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Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers' needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard "good practices" for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use.

In 2006, the National Institutes of Health (NIH) initiated the Clinical and Translational Science Awards (CTSAs) as part of the NIH Roadmap Initiative, in order to improve the conduct and impact of NIH's clinical and translational research portfolio. The CTSA program is intended not only to transform the training programs and research infrastructure at individual academic institutions, but also to create a nation-wide collaborative consortium to transform the biomedical research enterprise. In January 2009, the NIH CTSA National Consortium adopted Strategic Goals to maximize the CTSAs' impact on the Nation's healthcare and health. Of these, the CTSA Strategic Goal 4 is to promote the translation of the results of clinical and translational research into practice and public policy. To advance this goal, a committee was constituted to focus on the organization and development of the CTSA Consortium's comparative effectiveness research (CER) capacity, an increasingly important component of research translation into practice and policy. This Committee's Workgroups took on a number of deliverables in service of this objective, including producing this White Paper on how the CTSA Consortium might best facilitate CER, for NIH's Institutes and Centers (ICs), other Federal agencies, outside stakeholders, and the healthcare system overall. This White Paper offers some specific suggestions for how the CTSA Consortium might support this emerging and crucial national effort to generate, synthesize, and disseminate CER in order to improve healthcare decision-making and health outcomes. Important points of reference for this White Paper are two Congressionally mandated reports on CER released at the end of June 2009, one by the Institute of Medicine (IOM) and another by the Federal Coordinating Council for CER (FCC-CER). The definitions of CER by each report, and their recommendations for the CER enterprise, are highly germane to the purpose of this CTSA Consortium White Paper. The CER definition used in the IOM Report was, "The generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist patients, clinicians, purchasers, policy makers, and the public to make informed decisions that will improve health care at both the individual and population levels."… [ABSTRACT FROM PUBLISHER]

Medical folk wisdom (MFW) refers to widely held, but factually inaccurate, beliefs about disease, immunity, pregnancy, and other medically-relevant topics. Examples include the idea that fasting when feverish ("starving a fever") can increase the pace of recovery, or that showering after sex can prevent pregnancy. The pervasiveness of MFW, and whether or not it-like other forms of medically-relevant misinformation-shapes Americans' health behaviors and policy preferences is an important and under-studied question. We begin this research by proposing and validating a novel measure of MFW; including a short-form scale suitable for administration in public opinion surveys. We find that nearly all Americans-irrespective of socio-economic status, political orientation, and educational background-endorse at least some aspects of MFW. Concerningly, and consistent with the idea that folk wisdom challenges scientific expertise, we additionally find that those highest in MFW tend to place less value on medical expertise and the role experts play in shaping health policy. However, this skepticism does not appear to translate to peoples' health actions, as MFW appears to have an inconsistent effect on public participation in healthy behaviors.

The article focuses on the guidelines released by the Food & Drug Administration (FDA), which demonstrates the flexibility and willingness of the department to engage regulated entities in the U.S. It provides specific definitions for source documentation and direct data entry, and recommendations on how to use computerized systems in clinical investigations. It also includes advice for clinical sites, analytical laboratories, and central laboratories. INSET: FDA Regulations vs Guidances.

This article presents the necessary role of public health and population-based programs for supporting and enhancing the effectiveness of a reformed health care insurance system in the U.S. Preventive measures focused on chronic and infectious diseases and injuries provide much of the substance of these programs, but there are also core public health functions that are necessary to support and sustain efforts that address the health needs and conditions of populations, as distinct from individuals. The importance of a population-based approach is illustrated by a report, cited in a 1982 study by the Institute of Medicine, which concluded that only 10 percent of premature deaths in the U.S. could have been avoided through improvements in access to medical treatment. For health care reform to succeed, the supporting and complementary functions of public health must be enhanced. If the amount used by State and local health agencies and the U.S. Public Health Service for public health functions had maintained their proportionate position to the treatment services they support, their 1993 level would have been nearly 30 percent more than it actually is. The debate on reform of the U.S. health care system offers both mandate and opportunity to redress the erosion that has occurred in the public health infrastructure by establishing a secure and adequate funding base for the core functions of public health at every level.

The Safe Motherhood Initiative has successfully stimulated much interest in reducing maternal mortality. To accelerate programme implementation, this paper reviews lessons learned from the experience of industrial countries and from demonstration projects in developing countries, and proposes intervention strategies of policy dialogue, improved services and behavioural change. A typological approach with three hypothetical settings from resource poor to resource rich environments is used to address the variability in health behaviours and infrastructure encountered when programming for safe motherhood.

Background: Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas., Methods: A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document., Results: Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards., Conclusions: Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S., (© 2024. The Author(s).)

