Race and Socioeconomic Differences in the Long-term Outcomes of Childhood Maltreatment

Childhood maltreatment (CM) is associated with negative physical, psychological, and social outcomes throughout life. Among the important psychosocial outcomes for female victims of CM is the risk for subsequent violent victimization during adulthood. Few studies have examined the risk and protective factors associated with revictimization and following CM. Additionally, although both CM and adult violent victimization (AVV) are associated with factors that impact women's socioeconomic status, there is a paucity of research explicitly examining socioeconomic outcomes, such as neighborhood characteristics, among victimized women. Racial and socioeconomic differences exist in the prevalence of both CM and AVV, yet little data exists to show demonstrate, how those factors impact the CM-AVV relation. This study examined the role of race in the association between CM and AVV and related socioeconomic outcomes among adult women. The goals were to; 1) Characterize the association between CM and AVV; 2) Examine whether there are racial differences in the association between CM and AVV; and 3) Determine whether victimization history is associated with the characteristics of the neighborhood in which one resides.Women (n=477) participating in a longitudinal study of the effects of prenatal exposure to alcohol and marijuana were interviewed about their history of exposure to CM and AVV. Other measures included demographic characteristics, social support, substance use, depression and anxiety, and household environment.The results demonstrated an increased likelihood of experiencing AVV among women who reported a history of CM; regardless of the type of maltreatment experienced. Baseline illicit drug use partially mediated the CM-AVV relation. The risk of AVV associated with CM was not different by race; however, baseline marijuana use was found to mediate the CM-AVV relation for Caucasian women only. Victimization was not associated with neighborhood-level characteristics.There are several important public health implications of this study. When all forms of CM exposure are considered there is a substantial increase in the odds of experiencing AVV, both intimate partner violence and non-intimate partner violence. This study also suggests that approaches to prevent revictimization should differ depending on race, and that drug interventions may be more relevant for Caucasian women

Murine Typhus in Austin, Texas, USA, 2008

Physicians should be alert for possible cases in this area

Inferring school district learning modalities during the COVID-19 pandemic with a hidden Markov model

In this study, learning modalities offered by public schools across the United States were investigated to track changes in the proportion of schools offering fully in-person, hybrid and fully remote learning over time. Learning modalities from 14,688 unique school districts from September 2020 to June 2021 were reported by Burbio, MCH Strategic Data, the American Enterprise Institute's Return to Learn Tracker and individual state dashboards. A model was needed to combine and deconflict these data to provide a more complete description of modalities nationwide. A hidden Markov model (HMM) was used to infer the most likely learning modality for each district on a weekly basis. This method yielded higher spatiotemporal coverage than any individual data source and higher agreement with three of the four data sources than any other single source. The model output revealed that the percentage of districts offering fully in-person learning rose from 40.3% in September 2020 to 54.7% in June of 2021 with increases across 45 states and in both urban and rural districts. This type of probabilistic model can serve as a tool for fusion of incomplete and contradictory data sources in support of public health surveillance and research efforts.Comment: 25 pages, 4 figure

Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma

Abstract We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0-4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006-2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan 1 to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital's ED) nationwide over the study period. The average medical cost per ED visit and admission were US$2,612 (error bound: 1,644-3,581) and US$31,901 (error bound: 29,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9-82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse

SOPHE’s Resolution to Eliminate Racial and Ethnic Health Disparities: Process and Recommendations for Accountability

Health disparities are in the forefront of the public health agenda. Eliminating health disparities is one of two primary goals set for 2010. The Society for Public Health Education (SOPHE) has committed to working toward this effort in a variety of ways, including the development of a resolution to eliminate racial and ethnic disparities in health. This article describes the steps that were taken in the development of the resolution and offers recommendations to ensure that the action’s steps are conducted. Additionally, recommendations for other actions that can affect health disparities are offered. As a professional organization, SOPHE is in a prime position to lead the way on a number of activities designed to eliminate health disparities