Category Archives: Public health

Public Health and Medicine Are Essential Partners in Advancing Health

By | November 30, 2020
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Historically, public health has served the nation through sanitation, immunization, and other disease-prevention activities (e.g., disease tracking and quarantine). For example, public health developed wastewater treatment programs to help fight typhoid fever during the industrial revolution. It also helped educate the public (and the food industry) on safely preparing and preserving foods. As a result,… Read More »

Pandemic Reminds Us to Pay Attention to Lack of Supplement Regulation in the U.S.

By | November 21, 2020
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During the COVID-19 pandemic, health misinformation has been soaring across the internet and social media platforms. Despite a lack of supplement regulation, vitamin and supplement use have seen a sudden 28% increase in the US and a 25% increase globally during COVID-19. Vitamin C supplements have gained particular attention because of studies finding it might reduce… Read More »

Rural Telehealth in the COVID Era and Beyond

By | November 20, 2020
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National Rural Health Day provides an opportunity to reflect on the quality of medical care in rural and medically underserved communities. This year has posed additional challenges to fragile healthcare systems and vulnerable populations. Faced with new barriers, rural communities are adapting and innovating through telehealth. COVID-19 caught the entire country off balance, highlighting structural… Read More »

Becoming dementia friendly: Less stigma, more inclusion, better care

By | November 11, 2020
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Older man

With a growing recognition of the toll that dementia takes on individuals, families, and communities, there is a movement to prepare our society to better meet the needs of people living with dementia. This movement is referred to as becoming “dementia friendly,” and it can reduce stigma, increase inclusiveness, and improve care. A family example… Read More »

Using Digital Technologies for COVID-19 Exposure Notification and Tracking

By | November 8, 2020
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Our data says a lot about us – where we go, who we see, and what we do. And since our smartphones come with us everywhere, they are almost always collecting our data. To improve my understanding of how our data and devices can be used to fight the COVID-19 pandemic, I sat down with (over… Read More »

There is still much we don’t know about dementia and wandering

By | November 4, 2020
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older adult wandering

John bowled in a Friday night league for 20 years. It was often the highlight of his week – a chance to spend time with friends, blow off some steam, and enjoy some friendly competition. Now 75 and living with dementia, John has tried more than once to walk to a bowling alley that no… Read More »

On the Eve of a Public Health Election

By | November 2, 2020
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Health care and public health loom large today, on the eve of the presidential election. From COVID-19 to the Affordable Care Act (ACA), this is now clearly a public health election. Let’s review what’s on people’s minds and what’s at stake. Where are voters on health issues? In February of this year, health care was… Read More »

Racism in Reproductive Care and Beyond

By | October 29, 2020
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As I scrolled through Ms. Jones’ chart, I jotted down her chronic problems: hypertension, depression, and urinary incontinence. She was taking lisinopril and sertraline. She had seen gynecology back in February for surgical management of the incontinence. The chart said she wanted a hysterectomy as “definitive management.”  It seemed the surgery was canceled due to… Read More »

Is Sleep Driving Up Your Medical Costs?

By | October 22, 2020
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  Millions are losing sleep due to anxiety, fear, and the difficulty of maintaining a schedule during this pandemic. Research suggests that those who get insufficient sleep may be at risk for health conditions such as obesity and heart disease. Yet, too much sleep may increase the risk of other health conditions such as diabetes and… Read More »

APHA 2020 Annual Meeting Preview

By | October 21, 2020
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It’s that time again! The annual meeting for the American Public Health Association starts on October 24th with a twist–this year, the meeting is being held virtually. Everything from social events to scientific sessions will take place online. While I will miss seeing old and new friends in person, I am excited about the meeting.… Read More »

Addressing reproductive coercion during the COVID-19 pandemic

By | October 16, 2020
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Historically, women are disproportionately impacted by pandemic illness and COVID-19 is no exception. Addressing domestic violence (DV) and access to reproductive healthcare may reduce the gendered impact of COVID-19. Before the COVID-19 pandemic, we piloted a program to enhance reproductive health literacy, Sexual Health Empowerment for Birth Control (SHE-BC). This program may offer insights to… Read More »

Health and Housing Equity: a new report released by the American Public Health Association

By | October 12, 2020
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Row of stone buildings with boarded up windows, with new tall buildings all around.

