280 results on '"Howard K Koh"'
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2. Learning from COVID-19: government leaders’ perspectives to improve emergency risk communication
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Elena Savoia, Rachael Piltch-Loeb, Eva H. Stanton, and Howard K. Koh
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Emergency risk communication ,COVID-19 ,Government response ,Principles ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic highlighted the challenges of effective emergency risk communication (ERC) to protect public health, including the difficulty in tackling the spread of inaccurate information. This study aimed to understand those challenges and potential solutions by interviewing leading government spokespersons and their advisors from around the world with experience during large scale emergencies. Interviews were conducted with 27 individuals representing governments from 19 countries across five continents. Thematic analysis, using both a deductive and inductive approach, organized and identified salient themes and patterns that emerged from the interview data. Results The thematic analysis of the interviews’ data led to the identification of 9 principles of communication: 1) Timeliness, 2) Transparency, 3) Coordination, 4) Accuracy and Consistency, 5) Accountability and Integrity, 6) Independence from politics, 7) Responsiveness, 8) Equity, 9) Trust and Empathy. We also developed 36 recommendations actionable by government agencies to enhance the practice of the 9 principles. Examples include the need for: proactive communication strategies, permanent communication task forces integrated into preparedness and response efforts, robust processes to enhance open discussion of controversial topics within government agencies, clarification of how various branches of government coordinate to oversee specific aspects of the overall communication, and development of relationships across public and private entities ahead of a crisis. Conclusions Our findings suggest key practical recommendations for leaders of government agencies to enhance ERC capabilities going forward. Before a crisis, they must constantly review internal processes and integrate ERC functions into overall communication planning efforts. During a crisis, they must coordinate roles and responsibilities across branches of governments, strive to communicate to a range of populations to uphold equity, maintain transparency by avoiding information voids on controversial issues and build trust by building relationships with a variety of community leaders. After a crisis, government agencies should continue the practice of social listening to hear more about the public’s informational needs, strengthen civic participation processes, and understand how an always evolving information environment can best be leveraged during future crises.
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- 2023
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3. Exploring the spiritual foundations of public health leadership
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Howard K. Koh, Cathy C. Tso, Cyra Perry Dougherty, Emily E. Lazowy, Chelsea P. Heberlein, and Fawn A. Phelps
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spirituality ,leadership ,public health ,education ,meaning ,purpose ,Public aspects of medicine ,RA1-1270 - Abstract
The Covid-19 pandemic has laid bare the challenges of public health leadership. Faced with criticism, threats, and even violence, many public health leaders have left the field. A healthier future for the nation may well rest on training aspiring public health leaders to build deeper capacity for perseverance, healing, and resilience. Reflecting the growing experience of a team of public health educators at the Harvard T.H. Chan School of Public Health (Harvard Chan), this article offers recommendations for public health schools to recognize, and incorporate into leadership education, themes of spirituality—ie, the way people seek ultimate meaning and purpose and deep connectedness to something larger than themselves. Doing so can serve as a foundation for the lifelong journey of leadership. Over the past decade, Harvard Chan has incorporated meaning, purpose, and connectedness themes to complement more traditional coursework addressing research and translation. While many established leadership frameworks address the “what” and “how” of career development, the spirituality framework can support aspiring leaders to more fully understand their “why” and its alignment with challenging work. Such a deeply personal topic, traditionally kept private, has been shared and nurtured in Harvard Chan classrooms through a range of pedagogical strategies including personal reflection, one-on- one coaching, experiential learning, case discussions, and candid conversations with public health leaders. By encouraging a values-based foundation for decision-making in crises and difficult leadership moments, such grounding can help aspiring leaders navigate the challenges of public health leadership that inevitably lie ahead.