In recent years, there have been numerous calls by researchers to adopt multi-disciplinary and international perspectives to address the HIV pandemic. Meaningful and prudent public health policy should be based on sound empirical data and research. Henceforth, our study aims to contribute to the current literature by conducting a comprehensive global mapping and determine the landscapes of HIV/AIDS research covering the years between 1983 and 2017. Bibliometric and content analysis was used to describe trends in research productivity, usages, research collaborations, and clusters of research topics. Exploratory factor analysis, Jaccard's similarity index, and Ward dendrogram were applied to abstracts' contents to determine the development of interdisciplinary research landscapes. The United States of America continues to lead in research production and be main hub for author- and countrylevel collaborations. Research employing an epidemiological, social, and/or behavioral perspective for studying HIV/AIDS was found to dwarf in the presence of basic and biomedical HIV research. Interdisciplinary approaches to HIV research have been increasing with the creation of various research landscapes: strong constructs of studies examining health status, clinical responses, and HIV treatment, risk behaviors have been formed, while research topics relating to psycho-behavioral and cultural aspects as well as services have emerged along. To effectively prevent and control the disease, more researches are needed to provide culturally relevant and/or contextualized evidence of effective inter pracventions. It is also necessary to enhance the ability and partnership of local researchers as well as invest in research infrastructure at national and regional levels to implement high-quality studies since they are the "gate-keepers" who could respond to local changes in a timely manner. These types of research could be a helpful guide for international donors, governments, and academicians to set up research priorities in target groups and settings, and to develop future research agendas globally. [ABSTRACT FROM AUTHOR]

Introduction: This paper explores racial and socioeconomic disparities in newborn screening (NBS) policies across the United States. While inter-state inequality in healthcare policies is often considered a meaningful source of systemic inequity in healthcare outcomes, to the best of our knowledge, no research has explored racial and socioeconomic disparities in newborn screening policies based on state of residence., Methods: We investigate these disparities by calculating weighted average exposure to specific NBS tests by racial and socioeconomic group. We additionally estimate count models of the number (and type) of NBS conditions screened for by state racial and socioeconomic composition., Results: Adding to the knowledge base that social determinants of health and health disparities are linked, our analysis surprisingly reveals little evidence of substantial inter-state inequity in newborn screenings along racial and socioeconomic lines., Discussion: While there is substantial nationwide racial and socioeconomic inequity in terms of infant health, the distribution of state-level policies does not appear to be structured in a manner to be a driver of these disparities. Our findings suggest that efforts to reduce inequities in outcomes related to NBS should shift focus toward the delivery of screening results and follow-up care as discussion builds on expanding NBS to include more conditions and genomic testing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bedford and Vachuska.)

With the development of the market economy, agricultural trade has become more and more significant for the development of the agricultural economy, which has triggered people's further thinking and exploration on the impact of agricultural trade on agricultural carbon emissions. This paper takes the measurement of trade implied carbon as the carbon dioxide emission index under the impact of agricultural trade and analyzes the impact of trade implied carbon and implied carbon balance on carbon emission. Taking the impact of Sino-US agricultural trade as an empirical background, this paper measures the impact of environmental changes in agricultural trade opening on China's agricultural development and its carbon emissions, so as to predict changes in China's regional agricultural carbon emissions performance. After calculation, it is found that the scale of China's exports has decreased by 0.089%, which is lower than the decline of 0.361% in the United States. The trade conflict has a significant impact on China's import and export structure. Under the scenario of mutual tariffs on agricultural products, China's exports to the United States are expected to decrease by 6.28%, while China's imports from the United States decreased by 13.02%. The Sino-US agricultural trade dispute will reduce China's carbon emissions by 0.013% and the United States' carbon emissions by 0.024%, which is related to the negative impact on the economy. Improving the performance of agricultural carbon emissions is not only the need for the green and sustainable development of the agricultural economy but also conducive to improving the international competitiveness of agricultural products. [ABSTRACT FROM AUTHOR]

The article addresses further debate and decision-making by the American Public Health Association (APHA) on a public policy statement on safe drinking water. The paper provides the scientific basis and justification for the importance of improving water supplies in the U.S. The quality and safety of drinking water in the U.S. continues to be an important public health issue. Specific contaminants of concern include microbial contaminants and chemical contaminants. Recommended goals for the APHA are to foster greater involvement of the public health professional as advisor, educator and advocate on issues related to drinking water and health, and to promote understanding in public health practice and policy making of the potential public impact of water contamination.

Vaccine mandates can take many forms, and different kinds of mandates can implicate an array of values in diverse ways. It follows that good ethics arguments about particular vaccine mandates will attend to the details of individual policies. Furthermore, attention to particular mandate policies-and to attributes of the communities they aim to govern-can also illuminate which ethics arguments may be more salient in particular contexts. If ethicists want their arguments to make a difference in policy, they should attend to these kinds of empirical considerations. This paper focuses on the most common and contentious vaccine mandate reform in the contemporary United States: the elimination of nonmedical exemptions (NMEs) to school and daycare vaccine mandates. It highlights, in particular, debates about California's Senate Bill 277 (SB277), which was the first successful recent effort to eliminate NMEs in that country. We use media, secondary sources, and original interviews with policymakers and activists to identify and evaluate three ethics arguments offered by critics of SB277: parental freedom, informed consent, and children's rights to care and education. We then turn to one ethics argument often offered by advocates of SB277: harm prevention. We note, however, that three arguments for mandates that are common in the immunization ethics literature-fairness/free-riding, children's rights to vaccination, and utilitarianism-did not play a role in debates about SB277., (© 2023 John Wiley & Sons Ltd.)

