilizing individual-level variables (race, gender, age, and preventive inhaler use) from the Medicaid enrollment file and county-level variables reflecting population and health system characteristics from the Area Resource File (ARF). County-level measures of air quality were obtained from Environmental Protection Agency (EPA) data. The primary modifiable risk factor at the individual level was found to be the ratio of long-term controller medications to total asthma medications. County-level factors accounted for roughly 6% of the variance in the asthma ED visit risk. Increasing county-level racial segregation (OR=1.04, 95% CI=1.01-1.08) was associated with increasing risk of asthma ED visits. Greater supply of pulmonary physicians at the county level (OR=0.81, 95% CI=0.68-0.97) was associated with a reduction in risk of asthma ED visits. At the patient care level, proper use of controller medications is the factor most amenable to intervention. There is also a societal imperative to address negative social determinants, such as residential segregation.

  20. The association between health literacy and preventable hospitalizations in Missouri: implications in an era of reform.

    PubMed

    Cimasi, Robert J; Sharamitaro, Anne R; Seiler, Rachel L

    2013-01-01

    To evaluate the association between health literacy and preventable hospitalizations on a population level in Missouri, and the extent to which differing levels of health literacy are associated with county preventable hospitalization rates and associated charges. Secondary data from the 2008 Missouri Information for Community Assessment and Missouri Health Literacy Mapping Tool was used to determine health literacy and preventable hospitalization rates for the 114 counties and city of St. Louis comprising Missouri. Using correlation analysis, simple hierarchical regression models and nonparametric analysis, we investigated whether lower health literacy rates were associated with increased levels of preventable hospitalizations and charges, by county. Health literacy was found to be inversely associated with preventable hospitalization rates on a population level, accounting for 21 percent of the variation in preventable hospitalization rates. Preventable hospitalization rates significantly differed for counties with the highest and lowest health literacy levels. Lower levels of health literacy are significantly associated with increased rates of preventable hospitalizations and charges in a population-level analysis of Missouri counties. Additional research is needed to quantify the effects of successful community health literacy interventions.

  1. Local house prices and mental health.

    PubMed

    Joshi, Nayan Krishna

    2016-03-01

    This paper examines the impact of local (county-level) house prices on individual self-reported mental health using individual level data from the United States Behavioral Risk Factor Surveillance System between 2005 and 2011. Exploiting a fixed-effects model that relies on within-county variations, relative to the corresponding changes in other counties, I find that while individuals are likely to experience worse self-reported mental health when local house prices decline, this association is most pronounced for individuals who are least likely to be homeowners. This finding is not consistent with a prediction from a pure wealth mechanism but rather with the hypothesis that house prices act as an economic barometer. I also demonstrate that the association between self-reported mental health and local house prices is not driven by unemployment or foreclosure. The primary result-that lower local house prices have adverse impact on self-reported mental health of homeowners and renters-is consistent with studies using data from the United Kingdom.

  2. Strategy for Promoting the Equitable Development of Basic Education in Underdeveloped Counties as Seen from Cili County

    ERIC Educational Resources Information Center

    Shihua, Peng; Rihui, Tan

    2009-01-01

    Employing statistical analysis, this study has made a preliminary exploration of promoting the equitable development of basic education in underdeveloped counties through the case study of Cili county. The unequally developed basic education in the county has been made clear, the reasons for the inequitable education have been analyzed, and,…

  3. Water resources of Carbon County, Wyoming

    USGS Publications Warehouse

    Bartos, Timothy T.; Hallberg, Laura L.; Mason, Jon P.; Norris, Jodi R.; Miller, Kirk A.

    2006-01-01

    Carbon County is located in the south-central part of Wyoming and is the third largest county in the State. A study to describe the physical and chemical characteristics of surface-water and ground-water resources in Carbon County was conducted by the U.S. Geological Survey in cooperation with the Wyoming State Engineer's Office. Evaluations of streamflow and stream-water quality were limited to analyses of historical data and descriptions of previous investigations. Surface-water data were not collected as part of the study. Forty-five ground-water-quality samples were collected as part of the study and the results from an additional 618 historical ground-water-quality samples were reviewed. Available hydrogeologic characteristics for various aquifers in hydrogeologic units throughout the county also are described. Flow characteristics of streams in Carbon County vary substantially depending on regional and local basin char-acteristics and anthropogenic factors. Precipitation in the county is variable with high mountainous areas receiving several times the annual precipitation of basin lowland areas. For this reason, streams with headwaters in mountainous areas generally are perennial, whereas most streams in the county with headwaters in basin lowland areas are ephemeral, flowing only as a result of regional or local rainfall or snowmelt runoff. Flow characteristics of most perennial streams are altered substantially by diversions and regulation. Water-quality characteristics of selected streams in and near Carbon County during water years 1966 through 1986 varied. Concentrations of dissolved constituents and suspended sediment were smallest at sites on streams with headwaters in mountainous areas because of resistant geologic units, large diluting streamflows, and increased vegetative cover compared to sites on streams with headwaters in basin lowlands. Both water-table and artesian conditions occur in aquifers within the county. Shallow ground water is

  4. The Economic Impact of Johnson County Community College on Johnson County, 1993-94.

    ERIC Educational Resources Information Center

    Johnson County Community Coll., Overland Park, KS. Office of Institutional Research.

    In 1995, Johnson County Community College (JCCC), in Kansas, conducted a study to estimate the economic benefit contributed by the college to the Johnson County economy for 1993-94. Following a model developed by J. G. Ryan, direct economic impact was assessed by examining institutional expenditures, expenditures by college employees, and…

  5. 76 FR 65527 - Habitat Conservation Plan/Natural Community Conservation Plan for Yolo County, CA: Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-21

    ... palmate- bracted bird's-beak (Cordylanthus palmatus), threatened Colusa grass (Neostapfia colusana), and endangered Solano grass (Tuctoria mucronata). The following unlisted plant species are also proposed to be... Joaquin spearscale (Atriplex joaquiniana), Heckard's pepper-grass (Lepidium latipes var. heckardii), and...

  6. Public health assessment for Plymouth Avenue Landfill, Deland, Volusia County, Florida, Region 4. Cerclis No. FLD984167569. Final report

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

    Not Available

    1994-08-24

    The Plymouth Avenue Landfill is about 1.75 miles west of the City of DeLand in rural western Volusia County, Florida. From 1971 to 1988 it was a Class I landfill and received all types of nonhazardous industrial and municipal solid waste. From June 1978 to October 1980, the landfill reportedly received 4,500 gallons per week of process waste slurry from the Brunswick Corporation. The authors selected the following contaminants of concern: barium, chromium, 1,2-dichloroethene, iron, nitrate, sulfate, and vinyl chloride. Ingestion of ground water is a past completed human exposure pathway. Concentrations of the contaminants of concern found so farmore » are unlikely to have caused illness in the nearby residents. Analysis of water samples has been inadequate, however, to assess the public health threat from ingestion of sulfate, giardia, or vinyl chloride. Based on the information currently available, the authors classify the public health hazard at this landfill as indeterminate. Groundwater sampling is needed to determine the extent of vinyl chloride contamination.« less

  7. Epidemiology of cognitive aging and Alzheimer's disease: contributions of the cache county utah study of memory, health and aging.

