scholarly journals Understanding lead in water and avoidance strategies: a United States perspective for informed decision-making

2019 ◽  
Vol 17 (4) ◽  
pp. 540-555 ◽  
Author(s):  
Kelsey J. Pieper ◽  
Adrienne Katner ◽  
Rebecca Kriss ◽  
Min Tang ◽  
Marc A. Edwards
Keyword(s):  
Public Health ◽  
United States ◽  
Drinking Water ◽  
The United States ◽  
Global Network ◽  
Simplified Approach ◽  
Household Level ◽  
Wide Range ◽  
Avoidance Strategies ◽  
Significant Public Health

Abstract The pervasiveness of lead in drinking water poses a significant public health threat, which can be reduced by implementing preventive measures. However, the causes of elevated lead in water and the benefits of lead in water avoidance strategies are often misunderstood. Based on experiences in the United States, this paper describes an oversimplified ‘lead in water equation’ to explain key variables controlling the presence of lead in drinking water to better inform public health practitioners, government officials, utility personnel, and concerned residents. We illustrate the application of the equation in Flint, Michigan and explore the primary household-level water lead avoidance strategies recommended during the crisis, including flushing, filtration, bottled water use, and lead pipe removal. In addition to lead reduction, strategies are evaluated based on costs and limitations. While these lead avoidance strategies will reduce water lead to some degree, the costs, limitations, and effectiveness of these strategies will be site- and event-specific. This paper presents a simplified approach to communicate key factors which must be considered to effectively reduce waterborne lead exposures for a wide range of decision makers. This article has been made Open Access thanks to the generous support of a global network of libraries as part of the Knowledge Unlatched Select initiative.

Overview

2020 ◽  
pp. 121-138
Author(s):  
Yngvild Olsen ◽  
Anika A. H. Alvanzo ◽  
Jarratt D. Pytell
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Health Impacts ◽  
Opioid Use ◽  
The Us ◽  
Significant Public Health ◽  
History Of ◽  
Opioid Use Disorders ◽  
Barriers To Use

Substance use disorders (SUDs) are a significant cause of morbidity and mortality in the United States. In spite of the significant public health impacts of SUDs, medications approved by the US Food and Drug Administration (FDA) are underutilized for the treatment of SUDs. This chapter reviews the history of FDA-approved medications for alcohol, nicotine, and opioid use disorders and provides some background on barriers to use of these medications to treat patients with SUDs. Suggestions are provided to guide clinicians on a path forward to reduce these barriers and increase the use of FDA-approved medications for the treatment of SUDs.

Aetiology of alcohol problems

2012 ◽  
pp. 432-437
Author(s):  
Juan C. Negrete ◽  
Kathryn J. Gill
Keyword(s):  
Public Health ◽  
United States ◽  
Alcohol Abuse ◽  
Alcohol Dependence ◽  
The United States ◽  
Alcohol Problems ◽  
Harmful Drinking ◽  
Significant Public Health ◽  
Icd 10 ◽  
Health Complications

Approximately 8 out of every 10 persons living in Europe and the Americas would report consuming alcoholic beverages in their lifetime, and the norm is for drinking to start in adolescence: in 2003 the average age of first drink in the United States was 14 years old. Also in the year 2003, 79.3 per cent of persons aged 15 years or more in Canada reported to be current users of alcohol, and 22.6 per cent admitted to having exceeded the country's safe drinking guidelines (i.e. no more than 14 units/week for males and 12 units/week for females). The same survey elicited a rate of ‘hazardous drinkers’ of 13.6 per cent, defined as all respondents who scored 8+ on the AUDIT screening questionnaire.Epidemiological data in the United States indicates that roughly one in seven persons who start drinking will develop an alcohol dependence disorder in the course of their lives. The figure is higher among men when compared to women. Of course it is also higher if other clinical forms of alcohol misuse (i.e. alcohol abuse/harmful drinking) are included in the rates in addition to dependence. A moderate level of alcohol use appears to be relatively harmless; and there exist public health guidelines on ‘safe’ drinking practices. The recommendations vary considerably from country to country, but they all assume a greater vulnerability to alcohol effects in the female gender. In the United Kingdom, for instance, hazardous drinking is thought to start at 21 units/week for men and 16 units/week for women; and in the United States the equivalent guidelines are 14 and 7 drinks per week. It is among alcohol users who exceed such guidelines that the prevalence of dependence is the highest; up to 40 per cent of the more frequent violators. The expression ‘alcohol problems’ encompasses a wide range of untoward occurrences, from maladaptive, impaired, or harmful behaviour, to health complications and the condition of alcohol dependence. Alcohol problems are not incurred just by chronic excessive drinkers, but also by persons who drink heavily on isolated occasions (e.g. accidents, violence, poisoning, etc.). Given their high frequency and social costs, these consequences of acute inebriation represent the most significant public health burden of drinking. This section focuses rather on the causes of problems of a clinical nature, the ones presented by individuals who engage in patterns of repeated excessive drinking, i.e. ‘alcohol dependence’ and ‘alcohol abuse’ (DSM-IV nomenclature) or ‘harmful drinking’ (ICD-10 nomenclature).