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- 2023
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4. E-cigarette use behaviors of Asian American, Native Hawaiian, and Pacific Islander youth in the contiguous United States: Insights from the Monitoring the Future Study (2018–2019)
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Elizabeth K. Do, Kathleen Aarvig, Hope Muller-Tabanera, Sarah Mills, Jake Ryann Sumibcay, Howard K. Koh, Donna M. Vallone, and Elizabeth C. Hair
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Electronic cigarette use ,Youth and young adults ,Race/Ethnicity ,Asian Americans ,Native Hawaiians ,Pacific Islanders ,Medicine - Abstract
This study examines e-cigarette use behaviors of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth, in relation to other racial/ethnic groups in the United States. Data were obtained from the 2018 and 2019 Monitoring the Future surveys, which include a random, probability-based sample of youth in 8th, 10th, and 12th grades surveyed annually across the contiguous United States. Respondents provided information on race/ethnicity and e-cigarette use (n = 42,980). Measures of e-cigarette use included current (1 + of past 30 days) and regular use (10 + of past 30 days). Chi-square tests were used to determine differences in e-cigarette use by race/ethnicity. Associations between race/ethnicity, other sociodemographic factors, and e-cigarette use were explored using logistic regression analyses. Approximately 5.1% (n = 2,410) of the sample identified as AANHPI. A greater proportion of Native Hawaiian and Pacific Islanders reported current e-cigarette use (NHPI, 28.0%), relative to Asian American (AA, 10.3%), Black (9.5%), Hispanic or Latino (15.0%), American Indian or Alaskan Native (AIAN, 16.5%), multiracial (22.3%), and non-Hispanic White (25.2%) youth. Regular e-cigarette use was highest among non-Hispanic White (12.3%), followed by multiracial (10.7%), AIAN (7.8%), Hispanic or Latino (5.0%), AA (4.3%), and Black (3.0%) youth. Associations between race/ethnicity and e-cigarette use remained significant, after controlling for other sociodemographic factors. Continued monitoring of e-cigarette use is needed among AANHPI, a historically underrepresented population in tobacco research. Special attention should be paid to NHPI, who reported the highest rates of e-cigarette use.
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- 2023
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5. The opioid crisis: need for systems science research
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Mohammad S. Jalali, Michael Botticelli, Rachael C. Hwang, Howard K. Koh, and R. Kathryn McHugh
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opioids ,opioid use disorder ,systems science ,simulation modelling ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract The opioid epidemic in the United States has had a devastating impact on millions of people as well as on their families and communities. The increased prevalence of opioid misuse, use disorder and overdose in recent years has highlighted the need for improved public health approaches for reducing the tremendous harms of this illness. In this paper, we explain and call for the need for more systems science approaches, which can uncover the complexities of the opioid crisis, and help evaluate, analyse and forecast the effectiveness of ongoing and new policy interventions. Similar to how a stream of systems science research helped policy development in infectious diseases and obesity, more systems science research is needed in opioids.
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- 2020
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6. The opioid crisis: a contextual, social-ecological framework
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Mohammad S. Jalali, Michael Botticelli, Rachael C. Hwang, Howard K. Koh, and R. Kathryn McHugh
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opioids ,opioid use disorder ,social-ecological framework ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract The prevalence of opioid use and misuse has provoked a staggering number of deaths over the past two and a half decades. Much attention has focused on individual risks according to various characteristics and experiences. However, broader social and contextual domains are also essential contributors to the opioid crisis such as interpersonal relationships and the conditions of the community and society that people live in. Despite efforts to tackle the issue, the rates of opioid misuse and non-fatal and fatal overdose remain high. Many call for a broad public health approach, but articulation of what such a strategy could entail has not been fully realised. In order to improve the awareness surrounding opioid misuse, we developed a social-ecological framework that helps conceptualise the multivariable risk factors of opioid misuse and facilitates reviewing them in individual, interpersonal, communal and societal levels. Our framework illustrates the multi-layer complexity of the opioid crisis that more completely captures the crisis as a multidimensional issue requiring a broader and integrated approach to prevention and treatment.