    PubMed

    Hayden, Kathleen M; Welsh-Bohmer, Kathleen A

    2012-01-01

    Epidemiological studies of Alzheimer's disease (AD) provide insights into changing public health trends and their contribution to disease incidence. The current chapter considers how the population-based approach has contributed to our understanding of lifetime exposures that contribute to later disease risk and may act to modify onset of symptoms. We focus on the findings from a recent survey of an exceptionally long-lived population, the Cache County Utah Study of Memory, Health, and Aging. This study is confined to a single geographic population has allowed estimation of the genetic and environmental influences on AD expression across the expected human lifespan of 95+ years. Given the emphasis of this text on the behavioral neurosciences of aging, we highlight within the current chapter the particular contributions of this population-based study to the neuropsychology of aging and AD. We also discuss hypotheses generated from this survey with respect to factors that may either accelerate or delay symptom onset in AD and the conditions that appear to be associated with successful cognitive aging.

  8. Economic stress and well-being: Does population health context matter?

    PubMed

    Probst, Tahira M; Sinclair, Robert R; Sears, Lindsay E; Gailey, Nicholas J; Black, Kristen Jennings; Cheung, Janelle H

    2018-05-07

    The purpose of this study was to investigate the role of county-level population health determinants in predicting individual employee reactions to economic stress. Using multilevel modeling and a population health perspective, we tested a model linking nationally representative individual-level data (N = 100,968) on exposure to economic stressors and county-level population health determinants (N = 3,026) to responses on a composite measure of individual well-being that included the facets of purpose, community, physical, and social well-being, as well as life satisfaction. Results indicate that higher income- and employment-related economic stress were significantly related to poorer well-being. Additionally, living in a county with more positive population health determinants was significantly predictive of individual well-being. Finally, the Level-1 relationship between income-related stress and well-being was significantly attenuated for individuals living in counties with more positive population health determinants. In contrast, employment-related stress had a stronger negative relationship with well-being for individuals who lived in counties with more positive population health determinants. We discuss these findings in light of conservation of resources and relative deprivation theories, as well as how they may extend the scientific foundation for evidence-based social policy and evidence-based intervention programs aimed at lessening the effects of economic stress on individual well-being. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. Community quarantine to interrupt Ebola virus transmission - Mawah Village, Bong County, Liberia, August-October, 2014.

    PubMed

    Nyenswah, Tolbert; Blackley, David J; Freeman, Tabeh; Lindblade, Kim A; Arzoaquoi, Samson K; Mott, Joshua A; Williams, Justin N; Halldin, Cara N; Kollie, Francis; Laney, A Scott

    2015-02-27

    On September 30, 2014, the Bong County health officer notified the county Ebola task force of a growing outbreak of Ebola virus disease (Ebola) in Mawah, a village of approximately 800 residents. During September 9-16, household quarantine had been used by the community in response to a new Ebola infection. Because the infection led to a local outbreak that grew during September 17-20, county authorities suggested community quarantine be considered, and beginning on approximately September 20, the Fuamah District Ebola Task Force (Task Force) engaged Mawah leaders to provide education about Ebola and to secure cooperation for the proposed measures. On September 30, Bong County requested technical assistance to develop strategies to limit transmission in the village and to prevent spread to other areas. The county health team, with support from the Task Force and CDC, traveled to Mawah on October 1 and identified approximately two dozen residents reporting symptoms consistent with Ebola. Because of an ambulance shortage, 2 days were required, beginning October 1, to transport the patients to an Ebola treatment unit in Monrovia. Community quarantine measures, consisting of restrictions on entering or leaving Mawah, regulated river crossings, and market closures, were implemented on October 1. Local leaders raised concerns about availability of medical care and food. The local clinic was reopened on October 11, and food was distributed on October 12. The Task Force reported a total of 22 cases of Ebola in Mawah during September 9-October 2, of which 19 were fatal. During October 3-November 21, no new cases were reported in the village. Involving community members during planning and implementation helped support a safe and effective community quarantine in Mawah.

  10. Forest statistics for Central Alabama counties

    Treesearch

    Arnold Hedlund; J.M. Earles

    1972-01-01

    This report tabulates information from a new forest inventory of counties in central Alabama. The tables are intended for use as source data in compiling estimates for groups of counties. Because the sampling procedure is designed primarily to furnish inventory data for the State as a whole, estimates for individual counties have limited and variable accuracy.

  11. Forest statistics for Southwest Alabama counties

    Treesearch

    Arnold Hedlund; J. M. Earles

    1972-01-01

    This report tabulates information from a new forest inventory of counties in southwestern Alabama. The tables are intended for sue as source data in compiling estimates for groups of counties. Because the sampling procedure is designed primarily to furnish inventory data for the State as a whole, estimates for individual counties have limited and variable accuracy....

  12. Forest statistics for North Alabama counties

    Treesearch

    Arnold Hedlund; J. M. Earles

    1972-01-01

    This report tabulates information from a new forest inventory of counties in northern Alabama. The tables are intended for use as a source data in compiling estimates for groups of counties. Because the sampling procedure is designed primarily to furnish inventory data for the state as a whole, estimates for individual counties have limited and variable accuracy.

  13. Public health assessment for US Army, Badger Army Ammunition Plant, Baraboo, Sauk County, Wisconsin, Region 5: CERCLIS number WI9210020054. Final report

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

    Not Available

    1999-05-28

    Badger Army Ammunition Plant (BAAP) is located in Sauk County, Wisconsin, near the city of Baraboo. Over a 33 year period, until 1975, the plant operated intermittently to produce propellants for cannon, rocket, and small arms ammunition. Past industrial activities at this site have resulted in surface soil and groundwater contamination by organic and inorganic chemicals. A groundwater contamination plume originating from the Propellant Burning Ground extends beyond the plant's southern boundary. In April 1990, chloroform and/or carbon tetrachloride were found at concentrations above the Wisconsin Division of Health completed a public health assessment for the BAAP. The report documentedmore » the evaluation of investigations of environmental conditions and environmentally-related activities taking place at Badger. The Division concluded that people exposed to groundwater contaminants had a slight increased risk of developing cancer.« less

  14. Public health assessment for Odessa Superfund Site (a/k/a Sprague Road Groundwater Plume) Ector, Ector County, Texas, Region 6: CERCLIS number TX0001407444. Final report

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

    NONE

    1998-12-28

    The Sprague Road Groundwater Plume National Priorities List site, consists of three plumes of chromium contaminated water just outside the northern city limits of Odessa, Ector County, Texas. The chromium in the groundwater is a public health hazard to people who continue to use the chromium-contaminated water wells for drinking. Chromium in soil at Leigh Metal Plating Inc. presents a potential public health hazard. Although this facility is surrounded by a fence, access to the site is not entirely restricted. There is a five-foot pit on the National Chromium Corporation site that could present a physical hazard to children trespassingmore » on the site.« less

  15. Youth Representation on County Government Committees: Youth in Governance in Kenosha County, Wisconsin

    ERIC Educational Resources Information Center

    Calvert, Matthew; de Montmollin, John; Winnett, Tedi

    2015-01-01

    The Kenosha County Youth in Governance program was created to build leadership skills and civic engagement opportunities for high school-aged students by placing two youth representatives on each of the Kenosha County Board of Supervisors standing committees. In reviewing data from 3 years of youth participants, the program was effective in…