According to results of a survey of state Medicaid, health and welfare agencies, these agencies spent $61 million in federal and state funds on the provision of the contraceptive implant to low-income women in FY 1992. Some $57 million of this was federal funds, with Medicaid accounting for 84% of all public funds spent on the implant; only nine states committed monies from their own coffers. The Medicaid agencies of 13 states reported restrictions on the number of subsidized implants a woman could receive over her reproductive lifetime. No Medicaid agency has provisions to cover required or requested removals of the device among users who become ineligible for Medicaid while the implant is in place; only eight health departments have policies ensuring subsidized removals for such women.

Introduction: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-communicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasibility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs).Methods: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for 'Community Health Workers' and 'breast cancer screening', and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs.Results: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions.Conclusion: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct performance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area. [ABSTRACT FROM AUTHOR]

This article reports that the U.S. National Institutes of Health (NIH) has released a draft policy aimed at increasing public access to the results of NIH-funded research. In July, a congressional spending panel recommended that NIH post Mill-funded manuscripts within 6 months of publication, or immediately if NIH grants were used to pay publication costs. Librarians, patient organizations, and scientists who think taxpayers should have easier access to NIH-funded research urged NIH to follow the House language.

Objective: Although medication abortion has become more common in high-income countries, the procedure has not yet met early expectations for widening access to abortion. High-quality evidence can serve as a catalyst for changes in policy and practice. To direct research priorities, it is important to understand where quality evidence is concentrated and where gaps remain. High-income countries have developed a body of evidence that may have implications for the future of medication abortion. This literature review assesses the characteristics and quality of published studies on medication abortion conducted in the last 10 years in high-income countries and indicates future areas for research to advance policy and practice, and broaden access. Study design: A structured search for literature resulted in 207 included studies. A framework based upon the World Health Organization definition of sub-tasks for medication abortion was developed to categorize research by recognized stages of the medication abortion process. Using an iterative and inductive approach, additional sub-themes were created under each of these categories. Established quality assessment frameworks were drawn upon to gauge the internal and external validity of the included research. Results: Studies in the US and the UK have dominated research on MA in high-income countries. The political and social contexts of these countries will have shaped of this body of research. The past decade of research has focused largely on clinical aspects of medication abortion. Conclusion: Researchers should consider refocusing energies toward testing service delivery approaches demonstrating promise and prioritizing research that has broader generalizability and relevance outside of narrow clinical contexts. Plain English summary: Although medication abortion is more commonly available worldwide, it is not being used as often as people thought it would be, particularly in high income countries. In order to encourage changes in policy and practice that would allow greater use, we need good quality evidence. If we can understand where we do not have enough research and where we have good amounts of research, we can determine where to invest energies in further studies. Many high-income countries have produced research on medication abortion that could influence policy and practice in similarly resourced contexts. I conducted a literature review to be able to understand the type and quality of research on medication abortion conducted in high-income countries in the past 10 years. I conducted the review in an organized way to make sure that the papers reviewed discussed studies that I thought would be important for answering this question. The literature review found 207 papers. Each of these papers were reviewed and organized them by theme. I also used existing methods to determinine the quality of each study. Most of the research came from the US and the UK. Furthermore, most of the research conducted in the past 10 years was focused on clinical studies of medication abortion. In future studies, researchers should focus more on new ways of providing medication abortion to women that offers greater access. Also, the studies should be designed so that the results have meaning for a broader group of people or situations beyond where the study was done. [ABSTRACT FROM AUTHOR]

After three years of global rampage, the COVID-19 epidemic, the most serious infectious disease to occur worldwide since the 1918 influenza pandemic, is nearing its end. From the global experience, medical control and social control are the two main dimensions in the prevention and control of COVID-19. From the perspective of "two types of control", namely medical control and social control, this paper finds that the political system, economic structure, and cultural values of the United States greatly limit the government's ability to impose social control, forcing it to adopt medical control to fight the virus in a single dimension. In contrast, China's political system, economic structure, and cultural values allow its government to adopt stringent, extensive, and frequent social control, as well as medical control to fight the virus. This approach departs from the traditional pathway of fighting the epidemic, i.e., "infection–treatment–immunization", thereby outpacing the evolution of the virus and controlling its spread more rapidly. This finding helps explain why the Chinese government adopted a strict "zeroing" and "dynamic zeroing" policy during the first three years, at the cost of enormous economic, social, and even political legitimacy. It was not until late 2022, when the Omicron variant with the waning virulence became prevalent, that China chose to "coexist" with the virus, thus avoiding a massive epidemic-related death. While the United States adopted a pulsed-style strategy at the beginning of the epidemic, i.e., "relaxation–suppression–relaxation–suppression", and began to "coexist" with the virus in just one year, resulting in a large number of excess deaths associated with the epidemic. The study contributes to explaining the difference in the interplay between public health priorities and COVID-19 response strategies in China and the United States, based on the specific public health context and the perspective of "medical control" and "social control". [ABSTRACT FROM AUTHOR]

