scholarly journals Drug Overdose Surveillance and Information Sharing via a Public Database: The Role of the Medical Examiner/Coroner

2017 ◽  
Vol 7 (1) ◽  
pp. 60-72 ◽  
Author(s):  
Karl E. Williams ◽  
Michael D. Freeman ◽  
Lynn Mirigian
Keyword(s):  
Public Health ◽  
United States ◽  
Information Dissemination ◽  
National Level ◽  
The United States ◽  
Public Access ◽  
Medical Examiner ◽  
Health Crisis ◽  
Death Scene ◽  
Drug Death

The medical examiner/coroner (ME/C) death scene investigation systems of the United States play a pivotal role in the current public health crisis created by the expanding drug dependency epidemic in the United States. The first point of recognition of a drug-related death in a community is often the local ME/C agency. This circumstance places these entities in an ideal position to provide surveillance data regarding the epidemiology of drug-related deaths occurring within the jurisdiction of the agency. The ability to surveil for the distribution and determinants among drug-related deaths at the first point of contact enhances the capacity to recognize actionable trends at the local, state, and national levels, including the ability to identify secular (longer-term) trends among various drugs and population subgroups, as well as activity spikes (outbreaks) associated with high-potency formulations and drug combinations. In this article, we describe the development and implementation of an online website that provides public access to a wide array of drug-related death surveillance resources and tools. The website gives users access to a detailed dataset that includes information regarding specific drugs, demographic information pertaining to the decedent, and to investigational findings related to the circumstances of the death. A unique aspect of the database is that it is populated by ME/C agencies and accessed by the public with no intermediary agency, so that the lag time between the identification and investigation of the death as drug-related and community knowledge of the circumstances of the death is minimized. Wide dissemination of accurate drug death surveillance information in an easily accessible and customizable format promotes societal awareness of the drug death epidemic, but also provides information to public health, law enforcement, regulatory, and other community-based organizations that can benefit from the most up-to-date knowledge. We envision a national system of surveillance at the regional ME/C level that would allow for optimal information dissemination and sharing. Such a system would likely allow for more efficacious allocation of resources at the regional and national level.

Investigation and Review of Unexpected Infant and Child Deaths

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 734-735
Author(s):  
Keyword(s):  
Public Health ◽  
United States ◽  
Child Abuse ◽  
Child Death ◽  
Significant Proportion ◽  
The United States ◽  
Medical Examiner ◽  
Sudden Infant ◽  
Child Deaths ◽  
Death Investigation

A significant proportion of infant and child deaths are preventable. Of the 55 861 deaths of children aged 14 and younger in the United States in 1989, more than three fourths occurred in children under the age of 2 years.1 Approximately one third of the latter were unexpected, including those due to sudden infant death syndrome (SIDS) or trauma, or deaths that were otherwise unexplained. Child abuse deaths occur in greatest numbers among infants, followed by those in toddlers and preschool children.2 Children younger than 6 years of age are most vulnerable to abuse because of their small size, incomplete verbal skills, and often limited contact with adults other than their primary caretakers.3 With few exceptions, throughout the United States there is no uniform system for the investigation of infant and child deaths. Many jurisdictions lack appropriately trained pathologists, interagency collaboration hat would facilitate sharing of information about the family, and a surveillance system to evaluate data regarding infant deaths. As a result, progress in the understanding of SIDS is inhibited, cases of child abuse and neglect may be missed, familial genetic diseases go undiagnosed, public health threats may be unrecognized, and inadequate medical care may be undetected. Lack of adequate infant and child death investigation is an impediment to preventing illness, injury and death of other children at risk. Adequate death investigation requires the participation of numerous individuals including medical examiner/coroner, public health officials, the patient's physician, the pathologist, and personnel from agencies involved with child welfare and social services and law enforcement.

scholarly journals Opioid abuse in children: an emerging public health crisis in the United States!