  16. County-level heat vulnerability of urban and rural residents in Tibet, China.

    PubMed

    Bai, Li; Woodward, Alistair; Cirendunzhu; Liu, Qiyong

    2016-01-12

    Tibet is especially vulnerable to climate change due to the relatively rapid rise of temperature over past decades. The effects on mortality and morbidity of extreme heat in Tibet have been examined in previous studies; no heat adaptation initiatives have yet been implemented. We estimated heat vulnerability of urban and rural populations in 73 Tibetan counties and identified potential areas for public health intervention and further research. According to data availability and vulnerability factors identified previously in Tibet and elsewhere, we selected 10 variables related to advanced age, low income, illiteracy, physical and mental disability, small living spaces and living alone. We separately created and mapped county-level cumulative heat vulnerability indices for urban and rural residents by summing up factor scores produced by a principal components analysis (PCA). For both study populations, PCA yielded four factors with similar structure. The components for rural and urban residents explained 76.5 % and 77.7 % respectively of the variability in the original vulnerability variables. We found spatial variability of heat vulnerability across counties, with generally higher vulnerability in high-altitude counties. Although we observed similar median values and ranges of the cumulative heat vulnerability index values among urban and rural residents overall, the pattern varied strongly from one county to another. We have developed a measure of population vulnerability to high temperatures in Tibet. These are preliminary findings, but they may assist targeted adaptation plans in response to future rapid warming in Tibet.

  17. Unhealthy Competition: Consequences of Health Plan Choice in California Medicaid

    PubMed Central

    Chattopadhyay, Arpita; Bindman, Andrew B.

    2010-01-01

    Objectives. We compared the quality of care received by managed care Medicaid beneficiaries in counties with a choice of health plans and counties with no choice. Methods. This cross-sectional study among California Medicaid beneficiaries was conducted during 2002. We used a multivariate Poisson model to calculate adjusted rates of hospital admissions for ambulatory care–sensitive conditions by duration of plan enrollment. Results. Among beneficiaries with continuous Medicaid coverage, the percentage with 12 months of continuous enrollment in a health plan was significantly lower in counties with a choice of plans than in counties with no choice (79.2% vs 95.2%; P < .001). Annual ambulatory care–sensitive admission rates adjusted for age, gender, and race/ethnicity were significantly higher among beneficiaries living in counties with a choice of plans (6.58 admissions per 1000 beneficiaries; 95% confidence interval [CI] = 6.57, 6.58) than among those in counties with no choice (6.27 per 1000; 95% CI = 6.27, 6.28). Conclusions. Potential benefits of health plan choice may be undermined by transaction costs of delayed enrollment, which may increase the probability of hospitalization for ambulatory care–sensitive conditions. PMID:20864718

  18. Examining associations among obesity and per capita farmers' markets, grocery stores/supermarkets, and supercenters in US counties.

    PubMed

    Jilcott, Stephanie B; Keyserling, Thomas; Crawford, Thomas; McGuirt, Jared T; Ammerman, Alice S

    2011-04-01

    Fruit and vegetable consumption is an important component of a healthful diet, yet fruits and vegetables are underconsumed, especially among low-income groups with high prevalence rates of obesity. This study used data from the US Department of Agriculture Economic Research Service Food Environment Atlas to examine county-level associations among obesity prevalence and per capita farmers' markets, grocery stores/supermarkets, and supercenters, adjusted for natural amenities, percent black, percent Hispanic, median age, and median household income, stratified by county metropolitan status. In models that included all three of the food venues, supercenters and grocery stores per capita were inversely associated with obesity in the combined (metro and nonmetro) and metro counties. Farmers' markets were not significant in the model for combined (metro and nonmetro) or for metro counties alone, but were significantly inversely related to obesity rates in the model for nonmetro counties. In this ecologic study, density of food venues was inversely associated with county-level obesity prevalence. Thus, future research should examine similar associations at the individual-level. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  19. National Trends and Geographic Variation in Availability of Home Health Care: 2002–2015

    PubMed Central

    Wang, Yun; Leifheit-Limson, Erica C; Fine, Jonathan; Pandolfi, Michelle M; Gao, Yan; Liu, Fanglin; Eckenrode, Sheila; Lichtman, Judith H

    2017-01-01

    Objectives To evaluate national trends and geographic variation in the availability of home health care from 2002–2015 and identify county-specific characteristics associated with home health care. Design Observational study Setting All counties in the United States Participants All Medicare-certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system. Measurements County-specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years. Results The study included 15,184 Medicare-certified home health agencies that served 97% of U.S. ZIP codes. Between 2002–2003 and 2014–2015, the county-specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter-quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North-East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non-Hispanic white, non-Hispanic black, and Hispanic populations were more likely to have higher availability of home health care. Conclusion The availability of home health care increased nationwide during the study period, but there was much geographic variation. PMID:28322441

  20. Hancock County Awards Gala

    NASA Image and Video Library

    2008-08-26

    Gene Goldman (left), deputy director of NASA's John C. Stennis Space Center, accepts an Award of Excellence from Jack Zink, executive director of the Hancock County Port and Harbor Commission, during the 2008 Annual Hancock County Awards Gala. The Award of Excellence was presented to recognize Stennis Space Center's contribution to NASA's 50 years of excellence in space exploration.

  1. The Changing Epidemiology of Coccidioidomycosis in Los Angeles (LA) County, California, 1973–2011

    PubMed Central

    2015-01-01

    Coccidioidomycosis, also known as Valley Fever, is often thought of as an endemic disease of central California exclusive of Los Angeles County. The fungus that causes Valley Fever, Coccidioides spp., grows in previously undisturbed soil of semi-arid and arid environments of certain areas of the Americas. LA County has a few large areas with such environments, particularly the Antelope Valley which has been having substantial land development. Coccidioidomycosis that is both clinically- and laboratory-confirmed is a mandated reportable disease in LA County. Population surveillance data for 1973–2011 reveals an annual rate increase from 0.87 to 3.2 cases per 100,000 population (n = 61 to 306 annual cases). In 2004, case frequency started substantially increasing with notable epidemiologic changes such as a rising 2.1 to 5.7 male-to-female case ratio stabilizing to 1.4–2.2. Additionally, new building construction in Antelope Valley greatly rose in 2003 and displayed a strong correlation (R = 0.92, Pearson p<0.0001) with overall LA County incidence rates for 1996–2007. Of the 24 LA County health districts, 19 had a 100%-1500% increase in cases when comparing 2000–2003 to 2008–2011. Case residents of endemic areas had stronger odds of local exposures, but cases from areas not known to be endemic had greater mortality (14% versus 9%) with notably more deaths during 2008–2011. Compared to the 57 other California counties during 2001–2011, LA County had the third highest average annual number of cases and Antelope Valley had a higher incidence rate than all but six counties. With the large number of reported coccidioidomycosis cases, multi-agency and community partnering is recommended to develop effective education and prevention strategies to protect residents and travelers. PMID:26313151

  2. BETTER HEALTH FOR MIGRANTS.

    ERIC Educational Resources Information Center

    Florida State Board of Health, Jacksonville.