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- 2020
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7. The Exodus Of State And Local Public Health Employees: Separations Started Before And Continued Throughout COVID-19
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Jonathon P. Leider, Brian C. Castrucci, Moriah Robins, Rachel Hare Bork, Michael R. Fraser, Elena Savoia, Rachael Piltch-Loeb, and Howard K. Koh
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Health Policy - Published
- 2023
8. Oral Antiviral Therapy Utilization Among Adults with Recent COVID-19 in the United States
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Brandon Benchimol-Elkaim, Scott Dryden-Peterson, Donald R. Miller, Howard K. Koh, and Alan C. Geller
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Internal Medicine - Published
- 2023
9. Progress in Reducing Disparities in Premature Mortality in the USA: a Descriptive Study
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Jiemin Ma, K. Robin Yabroff, Rebecca L. Siegel, William G. Cance, Howard K. Koh, and Ahmedin Jemal
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Rural Population ,Mortality, Premature ,Racial Groups ,Ethnicity ,Internal Medicine ,Humans ,Health Status Disparities ,Mortality ,United States - Abstract
Eliminating health disparities among different segments of the US population is an overarching goal of the US Healthy People 2020 objectives.Examine changes in educational, rural-urban, and racial disparities in premature mortality during the past 10 years.Descriptive analysis of US mortality data from 2007 to 2017.Relative and absolute rural-urban, educational attainment, and Black-White disparities in premature mortality for all-cause and top 10 causes of death among persons ages 25-74 years, estimated as rate ratios and rate differences between ≤12 and ≥16 years of education, rural versus urban, and non-Hispanic Black (Black) versus non-Hispanic White (White), respectively, in 2007 and 2017.During 2007-2017, mortality rates in persons aged 25-74 years in the USA increased for several leading causes of death, especially in persons with16 years of education, rural residents, and White people. As a result, disparity in mortality between 2007 and 2017 widened on both relative and absolute scales for all-cause and for 6 of the top 10 causes of death by education and for all-cause and for 9 of the top 10 causes by rural/urban residence. In contrast, Black-White disparities narrowed for all-cause and for all 7 causes that Black people had a higher rate than White people. For all-cause mortality for example, absolute disparities in the number of deaths per 100,000 person-years between 2007 and 2017 increased from 454.0 (95%CI, 446.0-462.1) to 542.7 (535.6-549.7) for educational attainment and from 85.8 (82.8-88.8) to 140.5 (137.6-143.4) for rural versus urban; in contrast, absolute Black-White disparity decreased from 315.3 (311.0-319.7) to 221.7 (218.1-225.3).Educational and rural-urban disparities in premature mortality widened, whereas Black-White disparities narrowed in the USA between 2007 and 2017, though overall rates remained considerably higher in Black people.
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- 2022
10. Prioritizing Asian Americans, Native Hawaiians, and Pacific Islanders in the U.S. Health Equity Agenda
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Karen E, Kim, Holly J, Humphrey, and Howard K, Koh
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Native Hawaiian or Other Pacific Islander ,Asian ,Health Equity ,COVID-19 ,Humans ,General Medicine ,Pandemics ,Hawaii ,United States ,Education - Abstract
Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations are growing rapidly in the United States, yet AANHPIs remain understudied, overlooked, and misunderstood. During the COVID-19 pandemic, themes from the tragic history of anti-Asian bias and marginalization have resurfaced in a surge of renewed bigotry and xenophobic violence against AANHPIs. In this commentary, the authors discuss the role of medical schools in combating anti-Asian sentiment as an important step toward achieving health equity. Based on their collective expertise in health disparities research, medical education, and policy, they offer suggestions about how to disrupt the pattern of invisibility and exclusion faced by AANHPI populations. They consider ways that representative data, leadership in medical education, research funding, national policies, and broad partnerships can help address AANHPI health disparities.