The article provides information on how to print Medicaid prescriptions. The author shares his technique by using a blank, tamper-resistant check paper to meet the requirements for Medicaid prescriptions that the U.S. Centers for Medicare & Medicaid Services began phasing. He assures that the paper has enough security features to meet the requirements and it costs a tenth of other options.

Introduction: Over the last decade in the United States (US), the burden of chronic disease, health care costs, and fragmented care delivery have increased at alarming rates. To address these challenges, policymakers have prioritized new payment and delivery models to incentivize better integrated health and social services. Policy practice: This paper outlines three major national and state policy initiatives to improve integrated health and social care over the last ten years in the US, with a focus on the Medicaid public insurance program for Americans with low incomes. Activities supported by these initiatives include screening patients for social risks in primary care clinics; building new cross-sector collaborations; financing social care with healthcare dollars; and sharing data across health, social and community services. Stakeholders from the private sector, including health systems and insurers, have partnered to advance and scale these initiatives. This paper describes the implementation and effectiveness of such efforts, and lessons learned from translating policy to practice. Discussion and Conclusion: National policies have catalyzed initiatives to test new integrated health and social care models, with the ultimate goal of improving population health and decreasing costs. Preliminary findings demonstrated the need for validated measures of social risk, engagement across levels of organizational leadership and frontline staff, and greater flexibility from national policymakers in order to align incentives across sectors. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore the interdependence between donor countries' health aid expenditures. The specific form of interdependence considered is the leader effect, whereby an influential country has a positive leverage effect on other donor countries' aid expenditure. The opposite case of a free-rider effect, whereby a single donor country has a negative leverage effect on its peers, is also considered. Design/methodology/approach -- Focusing on the identification of the leader effect avoids the estimation bias present in the identification of the peer group effect, due to endogenous social effect. The empirical analysis focuses on Development Assistance for Health provided by 20 OECD countries over the period of 1990-2009. Aid commitment and aid disbursement are distinguished. Findings -- When aid dynamics, country heterogeneity, and endogeneity are accounted for, there is no evidence that the biggest donor -- the USA, or the most generous donors -- Norway and Sweden, exhibit any leverage effects on other donor countries' aid expenditures. Originality/value -- This is the first paper to examine the leader and free-rider effects in health aid provision as previous studies focus on peer effects. Any evidence of leader or free-rider effects (or the lack of it) adds to the understanding of international political economy especially in the area of foreign aid provision. [ABSTRACT FROM AUTHOR]

This systematic study aims at analyzing the differences between the approach of the European healthcare systems to the pharmaceutical market and the American one. This paper highlights the opportunities and the limitations given by the application of managed entry agreements (MEAs) in European countries as opposed to the American market, which does not regulate pharmaceutical prices. Data were collected from the Organisation for Economic Co-operation and Development (OECD), the European Medicines Agency, and the national healthcare agencies of US and European countries. A literature review was undertaken in PubMed, Scopus, MEDLINE, and Google for a period ten years (2010–2019). The period 2020–2021 was considered to compare health expenditure before and after the SARS-CoV-2 pandemic. Scarce information from national agencies has been given in terms of MEAs related to the COVID-19 pandemic. The comparison between the United States approach and the European one shows the importance of a market access regulation to reduce the cost of therapies, increasing the efficiency of national healthcare systems and the advantages in terms of quality and accessibility to the final users: patients. Nevertheless, it seems that the golden age of MEAs for Europe was during the examined period. Except for Italy, countries will move to other forms of reimbursements to obtain higher benefits, reducing the costs of an inefficient implementation and outcomes in the medium term. [ABSTRACT FROM AUTHOR]