    THIS ISSUE OF "FLORIDA HEALTH NOTES" DISCUSSES FLORIDA'S MIGRANTS AND THE MIGRANT HEALTH SERVICES PROVIDED BY THE STATE BOARD OF HEALTH AND THE COUNTY HEALTH DEPARTMENTS. THE FOLLOWING TOPICS ARE DISCUSSED--THEIR HOUSING AND SANITATION FACILITIES, THEIR LONG WORKING HOURS AND LOW WAGES, THEIR SUMMER MIGRATION PATTERNS, THEIR HEALTH…

  3. National Trends and Geographic Variation in Availability of Home Health Care: 2002-2015.

    PubMed

    Wang, Yun; Leifheit-Limson, Erica C; Fine, Jonathan; Pandolfi, Michelle M; Gao, Yan; Liu, Fanglin; Eckenrode, Sheila; Lichtman, Judith H

    2017-07-01

    To evaluate national trends and geographic variation in the availability of home health care from 2002 to 2015 and identify county-specific characteristics associated with home health care. Observational study. All counties in the United States. All Medicare-certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system. County-specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years. The study included 15,184 Medicare-certified home health agencies that served 97% of U.S. ZIP codes. Between 2002-2003 and 2014-2015, the county-specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter-quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non-Hispanic white, non-Hispanic black, and Hispanic populations were more likely to have higher availability of home health care. The availability of home health care increased nationwide during the study period, but there was much geographic variation. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  4. Data for four geologic test holes in the Sacramento Valley, California

    USGS Publications Warehouse

    Berkstresser, C.F.; French, J.J.; Schaal, M.E.

    1985-01-01

    The report provides geological and geophysical data for four of seven test holes drilled as a part of the Central Valley Aquifer Project, which is part of the Regional Aquifer Systems Analysis. The holes were drilled with a rotary well drilling machine to depths of 900 feet in the southwestern part of the Sacramento Valley in Solano and Yolo Counties. Geologic data for each well include lithology, texture, color, character of the contact, sorting, rounding, and cementation, determined from cuttings, cores, and sidewall covers. Fifty cores, 3 feet long, were obtained from each hole, and from eight to fourteen sidewall cores were collected. Geophysical data include a dual-induction log, spherically focused log (SFL), compensated neutron-formation density log, gamma-ray log, and a caliper log. These data are presented in four tables and on four plates. (USGS)

  5. Large-scale immigration and political response: popular reaction in California.

    PubMed

    Clark, W A

    1998-03-01

    Over the past 3 years, the level of political debate has grown over the nature and extent of the recent large-scale immigration to the US in general, and to California in particular. California's Proposition 187 to deny welfare benefits to illegal immigrants brought national attention to the immigration debate, and no doubt influenced recent decisions to significantly change the US's welfare program. The author studied the vote on Proposition 187 in the November 1994 California election to better understand the nature of reaction to large-scale immigration and recent arguments about anti-immigrant sentiment and nativism. The only counties which voted against the proposition were Sonoma, Marin, San Mateo, Santa Cruz, Yolo, Alameda, and Santa Clara, as well as the population of San Francisco. The vote generated political responses from across the border as well as within California. Statements from Mexican and other Central American governments reflected their concern over the possibility of returning populations, for whom there are neither jobs nor public services in their countries of origin. Findings are presented from a spatial analysis of the vote by census tracts in Los Angeles County.

  6. Behind Bars: Experiences Conducting Behavioral Addictions Research in a County Jail.

    PubMed

    Hickey, Kari L; Kerber, Cindy; Astroth, Kim Schafer; Kim, MyoungJin; Schlenker, Emily

    2015-10-01

    Individuals who are incarcerated experience disparities in mental health, warranting study by nurse researchers. However, nurse researchers' unfamiliarity with the jail environment may pose a barrier to conducting research with this vulnerable population. The current article presents an account of the planning and implementation needed to study perceived health and gambling behavior in county jail inmates. The challenges and rewards of research that aim to better understand the mental health issues affecting this population are also identified. Developing relationships with jail personnel and understanding the incarcerated population and their surroundings are key to conducting research in this environment. Copyright 2015, SLACK Incorporated.

  7. Cancer and noncancer mortality in populations living near uranium and vanadium mining and milling operations in Montrose County, Colorado, 1950-2000.

    PubMed

    Boice, John D; Mumma, Michael T; Blot, William J

    2007-06-01

    Mining and milling of uranium in Montrose County on the Western Slope of Colorado began in the early 1900s and continued until the early 1980s. To evaluate the possible impact of these activities on the health of communities living on the Colorado Plateau, mortality rates between 1950 and 2000 among Montrose County residents were compared to rates among residents in five similar counties in Colorado. Standardized mortality ratios (SMRs) were computed as the ratio of observed numbers of deaths in Montrose County to the expected numbers of deaths based on mortality rates in the general populations of Colorado and the United States. Relative risks (RRs) were computed as the ratio of the SMRs for Montrose County to the SMRs for the five comparison counties. Between 1950 and 2000, a total of 1,877 cancer deaths occurred in the population residing in Montrose County, compared with 1,903 expected based on general population rates for Colorado (SMR(CO) 0.99). There were 11,837 cancer deaths in the five comparison counties during the same 51-year period compared with 12,135 expected (SMR(CO) 0.98). There was no difference between the total cancer mortality rates in Montrose County and those in the comparison counties (RR = 1.01; 95% CI 0.96-1.06). Except for lung cancer among males (RR = 1.19; 95% CI 1.06-1.33), no statistically significant excesses were seen for any causes of death of a priori interest: cancers of the breast, kidney, liver, bone, or childhood cancer, leukemia, non-Hodgkin lymphoma, renal disease or nonmalignant respiratory disease. Lung cancer among females was decreased (RR = 0.83; 95% CI 0.67-1.02). The absence of elevated mortality rates of cancer in Montrose County over a period of 51 years suggests that the historical milling and mining operations did not adversely affect the health of Montrose County residents. Although descriptive correlation analyses such as this preclude definitive causal inferences, the increased lung cancer mortality seen among

  8. Creating a Community Coalition to Prevent Childhood Obesity in Yakima County, Washington: Rev It Up! 2008

    PubMed Central

    Brown, Jessica; Bindler, Ruth C.; Miller, Kris

    2012-01-01

    Background One-third of the US population is obese, and childhood obesity has tripled since the late 1970s. Childhood obesity is a significant health issue requiring interventions on individual, interpersonal, community, organizational, and policy levels. Community coalitions offer successful strategies for engaging community partners with health improvement goals. Community Context In 2008, Yakima County, an agricultural community in eastern Washington, was ranked the eighth fattest city in the United States. Recognizing the obesity problem, the Yakima Health District (YHD) established 2 objectives: to decrease rates of childhood obesity in Yakima County and to recruit and establish a community coalition of key stakeholders and experts to help address the problem. Methods The YHD spearheaded a movement to create a community coalition. The coalition applied for and received state and federal grants. In September 2008, the YHD held the first recruitment event for Rev It Up!, its community-based effort to address the obesity problem in Yakima. YHD invited the Washington State Department of Health to advise the coalition-building and action-planning process. Outcome The community coalition achieved 5 of 7 objectives, including developing a common vision, creating an advisory committee, and conducting a community inventory, prioritization process, and action plan. However, unexpected public health challenges in the YHD delayed coalition efforts. Interpretation Creating the Rev It Up! coalition met a community need and engaged community partners. Some potential partners were dissuaded by the 6-month period required to establish the coalition. Rev It Up! continues as a community effort to reduce rates of obesity in Yakima County. PMID:22765932

  9. Commodity Flow Study - Clark County, Nevada, USA

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

    Conway, S.Ph.D.; Navis, I.