2017 ◽  
Vol 82 (4) ◽  
pp. 562-563 ◽  
Author(s):  
Veerajalandhar Allareddy ◽  
Sankeerth Rampa ◽  
Veerasathpurush Allareddy
Keyword(s):  
Public Health ◽  
United States ◽  
The United States ◽  
Opioid Abuse ◽  
Health Crisis ◽  
Public Health Crisis

scholarly journals Policy liberalism and source of news predict pandemic-related health behaviors and trust in the scientific community

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252670
Author(s):  
Madeleine Reinhardt ◽  
Matthew B. Findley ◽  
Renee A. Countryman
Keyword(s):  
Public Health ◽  
United States ◽  
Health Behaviors ◽  
News Media ◽  
Perceived Risk ◽  
Scientific Community ◽  
The United States ◽  
World Health ◽  
Health Crisis ◽  
Health Measures

In March of 2020, the United States was confronted with a major public health crisis caused by the coronavirus disease (COVID-19). This study aimed to identify what factors influence adherence to recently implemented public health measures such as mask-wearing and social distancing, trust of scientific organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) on information pertaining to the pandemic, and level of perceived risk. Data were collected from June 30, 2020 to July 22, 2020 on 951 adult residents of the United States using an online survey through Microsoft Forms. Multiple linear regression was used to identify the strongest predictors for compliance to pandemic-related health measures, trust in the scientific community, and perceived risk. Results showed that the strongest predictor of all variables of interest was degree of policy liberalism. Additionally, participants who consumed more conservative news media conformed less to the pandemic health guidelines and had less trust in the scientific community. Degree of policy liberalism was found to have a significant moderating effect on the relationship between gender and conformity to pandemic-related health behaviors. These findings have concerning implications that factors like degree of policy liberalism and source of news are more influential in predicting adherence to life-saving health measures than established risk factors like pre-existing health conditions.

scholarly journals Public health strategies to combat opioid epidemic in the United States: A systematic review

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
F Balidemaj
Keyword(s):  
Public Health ◽  
United States ◽  
Systematic Review ◽  
The United States ◽  
Opioid Abuse ◽  
Opioid Epidemic ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Opioid Crisis ◽  
Public Health Strategies

Abstract Background The opioid epidemic in the United States is a national public health crisis. Driven by an increase in availability of pharmaceutical opioids and by an increase in their consumption, specifically, for pain treatment, more so in the past twenty years, it has led to an economic cost of prescription opioid abuse, overdose, and dependence in the United States estimated to be 78.5 billion USD. The purpose of this systematic review was to identify and evaluate public health strategies that contribute towards combatting the opioid crisis. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a search was conducted of the PubMed database for articles in English language that analyzed the most effective ways to regulate health markets to decrease the opioid crisis in the United States. Results The initial search yielded 2397 titles, of which 15 full-text articles were ultimately selected for inclusion in this systematic review. The review identified four categories in overcoming this epidemic nationwide, including required improvement in patient utilization of and access to safe and effective treatment options for opioid abuse and overdose, addressing the stigma correlated with opioid use, considering appropriate use of abuse deterrent formulations (ADF) along with patient education, and improving prescribing practices via utilization of drug monitoring programs, CDC opioid prescribing guidelines and provider continuing education. Conclusions Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. While the methods with promising improvement of the situation have been identified, implementing them has shown to be a challenge. Continued application is needed, while considering possible new steps that could help reinforce their utilization further. Key messages Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. The methods with promising improvement of the opioid crisis situation have been identified, however utilizing and implementing the existing public health strategies has shown to be a challenge.

scholarly journals Who is to blame for COVID-19? Examining politicized fear and health behavior through a mixed methods study in the United States

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256136
Author(s):  
Lisa J. Hardy ◽  
Adi Mana ◽  
Leah Mundell ◽  
Moran Neuman ◽  
Sharón Benheim ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Mixed Methods ◽  
Health Behaviors ◽  
The United States ◽  
Mixed Methods Design ◽  
Structured Interviews ◽  
Health Crisis ◽  
Government Power ◽  
Political Spectrum

Background Political ideologies drove public actions and health behaviors in the first year of the global pandemic. Different ideas about contagion, health behaviors, and the actions of governing bodies impacted the spread of the virus and health and life. Researchers used an immediate, mixed methods design to explore sociocultural responses to the virus and identified differences and similarities in anxiety, fear, blame, and perceptions of nation across political divides. Methods Researchers conducted 60 in-depth, semi-structured interviews and administered over 1,000 questionnaires with people living in the United States. The team analyzed data through an exploratory and confirmatory sequential mixed methods design. Results In the first months of the pandemic interviewees cited economic inequality, untrustworthy corporations and other entities, and the federal government as threats to life and pandemic control. Participants invoked ideas about others to determine blame. Findings reveal heavy associations between lack of safety during a public health crisis and blame of “culture” and government power across the political spectrum. Conclusion Data indicate anxiety across political differences related to ideas of contagion and the maleficence of a powerful elite. Findings on how people understand the nation, politics, and pandemic management contribute to understanding dimensions of health behaviors and underlying connections between anxiety and the uptake of conspiracy theories in public health. The article ends with recommendations drawn from project findings for future pandemic response.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Individualized Decision