Results and Recommendations From a National Public Health Workforce Development Systems Assessment Conducted in the United States

2020 ◽  
pp. 237337992090764
Author(s):  
Christina R. Welter ◽  
Betty Bekemeier ◽  
Jennifer McKeever
Keyword(s):  
Public Health ◽  
United States ◽  
Workforce Development ◽  
Health Workforce ◽  
Phase 1 ◽  
The United States ◽  
Public Health Workforce ◽  
Public Health Training ◽  
Wide Range ◽  
Health Workforce Development

Multiple public health workforce development assessments report individual worker knowledge and skill-based training needs. These assessments do not capture practitioners’ in-depth perceptions of complex public health challenges and whether workforce development approaches address these issues. To address this gap, the Public Health Learning Network—a national coalition of 10 Regional Public Health Training Centers located at United States accredited schools of public health, their partners, and the National Network of Public Health Institutes—conducted a public health workforce development assessment using a two-phased mixed-method design to explore systems-level gaps and opportunities for improving workforce development effectiveness. Phase 1 included a content analysis of major public health workforce development reports and peer-reviewed literature. Phase 2 included primary qualitative data collection of key informant interviews and focus groups via conference call with 43 participants representing 41 public health organizations at the local, state, and national levels. Results included a wide range of challenges with an emphasis on major systems changes, the shift in public health’s role to more effectively build community collective capacity, limited staff capacity and capability, and the need for more flexible and integrated training funding. Public health workforce development approaches recommended to address these challenges included improving pedagogical approaches toward more integrated, multimodal training delivered over time; increasing workforce capacity to address complex challenges such as racism and housing; and facilitating public health workforce development system coordination and alignment. Public Health Learning Network’s workforce assessment also identified opportunities for conceptualizing the definition and delivery of training toward ongoing learning.

scholarly journals Preliminary Study of Lead-Contaminated Drinking Water in Public Parks—An Assessment of Equity and Exposure Risks in Two Texas Communities

2021 ◽  
Vol 18 (12) ◽  
pp. 6443
Author(s):  
Leanne Fawkes ◽  
Garett Sansom
Keyword(s):  
Public Health ◽  
United States ◽  
Drinking Water ◽  
The United States ◽  
Median Income ◽  
Safe Drinking Water ◽  
Public Parks ◽  
Health Crisis ◽  
Contaminated Drinking Water ◽  
Lead Levels

Safe drinking water is celebrated as a public health achievement and is a top priority for the Environmental Protection Agency. Yet today, lead (Pb) contaminated drinking water has the potential to be a public health crisis in the United States. Despite efforts to provide safe drinking water, update water infrastructure, and ensure strict drinking water regulations, there are incidents of unsafe lead levels and reports of associated adverse health effects. While there has been increased attention paid to the quality of drinking water within individuals’ homes, little research has examined the presence and concentration of lead in water from drinking fountain sources located in public parks. In this study, we sampled drinking water from every accessible public park in the Bryan/College Station (BCS), TX metropolitan area (N = 56). With a lower detection level of 2.0 μg/L, we discovered a mean lead concentration of 1.3 μg/L across all sites and a maximum of 8.0 μg/L. Furthermore, neighborhoods below the median income for BCS were twice as likely to have detectable lead levels in their water and had 1.5 times the mean concentration. This study underscores the need for action and supports previous studies that have identified a disparate burden to lead exposure among low socioeconomic populations within the United States. By examining the water quality in drinking fountains in publicly accessible parks, the results of our study provide public health professionals with important information about where infrastructure should be improved and the potential harms of lead in drinking fountain water.

scholarly journals Concepts and Terms for Addressing Disparities in Public Health Emergencies: Accounting for the COVID-19 Pandemic and the Social Determinants of Health in the United States

2021 ◽  
pp. 1-25
Author(s):  
Cheryl A. Levine ◽  
Daire R. Jansson
Keyword(s):  
Public Health ◽  
United States ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
The United States ◽  
Determinants Of Health ◽  
Public Health Emergencies ◽  
Wide Range ◽  
Conceptual Shift ◽  
Systemic Health