    2008-07-01

    The United States Department of Energy has designated Clark County, Nevada as an 'Affected Unit of Local Government' due to the potential for impacts by activities associated with the Yucca Mountain High Level Nuclear Waste Repository project. Urban Transit, LLC has led a project team of transportation including experts from the University of Nevada Las Vegas Transportation Research Center to conduct a hazardous materials community flow study along Clark County's rail and truck corridors. In addition, a critical infrastructure analysis has also been carried out in order to assess the potential impacts of transportation within Clark County of high levelmore » nuclear waste and spent nuclear fuel to a proposed repository 90 miles away in an adjacent county on the critical infrastructure in Clark County. These studies were designed to obtain information relating to the transportation, identification and routing of hazardous materials through Clark County. Coordinating with the United States Department of Energy, the U.S. Department of Agriculture, the U. S. Federal Highway Administration, the Nevada Department of Transportation, and various other stakeholders, these studies and future research will examine the risk factors along the entire transportation corridor within Clark County and provide a context for understanding the additional vulnerability associated with shipping spent fuel through Clark County. (authors)« less

  10. Overcoming Barriers to Rural Children's Mental Health: An Interconnected Systems Public Health Model

    ERIC Educational Resources Information Center

    Huber, Brenda J.; Austen, Julie M.; Tobin, Renée M.; Meyers, Adena B.; Shelvin, Kristal H.; Wells, Michael

    2016-01-01

    A large, Midwestern county implemented a four-tiered public health model of children's mental health with an interconnected systems approach involving education, health care, juvenile justice and community mental health sectors. The community sought to promote protective factors in the lives of all youth, while improving the capacity,…

  11. Effect of eliminating open defecation on diarrhoeal morbidity: an ecological study of Nyando and Nambale sub-counties, Kenya.

    PubMed

    Njuguna, John

    2016-08-04

    Defecating in the open predisposes people to soil transmitted helminthes and diarrhoeal diseases. An estimated 5.6 million Kenyans defecate in the open. Kenya launched a program to eradicate open defecation by 2013 in the rural areas. By end of 2013, only two sub-counties had eliminated open defecation. These are Nambale and Nyando. The study looked at the impact of eradicating open defecation on diarrhea prevalence among children in these two sub-counties. Data on diarrhoea morbidity among children under 5 years was extracted from the Kenya Health Information System for all the sub-counties in Busia and Kisumu counties for 2012, 2013 and 2014 respectively. Prevalence was calculated for each sub-county in Kisumu for comparison with Nyando's. Prevalence was also calculated for each sub-county in Busia County and compared to that of Nambale sub-county. A Mann-Whitney U Test was done to test the null hypothesis that diarrhoea prevalence was similar in both open defecation and open defecation free sub-counties. A Mann-Whitney U Test revealed significant difference in diarrhoeal prevalence of open defecation sub-counties (Md = 18.4, n = 34) and open defecation free sub-counties (Md = 9.8, n = 5), U = 9, z = -3.2, p = .001. Among the two Counties, Nambale had the lowest prevalence. It recorded a decline from 9.8 to 5.7 % across the three years. Prevalence for diarrhoea cases in Nyando declined from 19.1 to 15.2 % across the three years. Nyando initially had the second highest prevalence in Kisumu County and by 2014 it had the lowest prevalence. The two sub-counties with open defecation free status had lower prevalence of diarrhoea cases compared to sub-counties which were yet to attain open defecation free status. This suggests that elimination of open defecation may reduce the number of diarrhoea cases.

  12. Systems, supplies, and staff: a mixed-methods study of health care workers' experiences and health facility preparedness during a large national cholera outbreak, Kenya 2015.

    PubMed

    Curran, Kathryn G; Wells, Emma; Crowe, Samuel J; Narra, Rupa; Oremo, Jared; Boru, Waqo; Githuku, Jane; Obonyo, Mark; De Cock, Kevin M; Montgomery, Joel M; Makayotto, Lyndah; Langat, Daniel; Lowther, Sara A; O'Reilly, Ciara; Gura, Zeinab; Kioko, Jackson

    2018-06-11

    From December 2014 to September 2016, a cholera outbreak in Kenya, the largest since 2010, caused 16,840 reported cases and 256 deaths. The outbreak affected 30 of Kenya's 47 counties and occurred shortly after the decentralization of many healthcare services to the county level. This mixed-methods study, conducted June-July 2015, assessed cholera preparedness in Homa Bay, Nairobi, and Mombasa counties and explored clinic- and community-based health care workers' (HCW) experiences during outbreak response. Counties were selected based on cumulative cholera burden and geographic characteristics. We conducted 44 health facility cholera preparedness checklists (according to national guidelines) and 8 focus group discussions (FGDs). Frequencies from preparedness checklists were generated. To determine key themes from FGDs, inductive and deductive codes were applied; MAX software for qualitative data analysis (MAXQDA) was used to identify patterns. Some facilities lacked key materials for treating cholera patients, diagnosing cases, and maintaining infection control. Overall, 82% (36/44) of health facilities had oral rehydration salts, 65% (28/43) had IV fluids, 27% (12/44) had rectal swabs, 11% (5/44) had Cary-Blair transport media, and 86% (38/44) had gloves. A considerable number of facilities lacked disease reporting forms (34%, 14/41) and cholera treatment guidelines (37%, 16/43). In FDGs, HCWs described confusion regarding roles and reporting during the outbreak, which highlighted issues in coordination and management structures within the health system. Similar to checklist findings, FGD participants described supply challenges affecting laboratory preparedness and infection prevention and control. Perceived successes included community engagement, health education, strong collaboration between clinic and community HCWs, and HCWs' personal passion to help others. The confusion over roles, reporting, and management found in this evaluation highlights a need to

  13. Sustainability: the elusive dimension of international health projects.

    PubMed

    Edwards, Nancy C; Roelofs, Susan M

    2006-01-01

    The Canada-China Yunnan Maternal and Child Health Project (1997-2003) sought to improve the quality of village life and promote development of productivity and social prosperity in Yunnan province, China. The project targeted grassroots maternal and child health workers: new and in-service village doctors; traditional village midwives; doctors at township health centres; doctors at county maternal and child health hospitals; and provincial health staff. Ten impoverished counties (population 2.2 million) in Yunnan province with high proportions of ethnic minority populations. There were three major innovations: training grassroots maternal and child health workers in participatory and community-based approaches and clinical skills; designing a model comprehensive referral system including provision of basic equipment; and introducing participatory monitoring and evaluation methods. Strategies to support sustainability were built into the project from the outset. Over 4,000 village, township, and county health workers received training. Maternal, infant, and under-five mortality rates declined over 30% in project counties. Project innovations were disseminated throughout the province, into other donor-funded initiatives, and integrated into national health projects by local partners. Maintaining the long-term benefits of international health interventions depends on sustaining innovations beyond short project timelines. Achieving sustainability poses a conundrum to implementing agencies. Three mechanisms influenced uptake in the Yunnan project: maintaining a good fit between core project elements and the existing health system; developing adequate organizational supports; and creating a handover plan from the outset. This project highlights some of the ways in which sustainability can be operationalized.

