PUBLIC HEALTH REPORTS

Survivor Health Connection Project: Understanding Experiences of Accessing Health Care Among Those Affected by Intimate Partner Violence During the COVID-19 Pandemic
Hendrix E, Segebrecht J, Thomas K, Branch T and Dawson S
Intimate partner violence (IPV) has short- and long-term health effects, including physical injuries and traumatic brain injury, as well as sexual, reproductive, and mental health issues. However, accessing necessary health care is often challenging for IPV survivors and became even more difficult during the COVID-19 pandemic. We examined access to health care among those affected by IPV during the COVID-19 pandemic to better connect survivors to health and social support services.
Perspectives of Parents, School Nurses, and Pediatricians on Vaccine Hesitancy in St Louis County, Missouri
Bradshaw J, Brzozowski A, Katti P, Chapman O, Pham A, Torgerson A, Wankum E, Snavely A and Baskin CR
To gather perspectives on childhood vaccination and vaccine hesitancy, the Saint Louis County Department of Public Health (DPH) surveyed parents seeking nonmedical exemptions, conducted focus groups of school nurses, and interviewed pediatricians.
Integrating an Ethics Advisory Committee Into Public Health Response: A Case Study of COVID-19, Infection Prevention and Control, and Essential Work in the United States
Lowe AE, Herstein JJ, Brett-Major D, Ferdinand AO, Lee LM, Wynia MK and Ramos AK
A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing. The Global Center for Health Security established an ethics advisory committee to support COVID-19 response efforts. The ethics advisory committee supported the development of guidance on infection prevention and control to promote justice, reciprocity, health, safety, and equity for workers in the meat processing industry. Our experience highlighted the fundamental role of ethical analysis in public health response efforts, but ethical analysis in this case required an interdisciplinary approach, including the need for effective community-relevant solutions. The integration of an ethics committee into public health emergency response efforts can address ethical concerns for workers in industries that must remain operational during public health emergencies.
Bridging the Gap: Integrating Legal Education Into Public Health Continuing Education
Ransom M
Evolution of Master of Public Health Core Curriculum: Trends and Insights
Pennel CL, Agana-Norman DFG, Stalnaker LA, Wiltz-Beckham D and Luna M
Revised accreditation criteria from the Council on Education for Public Health (CEPH) in 2016 prompted schools and programs of public health to shift their master of public health (MPH) core curricula. Our objective was to provide data on revisions to MPH core curricula at CEPH-accredited schools and programs of public health and other descriptive statistics on the MPH core curriculum and required courses as of 2023.
Unit-Based Correlates of Marginal Food Insecurity Among US Soldiers
Krattiger AD, Bliese PD and Adler AB
Although studies have addressed food insecurity among veterans, few have focused on active-duty soldiers or on variables associated with the military occupational context. We examined the link between marginal food insecurity (defined as anxiety over food sufficiency or shortage of food in the house) among US soldiers and demographic, behavioral health, and unit-related factors.
Internet Devices and Internet Access Among Migrant and Seasonal Farmworkers, North Carolina, 2023
Lee JGL, Roby M, Cofie LE, LePrevost CE, Harwell EL, Reed EC, Nieuwsma J, Bloss JE, Anderson GC, Santillán-Deras JR, Moore MA, Ketterman E and Russell RG
Migrant and seasonal farmworkers work in rural areas where internet access may be limited. We assessed internet access, cost of access, and devices available to farmworkers through a statewide survey in North Carolina.
Overdose Deaths and Cross-sector Collaboration
McCarty B and Curlin F
COVID-19, Stay-at-Home Orders, and Interpersonal Violence: Findings and Implications for Emergency Response Efforts
Diamond-Welch B, Finigan-Carr N, Decker MR and Chon KY
HIV Screening in a Sample of US Emergency Departments, 2022-2023
Bennett CL, Clay CE, Espinola JA and Camargo CA
Despite serving populations emphasized in the Ending the HIV Epidemic Initiative, emergency departments (EDs) infrequently offer routine HIV screening. The objective of this study was to characterize US EDs by whether they screen for HIV and to explore factors associated with screening. We surveyed a random sample of US ED directors to obtain data on ED-level and patient-level characteristics, as well as information on directors' perceived barriers to implementing preventive health services. Using descriptive statistics and regression modeling, we found that EDs that routinely screen for HIV, compared with those that do not, had higher median visit volumes (21 000 vs 12 600), were more often a teaching hospital (12.7% vs 4.3%), and had more availability of social workers (23.6% vs 9.4% had 24 hour/day coverage); their directors also less often expressed strong worry about costs (5.9% vs 28.2%), all significant at < .05; in the regression analysis, only worry about costs was significant (relative risk = 0.13; 95% CI, 0.03-0.51). Our findings may reflect a need for additional funding and resources allocated to EDs to promote HIV screening.