Earlier this fall the American Public Health Association (APHA) released a remarkable report on the relationship between Housing Equity and Health, “Creating The Healthiest Nation: Health and Housing Equity.” APHA’s Caucus on Homelessness is deeply appreciative of the report’s focus on US housing inequalities and the shortcomings of our current affordable housing programs to address… Read More »

Maintaining healthcare access during outbreaks

By | October 6, 2020
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Preserving access to care is a high priority, even in a pandemic. We need to strengthen the existing coordinated regional treatment network for better preparedness. One consequence of the COVID-19 pandemic has been that people are scared to seek health care because they fear getting infected in clinics and hospitals. Although in many cases it… Read More »

COVID-19: Issues of Equity in Allocating Resources

By | September 21, 2020
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Are COVID-19 resources going to who needs them most? Targeting tests, treatments, supplies, and vaccines to those most at risk of COVID-19, such as communities of color, would go a long way toward preventing the spread of the virus and reducing the health disparities exacerbated by the pandemic.  In the face of a dangerous pandemic,… Read More »

Rebuilding the Foundation of Rural Community Health after COVID-19

By | September 17, 2020
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COVID-19 has exposed the cracks in the foundation of America’s rural community health system. These cracks include increased risk of facility closures, loss of services, low investment in public health, maldistribution of health professionals, and payment policies ill-suited to low-volume rural providers. As a result, short-term relief to stabilize rural health systems and long-term strategies… Read More »

Health Equity: Lessons from AcademyHealth 2020

By | September 21, 2020
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Health equity and the disparities within our health care system were the predominant themes at AcademyHealth’s 2020 Annual Research Meeting (ARM), which concluded on August 6th. As usual, health services researchers gathered to disseminate the latest evidence across a broad range of health care topics and discuss the most pressing issues in health services research… Read More »

Potential effects of COVID-19 on health care utilization and quality measures

By | September 17, 2020
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What are the potential impacts of COVID-19 on health care utilization? How will changes in healthcare use impact quality measures? Researchers are asking many key questions to understand the impacts of COVID-19. It is clear that trends in healthcare use are changing. These changes will likely affect quality measure scores in the future. This is… Read More »

Pandemic PPE Waste: An Environmental Health Educational Opportunity

By | September 2, 2020
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PPE pandemic waste is a problem.

In our battle against COVID-19, one of our unique challenges is the use of face-coverings. Despite evidence that supports wearing face coverings, this has become a polarizing issue in a highly politically-divided climate. After shifting mask guidance in the early days of the pandemic, the WHO and the CDC issued formal guidelines on wearing face… Read More »

A Revisionist History of COVID-19

By | August 31, 2020
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Note from the Editors: Last week capped two jam-packed weeks of political nominating convention activities. COVID-19 was discussed at both conventions. The Washington Post fact-checked some of the health care claims at the Democratic convention. Here, with the permission of Kaiser Health News and Politifact, we are republishing their recent fact-checking of the COVID-19 content from the Republican… Read More »

Wildfires: Effects on Health and Care Delivery

By | August 27, 2020
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Climate change is a contributory factor to wildfires in California this year that have engulfed 1.4 million acres of land.  Most recently, lightning strikes sparked new fires in Northern California, including the L.N.U. Lightning Complex (currently the third largest fire in California history).  Wildfires contribute to poor health outcomes and disrupt care delivery.  In addition, the… Read More »

After COVID-19, We Must Build Back Better

By | August 17, 2020
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The COVID-19 pandemic has brought to light the gross underinvestment in public health, primary care, and the social determinants of health in the United States. Yet, this experience gives us a chance to rethink our health and social service systems, as these are often siloed. We see education, employment, healthcare, housing, and other social services… Read More »

In COVID-19 Response, ICE May Be Misusing a Common Disinfectant in Detention Facilities

By | August 6, 2020
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The U.S. government is reportedly harming people held in immigration detention centers with its excessive use of a common disinfectant. According to reports by immigrant advocacy groups, HDQ Neutral disinfectant is being sprayed dozens of times per day in enclosed environments. This is resulting in concerning health symptoms among detained people. This potentially egregious practice further… Read More »

Implementation of HCV Treatment Programs

By | November 8, 2022
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Successfully implementing an intervention within a complex service delivery system requires multiple, inter-related adoption strategies.  The Veterans Administration’s (VA) renewed emphasis on Hepatitis C treatment offered a perfect opportunity to study which strategies worked. In this post, I will review those findings. Then, I will discuss the importance of accounting for the complexity of strategy… Read More »

Moving Upstream to Reduce Harm from Fake Opioids

By | July 16, 2020
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When a call came in from the county coroner, it was never good news. Every once in a while, her work included a shock big enough to share with the public health team where I served as Medical Director. This was the case that Monday afternoon. Two teenage deaths, likely from opioid overdoses, likely the… Read More »