  14. Workplace assaults on minority health and mental health care workers in Los Angeles.

    PubMed Central

    Sullivan, C; Yuan, C

    1995-01-01

    Workplace violence is becoming increasingly recognized as a serious problem in health care settings. All 628 workers' compensation assaults claimed by minority Los Angeles County health care workers from 1986 through 1990 were abstracted. Population-at-risk data from county personnel computer tapes provided denominators by age, sex, race, job classification, and type of facility. Rates varied by type of facility (rate ratio = 38 for psychiatric hospitals vs public health facilities) and varied by job, with inpatient nursing attendants having the highest rate for caregivers. Most assaults were committed by patients (86%), followed by coworkers (8%). The average cost of an assault ($4879) was relatively low but related to the costlier problem of work-related emotional illness. PMID:7604900

  15. 77 FR 72968 - Revisions to the California State Implementation Plan, for Imperial County, Placer County and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ...EPA is taking direct final action to approve revisions to the Imperial County Air Pollution Control District (ICAPCD), Placer County Air Pollution Control District (PCAPCD) and Ventura County Air Pollution Control District (PCAPCD) portions of the California State Implementation Plan (SIP). Under authority of the Clean Air Act as amended in 1990 (CAA or the Act), we are approving local rules that address emission statements for ICAPCD and PCAPCD and definitions for VCAPCD.

  16. 7 CFR 1220.626 - FSA county office report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.626 FSA county office report. The county FSA office report shall be certified as accurate and complete by the CED or designee... county summary of requests on a form provided by the Administrator, FSA. Each county FSA office shall...

  17. 7 CFR 1220.626 - FSA county office report.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.626 FSA county office report. The county FSA office report shall be certified as accurate and complete by the CED or designee... county summary of requests on a form provided by the Administrator, FSA. Each county FSA office shall...

  18. 7 CFR 1220.626 - FSA county office report.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.626 FSA county office report. The county FSA office report shall be certified as accurate and complete by the CED or designee... county summary of requests on a form provided by the Administrator, FSA. Each county FSA office shall...

  19. 7 CFR 1220.626 - FSA county office report.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.626 FSA county office report. The county FSA office report shall be certified as accurate and complete by the CED or designee... county summary of requests on a form provided by the Administrator, FSA. Each county FSA office shall...

  20. 7 CFR 1220.626 - FSA county office report.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.626 FSA county office report. The county FSA office report shall be certified as accurate and complete by the CED or designee... county summary of requests on a form provided by the Administrator, FSA. Each county FSA office shall...

  1. Action Tweets Linked to Reduced County-Level HIV Prevalence in the United States: Online Messages and Structural Determinants

    PubMed Central

    Ireland, Molly E.; Chen, Qijia; Schwartz, H. Andrew; Ungar, Lyle H.; Albarracin, Dolores

    2016-01-01

    HIV is uncommon in most US counties but travels quickly through vulnerable communities when it strikes. Tracking behavior through social media may provide an unobtrusive, naturalistic means of predicting HIV outbreaks and understanding the behavioral and psychological factors that increase communities'; risk. General action goals, or the motivation to engage in cognitive and motor activity, may support protective health behavior (e.g., using condoms) or encourage activity indiscriminately (e.g., risky sex), resulting in mixed health effects. We explored these opposing hypotheses by regressing county-level HIV prevalence on action language (e.g., work, plan) in over 150 million tweets mapped to US counties. Controlling for demographic and structural predictors of HIV, more active language was associated with lower HIV rates. By leveraging language used on social media to improve existing predictive models of geographic variation in HIV, future targeted HIV-prevention interventions may have a better chance of reaching high-risk communities before outbreaks occur. PMID:26650382

  2. Understanding the socioeconomic heterogeneity in healthcare in US counties: the effect of population density, education and poverty on H1N1 pandemic mortality.

    PubMed

    Ponnambalam, L; Samavedham, L; Lee, H R; Ho, C S

    2012-05-01

    The recent outbreak of H1N1 has provided the scientific community with a sad but timely opportunity to understand the influence of socioeconomic determinants on H1N1 pandemic mortality. To this end, we have used data collected from 341 US counties to model H1N1 deaths/1000 using 12 socioeconomic predictors to discover why certain counties reported fewer H1N1 deaths compared to other counties. These predictors were then used to build a decision tree. The decision tree developed was then used to predict H1N1 mortality for the whole of the USA. Our estimate of 7667 H1N1 deaths are in accord with the lower bound of the CDC estimate of 8870 deaths. In addition to the H1N1 death estimates, we have listed possible counties to be targeted for health-related interventions. The respective state/county authorities can use these results as the basis to target and optimize the distribution of public health resources.

  3. Helping the auto repair industry manage hazardous wastes: an education project in King County, Washington.

    PubMed

    McKenrick, Laurence L; Ii, Keiko; Lawrence, Bill; Kaufmann, Michael; Marshall, Mark

    2003-11-01

    From January 1, 2000, to August 31, 2001, a team of environmental health specialists from Public Health-Seattle & King County, a partner in King County's Local Hazardous Waste Management Program, made educational visits to 981 automotive repair shops. The purpose was to give the auto repair industry technical assistance on hazardous waste management without using enforcement action. Through site inspections and interviews, the environmental health staff gathered information on the types and amounts of conditionally exempt small-quantity generator (CESQG) hazardous wastes and how they were handled. Proper methods of hazardous waste management, storage, and disposal were discussed with shop personnel. The environmental health staff measured the impact of these educational visits by noting changes made between the initial and follow-up visits. This report focuses on nine major waste streams identified in the auto repair industry. Of the 981 shops visited, 497 were already practicing proper hazardous waste management and disposal. The remaining 484 shops exhibited 741 discrepancies from proper practice. Environmental health staff visited these shops again within six months of the initial visit to assess changes in their practices. The educational visits and technical assistance produced a 76 percent correction of all the discrepancies noted.

  4. High-speed railway real-time localization auxiliary method based on deep neural network

    NASA Astrophysics Data System (ADS)

    Chen, Dongjie; Zhang, Wensheng; Yang, Yang

    2017-11-01

    High-speed railway intelligent monitoring and management system is composed of schedule integration, geographic information, location services, and data mining technology for integration of time and space data. Assistant localization is a significant submodule of the intelligent monitoring system. In practical application, the general access is to capture the image sequences of the components by using a high-definition camera, digital image processing technique and target detection, tracking and even behavior analysis method. In this paper, we present an end-to-end character recognition method based on a deep CNN network called YOLO-toc for high-speed railway pillar plate number. Different from other deep CNNs, YOLO-toc is an end-to-end multi-target detection framework, furthermore, it exhibits a state-of-art performance on real-time detection with a nearly 50fps achieved on GPU (GTX960). Finally, we realize a real-time but high-accuracy pillar plate number recognition system and integrate natural scene OCR into a dedicated classification YOLO-toc model.

