scholarly journals Evidence-based lead mitigation strategies: Are the DIY lead mitigation recommendations by health departments supported by research?

2020 ◽  
Vol 3 ◽  
Author(s):  
Seth Losiewicz ◽  
Heidi Beidinger-Burnett ◽  
Christopher Knaub
Keyword(s):  
Literature Review ◽  
Cost Effective ◽  
Health Department ◽  
The United States ◽  
Mitigation Strategies ◽  
Evidence Based ◽  
Health Departments ◽  
State Health ◽  
Lead Levels ◽  
Lead Hazards

Background: Legislation outlawing leaded paint in 1978 and tetraethyl lead from gasoline in 1992 effectively decreased blood lead levels (BLLs), but the effects of lead are still felt in the United States to this day. There is no safe level of lead in the body, and even low level lead exposure can lead to cognitive and developmental delays such as learning delay and disabilities; low IQ; and attention-deficit/hyperactivity disorder. The CDC has determined that a BLL of 5 μg/dL or higher is cause for environmental and educational intervention. Today, the EPA estimates that there are approximately 24 million housing units containing significant lead hazards, with 4 million being home to children. Many of the families that are faced with lead hazards in their homes are minorities and low socioeconomic status. To assist families with possible lead hazards in the home, interim controls of lead hazards may be paramount to reducing lead levels in the household in a simple, cost effective manner. Methods: To that end, our research had two aims (a) conduct a systematic literature review to learn about do-it-yourself (DIY) interim controls that are evidence-based and effective in reducing lead hazards in the home and (b) conduct interviews with key personnel at each state health department to learn more about their lead prevention programs and the DIY mitigation strategies recommended to families. Results: Our provisional findings suggest there is an inconsistent, wide range of mitigation strategies recommended by the state health departments that often lack empirical evidence. . While our literature review identified effective interim controls, the literature is outdated. Conclusion and Potential Impact: We recommend more studies are needed to identify cost effective interim controls and the standardization of health department DIY interim controls across the nation.

scholarly journals Understanding evidence-based lead mitigation: Is the lead mitigation advice and strategies being communicated to citizens evidence-based?

2020 ◽  
Vol 3 ◽  
Author(s):  
Shania James ◽  
Heidi Beidinger-Burnett
Keyword(s):  
Literature Review ◽  
Low Cost ◽  
Lead Level ◽  
Blood Lead ◽  
Mitigation Strategies ◽  
Lead Contamination ◽  
Evidence Based ◽  
State Health ◽  
User Friendliness ◽  
Lead Hazards

Background and Hypothesis: The CDC has declared that there is no safe blood lead level for a child, but still approximately 37 million homes are lead-contaminated of which 4 million are home to small children. Lead abatement is an expensive strategy to remove all lead hazards rendering a home lead-free. Many of these lead-contaminated homes are in lower socioeconomic areas which makes lead abatement nearly impossible. Given the expense of lead abatement, low-cost interim controls are needed to reduce lead exposure thus creating a lead-safe home. We hypothesize that updated lead mitigation strategies need pursued, and there is a large disparity of lead information disseminated between health departments.    Project Methods: Using JSTOR and Boolean criteria, we conducted a systematic literature review on evidence-based, do-it-yourself (DIY) lead mitigation strategies for sources of lead contamination. Once the literature review was completed, QualtricsR was used to quantitatively and qualitatively evaluate the 50 state health department’s websites for lead policy, user friendliness, and recommended lead interim controls as compared to the literature review.     Results: Results from the literature indicate that there is a lack of current information regarding new strategies for lead mitigation. Research prior to the year 2000 shows that cleaning flat surfaces by wet mopping, washing hands frequently, mulching, removing shoes before entering the home, and painting over deteriorating paint significantly reduces lead accumulation in the home. Preliminary results from the website review found that there is no baseline of uniform information being distributed, and evidence-based practices are not included for each state health department.    Potential Impact: The lack of continuity nationwide for lead mitigation showcases that families are not receiving all of the information that research has to offer to help keep their homes safe. This research indicates that there is a need for national lead policies and recommendations, so each family in the U.S. is equally informed.  

scholarly journals Applied Epidemiology Workforce Growth and Capacity Challenges: The Council of State and Territorial Epidemiologists 2017 Epidemiology Capacity Assessment

2019 ◽  
Vol 134 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Jessica Arrazola ◽  
Mia N. Israel ◽  
Nancy Binkin
Keyword(s):  
Public Health ◽  
Health Department ◽  
The United States ◽  
Current Status ◽  
Public Health Department ◽  
Health Departments ◽  
State Health ◽  
Public Health Services ◽  
Full Capacity ◽  
Council Of State

Objectives: To better understand the current status and challenges of the state public health department workforce, the Council of State and Territorial Epidemiologists (CSTE) assessed the number and functions of applied public health epidemiologists at state health departments in the United States. Methods: In 2017, CSTE emailed unique online assessment links to state epidemiologists in the 50 states and the District of Columbia (N = 51). The response rate was 100%. CSTE analyzed quantitative data (27 questions) on funding, the number of current and needed epidemiologists, recruitment, retention, perceived capacity, and training. CSTE coded qualitative data in response to an open-ended question that asked about the most important problems state epidemiologists face. Results: Most funding for epidemiologic activities came from the federal government (mean, 77%). State epidemiologists reported needing 1199 additional epidemiologists to achieve ideal capacity but noted challenges in recruiting qualified staff members. Respondents cited opportunities for promotion (n = 45, 88%), salary (n = 41, 80%), restrictions on merit raises (n = 36, 70%), and losses to the private or government sector (n = 33, 65%) as problems for retention. Of 4 Essential Public Health Services measured, most state epidemiologists reported substantial-to-full capacity to monitor health status (n = 43, 84%) and diagnose and investigate community health problems (n = 47, 92%); fewer respondents reported substantial-to-full capacity to conduct evaluations (n = 20, 39%) and research (n = 11, 22%). Conclusions: Reliance on federal funding negatively affects employee retention, core capacity, and readiness at state health departments. Creative solutions for providing stable funding, developing greater flexibility to respond to emerging threats, and enhancing capacity in evaluation and applied research are needed.

