Safeguarding people living in vulnerable conditions in the COVID-19 era through universal health coverage and social protection

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities. The world is at a never more crucial moment, requiring collaboration and cooperation from all sectors to mitigate the inequality gaps and improve people's health and wellbeing with universal health coverage and social protection, in addition to implementation of the health in all policies approach

Displacement and Resettlement: Understanding the Role of Climate Change in Contemporary Migration

How do we understand displacement and resettlement in the context of climate change? This chapter outlines challenges and debates in the literature connecting climate change to the growing global flow of people. We begin with an outline of the literature on environmental migration, specifically the definitions, measurements, and forms of environmental migration. The discussion then moves to challenges in the reception of migrants, treating the current scholarship on migrant resettlement. We detail a selection of cases in which the environment plays a role in the displacement of a population, including sea level rise in Pacific Island States, cyclonic storms in Bangladesh, and desertification in West Africa, as well as the role of deforestation in South America’s Southern Cone as a driver of both climate change and migration. We outline examples of each, highlighting the complex set of losses and damages incurred by populations in each case

System-based mobile primary pediatric care for homeless children: the anatomy of a working program.

The New York Children's Health Project (NYCHP) of the Montefiore Medical Center-Albert Einstein College of Medicine has been providing comprehensive health services to homeless and medically under served children since 1987. Fully equipped mobile child health offices have been the major mechanism for bringing pediatrician-led teams to places that are convenient for and accessible to under served children and their families. Mobile units have been used for decades in a variety of health car e settings. However, most applications have been for episodic care programs, health screening initiatives, or health education. The NYCHP is designed to provide primary health care with a focus on continuity and comprehensive services, even though the core patient population, consisting of homeless children and youth, is transiently housed in the city's shelter system

Ethical and Legal Challenges Posed by mandatory Hurricane Evacuation: Duties and Limits

When Hurricane Katrina made landfall in August 2005, between 70,000 and 100,000 residents of New Orleans either did not or could not comply with the order that had been issued to evacuate. The events surrounding Katrina raised critical legal and ethical questions about the use of mandatory evacuation orders. We discuss four key ethical issues that must be confronted when considering whether to issue an order of mandatory evacuation: the costs of precautionary action in the face of uncertainty, the duty to provide for people, paternalism and the preemption of individual choice, the acceptability of compulsory measures

Missed opportunities: Do states require screening of children for health conditions that interfere with learning?

Investigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion.No state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC).The lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school

Chronicles From Out-of-State Professionals: Providing Primary Care to Underserved Children After a Disaster: A National Organization Response

Hundreds of thousands of lives in the Gulf Coast region were affected by Hurricane Katrina. The Children's Health Fund (CHF) responded rapidly to the needs of children and their families after the hurricane. CHF is a national organization that supports direct health services, education, and advocacy for medically underserved children. Although CHF's principle mission is the provision of extended primary care services for children and adolescents, the organization is capable of mobilizing rapidly in response to acute medical and public health crises. In fact, the CHF has responded to catastrophic events twice before the Gulf Coast storms of 2005. The first was the 1992 deployment of a mobile medical unit (MMU) to South Florida in the immediate aftermath of category 5 Hurricane Andrew. Then, in 2001 after the terrorist attacks on the World Trade Center in New York City, New York, the CHF deployed 2 MMUs (fully equipped, self-contained “medical offices on wheels”) to the triage-and-response efforts at ground zero. Thus, in the aftermath of Hurricane Katrina, within days of the storm's landfall, the CHF was able to deploy MMUs to the Biloxi-Gulfport community in Mississippi and a number of shelter sites for displaced persons in Louisiana