  5. Association of Access to Publicly Funded Family Planning Services With Adolescent Birthrates in California Counties

    PubMed Central

    Chabot, Marina J.; Navarro, Sandy; Swann, Diane; Darney, Philip; Thiel de Bocanegra, Heike

    2014-01-01

    Objectives. We examined the association of adolescent birthrates (ABRs) with access to and receipt of publicly funded family planning services in California counties provided through 2 state programs: Medi-Cal, California’s Medicaid program, and the Family Planning, Access, Care, and Treatment (Family PACT) program. Methods. Our key data sources included the California Health Interview Survey and California Women’s Health Survey, Medi-Cal and Family PACT claims data, and the Birth Statistical Master File. We constructed a linear regression analysis measuring the relationship of access to and receipt of family planning services with ABRs when controlling for counties’ select covariates. Results. The regression analysis indicated that a higher access rate to Family PACT in a county was associated with a lower ABR (B = −0.19; P < .01) when controlling for unemployment rate, percentage of foreign-born adolescents, and percentage of adult low-income births. Conclusions. Efforts to reduce ABRs, specifically in counties that had persistently high rates are critical to achieving a healthy future for the state and the nation. Family PACT played a crucial role in helping adolescents avoid unintended and early childbearing. PMID:24354841

  6. Seat-Belt Use In US Counties: Limited Progress Toward Healthy People 2020 Objectives.

    PubMed

    Sunshine, Jacob; Dwyer-Lindgren, Laura; Chen, Alan; Mokdad, Ali H

    2017-04-01

    Spikes in automobile fatalities in 2015 and 2016 have renewed discussions about automobile safety. We measured the prevalence of reported seat-belt compliance in every US county from 2002 to 2012 and found considerable variation. Project HOPE—The People-to-People Health Foundation, Inc.

  7. Summary and results of the joint WMD-DAC/Alameda County bioterrorism response plan exercise.

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

    Manley, Dawn Kataoka; Lipkin, Joel; West, Todd H.

    2003-11-01

    On June 12,2003, the Alameda County Public Health Department and Sandia National Laboratories/CA jointly conducted an exercise that used a Weapons of Mass Destruction-Decision Analysis Center (WMD-DAC) bioterrorism attack simulation to test the effectiveness of the county's emergency response plan. The exercise was driven by an assumed release (in the vicinity of the Berkeley Marina), and subsequent spread, of a small quantity of aerosolized, weapons-grade anthrax spores. The simulation used several key WMD-DAC capabilities, namely: (1) integration with an atmospheric dispersion model to calculate expected dose levels in the affected areas, (2) a individual-tracking capability for both infected and non-infectedmore » persons as they made decisions, sought treatment, and received prophylaxis drugs, and (3) a user interface that allows exercise participants to affect the scenario evolution and outcome. The analysis of the county's response plan included documenting and reviewing the decisions made by participants during the exercise. Twenty-six local and regional officials representing the health care system, emergency medical services and law enforcement were involved in responding to the simulated attack. The results of this joint effort include lessons learned both by the Alameda County officials regarding implementation of their bioterrorism response plan and by the Sandia representatives about conducting exercises of this type. These observations are reviewed in this report, and they form a basis for providing a better understanding of group/individual decision processes and for identifying effective communication options among decision makers.« less

  8. Comparison of Hydrologic Data from Monroe County, Michigan, 1991-2001

    USGS Publications Warehouse

    Nicholas, J.R.; Blumer, Stephen P.; McGowan, Rose M.

    2001-01-01

    are reported by the USGS in the report by Nicholas and others (1996). Later data come from a variety of sources including USGS, MDEQ, Monroe County, National Oceanic and Atmospheric Administration, U.S. Army Corps of Engineers, and ground-water users. All non-USGS data in this report are given as reported; data verification was not a part of this initial phase. The types of data chosen for comparison in this report include water levels of Lake Erie, precipitation at Monroe, streamflow in the River Raisin at Manchester, ground-water use, ground-water levels, and ground-water quality. The authors acknowledge the cooperation and provision of data and information by several agencies. Ground-water use for irrigation was provided by Ron Van Til of MDEQ. Quarry discharges were provided by Jennifer Rogers of MDEQ. Ground-water-level data for 1993 to 2001 were provided by the Monroe County Health Department. The authors also acknowledge Carlos Hernandez, Chris Hoard, Tom Morgan, Tom Sabin, and Dave Westjohn for collecting streamflow, ground-water, and ground-water-quality data in autumn, 2001. Sharon Baltusis and Jaye Lunsford assisted in the compilation and presentation of hydrologic data in this report.

  9. Program of Education for Community Coordination and Action in Warren County: What Kind of a County Do We Want Warren County To Be?

    ERIC Educational Resources Information Center

    Koontz, Donald H.; Wallerstedt, Jane

    A program initiated by Simpson College and assisted by a committee of representatives from Warren County, Iowa, to assist the population of the County to understand their community and its problems and set priorities in meeting these problems is reported. Two hundred key leaders, representative of the geographic, educational, economic, religious,…

  10. Hydrogeology of Cibola County, New Mexico

    USGS Publications Warehouse

    Baldwin, J.A.; Rankin, D.R.

    1995-01-01

    The hydrogeology of Cibola County, New Mexico, was evaluated to determine the occurrence, availability, and quality of ground-water resources. Rocks of Precambrian through Quaternary age are present in Cibola County. Most rocks are sedimentary in origin except for Precambrian igneous and metamorphic rocks exposed in the Zuni Uplift and Tertiary and Quaternary basalts in northern and central parts of the county. The most productive aquifers in the county include (youngest to oldest) Quaternary deposits, sandstones in the Mesaverde Group, the Dakota-Zuni-Bluff aquifer, the Westwater Canyon aquifer, the Todilto- Entrada aquifer, sandstone beds in the Chinle Formation, and the San Andres-Glorieta aquifer. Unconsolidated sand, silt, and gravel form a mantle ranging from a few inches to 150 to 200 feet over much of the bedrock in Cibola County. Well yields range from 5 to 1,110 gallons per minute. Dissolved-solids concentrations of ground water range from 200 to more than 5,200 milligrams per liter. Calcium, magnesium, bicarbonate, and sulfate are the predominant ions in ground water in alluvial material. The Mesaverde Group mainly occurs in three areas of the county. Well yields range from less than 1 to 12 gallons per minute. The predominant ions in water from wells in the Mesaverde Group are calcium, sodium, and bicarbonate. The transition from calcium-predominant to sodium-predominant water in the southwestern part of the county likely is a result of ion exchange. Wells completed in the Dakota-Zuni-Bluff aquifer yield from 1 to 30 gallons per minute. Dissolved-solids concentrations range from 220 to 2,000 milligrams per liter in water from 34 wells in the western part of the county. Predominant ions in the ground water include calcium, sodium, sulfate, and bicarbonate. Calcium predominates in areas where the aquifer is exposed at the surface or is overlain with alluvium. Sandstones in the Chinle Formation yield from 10 to 300 gallons per minute to wells in the Grants

  11. Measuring county resilience after the 2008 Wenchuan earthquake

    NASA Astrophysics Data System (ADS)

    Li, X.; Lam, N.; Qiang, Y.; Li, K.; Yin, L.; Liu, S.; Zheng, W.

    2015-01-01

    The catastrophic earthquake in 2008 has caused serious damage to Wenchuan County and the surrounding area in China. In recent years, great attention has been paid to the resilience of the affected area. This study applied a new framework, the Resilience Inference Measurement (RIM) model, to quantify and validate the community resilience of 105 counties in the affected area. The RIM model uses cluster analysis to classify counties into four resilience levels according to the exposure, damage, and recovery conditions, and then applies discriminant analysis to quantify the influence of socioeconomic characteristics on the county resilience. The analysis results show that counties located right at the epicenter had the lowest resilience, but counties immediately adjacent to the epicenter had the highest resilience capacities. Counties that were farther away from the epicenter returned to normal resiliency. The socioeconomic variables, including sex ratio, per capita GDP, percent of ethnic minority, and medical facilities, were identified as the most influential socio-economic characteristics on resilience. This study provides useful information to improve county resilience to earthquakes and support decision-making for sustainable development.

