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The National Institutes of Health (NIH) recognized the need for a research program to address the underlying structural factors that impact health. To inform the development of the NIH Common Fund Community Partnerships to Advance Science for Society (ComPASS) Program, NIH obtained input through community listening sessions. Through its design, ComPASS recognizes the essential role of community organizations as the lead in addressing persistent structural and social challenges to accelerate progress toward advancing health equity. (Am J Public Health. 2024;114(7):685–689. https://doi.org/10.2105/AJPH.2024.307656) [ABSTRACT FROM AUTHOR]

The article discusses the need to focus on the centrality of work or its absence in the lives of virtually everyone by bringing worker health and safety into the mainstream of public health. Topics include climate change-related hazards, consequences of failures of collaboration and communication between the occupational safety and health (OSH) regulatory system and the mainstream public health system, and challenges in integrating OSH with mainstream public health and health care.

Objectives. To produce a database of private insurance hearing aid mandates in the United States and quantify the share of privately insured individuals covered by a mandate. Methods. We used health-related policy surveillance methods to create a database of private insurance hearing aid mandates through January 2023. We coded salient features of mandates and combined policy data with American Community Survey and Medicare Expenditure Panel Survey–Insurance Component data to estimate the share of privately insured US residents covered by a mandate from 2008 to 2022. Results. A total of 26 states and 1 territory had private insurance hearing aid mandates. We found variability for mandate exceptions, maximum age eligibility, allowable frequency of benefit use, and coverage amounts. Between 2008 and 2022 the proportion of privately insured youths (aged ≤ 18 years) living where there was a private insurance hearing aid mandate increased from 3.4% to 18.7% and the proportion of privately insured adults (19–64 years) increased from 0.3% to 4.6%. Conclusions. Hearing aid mandates cover a small share of US residents. Mandate exceptions in several states limit coverage, particularly for adults. Public Health Implications. A federal mandate would improve hearing aid access. States can also improve access by adopting exception-free mandates with limited utilization management and no age restrictions. (Am J Public Health. 2024;114(4):407–414. https://doi.org/10.2105/AJPH.2023.307551) [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). The MEPS is widely used to study how policy changes and major shocks, such as the COVID-19 pandemic, affect insurance coverage, access, and preventive and other health care utilization and how these relate to population health. We describe how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules. The impact of the pandemic on response rates varied considerably across the MEPS. Investigations to date show little effect on the quality of data collected. However, lower response rates may reduce the statistical precision of some estimates. We also describe several enhancements made to the MEPS that will allow researchers to better understand the impact of the pandemic on US residents, employers, and the US health care system. (Am J Public Health. 2021;111(12):2157–2166. https://doi.org/10.2105/AJPH.2021.306534) [ABSTRACT FROM AUTHOR]

The author discusses an article by Vandenbroucke and Pearce, published in the issue, on technical issues surrounding the measurement of excess deaths during the COVID-19 pandemic. Topics include evidence of deteriorating health among Americans, explanations for the complacency on the deteriorating health outcomes, and concerns of powerful corporations and their shareholders.

Objectives. To identify and categorize US state legislation introduced between January 1, 2021, and May 20, 2022, that addresses emergency health authority. Methods. We adapted standard policy surveillance methods to collect and code state bills and enacted laws limiting or expanding the emergency public health authority of state and local officials and agencies. Results. State legislators introduced 1531 bills addressing public health authority; 191 of those were enacted in 43 states and the District of Columbia, including 17 expanding and 65 contracting emergency authority, 163 regulating use, and 30 preempting local use of specific measures such as mask mandates. Conclusions. State laws setting the scope and limits of emergency authority are crucial to effective public health response. These laws are changing in ways that threaten to reduce response capacity. Tracking changes in health law infrastructure is important for evaluating changes in health authority and ensuring that stakeholders recognize these changes. Public Health Implications. The COVID-19 pandemic called for quick, decisive action to limit infections, and when the next outbreak hits, new laws limiting health authority will make such action even more difficult. (Am J Public Health. 2023;113(3):288–296. https://doi.org/10.2105/10.2105/AJPH.2022.307214) [ABSTRACT FROM AUTHOR]

The article discusses a study by S. H. Woolf, published in the issue on the place of the U.S. in global life expectancy trends. Topics include U.S. life expectancy in global-historical context, reason that life expectancy elsewhere has increased more, and diverse factors that influence life expectancy.