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- 2022
11. Responding to the opioid crisis in North America and beyond: recommendations of the Stanford–Lancet Commission
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Keith Humphreys, Chelsea L Shover, Christina M Andrews, Amy S B Bohnert, Margaret L Brandeau, Jonathan P Caulkins, Jonathan H Chen, Mariano-Florentino Cuéllar, Yasmin L Hurd, David N Juurlink, Howard K Koh, Erin E Krebs, Anna Lembke, Sean C Mackey, Lisa Larrimore Ouellette, Brian Suffoletto, and Christine Timko
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Analgesics, Opioid ,Male ,Health Policy ,North America ,Practice Guidelines as Topic ,COVID-19 ,Humans ,Pain ,Female ,General Medicine ,Opioid Epidemic ,Global Health ,Opioid-Related Disorders - Published
- 2022
12. Training Clinicians to Care for Patients Where They Are
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James J. O’Connell, Jill S. Roncarati, Margaret M. Sullivan, Emily E. Lazowy, and Howard K. Koh
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Health (social science) ,Social Problems ,SARS-CoV-2 ,Download ,business.industry ,Health Policy ,media_common.quotation_subject ,COVID-19 ,Public relations ,Mental health ,United States ,Health equity ,Issues, ethics and legal aspects ,Ill-Housed Persons ,Workforce ,Health care ,Humans ,Quality (business) ,business ,Psychology ,Pandemics ,Curriculum ,media_common ,Social influence - Abstract
Homelessness remains a pervasive, long-standing problem in the United States and is poised to increase as a result of the COVID-19 pandemic. Individuals experiencing homelessness bear a higher burden of complex medical and mental health illnesses and often struggle to obtain quality and timely health care. The United States desperately needs to train a workforce to confront this large and growing crisis, but few health professional schools currently devote curricula to the clinical needs of people experiencing homelessness. This article discusses educational and curricular strategies for health professional students. Understanding the health needs of--and the social influences on the lives of--people experiencing homelessness is crucial for addressing this health equity challenge. [ABSTRACT FROM AUTHOR] Copyright of AMA Journal of Ethics is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2021
13. The Tobacco Industry and Harm Reduction
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Howard K. Koh and Michael C. Fiore
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Harm Reduction ,Smoking ,Tobacco Industry ,Tobacco Smoke Pollution ,General Medicine - Abstract
This Viewpoint discusses the ways in which the tobacco industry can advance their stated goals of harm reduction and a smoke-free future.
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- 2022
14. Overcome Health Inequities to Eliminate Viral Hepatitis
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Ronald O. Valdiserri, Howard K. Koh, and John W. Ward
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General Medicine - Abstract
This Viewpoint outlines the progress made toward eliminating hepatitis B and C but emphasizes the work that remains to prioritize diagnosis and treatment of populations disproportionately affected by viral hepatitis, including ensuring that there are systems in place to treat those infected and care for those at risk.
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- 2023
15. Invited Commentary: Religious Service Attendance and Implications for Clinical Care, Community Participation, and Public Health
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Tracy A. Balboni, Howard K. Koh, and Tyler J. VanderWeele
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medicine.medical_specialty ,Epidemiology ,media_common.quotation_subject ,Social support ,Promotion (rank) ,Invited Commentary ,Spirituality ,medicine ,Humans ,AcademicSubjects/MED00860 ,media_common ,Service (business) ,religious service attendance ,business.industry ,Public health ,Interpretation (philosophy) ,Attendance ,social support ,Public relations ,spirituality ,Mental health ,Religion ,Editor's Choice ,community ,Public Health ,randomized encouragement trial ,business ,Psychology ,mental health - Abstract
In this commentary, we review the evidence concerning associations between religious service attendance and subsequent health and wellbeing outcomes. The evidence base for a link between religious service attendance and health has increased substantially over the past 2 decades. The interpretation and implications of this research require careful consideration (Am J Epidemiol. 2022;191(1):20–30). It would be inappropriate to universally promote service attendance solely on the grounds of the associations with health. Nevertheless, a more nuanced approach, within both clinical care and public health, may be possible—one that encouraged participation in religious community for those who already positively self-identified with a religious or spiritual tradition and encouraged other forms of community participation for those who did not. Discussion is given to potential future research directions and the challenges and opportunities for promotion efforts by the public health community.