  12. Illinois Kids Count: A Snap Shot of Our Future. County by County Profiles of Child Well-Being '92.

    ERIC Educational Resources Information Center

    Voices for Illinois Children, Chicago.

    This booklet presents statistics concerning the well-being of Illinois' 3.3 million children between 1980 and 1990. Statistics are compared county by county for each of the state's 102 counties, and statewide statistics are compared with those of the entire nation. A statewide analysis focuses on spending per pupil on education, the percentage of…

  13. Trace Elements Contamination and Human Health Risk Assessment in Drinking Water from the Agricultural and Pastoral Areas of Bay County, Xinjiang, China

    PubMed Central

    Turdi, Muyessar; Yang, Linsheng

    2016-01-01

    Tap water samples were collected from 180 families in four agricultural (KYR: Keyir, KRW: Kariwak, YTR: Yatur, DW: Dawanqi) and two pastoral areas (B: Bulong and Y: Yangchang) in Bay County, Xinjiang, China, and levels of seven trace elements (Cd, Cr, As Ni, Pb, Zn, Se) were analyzed using inductively-coupled plasma mass spectrometry (ICP-MS) to assess potential health risks. Remarkable spatial variations of contamination were observed. Overall, the health risk was more severe for carcinogenic versus non-carcinogenic pollutants due to heavy metal. The risk index was greater for children overall (Cr > As > Cd and Zn > Se for carcinogenic and non-carcinogenic elements, respectively). The total risk index was greater in agricultural areas (DW > KYR > YTR > KRW > B > Y). Total risk indices were greater where well water was the source versus fountain water; for the latter, the total health risk index was greater versus glacier water. Main health risk factors were Cr and As in DW, KYR, YTR, KRW, and B, and Zn, Cr, and As in the Y region. Overall, total trace element–induced health risk (including for DW adults) was higher than acceptable (10−6) and lower than priority risk levels (10−4) (KYR, YTR, KRW, Y, and B). For DW children, total health risk reached 1.08 × 10−4, higher than acceptable and priority risk levels (10−4). PMID:27669274

  14. Trace Elements Contamination and Human Health Risk Assessment in Drinking Water from the Agricultural and Pastoral Areas of Bay County, Xinjiang, China.

    PubMed

    Turdi, Muyessar; Yang, Linsheng

    2016-09-23

    Tap water samples were collected from 180 families in four agricultural (KYR: Keyir, KRW: Kariwak, YTR: Yatur, DW: Dawanqi) and two pastoral areas (B: Bulong and Y: Yangchang) in Bay County, Xinjiang, China, and levels of seven trace elements (Cd, Cr, As Ni, Pb, Zn, Se) were analyzed using inductively-coupled plasma mass spectrometry (ICP-MS) to assess potential health risks. Remarkable spatial variations of contamination were observed. Overall, the health risk was more severe for carcinogenic versus non-carcinogenic pollutants due to heavy metal. The risk index was greater for children overall (Cr > As > Cd and Zn > Se for carcinogenic and non-carcinogenic elements, respectively). The total risk index was greater in agricultural areas (DW > KYR > YTR > KRW > B > Y). Total risk indices were greater where well water was the source versus fountain water; for the latter, the total health risk index was greater versus glacier water. Main health risk factors were Cr and As in DW, KYR, YTR, KRW, and B, and Zn, Cr, and As in the Y region. Overall, total trace element-induced health risk (including for DW adults) was higher than acceptable (10(-6)) and lower than priority risk levels (10(-4)) (KYR, YTR, KRW, Y, and B). For DW children, total health risk reached 1.08 × 10(-4), higher than acceptable and priority risk levels (10(-4)).

  15. Factors affecting the implementation of health legislation and its impact on the rural poor in China: a case study of implementation of the maternal and infant health care law in two poor counties.

    PubMed

    Tolhurst, Rachel; Zhang, Tuohong; Yang, Hui; Gao, Jun; Tang, Shenglan

    2004-01-01

    This paper presents and discusses a case study of health legislation in China. In the transition to a market economy, legislation has been developed to offset the weakening in the central planning mechanism and political control that have historically influenced the behaviour of institutions and individuals in the Ministry of Health. There has been relatively little empirical examination of the implementation and impact of legislation as a tool for influencing health service provision in low-income countries. The study aimed to contribute towards filling this gap by exploring the factors affecting the implementation and impact of the Maternal and Infant Health Care Law, through a case study of two poor, rural counties in Chongqing municipality, China. The study found that key local actors perceive health legislation to be an important tool for safeguarding access to essential health care. However, the implementation of health legislation is inevitably a political process. The study illustrates the difficulties involved in efforts to influence provider behaviour through a national level legislative framework in a situation of decentralization of control over those providers, due to extreme regional variation in economic situations and limited resource inputs from the centre. Lessons are drawn for Chinese and international policy makers.

  16. Tri-county pilot study. [Texas

    NASA Technical Reports Server (NTRS)

    Reeves, C. A. (Principal Investigator); Austin, T. W.; Kerber, A. G.

    1976-01-01

    The author has identified the following significant results. An area inventory was performed for three southeast Texas counties (Montgomery, Walker, and San Jacinto) totaling 0.65 million hectares. The inventory was performed using a two level hierarchy. Level 1 was divided into forestland, rangeland, and other land. Forestland was separated into Level 2 categories: pine, hardwood, and mixed; rangeland was not separated further. Results consisted of area statistics for each county and for the entire study site for pine, hardwood, mixed, rangeland, and other land. Color coded county classification maps were produced for the May data set, and procedures were developed and tested.

  17. The Affordable Care Act: overview and implications for county and city behavioral health and intellectual/developmental disability programs.

    PubMed

    Manderscheid, Ron

    2014-01-01

    The author begins by reviewing the 5 key intended actions of the Affordable Care Act (ACA)-insurance reform, coverage reform, quality reform, performance reform, and information technology reform. This framework provides a basis for examining how populations served and service programs will change at the county and city levels as a result of the ACA, and how provider staff also will change over time as a result of these developments. The author concludes by outlining immediate next steps for county and city programs.

  18. 43 CFR 2806.21 - When and how are counties or other geographical areas assigned to a County Zone Number and Per...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... geographical areas assigned to a County Zone Number and Per Acre Zone Value? 2806.21 Section 2806.21 Public... MANAGEMENT ACT Rents Linear Rights-Of-Way § 2806.21 When and how are counties or other geographical areas assigned to a County Zone Number and Per Acre Zone Value? Counties (or other geographical areas) are...

  19. 43 CFR 2806.21 - When and how are counties or other geographical areas assigned to a County Zone Number and Per...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... geographical areas assigned to a County Zone Number and Per Acre Zone Value? 2806.21 Section 2806.21 Public... MANAGEMENT ACT Rents Linear Rights-Of-Way § 2806.21 When and how are counties or other geographical areas assigned to a County Zone Number and Per Acre Zone Value? Counties (or other geographical areas) are...

  20. 43 CFR 2806.21 - When and how are counties or other geographical areas assigned to a County Zone Number and Per...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... geographical areas assigned to a County Zone Number and Per Acre Zone Value? 2806.21 Section 2806.21 Public... MANAGEMENT ACT Rents Linear Rights-Of-Way § 2806.21 When and how are counties or other geographical areas assigned to a County Zone Number and Per Acre Zone Value? Counties (or other geographical areas) are...