COVID-19 & Violence Against Healthcare Workers

By | July 13, 2020
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As COVID-19 cases continue to rise, the pandemic has spotlighted the heroic efforts of our nation’s healthcare workers. Healthcare workers are providing much needed front-line patient care. However, in doing so, they also place themselves at risk of exposure to infectious disease, psychological distress, and burnout. But as the COVID-19 pandemic continues, another concern for… Read More »

Deportation and the Traumatizing of a Generation

By | June 18, 2020
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With less than five weeks to go before welcoming a second child, the patient sat in my exam room in tears. By all accounts, this was a routine appointment at the end of a routine pregnancy. Except on this particular day, clutching family photos from their recent baby shower, the patient shared with me that… Read More »

Framing Success for Supportive Housing Services

By | June 11, 2020
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In this post we reflect on the definition of success in a study measuring the value of peer support services administered through the HUD VASH program and discuss client-centered definitions of value. We propose designing and understanding programmatic success goals tailored to unique need categories within veteran participant groups. With stay-at-home orders lifting all across… Read More »

#SexEdForAll: What We Need to Prevent Intimate Partner Violence

By | June 1, 2020
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We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that! That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in… Read More »

Spain, Belgium, and Others Are Releasing Immigrant Detainees During COVID-19. Why the United States Should, Too

By | May 29, 2020
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May 6 heralded another grim milestone in the United States: the first COVID-19-related death of an Immigration and Customs Enforcement (ICE) detainee, a 57-year-old man from El Salvador. Despite having high blood pressure and possibly diabetes, he had been denied release on bond by a judge. He continued to be held in Otay Mesa Detention… Read More »

For pennies on the dollar, public health is succeeding out of the spotlight

By | May 26, 2020
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Every night at 8pm, my neighborhood in Los Angeles, like many, cheers for the front-line health care providers who care for our communities. My family joins in the nightly raucous thanks. But a few nights ago, we paused. Where were the cheers for the public health professionals? Medical professionals have been in the spotlight, doing the… Read More »

COVID-19: Lessons for Climate Change Strategy

By | May 13, 2020
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We are in the midst of two global public health catastrophes: the rapid spread of COVID-19 and the more insidious, chronic effects of climate change. The swift spread of COVID-19 has devastated many countries and their economies. But global changes in environmental conditions have been harming communities for decades. The World Health Organization estimates that… Read More »

Beyond Evidence Reporting: Evidence Translation in an Era of Uncertainty

By | June 12, 2020
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illustration of audience for evidence translation

For decades, peer-reviewed journals have been a critical pathway for disseminating and advancing scientific knowledge. However, curbing the spread of misinformation requires evidence translation by experts into plain English. The rapidly evolving knowledge base on COVID-19 shines a spotlight on the issue. For example, a recent article in the New England Journal of Medicine offered… Read More »

Risks of inpatient psychiatry during COVID-19 and beyond

By | May 3, 2020
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Two patients sitting in a common area of a psychiatric ward, watching television

COVID-19 has revealed many vulnerabilities in our societal structure. One particular vulnerability is the risk inherent in our use of congregate institutions to house and treat people. This includes the risks of inpatient psychiatric facilities. Inadvertently, the pandemic has surfaced critical questions that we should seek to answer even when the virus is under control: What is the right… Read More »

COVID-19 and homelessness

By | May 1, 2020
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Our neighbors who are experiencing homelessness during this SARS-COV-2 pandemic are facing unique risks and extreme hardships. In the corner of American society almost defined by economic and racial disparities, COVID-19 has compounded and taken advantage of these long-standing vulnerabilities. An outsized burden of risk factors for COVID-19 compound the risks of crowded shelters and… Read More »

Telehealth for Addiction, Part 2 – Confidentiality: Real Concerns in Virtual Settings

By | April 22, 2020
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As of April 17, 2020, the novel coronavirus has infected more than 2.4 million people globally and led to 170,000 deaths. The global response to the COVID-19 pandemic largely emphasizes social distancing and shelter-in-place ordinances. These policies impact everyone, also upending the lives of those not directly affected by the virus COVID-19 pandemic. Like other… Read More »

Access to Abortion during COVID-19 and Beyond

By | April 19, 2020
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Women do not stop needing access to abortions in a pandemic.  They should not need to place themselves and others at risk of COVID-19 to access one.  But that is exactly what is happening — due in part to new bans, but mostly as a result of years of dwindling access across the country. The current… Read More »

Is hydroxychloroquine ready for prime time for COVID-19? Not just yet.

