Social Work as an Important Collaborator in Transdisciplinary Public Health Law: Why Does It Matter and Where Does It Fit?

Public health law has been a growing field over the last few decades. From the early days of its initial recognition as an academic and professional field to its more recent texts and treatises, public health law is continuing to define itself. To that end, Burris et al. recently published two works describing a transdisciplinary model of public health law and five essential services of public health law. This article examines how the inclusion of social work in the model can be instrumental in forming better public health laws. The intentional inclusion of social work collaborators would supplement legal and public health expertise with expertise to meaningfully engage the community in law and policy development, implementation, and enforcement. Three areas specifically can be impacted by this engagement: (1) giving the community a voice in designing public health interventions in a way that increases buy-in; (2) using community organizing expertise to assist in getting evidence-based legal interventions with realistic enforcement mechanisms enacted into law at the local, state, or federal level; and (3) assisting in data collection for policy surveillance components by bringing in on-the-ground experts

Coronavirus Health Inequities in the United States Highlight Need for Continued Community Development Efforts

The coronavirus (SARS-CoV-2) pandemic of 2020 has shown a spotlight on inequity in the USA. Although these inequities have long existed, the coronavirus and its disparate impact on health in different communities have raised the visibility of these deeply ingrained inequities to a level that has created a new awareness across the US population and an opportunity to use this heightened awareness of the existing conditions for change. ‘Community and social development’ efforts in the post-pandemic USA can be informed by a health justice framework, across economic, societal and cultural, environmental and social dimensions. Dimensions which have all been implicated in the coronavirus response and complement other social and community development models. Although health disparities and inequities did not begin with coronavirus and will not end in the post-pandemic USA, social and community development efforts which value health justice and concentrate on social determinants of health can provide needed policies and programmes for a more equitable US health system

LGBTQ+ Individuals, Health Inequities, and Policy Implications

When the Office of Disease Prevention and Health Promotion (“ODPHP”) released its Healthy People 2020 goals and objectives, it recognized the public health needs of the lesbian, gay, bisexual, and transgender (“LGBT”) community for the first time. The stated goal of Healthy People 2020 is to “improve the health, safety, and wellbeing of [LGBT] individuals.” One barrier to obtaining the needed information for achieving this goal is a lack of necessary data collection, particularly as it regards the LGBTQ+ community. This paper will provide a basic overview of health inequities experienced by the LGBTQ+ community and introduce interventions of interest to the legal and public health communities

Institutional Capacity to Respond to the Ethical Challenges of Patient Sexual Expression in State Psychiatric Hospitals in the United States

Patient sexual expression in psychiatric institutions is a major clinical and administrative challenge. For this study, hospital facility directors were surveyed and asked about the existence and nature of formal policies regarding patient sexuality-related needs and staff preparedness to handle various forms of patient sexual expression. Consistent with prior studies, the survey fi ndings show formal policies tend to enforce a punitive response to sexual behavior. More important, the results also reveal a workforce poorly prepared to negotiate the complex ethical issues that arise in addressing patient sexual expression in state psychiatric institutions in the U.S

Altered standards of care for health care providers in the pandemic influenza

Pandemic influenza will pose tremendous challenges to health care providers, state public health authorities, and the public. All will have to conduct business under the most adverse of circumstances. It will be difficult for providers to meet the customary legal standards of care imposed by state and federal regulatory authorities, as well as the common law tort system. This white paper will explore the legal issues associated with altered standards of care in pandemic influenza.William S. and Christine S. Hall Center for Law and Health at the Indiana University School of Law – Indianapolis; Indiana University Center for Bioethics; Indiana State Department of Healt

Length of carotid stenosis predicts peri-procedural stroke or death and restenosis in patients randomized to endovascular treatment or endarterectomy.

BACKGROUND: The anatomy of carotid stenosis may influence the outcome of endovascular treatment or carotid endarterectomy. Whether anatomy favors one treatment over the other in terms of safety or efficacy has not been investigated in randomized trials. METHODS: In 414 patients with mostly symptomatic carotid stenosis randomized to endovascular treatment (angioplasty or stenting; n = 213) or carotid endarterectomy (n = 211) in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), the degree and length of stenosis and plaque surface irregularity were assessed on baseline intraarterial angiography. Outcome measures were stroke or death occurring between randomization and 30 days after treatment, and ipsilateral stroke and restenosis ≥50% during follow-up. RESULTS: Carotid stenosis longer than 0.65 times the common carotid artery diameter was associated with increased risk of peri-procedural stroke or death after both endovascular treatment [odds ratio 2.79 (1.17-6.65), P = 0.02] and carotid endarterectomy [2.43 (1.03-5.73), P = 0.04], and with increased long-term risk of restenosis in endovascular treatment [hazard ratio 1.68 (1.12-2.53), P = 0.01]. The excess in restenosis after endovascular treatment compared with carotid endarterectomy was significantly greater in patients with long stenosis than with short stenosis at baseline (interaction P = 0.003). Results remained significant after multivariate adjustment. No associations were found for degree of stenosis and plaque surface. CONCLUSIONS: Increasing stenosis length is an independent risk factor for peri-procedural stroke or death in endovascular treatment and carotid endarterectomy, without favoring one treatment over the other. However, the excess restenosis rate after endovascular treatment compared with carotid endarterectomy increases with longer stenosis at baseline. Stenosis length merits further investigation in carotid revascularisation trials

Internalization as a mediator of the relationship between conformity to masculine norms and body image attitudes and behaviors among young men in Sweden, US, UK, and Australia

© 2015 Elsevier Ltd. We examined whether internalization of sociocultural body ideals mediated the relationship between conformity to masculine norms and drive for muscularity, leanness, and thinness in a sample of males from Sweden, US, UK, and Australia. Over six hundred young men [n= 142 (Sweden); n= 192 (US); n= 141 (UK); n= 160 (Australia)] completed an online survey that included assessments of masculine role norms, body image, and internalization of sociocultural body ideals. Path analyses confirmed internalization as a mediator between greater conformity to masculine norms and body image measures (drive for thinness, desire for leanness, and desire for muscularity) across the sample. However, significant cross-country differences in the strength of these mediation effects were found. Mediation effects among US, Australian, and Swedish males were comparable, whereas these effects were weaker in the UK sample. Findings confirmed the importance of internalization of sociocultural body ideals in the tested models

The Alcohol Intervention Training Program (AITP): A response to alcohol misuse in the farming community

Background Farm men and women in Australia have higher levels of problematic alcohol use than their urban counterparts and experience elevated health risks associated with excessive alcohol consumption. The Sustainable Farm Families (SFF) program has worked successfully with farm men and women to address health, well- being and safety and has identified that further research and training is required to understand and address alcohol misuse behaviours. This project will add an innovative component to the program by training health professionals working with farm men and women to discuss and respond to alcohol-related physical and mental health problems. Methods/Design A mixed method design with multi-level evaluation will be implemented following the development and delivery of a training program (The Alcohol Intervention Training Program {AITP}) for Sustainable Farm Families health professionals. Pre-, post- and follow-up surveys will be used to assess both the impact of the training on the knowledge, confidence and skills of the health professionals to work with alcohol misuse and associated problems, and the impact of the training on the attitudes, behaviour and mental health of farm men and women who participate in the SFF project. Evaluations will take a range of forms including self-rated outcome measures and interviews. Discussion The success of this project will enhance the health and well-being of a critical population, the farm men and women of Australia, by producing an evidence-based strategy to assist them to adopt more positive alcohol-related behaviours that will lead to better physical and mental health