Abstract Public health emergencies, including the coronavirus (COVID-19) pandemic, highlight disproportionate impacts faced by populations with existing disparities. Concepts and terms used to describe populations disproportionately impacted in emergencies vary over time and across disciplines, but United States (U.S.) federal guidance and law require equal access to our nation’s emergency resources. At all levels of emergency planning, public health and their partners must be accountable to populations with existing inequities, which requires a conceptual shift towards using the data-driven social determinants of health (SDOH). SDOH are conditions in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks. This article reviews the historic use of concepts and terms to describe populations disproportionately impacted by emergencies. It also recommends a shift in emergency activities towards interventions that target the SDOH to adequately address long-standing systemic health disparities and socioeconomic inequities in the U.S.

Characterization of the first carbapenem-resistant Pseudomonas aeruginosa clinical isolate harboring bla SIM-1 from the United States

2021 ◽  
Author(s):  
Catharine Prussing ◽  
Theresa Canulla ◽  
Navjot Singh ◽  
Patricia McAuley ◽  
Michael Gosciminski ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Pseudomonas Aeruginosa ◽  
Clinical Isolate ◽  
Antimicrobial Therapy ◽  
The United States ◽  
Health Concerns ◽  
Carbapenem Resistant ◽  
Significant Public Health

The emergence and transmission of metallo-β-lactamases are significant public health concerns that threaten the utility of antimicrobial therapy (1, 2).…

scholarly journals Promising Agents for Chemoprevention of Skin Cancer

2006 ◽  
Vol 13 (5) ◽  
pp. 185-186
Author(s):  
S. P. Stratton ◽  
M. S. Stratton ◽  
D. S. Alberts
Keyword(s):  
Public Health ◽  
United States ◽  
Skin Cancer ◽  
Health Problem ◽  
Public Health Problem ◽  
The United States ◽  
Northern Europe ◽  
Significant Public Health Problem ◽  
The World ◽  
Significant Public Health

Skin cancer presents a significant public health problem because of its increasing incidence in the United States, Australia, Northern Europe, and other temperate climates around the world. [...]

scholarly journals Therapeutic options and challenges for substances of abuse

2007 ◽  
Vol 9 (4) ◽  
pp. 431-445 ◽  
Keyword(s):  
Public Health ◽  
United States ◽  
Substance Use ◽  
The United States ◽  
Health Concern ◽  
Pharmacological Treatments ◽  
Public Health Concern ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Substances Of Abuse

Addiction to substances continues to be a significant public health concern in the United States. The following review of current pharmacological treatments discusses a range of substances: nicotine, alcohol, cocaine, and opioids. The goal is to provide an overview of currently available and new pharmacological treatments for substance use disorders, while also addressing the pharmacotherapeutic challenges remaining. The significant advances in pharmacotherapy have had limited utilization, however. For example, naltrexone for alcoholism is infrequently prescribed, buprenorphine for opiates still has relatively few qualified prescribers, and stimulants have no Food and Drug Administration-approved pharmacotherapy. These pharmacotherapies are needed, with the rate of even the relatively uncommon abuse of opiates now rising sharply.

scholarly journals Delivering Public Health Insurance Through Private Plan Choice in the United States

2017 ◽  
Vol 31 (4) ◽  
pp. 3-22 ◽  
Author(s):  
Jonathan Gruber
Keyword(s):  
Public Health ◽  
United States ◽  
Health Insurance ◽  
Low Income ◽  
Private Insurance ◽  
The United States ◽  
Public Health Insurance ◽  
Market Failures ◽  
Wide Range ◽  
The Government

The United States has seen a sea change in the way that publicly financed health insurance coverage is provided to low-income, elderly, and disabled enrollees. When programs such as Medicare and Medicaid were introduced in the 1960s, the government directly reimbursed medical providers for the care that they provided, through a classic “single payer system.” Since the mid-1980s, however, there has been an evolution towards a model where the government subsidizes enrollees who choose among privately provided insurance options. In the United States, privatized delivery of public health insurance appears to be here to stay, with debates now focused on how much to expand its reach. Yet such privatized delivery raises a variety of thorny issues. Will choice among private insurance options lead to adverse selection and market failures in privatized insurance markets? Can individuals choose appropriately over a wide range of expensive and confusing plan options? Will a privatized approach deliver the promised increases in delivery efficiency claimed by advocates? What policy mechanisms have been used, or might be used, to address these issues? A growing literature in health economics has begun to make headway on these questions. In this essay, I discuss that literature and the lessons for both economics more generally and health care policymakers more specifically.

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