By | April 17, 2020
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In early April, President Trump, in his daily press briefing, told Americans to take the drug hydroxychloroquine, calling it a “game changer” for people with COVID-19: “I really think they should take it. But it’s their choice. And it’s their doctor’s choice or the doctors in the hospital. But hydroxychloroquine. Try it, if you’d like.”… Read More »

COVID-19: High risk of severe illness

By | April 13, 2020
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There is a lot of attention being paid to the proportions of severe and fatal cases in discussions of COVID-19. Unless you’ve been living under a rock since January, you know that there are groups who are more likely to get very sick or die during this pandemic. In this post, we explore the evidence… Read More »

COVID-19 and Rural America

By | April 17, 2020
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We have seen hospitals filled, high daily death tolls, and exhausted healthcare workers in large cities, like New York and Seattle. How will COVID-19 affect rural America? While initially many rural Americans felt protected by nature of their location, they are now feeling the effects of COVID-19 close to home. Small towns may serve as… Read More »

Telehealth for Addiction: Online Support Groups

By | April 7, 2020
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The current requirements for social distancing affect support groups for people with substance use disorders, but online support groups may provide the perfect solution. This post is the first in a series of planned posts on telehealth for addiction. COVID-19, the disease caused by the novel coronavirus called SARS-CoV2, is putting tremendous strain on all… Read More »

COVID-19: health and the coming economic recession

By | April 3, 2020
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The first reports of COVID-19, the name now used to describe the disease caused by a novel coronavirus, first emerged around New Year’s day of 2020. Since then, the conversation has shifted from containment efforts in Wuhan, China to social distancing and mandatory closures across the U.S., including in New York, California, Illinois [pdf], Massachusetts,… Read More »

Crafting more effective homemade masks and putting them to work

By | March 30, 2020
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The COVID-19 pandemic is placing healthcare professionals in the untenable position of rationing personal protective equipment (PPE) and working with suboptimal protection. This post explores which materials may be best suited for crafting homemade masks and considers how to use homemade masks productively. Personal protective equipment is critical when caring for patients with respiratory infection.… Read More »

Local health departments and COVID-19

By | April 27, 2020
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Public Health Systems Say No to COVID-19

The rapid emergence of COVID-19 reminds us of the importance of the public health system. Local health departments (LHDs) play a central role in emergency preparedness and response. Effective epidemic response rests on the performance of the essential public health activities— assessment, policy development, and assurance—by LHDs. Evidence suggests that LHDs can improve population health… Read More »

Healthcare utilization in the SARS-CoV-2 pandemic

By | April 22, 2020
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This post summarizes what we know right now about the SARS-CoV-2 virus and the disease it causes, COVID-19. The information contained in this post may change as the situation changes, or may become obsolete. We will attempt to update if any of this changes substantively.  News and social media outlets have fallen short of useful… Read More »

Updated guidance on using telehealth during this public health emergency

By | April 15, 2020
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telehealth

Yesterday, the Centers for Medicare and Medicaid Services (CMS) unveiled new guidance about using telehealth during this public health emergency due to the coronavirus outbreak.  This guidance will help increase access to telehealth services.  In addition, this will help people receive care who may not be able to visit their providers in person.  While the… Read More »

Using Telehealth to Fight the Novel Coronavirus

By | March 10, 2020
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tablet for telehealth

COVID-19, the disease caused by the novel coronavirus, is spreading across the US and around the world. Can providers use telehealth to help  identify and manage the novel coronavirus while helping organizations manage capacity and prevent the spread of COVID-19?  Read on to find out more. Because of its airborne person-to-person transmission, coronavirus and related… Read More »

The myth of female hysteria and women’s health disparities

By | March 5, 2020
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What role might the myth of “female hysteria” play in women’s health disparities? For thousands of years, women’s health complaints were often diagnosed as “female hysteria” – a catch-all term that basically implied “it’s all in her head.” The condition was sometimes believed to be caused by a wandering uterus and/or sexual frustration. Doctors treated… Read More »

Are Community Health Workers Worth It?

By | February 2, 2022
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Patients are sometimes referred to as “frequent flyers” when they visit an emergency department multiple times for the same issue. Often this is because discharged patients miss necessary follow-up care. This results in further worsening health, and may contribute to the frequent flying. To address this cycle, patients may be referred to a community health… Read More »

Much ado about rural health

By | February 5, 2020
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As of late, rural health has been a hot topic and buzzword in the public health and health policy spheres. Health Affairs recently published an entire issue related to topics on rural health. The American Journal of Public Health recently issued a call for manuscripts for a special issue dedicated entirely to rural health. Rural… Read More »