Abstract Background: The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.Methods: Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between R t and NPIs through a generalized linear model (GLM). Results: Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46%-57%), wearing (face) masks 29% (15%-42%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-14%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 7% (2%-11%).Conclusions: This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals Attitudes and Perceptions Toward COVID-19 Digital Surveillance: Survey of Young Adults in the United States

10.2196/23000 ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. e23000
Author(s):  
Lauren Maytin ◽  
Jason Maytin ◽  
Priya Agarwal ◽  
Anna Krenitsky ◽  
JoAnn Krenitsky ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Young Adults ◽  
Online Survey ◽  
The United States ◽  
Contact Tracing ◽  
Health Crisis ◽  
Response Options ◽  
Health Technologies ◽  
Digital Surveillance

Background COVID-19 is an international health crisis of particular concern in the United States, which saw surges of infections with the lifting of lockdowns and relaxed social distancing. Young adults have proven to be a critical factor for COVID-19 transmission and are an important target of the efforts to contain the pandemic. Scalable digital public health technologies could be deployed to reduce COVID-19 transmission, but their use depends on the willingness of young adults to participate in surveillance. Objective The aim of this study is to determine the attitudes of young adults regarding COVID-19 digital surveillance, including which aspects they would accept and which they would not, as well as to determine factors that may be associated with their willingness to participate in digital surveillance. Methods We conducted an anonymous online survey of young adults aged 18-24 years throughout the United States in June 2020. The questionnaire contained predominantly closed-ended response options with one open-ended question. Descriptive statistics were applied to the data. Results Of 513 young adult respondents, 383 (74.7%) agreed that COVID-19 represents a public health crisis. However, only 231 (45.1%) agreed to actively share their COVID-19 status or symptoms for monitoring and only 171 (33.4%) reported a willingness to allow access to their cell phone for passive location tracking or contact tracing. Conclusions Despite largely agreeing that COVID-19 represents a serious public health risk, the majority of young adults sampled were reluctant to participate in digital monitoring to manage the pandemic. This was true for both commonly used methods of public health surveillance (such as contact tracing) and novel methods designed to facilitate a return to normal (such as frequent symptom checking through digital apps). This is a potential obstacle to ongoing containment measures (many of which rely on widespread surveillance) and may reflect a need for greater education on the benefits of public health digital surveillance for young adults.

scholarly journals Evaluating Surveillance for and Estimating Administration of Rabies Postexposure Prophylaxis in the United States, 2012–2018

2021 ◽  
Vol 15 (10) ◽  
pp. e0009878
Author(s):  
Erin R. Whitehouse ◽  
Marissa K. Person ◽  
Catherine M. Brown ◽  
Sally Slavinski ◽  
Agam K. Rao ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
National Level ◽  
State Level ◽  
The United States ◽  
Surveillance Data ◽  
Human Rabies ◽  
Accurate Assessment ◽  
Postexposure Prophylaxis ◽  
Ed Visits

Background An evaluation of postexposure prophylaxis (PEP) surveillance has not been conducted in over 10 years in the United States. An accurate assessment would be important to understand current rabies trends and inform public health preparedness and response to human rabies. Methodology/Principle findings To understand PEP surveillance, we sent a survey to public health leads for rabies in 50 U.S. states, Puerto Rico, Washington DC, Philadelphia, and New York City. Of leads from 54 jurisdictions, 39 (72%) responded to the survey; 12 reported having PEP-specific surveillance, five had animal bite surveillance that included data about PEP, four had animal bite surveillance without data about PEP, and 18 (46%) had neither. Although 12 jurisdictions provided data about PEP use, poor data quality and lack of national representativeness prevented use of this data to derive a national-level PEP estimate. We used national-level and state specific data from the Healthcare Cost & Utilization Project (HCUP) to estimate the number of people who received PEP based on emergency department (ED) visits. The estimated annual average of initial ED visits for PEP administration during 2012–2017 in the United States was 46,814 (SE: 1,697), costing upwards of 165 million USD. State-level ED data for initial visits for administration of PEP for rabies exposure using HCUP data was compared to state-level surveillance data from Maryland, Vermont, and Georgia between 2012–2017. In all states, state-level surveillance data was consistently lower than estimates of initial ED visits, suggesting even states with robust PEP surveillance may not adequately capture individuals who receive PEP. Conclusions Our findings suggest that making PEP a nationally reportable condition may not be feasible. Other methods of tracking administration of PEP such as syndromic surveillance or identification of sentinel states should be considered to obtain an accurate assessment.