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- 2021
16. A Summary of the 2020 Gastric Cancer Summit at Stanford University
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Dennis Deapen, David A. Greenwald, Andrew T. Chan, Bryant Lin, Chin Hur, Richard M. Peek, Meira Epplein, Hanlee P. Ji, Howard K. Koh, John M. Inadomi, Yanghee Woo, Joo Ha Hwang, Christian C. Abnet, Hwoon-Yong Jung, Il Ju Choi, Shailja C. Shah, Jeremy L. Davis, Robert J. Huang, Charles S. Rabkin, Chisato Hamashima, Michael G. Bruce, Samuel So, Latha Palaniappan, Asad Umar, Khay Guan Yeoh, M. Constanza Camargo, Elena M. Stoffel, Julie Parsonnet, Alejandro H. Corvalan, Eunjung Lee, Fernando Alarid-Escudero, M. Blanca Piazuelo, Keith T. Wilson, Aki Smith, and Manuel R. Amieva
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0301 basic medicine ,geography ,Summit ,geography.geographical_feature_category ,Hepatology ,business.industry ,Gastroenterology ,Cancer ,medicine.disease ,Article ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Asian americans ,Health care ,Screening programs ,Overall survival ,Medicine ,030211 gastroenterology & hepatology ,East Asia ,business ,Cancer risk ,Demography - Abstract
There exists no coherent national strategy for the early detection or prevention of gastric cancer in the United States (US), even among identified high-risk groups such as Asian Americans, African Americans, Hispanic Americans, and Alaska Native/American Indian peoples. As a result, patients with gastric cancer in the US are diagnosed at later stages and demonstrate worse overall survival compared to nations of East Asia with established screening programs (Table 1). The under-recognition of gastric cancer risk within minority communities is a significant unaddressed healthcare disparity.
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- 2020
17. Flourishing After a Pandemic: Healthy People 2030
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Howard K. Koh, Carter Blakey, and Emmeline Ochiai
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Health Policy ,Flourishing ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Health Status ,Public Health, Environmental and Occupational Health ,Editorials ,Mental health ,Mental Health ,Environmental health ,Pandemic ,Humans ,Sociology ,Pandemics - Published
- 2021
18. Melanoma
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Howard K. Koh, Alan C. Geller, and Robert A. Lew
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- 2021
19. Toward Healing and Health Equity for Asian American, Native Hawaiian, and Pacific Islander Populations
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Howard K. Koh, Jeffrey B Caballero, and Juliet K Choi
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Native Hawaiian or Other Pacific Islander ,Coronavirus disease 2019 (COVID-19) ,Asian ,Health Equity ,business.industry ,media_common.quotation_subject ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,General Medicine ,Cultural Diversity ,Racism ,Health equity ,United States ,Native hawaiian ,Asian americans ,Cultural diversity ,Medicine ,Pacific islanders ,Ethnology ,Humans ,Healthcare Disparities ,business ,Delivery of Health Care ,American Indian or Alaska Native ,media_common - Published
- 2021
20. Establishing Academic Homes for Homelessness: A Call to Action
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Howard K. Koh, Jennifer Hrabchak Molinsky, Katherine A. Koh, Jill S. Roncarati, Margaret M. Sullivan, Emily E. Lazowy, and James J. O’Connell
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Public Health, Environmental and Occupational Health - Abstract
Although homelessness ranks as one of society’s most pressing and visible health equity challenges, the academic community has not actively addressed its health impacts, root causes, and potential solutions. Few schools and programs of public health even offer a basic course for students. In the COVID-19 pandemic era, academia must demonstrate urgency to address homelessness and educate learners, motivate fledgling researchers, inform policy makers, offer community-engaged and evidence-based studies, and join in the growing national debate about best approaches. At a minimum, every public health student should understand the interdisciplinary challenges of homelessness, its implications for health equity, and opportunities to address the crisis. We call for academia, particularly schools and programs of public health, to engage more fully in national partnerships to care for members of society who are most marginalized, in terms of health and behavioral health outcomes, quality of life, and connectedness.