Objectives. To examine trends in partisan polarization of childhood vaccine bills and the impact of polarization on bill passage in the United States. Methods. We performed content analysis on 1497 US state bills (1995–2020) and obtained voting returns for 228 legislative votes (2011‒2020). We performed descriptive and statistical analyses using 2 measures of polarization. Results. Vote polarization rose more rapidly for immunization than abortion or veterans' affairs bills. Bills in 2019–2020 were more than 7 times more likely to be polarized than in 1995–1996 (odds ratio [OR] = 7.04; 95% confidence interval [CI] = 3.54, 13.99). Bills related to public health emergencies were more polarized (OR = 1.76; 95% CI = 1.13, 2.75). Sponsor polarization was associated with 34% lower odds of passage (OR = 0.66; 95% CI = 0.42, 1.03). Conclusions. State lawmakers were more divided on vaccine policy, but partisan bills were less likely to pass. Bill characteristics associated with lower polarization could signal opportunities for future bipartisanship. Public Health Implications. Increasing partisan polarization could alter state-level vaccine policies in ways that jeopardize childhood immunization rates or weaken responsiveness during public health emergencies. Authorities should look for areas of bipartisan agreement on how to maintain vaccination rates. (Am J Public Health. 2022;112(10):1471–1479. https://doi.org/10.2105/AJPH.2022.306964) [ABSTRACT FROM AUTHOR]

Objectives. To detail baseline drinking water sample lead concentrations and features of US state-level programs and policies to test school drinking water for lead in 7 states' operating programs between 2016 and 2018. Methods. We coded program and policy documents using structured content analysis protocols and analyzed state-provided data on lead concentration in drinking water samples collected in public schools during initial testing phases. Results. We analyzed data from 5688 public schools, representing 35% of eligible schools in 7 states. The number of samples per school varied. The proportion of schools identifying any sample lead concentration exceeding 5 parts per billion varied (13%–81%). Four states exceeded 20%. Other program features varied among states. Instances of lead above the state action level were identified in all states. Conclusions. In 2018, many US public school students attended schools in states without drinking water lead-testing programs. Testing all drinking water sources may be recommended. Public Health Implications. Initiating uniform school drinking water lead testing programs and surveillance over time could be used to reduce risk of lead exposure in drinking water. (Am J Public Health. 2022;112(S7):S679–S689. https://doi.org/10.2105/AJPH.2022.306961) [ABSTRACT FROM AUTHOR]

The authors address the Opioid Industry Documents Archive (OIDA) designed to maximize the generation of fundamental new knowledge regarding the opioid overdose epidemic that can inform policies and practice changes to prevent future harms. Topcis discussed include factors that have contributed to the opioid epidemic, brief background of the University of California, San Francisco (UCSF) Industry Documents Library (IDL), and what OIDA contain.

There are few educational programs in the United States that have a primary focus on preparing nurses to engage in all levels of public health, health policy, and climate change. The United Nations sustainability development goals (SDG) and the Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity (2021) report underscored the importance of key stakeholders, including nurses, engaging in advocacy and policy to promote health equity. We discuss the role of nursing at the intersection of public health, policy, climate change, and the SDG. We also discuss the history and merger of the University of California San Francisco (UCSF) School of Nursing public health and health policy specialties, a significant innovation in our effort to promote health equity. We provide a brief overview of the redesigning of our curriculum that meets the needs of today's learners by including content on climate change, data analytics, and racial, social, and environmental justice. Finally, we emphasize the need to train the next cadre of nurses interested in careers in public health and health policy for us to meet the challenges facing our communities. (Am J Public Health. 2022;112(S3):S321–S327. https://doi.org/10.2105/AJPH.2022.306826) [ABSTRACT FROM AUTHOR]

An editorial is presented in which the authors discuss changes made during the COVID-19 pandemic to federal and U.S. state regulations governing methadone take-home doses (THDs) for patients who had been attending daily opioid treatment programs (OTPs). The article examines how the COVID-19 pandemic impacted housing interventions on THD expansion, incarceration, and the significance to public health.