There is a growing recognition in the fields of public health and medicine that social determinants of health (SDOH) play a key role in driving health inequities and disparities among various groups, such that a focus upon individual-level medical interventions will have limited effects without the consideration of the macro-level factors that dictate how effectively individuals can manage their health. While the health impacts of mass incarceration have been explored, less attention has been paid to how the "war on drugs" in the United States exacerbates many of the factors that negatively impact health and wellbeing, disproportionately impacting low-income communities and people of colour who already experience structural challenges including discrimination, disinvestment, and racism. The U.S. war on drugs has subjected millions to criminalisation, incarceration, and lifelong criminal records, disrupting or altogether eliminating their access to adequate resources and supports to live healthy lives. This paper examines the ways that "drug war logic" has become embedded in key SDOH and systems, such as employment, education, housing, public benefits, family regulation (commonly referred to as the child welfare system), the drug treatment system, and the healthcare system. Rather than supporting the health and wellbeing of individuals, families, and communities, the U.S. drug war has exacerbated harm in these systems through practices such as drug testing, mandatory reporting, zero-tolerance policies, and coerced treatment. We argue that, because the drug war has become embedded in these systems, medical practitioners can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and by becoming engaged in policy reform efforts. A drug war logic that prioritises and justifies drug prohibition, criminalisation, and punishment has fuelled the expansion of drug surveillance and control mechanisms in numerous facets of everyday life in the United States negatively impacting key social determinants of health, including housing, education, income, and employment. The U.S. drug war's frontline enforcers are no longer police alone but now include physicians, nurses, teachers, neighbours, social workers, employers, landlords, and others. Physicians and healthcare providers can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and engaging in policy reform. [ABSTRACT FROM AUTHOR]

In June 2022, the United States Supreme Court decision Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade, removing almost 50 years of precedent and enabling the imposition of a wide range of state‐level restrictions on abortion access. Historical data from the United States and internationally demonstrate that the removal of safe abortion options will increase complications and the health risks to pregnant patients. Because the emergency department is a critical access point for reproductive health care, emergency clinicians must be prepared for the policy, clinical, educational, and legal implications of this change. The goal of this paper, therefore, is to describe the impact of the reversal of Roe v. Wade on health equity and reproductive justice, the provision of emergency care education and training, and the specific legal and reproductive consequences for emergency clinicians. Finally, we conclude with specific recommended policy and advocacy responses for emergency medicine clinicians. [ABSTRACT FROM AUTHOR]

INTRODUCTION JUUL is a high-nicotine pod-based vaping device that is popular among adolescents and young adults. On 23 June 2022, the US Food and Drug Administration (FDA) denied authorization to market JUUL, and ordered JUUL Labs to remove products from the US market. The next day, a US federal appeals court temporarily suspended the ban. The mixed public discourse surrounding the FDA ban warrants further investigation. METHODS This study examined Twitter data to describe public reaction to these announcements. Posts containing terms 'JUUL' and/or '#JUUL' (N=97548 unique tweets) were collected from 23 June to 3 July 2022, from Twitter's Streaming Application Programming Interface (API). After removing retweets, we used an inductive approach to become familiar with the data, generated a codebook, and conducted a content analysis on a random sample of n=4000 tweets. RESULTS A total of 2755 (68.9%) tweets discussed JUUL in the context of the FDA ban. News (n=1425/2755; 51.7%) about the JUUL ban, government distrust (n=588; 21.3%), and individual rights (n=253; 9.2%) were the most prevalent themes. Less commonly discussed themes included inconsistencies between policies (n=174; 6.3%), mentions of switching to other products (n=162; 5.9%), smoking cessation (n=99; 3.6%), and craving for JUUL (n=94; 3.4%). Sentiment analysis of JUUL ban-related posts (n=2755) demonstrated that 1989 (72.2%) tweets were categorized as neutral, while anti-ban posts (n=566; 20.5%) were more prevalent than pro-ban posts (n=200; 7.3%). CONCLUSIONS Besides straightforward announcements of the JUUL ban and its suspension, Twitter posts discussed government distrust, individual rights, and policy inconsistencies. While most posts conveyed neutral sentiments, anti-ban posts were almost three times more prevalent than pro-ban posts. Our findings suggest that text-based social media platforms like Twitter may be an effective instrument to understand opinions, attitudes, and beliefs regarding the FDA's JUUL ban. [ABSTRACT FROM AUTHOR]

Chinese medicine has a long history in the United States, dating back to its colonial period and extending up to the present. This essay focuses on the earliest generation of practitioners of traditional Chinese medicine in the United States. Although acupuncture is the modality most commonly associated with Chinese medicine in today's medical marketplace, up until the 1970s, Chinese healers in the United States typically specialized in herbalism. Well before mass emigration from China to the United States began, Chinese material medica crossed the oceans, in both directions: Chinese medicinal teas and herbs came west while Appalachian ginseng went east. Beginning in the 1850s, Chinese immigrants came to the United States and transplanted their health practices, sometimes quite literally by propagating medicinal plants in their adopted home. Over time, Chinese doctors learned how to sell their services to non-Chinese patients by presenting herbalism as "nature's remedies.". [ABSTRACT FROM AUTHOR]

