Urgent Challenges for Local Public Health Informatics

This editorial highlights the urgent challenges for local public health informatics and provides solutions to face these challenges

Participation in One Health Networks and Involvement in the COVID-19 Pandemic Response: A Global Study

The COVID-19 pandemic exemplifies a One Health issue at the intersection of human, animal, and environmental health that requires collaboration across sectors to manage it successfully. The global One Health community includes professionals working in many different fields including human medicine, veterinary medicine, public health, ecosystem health, and, increasingly, social sciences. The aims of this cross-sectional study were to describe the involvement of the global One Health community in COVID-19 pandemic response activities. One Health networks (OHNs) have formed globally to serve professionals with common interests in collaborative approaches. We assessed the potential association between being part of an OHN and involvement in COVID-19 response activities. Data were collected in July-August 2020 using an online questionnaire that addressed work characteristics, perceived connection to OHNs, involvement in COVID-19 pandemic response activities, and barriers and facilitators to the involvement. The sample included 1,050 respondents from 94 countries across a range of organizations and work sectors including, but not restricted to, those typically associated with a One Health approach. Sixty-four percent of survey respondents indicated involvement in pandemic response activities. Being part of an OHN was positively associated with being involved in the COVID-19 response (odds ratio: 1.8, 95% confidence interval: 1.3–2.4). Lack of opportunities was a commonly reported barrier to involvement globally, with lack of funding the largest barrier in the WHO African region. This insight into diverse workforce involvement in the pandemic helps fill a gap in the global health workforce and public health education literature. An expanded understanding of the perceived roles and value of OHNs can inform targeted interventions to improve public health education and workforce capacity to prepare for and respond to public health emergencies

Arterial roads and area socioeconomic status are predictors of fast food restaurant density in King County, WA

<p>Abstract</p> <p>Background</p> <p>Fast food restaurants reportedly target specific populations by locating in lower-income and in minority neighborhoods. Physical proximity to fast food restaurants has been associated with higher obesity rates.</p> <p>Objective</p> <p>To examine possible associations, at the census tract level, between area demographics, arterial road density, and fast food restaurant density in King County, WA, USA.</p> <p>Methods</p> <p>Data on median household incomes, property values, and race/ethnicity were obtained from King County and from US Census data. Fast food restaurant addresses were obtained from Public Health-Seattle & King County and were geocoded. Fast food density was expressed per tract unit area and per capita. Arterial road density was a measure of vehicular and pedestrian access. Multivariate logistic regression models containing both socioeconomic status and road density were used in data analyses.</p> <p>Results</p> <p>Over one half (53.1%) of King County census tracts had at least one fast food restaurant. Mean network distance from dwelling units to a fast food restaurant countywide was 1.40 km, and 1.07 km for census tracts containing at least one fast food restaurant. Fast food restaurant density was significantly associated in regression models with low median household income (p < 0.001) and high arterial road density (p < 0.001) but not with percent of residents who were nonwhite.</p> <p>Conclusion</p> <p>No significant association was observed between census tract minority status and fast food density in King County. Although restaurant density was linked to low household incomes, that effect was attenuated by arterial road density. Fast food restaurants in King County are more likely to be located in lower income neighborhoods and higher traffic areas.</p

Disease Surveillance and Achieving Synergy In Public Health Quality Improvement

Efforts to describe and improve quality in public health are closely tied to disease surveillance systems and capabilities. This roundtable will engage participants around how a new national framework for public health quality relates to their work in surveillance. The audience will be invited to provide examples, from their experience, of feasible and practical variables to measure the priority public health aims; data sources; and gaps that are impeding progress in quality improvement. This roundtable will inform a new initiative to develop measures that resonate with the roles of public health at the local, state, federal and global levels