Objectives. To identify key gaps in overdose prevention interventions for mothers who use drugs and the paradoxical impact of institutional practices that can increase overdose risk in the context of punitive drug policies and a toxic drug supply. Methods. Semistructured interviews were conducted with 40 women accessing 2 women-only, low-barrier supervised consumption sites in Greater Vancouver, British Columbia, Canada, between 2017 and 2019. Our analysis drew on intersectional understandings of structural, everyday, and symbolic violence. Results. Participants' substance use and overdose risk (e.g., injecting alone) was shaped by fear of institutional and partner scrutiny and loss (or feared loss) of child custody or reunification. Findings indicate that punitive policies and institutional practices that frame women who use drugs as unfit parents continue to negatively shape the lives of women, most significantly among Indigenous participants. Conclusions. Nonpunitive policies, including access to safe, nontoxic drug supplies, are critical first steps to decreasing women's overdose risk alongside gender-specific and culturally informed harm-reduction responses, including community-based, peer-led initiatives to maintain parent–child relationships. (Am J Public Health. 2022;112(S2):S191–S198. https://doi.org/10.2105/AJPH.2022.306776) [ABSTRACT FROM AUTHOR]

An editorial is presented in which the authors discuss several aspects of the Paris Agreement under the United Nations Framework Convention on Climate Change that may be significant and applicable in global governance of antimicrobial resistance (AMR), particularly in the wake of the COVID-19 pandemic. The authors call for an international treaty concerning pandemics.

The author comments on the essay "Health Justice: A Framework for Mitigating the Impacts of HIV and COVID-19 on Disproportionately Affected Communties, published in the issue, which proposes a health justice framework, specific to HIV and COVID-19, in the context of health and human rights. Topics covered include relationships between health and human rights identified in the early work of Jonathan Mann and colleagues, the structural interventions proposed and inequities in healthcare access.

Objectives. To assess the effect of a 2017 excise tax on sugar and artificially sweetened beverages in Philadelphia, Pennsylvania, on the shopping patterns of low-income populations using Supplemental Nutrition Assistance Program (SNAP) data. Methods. I used a synthetic controls approach to estimate the effect of the tax on Philadelphia and neighboring Pennsylvania counties (Bucks, Delaware, and Montgomery) as measured by total SNAP sales ("SNAP redemption") and SNAP redemption per SNAP participant. I assembled biannual data (2005–2019) from all US counties for SNAP redemption and relevant predictors. I performed placebo tests to estimate statistically significant effects and conducted robustness checks. Results. Detectable increases in SNAP spending occurred in all 3 Philadelphia neighboring counties. Per-participant SNAP spending increased in 2 of the neighboring counties and decreased in Philadelphia. These effects were robust across multiple specifications and placebo tests. Conclusions. The tax contributed to increased SNAP shopping in Philadelphia's neighboring counties across both outcome measures, and decreased spending in Philadelphia (at least by 1 measure). This raises questions about retailer behavior, the effectiveness of the tax's public health aim of reducing sugar-sweetened beverage consumption, and policy aims of investing in low-income communities. (Am J Public Health. 2021;111(11):1986–1996. https://doi.org/10.2105/AJPH.2021.306464) [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433) [ABSTRACT FROM AUTHOR]

The article discusses a study by De Ramos et al which reported on their pioneering study documenting Latino-White inequities in COVID-19 outcomes across U.S. cities. Topics include the recognition of structural racism as the fundamental cause of racial/ethnic inequities in health, disparities over the continuum of COVID-19, and key mechanisms that put Latinos at greater risk for severe illness and death from COVID-19.

An editorial is presented in which the author argues that the number of community health workers (CHWs) in the U.S. must be increased in order to provide essential services to traditionally underserved groups. The editorial refers to an article published in the journal concerning an effort in Detroit, Michigan, involving Medicare health plans, community-based groups, academia, and a health department. The editorial also discusses health disparities amid the COVID-19 pandemic and medical policy.

An editorial is presented in which the authors discuss the public health response to the drug overdose problem in the U.S. as a racial justice issue.