Immediately after the liberation, the health care system debate was studied focusing on the orientation of the American and Soviet medical systems, roughly divided into Lee Yong-seol and Choi Eung-seok. However, the existence of people who are not explained in the American and Soviet health care systems' orientation led to the need to reconsider the existing premise. Therefore, this study identifies the characters that were not explained in the perspective of existing studies, and reevaluates the arguments of Lee Yong-seol and Choi Eung-seok. This paper raises the following questions: First, what is the background of the policy orientation that Lee Yong-seol and Choi Eung-seok had? Second, if there are people who made different arguments from Lee Yong-seol and Choi Eung-seok, what direction did they set and argue? third, how the orientations of Lee Yong-seol and Choi Eung-seok and etc. converge into the answer to the Joint Soviet-American Commission? In response to theses questions, this study confirms the following: first, Lee Yong-seol's and Choi Eung-seok's health care policies were established based on realism and empiricism. As a policyholder, Lee Yong-seol emphasized withholding medical state administration and raising the level of medical education and medical systems according to the condition at that time, although the American system was mobilized by Lee as the basis for his judgment and administrative assets. On the other hand, Choi Eung-seok aimed for a Soviet-style systems in health care but this was realistically put on hold. Choi insisted on the establishment of the Medical Service Associations and rural cooperative hospitals that appeared in Japan's medical socialization movement. In summary, immediately after the liberation, Lee Yong-seol's and Choi Eung-seok's policy arguments were based on policies that could be implemented in Korea, and the American system and Soviet system served as criteria for the policy resources. Second, Jeong Gu-chung and Kim Yeon-ju show that the topography of the health care debate immediately after the liberation was not represented only by Lee Yong-seol and Choi Eung-seok. Both Jeong and Kim were consequently led to medical socialization, which was the implementation of a health care system that encompasses social reform, but the context was different. Jeong drew the hierarchy of the health care system, which peaked in the United States, from the perspective of social evolution based on his eugenics, but the representation suitable for Korea was the Soviet model absorbed into his understanding. On the contrary, Kim argued that representations suitable for Korea should be found in Korea. As national medical care, Kim's idea aimed at a medical state administration that provides equal opportunities for all Koreans. Third, the aspect of convergence to the Joint Soviet-American Commission reply proposal was complicated. Among the policies of Lee Yong-seol, the promotion of missionary medical institutions and the gradual planning of medical institutions converged into the three organizations' proposal, and Choi Eung-seok's policy was almost the same as that of the Democracy National Front and the South Korean Labor Party. However, the medical system of Japan, the colonial home country, appears to have been based on Lee Gap-soo, chairman of the Korean Medical Association in the colonial period, and the plan was in line with the use of the union system of the left-wing organizations' proposal in the south. It was in accordance with a common task to expand health care from colonial conditions to different status.

Introduction: Prior to the COVID-19 pandemic, telehealth utilization was growing slowly and steadily, although differentially across medical specialties in the United States. The pandemic dramatically expanded physician use of telehealth, but our understanding of how much telehealth use has changed in primary care in the United States, the correlates of physician telehealth uptake, and the frequency with which primary care physicians intend to use telehealth after the pandemic are unknown. This paper is designed to assess these important questions. Methods: Using data from an original national survey of 625 primary care physicians conducted from May 14 to May 25, 2021, we investigate the frequency of physician telehealth use before and during the pandemic and intended use after the pandemic. We also assess the correlates of changes in telehealth use by physicians, comparing telehealth use before the pandemic to use during and after the pandemic. Results: The proportion of primary care physicians using telehealth often, jumped from 5.3% (95% CI 3.5, 7.0) before the pandemic to 46.2% (95% CI 42.3, 50.2) during the pandemic. More importantly, over 70% of physicians intended to use telehealth at least occasionally after the pandemic compared to just 18.7% before, with younger physicians, physicians without telehealth training in medical school, and Asian physicians most likely to increase their telehealth use long-term. Discussion: The COVID-19 pandemic has spurred expansion in telehealth use by primary care physicians that will continue to shape care delivery well beyond the pandemic. Policy change could be needed to facilitate this growth of telehealth long-term. [ABSTRACT FROM AUTHOR]

Population ageing is a phenomenon affecting developed and developing countries alike and represents a major global challenge. This paper is concerned with the impact of ageing populations, in developing countries, on the future provision of health and social care services to the growing elderly population. As well as reviewing previous research and available data, the paper presents the findings of a series of qualitative interviews with policy makers and clinicians in a small number of developing countries in various parts of the world. The paper argues that developing countries cannot expect to see major increases in financial resources available to health and social care for the foreseeable future. Thus, the key issue is establishing how best the available public funding for delivering health and social care services to the elderly can best be used to maximize public value at a time when public services around the world face ongoing austerity measures. The paper focuses on a number of key strategic themes to achieve this which are as follows: the strengthening of public health infrastructure and capabilities; the reconfiguration of existing health systems; a stronger focus on elderly medicine as a distinct specialty; a strengthened role for mobile healthcare, particularly in rural areas; the development of models of generic health and social care assistants; the promotion of community based social care; the utilization of appropriate public/ private health care partnerships. [ABSTRACT FROM AUTHOR]

Increasingly, health outcomes are tied to nutritional opportunities based on the availability of foods and cultural patterns of consumption. This paper demonstrates how Esri Community Analyst can help in identifying at-risk communities. The methodology that results argues a means by which national data made available by Esri in a 'one-stop shop' can be utilized in a simplified, user-friendly way to identify specific populations with higher prevalence of certain diseases and areas where nutritional needs are likely unmet. For demonstration purposes, this paper presents a case study for South Carolina, USA. [ABSTRACT FROM AUTHOR]

Fourier analysis can provide policymakers useful information for analysing the pandemic behaviours. This paper proposes a Fourier analysis approach for examining the cycle length and the power spectrum of the pandemic by converting the number of deaths due to coronavirus disease 2019 in the US to the frequency domain. Policymakers can control the pandemic by using observed cycle length whether they should strengthen their policy or not. The proposed Fourier method is useful for analysing waves in other medical applications.