Cannabis Vaping Among US Adults With Disabilities: Findings From the 2022 Behavioral Risk Factor Surveillance System
Olufemi E, Olatokunbo O, Wei L, Ben Taleb Z and Kalan ME
Studies have demonstrated that people with disabilities are more likely to use cannabis than people without disabilities. However, less is known about novel forms of use, such as cannabis vaping, in this population. We examined the correlates of cannabis vaping among people with disabilities and the association between cannabis vaping and the frequency of cannabis use in any form.
Addressing Polarizing Issues in Public Health: Ten Principles for Effective Dialog
Narayan KMV and Patel SA
A Shift in Approach to Addressing Public Health Inequities and the Effect of Societal Structural and Systemic Drivers on Social Determinants of Health
Mercado CI, Bullard KM, Bolduc MLF, Andrews CA, Freggens ZRF, Liggett G, Banks D, Johnson SB, Penman-Aguilar A and Njai R
Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age that influence health outcomes, and structural and systemic drivers of health (SSD) are the social, cultural, political, and economic contexts that create and shape SDOH. With the integration of constructs from previous examples, we propose an SSD model that broadens the contextual effect of these driving forces or factors rooted in the Centers for Disease Control and Prevention's SDOH framework. Our SSD model (1) presents systems and structures as multidimensional, (2) considers 10 dimensions as discrete and intersectional, and (3) acknowledges health-related effects over time at different life stages and across generations. We also present an application of this SSD model to the housing domain and describe how SSD affect SDOH through multiple mechanisms that may lead to unequal resources, opportunities, and consequences contributing to a disproportionate burden of disease, illness, and death in the US population. Our enhanced SDOH framework offers an innovative and promising model for multidimensional, collaborative public health approaches toward achieving health equity and eliminating health disparities.
COVID Just-in-Time Extension for Community Health Outcomes: A Collaborative Information-Sharing Platform for a School Health Community
Chopra P, Chiappone A, Goldenstein S, Pilonetti T, Gillis R, Dodson D, Tan S, Thomas JF and Cataldi JR
The COVID-19 pandemic challenged school health professionals to navigate a dynamic public health emergency and to stay aware of changing recommendations. This study aimed to determine the value of the COVID Just-in-Time ECHO (Extension for Community Health Outcomes) Learning Series for Schools among participating school health personnel and to describe their ongoing information needs during the pandemic. School health, public health, and education professionals across Colorado participated in this ECHO series. Participants attended 1-hour sessions every 2 to 4 weeks from March 2020 through December 2021 for a total of 34 sessions. Data collection included postsession and postseries surveys assessing what participants found most valuable and what additional information they needed. School nurses represented 113 of 224 participants (50%). ECHO content noted as being the most valuable included epidemiology updates and special topics as chosen by participant input. Postseries surveys identified the value of experiencing shared knowledge among Just-in-Time ECHO participants. Participants identified ongoing needs for information about COVID-19 guidance and risk mitigation in schools throughout the sessions. In postseries surveys, participants reported additional ongoing information needs related to COVID-19 outside schools. This ECHO series delivered reliable and time-sensitive information for school health personnel and school leaders and may provide a useful model for information sharing among education and public health professionals.
An Immediate but Fleeting Interest in MPH Programs After the Onset of COVID-19: An Interrupted Time-Series Analysis
Bather JR, Burke EM, Plepys CM, Rajbhandari-Thapa J, Furr-Holden D and Goodman MS
The relationship between the onset of the COVID-19 pandemic and interest in master of public health (MPH) programs is unknown. We examined trends in MPH application rates for 31 MPH concentrations and specifically for the MPH concentration in epidemiology and differences by race and ethnicity before and after the onset of the COVID-19 pandemic.