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- 2022
21. Patient-Centered Climate Action and Health Equity
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Aaron S, Bernstein, Kristin L, Stevens, and Howard K, Koh
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Health Equity ,Climate ,Climate Change ,Health Policy ,Patient-Centered Care ,Humans ,General Medicine - Published
- 2022
22. Spirituality in Serious Illness and Health
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Tracy A. Balboni, Tyler J. VanderWeele, Stephanie D. Doan-Soares, Katelyn N. G. Long, Betty R. Ferrell, George Fitchett, Harold G. Koenig, Paul A. Bain, Christina Puchalski, Karen E. Steinhauser, Daniel P. Sulmasy, and Howard K. Koh
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General Medicine - Published
- 2022
23. The legal determinants of health: harnessing the power of law for global health and sustainable development
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Sara Hossain, Susan C. Kim, Eric A. Friedman, Howard K. Koh, Gian Luca Burci, Katherine DeLand, Eric Goosby, Katie Gottschalk, Mary C. DeBartolo, Agnes Binagwaho, Rodrigo Uprimny, Timothy G Evans, Gorik Ooms, John T Monahan, Mirta Roses Periago, Jenny Kaldor, Lawrence O. Gostin, Alicia Ely Yamin, Ala Alwan, and Luisa Cabal
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medicine.medical_specialty ,Public health ,General Medicine ,Population health ,030204 cardiovascular system & hematology ,Rule of law ,Statute ,03 medical and health sciences ,0302 clinical medicine ,Law ,Political science ,Global health ,medicine ,Health law ,030212 general & internal medicine ,Social determinants of health ,Health policy - Abstract
Health risks in the 21st century are beyond the control of any government in any country. In an era of globalisation, promoting public health and equity requires cooperation and coordination both within and among states. Law can be a powerful tool for advancing global health, yet it remains substantially underutilised and poorly understood. Working in partnership, public health lawyers and health professionals can become champions for evidence-based laws to ensure the public's health and safety. This Lancet Commission articulates the crucial role of law in achieving global health with justice, through legal instruments, legal capacities, and institutional reforms, as well as a firm commitment to the rule of law. The Commission's aim is to enhance the global health community's understanding of law, regulation, and the rule of law as effective tools to advance population health and equity. The term law throughout is used to mean legal instruments such as statutes, treaties, and regulations that express public policy, as well as the public institutions (eg, courts, legislatures, and agencies) responsible for creating, implementing, and interpreting the law. By establishing the rules and frameworks that shape social and economic interactions, laws exert a powerful force on all the social determinants of health. Well designed laws can help build strong health systems, ensure safe and nutritious foods, evaluate and approve safe and effective drugs and vaccines, create healthier and safer workplaces, and improve the built and natural environments. However, laws that are poorly designed, implemented, or enforced can harm marginalised populations and entrench stigma and discrimination. This Commission brings together global leaders in the fields of health, law, and governance. We make the case for better, more strategic linkages between health and law, and the professionals who work in both fields. We begin by providing a short explanation of legal terms and concepts, and the actors and institutions that govern health. Our report is structured around four legal determinants of health, each of which powerfully affects health outcomes. We use the term legal determinants of health because it demonstrates the power of law to address the underlying social and economic causes of injury and disease. These four legal determinants show how law can substantially influence health and equity. We do not endeavour a systematic review of law in global health, but rather to advocate for, and demonstrate, the crucial value of law in advancing global health with justice. Finally, drawing on identified areas for reform, as well as principles of good governance and the right to health, we offer seven concrete recommendations for action.