China's responses to COVID-19 reveal an evolving dynamic of (a) containment and control; (b) limited disclosure; and (c) escalat- ing resistance. Tese stand against a background of historical griev- ance against the West and alienation from the international health policy community exemplifed by the United States and its European allies with whom China has ongoing disputes over trade, human rights, and security. China's COVID-19 response involves reaction to conficting WHO themes of modernization and colonialization that both invite and inhibit participation by developing countries. Proclaiming support for modernization in medical training, equipment, and services, the PRC has also emphasized the role of Chinese Traditional Medicine, while resisting WHO calls for disclosure of raw data, lab records, and case fles. China's posture will require a measure of accommodation in global eforts to contain the pandemic and prepare for future outbreaks, combined with renewed eforts to improve cooperation and transparency. [ABSTRACT FROM AUTHOR]

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Background: Assessing the consequences of research is an increasingly important task in research and innovation policy. This paper takes a broader view of those consequences than the conventional economic approach, placing researchers and their activities in the centre of the assessment process and examining results for professional practice and general education as well as contributions to knowledge.Methods: The paper uses historical and documentary analysis to illustrate the approach, focusing on U.S. biomedicine over the past century. At aggregate level, the analysis attributes portions of the change in aggregate health indicators to research and research-based institutions, through several available types of logic: either through correlations between timing of institutional changes and changes in the indicators or through direct or indirect causal connections.Results: The analysis shows that while biomedical research has certainly contributed to improved health in the United States, other factors have also contributed. In some ways the institutional structure of science-based medicine has worked against creating benefits for some groups in U.S. society.Conclusions: The paper concludes with a call for more strategic attention to dimensions of impact other than knowledge outcomes and for participatory planning for research. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic precipitated catastrophic job loss, unprecedented unemployment rates, and severe economic hardship in renter households. As a result, housing precarity and the risk of eviction increased and worsened during the pandemic, especially among people of color and low-income populations. This paper considers the implications of this eviction crisis for health and health inequity, and the need for eviction prevention policies during the pandemic. Eviction and housing displacement are particularly threatening to individual and public health during a pandemic. Eviction is likely to increase COVID-19 infection rates because it results in overcrowded living environments, doubling up, transiency, limited access to healthcare, and a decreased ability to comply with pandemic mitigation strategies (e.g., social distancing, self-quarantine, and hygiene practices). Indeed, recent studies suggest that eviction may increase the spread of COVID-19 and that the absence or lifting of eviction moratoria may be associated with an increased rate of COVID-19 infection and death. Eviction is also a driver of health inequity as historic trends, and recent data demonstrate that people of color are more likely to face eviction and associated comorbidities. Black people have had less confidence in their ability to pay rent and are dying at 2.1 times the rate of non-Hispanic Whites. Indigenous Americans and Hispanic/Latinx people face an infection rate almost 3 times the rate of non-Hispanic whites. Disproportionate rates of both COVID-19 and eviction in communities of color compound negative health effects make eviction prevention a critical intervention to address racial health inequity. In light of the undisputed connection between eviction and health outcomes, eviction prevention, through moratoria and other supportive measures, is a key component of pandemic control strategies to mitigate COVID-19 spread and death.

Policy Points Reflecting on current response deficiencies, we offer a model for a national contingency supply chain cell (NCSCC) construct to manage the medical materials supply chain in support of emergencies, such as COVID-19. We develop the following: a framework for governance and response to enable a globally independent supply chain; a flexible structure to accommodate the requirements of state and county health systems for receiving and distributing materials; and a national material "control tower" to improve transparency and real-time access to material status and location., Context: Much of the discussion about the failure of the COVID-19 supply chain has centered on personal protective equipment (PPE) and the degree of vulnerability of care. Prior research on supply chain risks have focused on mitigating the risk of disruptions of specific purchased materials within a bounded region or on the shifting status of cross-border export restrictions. But COVID-19 has impacted every purchase category, region, and border. This paper is responsive to the National Academies of Sciences, Engineering and Medicine recommendation to study and monitor disasters and to provide governments with course of action to satisfy legislative mandates., Methods: Our analysis draws on our observations of the responses to COVID-19 in regard to acquisition and contracting problem-solving, our review of field discussions and interactions with experts, a critique of existing proposals for managing the strategic national stockpile in the United States a mapping of the responses to national contingency planning phases, and the identification of gaps in current national healthcare response policy frameworks and proposals., Findings: Current proposals call for augmenting a system that has failed to deliver the needed response to COVID-19. These proposals do not address the key attributes for pandemic plan renewal: flexibility, traceability and transparency, persistence and responsiveness, global independence, and equitable access. We offer a commons-based framework for achieving the opportunities and risks which are responsive to a constellation of intelligence assets working in and across focal targets of global supply chain risk., Conclusions: The United States needs a "commons-based strategy" that is not simply a stockpile repository but instead is a network of repositories, fluid inventories, and analytic monitoring governed by the experts. We need a coordinated effort, a "commons" that will direct both conventional and new suppliers to meet demands and to eliminate hoarding and other behaviors., (© 2020 Milbank Memorial Fund.)