Steps Toward Decreasing Maternal Alcohol Consumption in Israel: Nationwide Trends During a Decade
Senecky Y, Zrubavel Yaaron N, Chodick G, Berger A, Hen-Herbst L, Fund IB, Massalha M, Matot R and Ganelin-Cohen E
Prenatal alcohol exposure poses a substantial risk to fetal development. Efforts were made in 2011-2020 to increase public awareness of and prevent alcohol consumption during pregnancy. We conducted a cross-sectional survey in Israel of pregnant women's alcohol consumption from January 2021 through June 2023 and compared our results with the results of a survey conducted during 2009-2010 to assess changes over time.
Data Improvement: A Strategy to Improve Understanding of Violence Against Transgender Populations
Fletcher S and Todd K
Evaluation and Revision of Historical ESSENCE Syndromic Surveillance Definition Used to Identify Work-Related Emergency Department Visits
Harduar Morano L, Kite Powell A and Luckhaupt SE
Occupational health surveillance programs have rarely incorporated syndromic surveillance. We documented a process for evaluating and revising syndromic surveillance definitions, using the example of work-related emergency department (ED) visits.
The Effectiveness of Face Mask Mandates on COVID-19 Transmission in Utah
Horn AC, Shoemaker HE and Keegan LT
Throughout the COVID-19 pandemic, the effectiveness of face mask mandates was intensely debated. The objective of this study was to describe how face mask mandates at the state, county, and local levels differed in their effectiveness in reducing the number of COVID-19 cases in the jurisdiction where the mandate was implemented and throughout Utah.
Increased Emergency Department Identification of Young People Experiencing Trafficking During the COVID-19 Pandemic: An Interrupted Time-Series Analysis
Panda P, Deng Y, Fang A, Ward V, Wang E, Newberry J, Mathur M and Patel A
Human trafficking is a public health issue affecting young people across the United States, and trafficked young people frequently present to emergency departments (EDs). The identification of trafficked young people by pediatric EDs during the COVID-19 pandemic is not well understood. We examined trends in the identification of young people with current or lifetime experiences of trafficking in US pediatric EDs before and during the COVID-19 pandemic.
SARS-CoV-2 Infection and Other Communicable Diseases Identified Among Evacuees From Afghanistan Arriving in Virginia and Pennsylvania, August to September 2021
Gearhart SL, Preston LE, Christensen DL, Kinzer MH, Ohlsen EC, Kim C, Palo MR, Rothney E, Klevos AD, Pieracci EG, Hausman LB, Rey A, Sockwell D, Lawman H, Alvarado-Ramy F, Brown C and Gertz AM
In 2021, the US government undertook Operation Allies Welcome, in which evacuees from Afghanistan arrived at 2 US ports of entry in Virginia and Pennsylvania. Because of the rapid evacuation process, the US government granted evacuees an exemption to a Centers for Disease Control and Prevention (CDC) requirement in place at that time-namely, that air passengers present a negative SARS-CoV-2 viral test result or documentation of recovery from COVID-19 before they boarded international flights bound for the United States. This study describes cases of SARS-CoV-2 infection detected among 65 068 evacuees who arrived at the 2 ports of entry in August and September 2021. Because evacuees were a population at increased risk for infection with diseases of public health concern, CDC staff helped coordinate on-site and on-arrival testing, visually observed evacuees for signs and symptoms of communicable disease, and referred evacuees for further evaluation and treatment as needed. CDC staff used antigen or nucleic acid amplification tests at the ports of entry to evaluate evacuees aged ≥2 years without documentation of recent SARS-CoV-2 infection. CDC staff isolated evacuees with confirmed SARS-CoV-2 infection and quarantined their close contacts, consistent with CDC guidance at the time, before evacuees rejoined the repatriation process. Of 65 068 evacuees, 214 (0.3%) were confirmed as having SARS-CoV-2 infection after port-of-entry testing. Cases of measles, varicella, pertussis, tuberculosis, hepatitis A, malaria, leishmaniasis, and diarrheal illness were also identified. Although the percentage of SARS-CoV-2 infection was low in this evacuated population, communicable disease detection at US ports of entry, along with vaccination efforts, was an important part of a multilayered approach to mitigate the transmission of disease in congregate housing facilities and into US communities.