scholarly journals Perceived vulnerability to COVID-19 infection from event attendance: Results from Louisiana, USA, two weeks preceding the national emergency declaration

2020 ◽  
Author(s):  
Ran Li ◽  
Bingcheng Yang ◽  
Jerrod Penn ◽  
Bailey Houghtaling ◽  
Juan Chen ◽  
...  
Keyword(s):  
Public Health ◽  
National Health ◽  
National Level ◽  
Income Group ◽  
The United States ◽  
State University ◽  
Health Crisis ◽  
National Crisis ◽  
Public Health Crisis ◽  
Louisiana State University

AbstractIn response to the mounting threat of COVID-19, we added questions to an ongoing food preference study held at Louisiana State University from March 3-12 of 2020. We asked 356 participants: (1) In your opinion, how likely is it that the spread of COVID-19 (the coronavirus) will cause a public health crisis in the United States? (2) How concerned are you that you will contract COVID-19 by attending events on campus? Participants’ estimates of an impending national health crisis increased significantly during the study’s second week (March 9-12) while concern about personally contracting COVID-19 from attending campus events increased only marginally during the study’s final days. We find those expressing a higher likelihood of an impending national crisis were more concerned about contracting COVID-19 by attending campus events, suggesting a possible transmission from perceptions of national-level events to perceived personal vulnerability via local exposure. However, about 30% of participants perceived that COVID-19 would likely cause a public health crisis yet did not express concern about contracting COVID-19 from event attendance. These participants were significantly more likely to be younger students who agreed to participate in response to recruitment using same day flyer distribution. Women expressed a higher likelihood of an emerging national health crisis, although they were not more concerned than men that attending campus events would result in virus contraction. Other groups (e.g., white, students younger than 25, highest income group) displayed similar concern about a national-level crisis, yet were significantly less concerned about contracting COVID-19 from attending campus events than others. Also, participants randomly assigned to information emphasizing the national impacts of food waste expressed significantly greater concern of contracting COVID-19 by attending campus events. These results provide some initial insight about how people perceived national and personal risks in the early stages of the COVID-19 crisis in Louisiana.

scholarly journals Attitudes and Perceptions Toward COVID-19 Digital Surveillance: Survey of Young Adults in the United States (Preprint)

2020 ◽  
Author(s):  
Lauren Maytin ◽  
Jason Maytin ◽  
Priya Agarwal ◽  
Anna Krenitsky ◽  
JoAnn Krenitsky ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Young Adults ◽  
Online Survey ◽  
The United States ◽  
Contact Tracing ◽  
Health Crisis ◽  
Response Options ◽  
Health Technologies ◽  
Digital Surveillance

BACKGROUND COVID-19 is an international health crisis of particular concern in the United States, which saw surges of infections with the lifting of lockdowns and relaxed social distancing. Young adults have proven to be a critical factor for COVID-19 transmission and are an important target of the efforts to contain the pandemic. Scalable digital public health technologies could be deployed to reduce COVID-19 transmission, but their use depends on the willingness of young adults to participate in surveillance. OBJECTIVE The aim of this study is to determine the attitudes of young adults regarding COVID-19 digital surveillance, including which aspects they would accept and which they would not, as well as to determine factors that may be associated with their willingness to participate in digital surveillance. METHODS We conducted an anonymous online survey of young adults aged 18-24 years throughout the United States in June 2020. The questionnaire contained predominantly closed-ended response options with one open-ended question. Descriptive statistics were applied to the data. RESULTS Of 513 young adult respondents, 383 (74.7%) agreed that COVID-19 represents a public health crisis. However, only 231 (45.1%) agreed to actively share their COVID-19 status or symptoms for monitoring and only 171 (33.4%) reported a willingness to allow access to their cell phone for passive location tracking or contact tracing. CONCLUSIONS Despite largely agreeing that COVID-19 represents a serious public health risk, the majority of young adults sampled were reluctant to participate in digital monitoring to manage the pandemic. This was true for both commonly used methods of public health surveillance (such as contact tracing) and novel methods designed to facilitate a return to normal (such as frequent symptom checking through digital apps). This is a potential obstacle to ongoing containment measures (many of which rely on widespread surveillance) and may reflect a need for greater education on the benefits of public health digital surveillance for young adults.

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