scholarly journals Implementing a Data to Care Strategy to Improve Health Outcomes for People With HIV: A Report From the Care and Prevention in the United States Demonstration Project

2018 ◽  
Vol 133 (2_suppl) ◽  
pp. 60S-74S ◽  
Author(s):  
Patricia Sweeney ◽  
Tamika Hoyte ◽  
Mesfin S. Mulatu ◽  
Jacquelyn Bickham ◽  
Antoine D. Brantley ◽  
...  
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Medical Care ◽  
Treatment Adherence ◽  
Viral Suppression ◽  
The United States ◽  
Health Departments ◽  
State Health ◽  
Improve Health

Objectives: The Care and Prevention in the United States Demonstration Project included implementation of a Data to Care strategy using surveillance and other data to (1) identify people with HIV infection in need of HIV medical care or other services and (2) facilitate linkages to those services to improve health outcomes. We present the experiences of 4 state health departments: Illinois, Louisiana, Tennessee, and Virginia. Methods: The 4 state health departments used multiple databases to generate listings of people with diagnosed HIV infection (PWH) who were presumed not to be in HIV medical care or who had difficulty maintaining viral suppression from October 1, 2013, through September 29, 2016. Each health department prioritized the listings (eg, by length of time not in care, by viral load), reviewed them for accuracy, and then disseminated the listings to staff members to link PWH to HIV care and services. Results: Of 16 391 PWH presumed not to be in HIV medical care, 9852 (60.1%) were selected for follow-up; of those, 4164 (42.3%) were contacted, and of those, 1479 (35.5%) were confirmed to be not in care. Of 794 (53.7%) PWH who accepted services, 694 (87.4%) were linked to HIV medical care. The Louisiana Department of Health also identified 1559 PWH as not virally suppressed, 764 (49.0%) of whom were eligible for follow-up. Of the 764 PWH who were eligible for follow-up, 434 (56.8%) were contacted, of whom 269 (62.0%) had treatment adherence issues. Of 153 PWH who received treatment adherence services, 104 (68.0%) showed substantial improvement in viral suppression. Conclusions: The 4 health departments established procedures for using surveillance and other data to improve linkage to HIV medical care and health outcomes for PWH. To be effective, health departments had to enhance coordination among surveillance, care programs, and providers; develop mechanisms to share data; and address limitations in data systems and data quality.

Use of Evidence-Based Interventions in State Health Departments

2010 ◽  
Vol 16 (6) ◽  
pp. E9-E15 ◽  
Author(s):  
Elizabeth A. Dodson ◽  
Elizabeth A. Baker ◽  
Ross C. Brownson
Keyword(s):  
Evidence Based ◽  
Health Departments ◽  
State Health

Shooting the Moon: Should states require the H1N1 vaccine for healthcare workers?

2009 ◽  
Vol 7 (6) ◽  
pp. 11
Author(s):  
Paris Nourmohammadi, JD ◽  
Brigid Ryan, JD
Keyword(s):  
New York ◽  
Healthcare Workers ◽  
New York State ◽  
Mitigation Strategies ◽  
World Health ◽  
Health Departments ◽  
State Health ◽  
H1n1 Vaccine ◽  
Policy Makers ◽  
York State

On June 11, 2009, the director of the World Health Organization (WHO) raised the phase of alert in the Global Influenza Plan from level five to level six. The cause for this was the H1N1 virus which had already affected several countries. A level five alert is declared when more than one country in a single WHO geographic region is affected by the same virus. A level six declaration means that community outbreaks are occurring in at least two WHO geographic regions. Once such a declaration is made, little time remains before mitigation efforts must be planned and communicated to the public. In the wake of the WHO declaration, policy makers are clamoring for adequate disease mitigation strategies. Some health departments intend to require employees to wear personal protective equipment while on the job. Other state health departments are encouraging employees to stay home sick if they think they might have the flu. The New York State Health Department has issued an order requiring all healthcare workers to be vaccinated for H1N1 or risk being terminated. This article will explore the New York State policy and make recommendations to policy makers about how to prevent the spread of H1N1.

Employer Requirements to Work during Emergency Responses: Key Ethics Considerations

2017 ◽  
Vol 45 (S1) ◽  
pp. 73-76 ◽  
Author(s):  
Lainie Rutkow ◽  
Holly A. Taylor ◽  
Tia Powell
Keyword(s):  
Emergency Preparedness ◽  
Health Workers ◽  
Health Department ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Local Public Health ◽  
Public Health Workers ◽  
Emergency Responses

Local health departments and their employees are at the forefront of emergency preparedness and response. Yet, recent studies have found that some local public health workers are unwilling to report to work in a variety of disaster scenarios. This can greatly compromise a response, as many local health departments need “all hands on deck” to effectively meet increased demands. To address these concerns, local health departments have employed varied policy strategies to ensure that employees do report to work. After describing different approaches taken by local health departments throughout the United States, we briefly identify and explore key ethics considerations that arise for local health departments when employees are required to report to work for emergency responses. We then discuss how these ethics considerations may inform local health department practices intended to promote a robust emergency response.

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