This paper explores drug and alcohol policies at Tribal Colleges and Universities (TCUs). A research team conducted a needs assessment of Alcohol and Other Drug (AOD) use and policies in 27 TCUs, surveying key informants on perceived AOD prevalence. Student body size did not affect levels of AOD training or treatment. Larger TCU size increased the likelihood of on-campus housing, which increased the prevalence of zerotolerance policies and greater access to AOD services. Reservation policies, local resources, and cultural practices did not appear to affect TCU AOD policies. Designed properly, these policies can support desirable academic outcomes for TCU students.

The article presents updates on family medicine from the American Academy of Family Physicians (AAFP) concerning opportunities and challenges in emergency medicine (EM) in the U.S. It states that the AAFP policy and paper offer a basis for changes to assure that family physicians are component of the future of emergency medicine. In addition, the integration of family medicine and EM in other countries also drafted in the paper.

The Centers for Disease Control and Prevention administered the original Maternity Practices in Infant Nutrition and Care (mPINC) survey, a census of all US birth facilities, from 2007 to 2015 to monitor infant feeding‐related maternity care practices and policies. The purpose of this paper is to describe the many uses of mPINC data. Hospitals, organizations and governments (federal, state and local) have used the mPINC survey as a tool for improving care among the populations they serve. Nationally, the mPINC survey has been used to document marked improvements in infant feeding‐related maternity care. Researchers have used the mPINC data to examine a variety of questions related to maternity care practices and policies. The newly revised mPINC survey (2018) has been designed to capture changes that have occurred over the past decade in infant feeding‐related US maternity care. Hospitals, organizations, governments and researchers will be able to continue using this important tool in their efforts to ensure US maternity care practices and policies are fully supportive of breastfeeding. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study on how to lower the health disparities of the effect of air pollution on racial/ethnic communities in the U.S. Topics mentioned include the use of race-specific concentration-response functions (CRFs) in calculating the link between exposure to fine particulates and mortality for Asian, African American, and Hispanic Americans, the impact of federal policies to improve air quality on communities of color, and the various aspects of systemic racism.

Background Physical inactivity rates have remained high worldwide since 2001. Public policies are an essential upstream lever to target individual physical activity (PA) behaviour. However, implementers have different strategies and face implementation challenges that are poorly understood. The present study analyzes the implementation processes of public policies to promote PA in terms of: (i) the policies covered and their legal quality, (ii) the actors and stakeholders involved in the implementation process and (iii) the used implementation strategies (vertical, horizontal or a mix). Methods A scoping review was systematically conducted (registered Open Science Framework: osf.io/7w84q/), searching 10 databases and grey literature until March 2022. Of the 7741 titles and abstracts identified initially, 10 studies were included. Results The current evidence includes high-income countries (USA, n  = 7; UK, New Zealand and Oman, n  = 1 each). Policy areas covered are education (school sector) and PA promotion in general (national PA plans or city-wide approaches). The legal classification ranges from laws (school sector) to coordination and budgeting to non-legally binding recommendations. The jurisdictions covered were federal (n  = 4), state (n  = 1), county (n  = 1), school district (n  = 1) and city (n  = 3). Implementation strategies for city-wide approaches are characterized by a coordinated approach with vertical and horizontal integration; federal PA policies by a mix of implementation strategies; and the school sector by a strict horizontal top-down integration without the involvement of other actors. Conclusion Implementation strategies differ by policy field. Therefore, continuous evaluation of the implementation process is necessary to align policy implementation with policy goals to promote individual PA behaviour. [ABSTRACT FROM AUTHOR]

In the United States, undocumented residents face unique barriers to healthcare access that render them disproportionately dependent on the emergency department (ED) for care. Consequently, ED providers are integral to the health of this vulnerable population. Yet special considerations, both clinical and social, generally fall outside the purview of the emergency medicine curriculum. This paper serves as a primer on caring for undocumented patients in the ED, includes a conceptual framework for immigration as a social determinant of health, reviews unique clinical considerations, and finally suggests a blueprint for immigration-informed emergency care.