The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgia.The agency's main goal is the protection of public health and safety through the control and prevention of disease, injury, and disability in the US and worldwide. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. The CDC also conducts research and provides information on non-infectious diseases, such as obesity and diabetes, and is a founding member of the International Association of National Public Health Institutes.The current Director of the CDC is Rochelle Walensky. The Director reports to the United States Secretary of Health and Human Services.
Objective:Develop a near-comprehensive opioid medications valueset for population measures of opioid related treatments and outcomes. The opioid valueset should be free, open source, and conform to the RxNorm standard federally mandated in every US-certified electronic health record. Materials and Methods:Cumulus opioid valueset was manually curated by the authors and expanded using computer assisted curation. Opioid classifier rules were developed to select opioid RxNorm concepts with known opioid receptor interactions, ingredients, keywords, and drug product formulations. Twelve publicly available valuesets were used to develop and validate the Cumulus opioid valueset. Validation accuracy was measured against a corpus of opioid medication orders and non-opioid pain relievers. Results:Cumulus opioid valueset recall was >99.9% when measured against opioid prescription RxNorm codes from UC Davis Health and Brigham and Women's Hospital. Cumulus opioid valueset was 100% specific compared to three valuesets of non-opioid pain relievers. Discussion and Conclusion:To the authors' knowledge, Cumulus opioid valueset is the largest publicly available valueset of opioid medications (8926 RxNorm concepts). The intended use of this opioid valueset is for population health measures of opioid medications and related patient outcomes.
CONTEXT:Public health emergencies disproportionately affect marginalized communities across the United States, challenging public health to address local-level factors contributing to persistent differences in community health outcomes. The Centers for Disease Control and Prevention (CDC) capability standards for public health preparedness recommend strengthening community partnerships to better understand and address these factors, including engagement of trusted community spokespersons. Even with growing governmental public health interest in community engagement, more examples are needed for deeper engagement across the public health emergency spectrum. APPROACH:Using 2 US-based case studies, we explore how to deeply engage communities throughout the preparedness-response-recovery continuum to help mitigate disproportionate outcomes of public health emergencies. IMPLEMENTATION:Community-led groups in Detroit and Dearborn, Michigan and Helena, Arkansas identified priority public health challenges and advised on how to address them. In Detroit, Wayne State University's Hub for Evaluation and Learning set up a Community Steering Council that identified challenges in housing and mental health as key indicators of poor public health. In Helena, the Healthy Community Initiative, through its Community Action Board, identified and addressed a severe water crisis with input from community health workers. Both communities set up mechanisms for community members to share their concerns and help public health address these issues as part of their prevention strategies. EVALUATION:Both communities reported improved capacity to identify and respond to public health crises through engagement with local leaders and creation of community-led groups for consistent involvement before, during, and after public health events. DISCUSSION:Local leadership groups are uniquely positioned to maintain relationships with communities at higher risk for negative public health outcomes. Such groups can draw upon community knowledge and assets to develop solutions tailored to area-specific assets and needs. Successful public health outcomes in disproportionately impacted communities are more likely when governmental public health considers community groups as integral to the public health infrastructure.
BackgroundMaternal and Perinatal Death Surveillance and Response (MPDSR) is an important accountability mechanism for preventing avoidable deaths and addressing gaps in care. Health facilities in resource constrained settings often face barriers to implementing and sustaining MPDSR. The purpose of this study was to identify factors that may influence MPDSR implementation outcomes in health facilities in Tanzania.MethodsSemi-structured, in-depth interviews (IDIs) were conducted in January 2024 with 17 delivery care providers (e.g., doctors, midwives, anesthesiologists) and 5 health administrators who oversaw or facilitated the facility's MPDSR process. The implementation outcomes framework and the Practical, Robust, Implementation and Sustainability Model (PRISM) were used to guide the study, the development of interview guides, and analysis. We analyzed transcripts using a multistage approach and the constant comparative method.ResultsWe identified several factors that may have impacted MPDSR implementation outcomes, which we grouped into three primary themes: (1) organizational and staff perspectives on MPDSR, (2) characteristics of the implementation setting, and (3) implementation and sustainability infrastructure. Subthemes included more specific barriers and facilitators that were related to MPDSR implementation outcomes. Prominent facilitators included positive perspectives of MPDSR, ongoing training and mentorship, and community engagement. Major barriers included lack of organizational readiness, resource, financial and other constraints, and blame culture.ConclusionsIdentifying factors that influence MPDSR implementation outcomes is important for understanding barriers and facilitators to implementation. Fostering safe environments (i.e., no blaming), addressing barriers to staff participation and motivation, and implementing monitoring systems for MPDSR recommendations may help strengthen implementation outcomes and, ultimately, sustainability.
BACKGROUND:Early-onset colorectal cancer (EOCRC) is rising nationally, with South Dakota experiencing a reversal in historical trends. Traditionally, American Indian populations have had higher EOCRC rates attributed to healthcare access disparities and socioeconomic factors. Recent data now reveals that the White population exhibits higher EOCRC incidence in South Dakota. METHODS:We analyzed data from the South Dakota Cancer Registry (2007-2022) to calculate EOCRC incidence rates for American Indian and White populations. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were computed. Behavioral risk factors and insurance coverage were also reviewed. RESULTS:The White population's EOCRC incidence rose to 9.6 per 100,000 in 2018-2022, surpassing the American Indian rate of 7.8 per 100,000 (IRR = 1.27, 95% CI: 1.10-1.45). From 2021 to 2022, insurance coverage improved for both American Indians (46.6% to 55.5%) and Whites (81.5% to 83.4%). However, lifestyle disparities persisted. In 2021, American Indians reported higher fruit but lower vegetable intake than Whites. In 2022, physical activity was lower among American Indians (63.3%) than Whites (77.8%). In 2022-2023, obesity prevalence was significantly higher among American Indians (50.2%) than Whites (34.7%). Binge and heavy drinking percentages were elevated among Whites (30.8% and 10.1%, respectively) compared to American Indians (20.0% and 5.4%). Commercial tobacco use was reported higher among American Indians (45.1%) when compared to Whites (27.0%). CONCLUSION:This shift highlights the success of American Indian-focused interventions and underscores emerging challenges among the White population.
Annually, there are 5.57 to 9.23 million typhoid fever cases and 46,200 to 163,000 associated deaths, mainly in low- and middle-income countries. High incidence is estimated in the Southeast Asian, African, and Eastern Mediterranean (EMR) regions of the WHO. We reviewed EMR typhoid surveillance and vaccination recommendations to inform regional prevention and control efforts. Separate surveys were sent to surveillance and immunization officers in all 21 EMR countries and the occupied Palestinian territory, with 17 surveys (77%) and 13 surveys (59%) completed, respectively. Fifteen countries routinely collected typhoid surveillance data. Eleven countries (73%) used standard case definitions. Nine countries (53%) implemented health facility-based surveillance with laboratory confirmation. Five countries (33%) primarily used blood culture (the gold standard). Seven countries performed antimicrobial susceptibility testing, and two countries recommended typhoid vaccination. Strengthening typhoid and antimicrobial resistance surveillance is important to monitor burden and resistance trends and inform typhoid prevention and control measures.