Disease Surveillance and Achieving Synergy In Public Health Quality Improvement

OBJECTIVE: To examine disease surveillance in the context of a new national framework for public health quality and to solicit input from practitioners, researchers, and other stakeholders to identify potential metrics, pivotal research questions, and actions for achieving synergy between surveillance practice and public health quality. INTRODUCTION: National efforts to improve quality in public health are closely tied to advancing capabilities in disease surveillance. Measures of public health quality provide data to demonstrate how public health programs, services, policies, and research achieve desired health outcomes and impact population health. They also reveal opportunities for innovations and improvements. Similar quality improvement efforts in the health care system are beginning to bear fruit. There has been a need, however, for a framework for assessing public health quality that provides a standard, yet is flexible and relevant to agencies at all levels. The U.S. Health and Human Services (HHS) Office of the Assistant Secretary for Health, working with stakeholders, recently developed and released a Consensus Statement on Quality in the Public Health System that introduces a novel evaluation framework. They identified nine aims that are fundamental to public health quality improvement efforts and six cross-cutting priority areas for improvement, including population health metrics and information technology; workforce development; and evidence-based practices (1). Applying the HHS framework to surveillance expands measures for surveillance quality beyond typical variables (e.g., data quality and analytic capabilities) to desired characteristics of a quality public health system. The question becomes: How can disease surveillance help public health services to be more population centered, equitable, proactive, health-promoting, risk-reducing, vigilant, transparent, effective, and efficient—the desired features of a quality public health system? Any agency with a public health mission, or even a partial public health mission (e.g., tax-exempt hospitals), can use these measures to develop strategies that improve both the quality of the surveillance enterprise and public health systems, overall. At this time, input from stakeholders is needed to identify valid and feasible ways to measure how surveillance systems and practices advance public health quality. What exists now and where are the gaps? METHODS: Improving public health by applying quality measures to disease surveillance will require innovation and collaboration among stakeholders. This roundtable will begin a community dialogue to spark this process. The first goal will be to achieve a common focus by defining the nine quality aims identified in the HHS Consensus Statement. Attendees will draw from their experience to discuss how surveillance practice advances the public health aims and improves public health. We will also identify key research questions needed to provide evidence to inform decision-making. RESULTS: —How is surveillance used to identify and address health disparities and, thereby, make public health more equitable? What are the data sources? Are there targets? How can research and evaluation help to enhance this surveillance capability and direct action? —How do we identify and address factors that inhibit quality improvement in surveillance? What are the gaps in knowledge, skills, systems, and resources? —Where can standardization play a positive role in the evaluation of quality in public health surveillance? —How can we leverage resources by aligning national, state, and local goals? —What are the key research questions and the quality improvement projects that can be implemented using recognized models for improvement? —How can syndromic surveillance, specifically, advance the priority aims? The roundtable will conclude with a list of next steps to develop metrics that resonate with the business practices of public health at all levels

Utility of Syndromic Surveillance Using Novel Clinical Data Sources

Discusses the current state of syndromic surveillance using inpatient and ambulatory clinical data in the United States and the potential utility of the data. The Meaningful Use Stages 2 and 3 regulations incentivize the use of these data sources. Existing systems effectively perform a range of activities from influenza-like illness surveillance to heart disease risk factor surveillance. With further development, ambulatory and inpatient data could become an integral part of syndromic surveillance practice

Preparing for the Impact of the ICD-9/10 Transition on Syndromic Surveillance

Prior to the October 1, 2015 transition deadline, all public health jurisdictions should prepare for the impact that the ICD-9/10 transition will have on their syndromic surveillance practice. This change presents challenges involving resources, funding, and time constraints for code translation and syndrome classification. It will also require new statistical methodologies to accommodate changes to coding practices. This session describes the process developed to incorporate practical public health input to translate syndromic surveillance syndromes and sub-syndromes from ICD-9 diagnostic codes to ICD-10 codes. These translations will be a solution that addresses how the challenge of the transition can be used to improve surveillance practice

Is There a Need for One Health Surveillance (OHS)?

The study reports the results of an electronic survey to identify surveillance stakeholder attitudes towards One Health Surveillance (OHS) and a workshop held at the 2014 ISDS conference to identify strategies from improving surveillance. The majority of respondents reported that OHS is valued and needed. Many respondents reported that improving surveillance is of medium to high priority, but that improvements would be difficult to make. Practical approaches for moving forward included cross domain staff exchanges, tools for data integration and reporting diseases across domains