- Published
- 2019
24. Deaths From COVID-19
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Alan C. Geller, Tyler J. VanderWeele, and Howard K. Koh
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Extramural ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Medicine ,General Medicine ,business ,Virology ,Cause of death - Published
- 2020
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25. Health Policy Considerations for Spiritual Care in the United States
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Eric Coles and Howard K. Koh
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State (polity) ,Nursing ,media_common.quotation_subject ,Workforce ,Spirituality ,Spiritual care ,Disease ,Psychology ,Reimbursement ,World health ,Health policy ,media_common - Abstract
A growing body of evidence links spirituality with improved health outcomes. In 1946, the World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The United States has the most expensive healthcare system in the world, without the health outcomes to match. Creating guidelines for spiritual care in practice and broader policy for populations will require addressing fundamental issues about data, evidence, feasibility, workforce, training, and reimbursement. Information regarding screening and evaluation of patients’ spiritual needs can now be integrated into electronic health records (EHRs). A future vision of spiritual care could arise by addressing basic questions about what, why, how, who and for whom, when, and why. A generalist-specialist model, team-based and coordinated, could potentially bring together medical and spiritual care providers to offer better person-centered services.
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- 2020
26. Religious Service Attendance and Deaths Related to Drugs, Alcohol, and Suicide Among US Health Care Professionals
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Ichiro Kawachi, Howard K. Koh, Michael Botticelli, Ying Chen, and Tyler J. VanderWeele
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Adult ,Male ,Religion and Psychology ,medicine.medical_specialty ,Health Personnel ,Population ,Poison control ,Nurses ,Suicide prevention ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,Health care ,Suicide, Completed ,medicine ,Online First ,Humans ,education ,Proportional Hazards Models ,Original Investigation ,education.field_of_study ,Ethanol ,business.industry ,Public health ,Research ,Attendance ,Middle Aged ,United States ,030227 psychiatry ,Psychiatry and Mental health ,Suicide ,Pharmaceutical Preparations ,Family medicine ,Female ,Drug Overdose ,business ,Alcohol-Related Disorders ,030217 neurology & neurosurgery ,Comments ,Cohort study - Abstract
This cohort study assesses the association of frequent religious service attendance with deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) among US health care professionals., Key Points Question Is frequent religious service attendance associated with a lower risk of deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) among US health care professionals? Findings In this cohort study of 66 492 female registered nurses and 43 141 male health care professionals in the US, attendance at religious services at least once per week was associated with a 68% lower hazard of death from despair among women and a 33% lower hazard among men compared with never attendance. Meaning The findings suggest that frequent attendance at religious services is associated with lower subsequent risk of deaths from despair., Importance The increase in deaths related to drugs, alcohol, and suicide (referred to as deaths from despair) has been identified as a public health crisis. The antecedents associated with these deaths have, however, seldom been investigated empirically. Objective To prospectively examine the association between religious service attendance and deaths from despair. Design, Setting, and Participants This population-based cohort study used data extracted from self-reported questionnaires and medical records of 66 492 female registered nurses who participated in the Nurses’ Health Study II (NHSII) from 2001 through 2017 and 43 141 male health care professionals (eg, dentist, pharmacist, optometrist, osteopath, podiatrist, and veterinarian) who participated in the Health Professionals Follow-up Study (HPFS) from 1988 through 2014. Data on causes of death were obtained from death certificates and medical records. Data analysis was conducted from September 2, 2018, to July 14, 2019. Exposure Religious service attendance was self-reported at study baseline in response to the question, “How often do you go to religious meetings or services?” Main Outcomes and Measures Deaths from despair, defined specifically as deaths from suicide, unintentional poisoning by alcohol or drug overdose, and chronic liver diseases and cirrhosis. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) of deaths from despair by religious service attendance at study baseline, with adjustment for baseline sociodemographic characteristics, lifestyle factors, psychological distress, medical history, and other aspects of social integration. Results Among the 66 492 female participants in NHSII (mean [SD] age, 46.33 [4.66] years), 75 incident deaths from despair were identified (during 1 039 465 person-years of follow-up). Among the 43 141 male participants in HPFS (mean [SD] age, 55.12 [9.53] years), there were 306 incident deaths from despair (during 973 736 person-years of follow-up). In the fully adjusted models, compared with those who never attended religious services, participants who attended services at least once per week had a 68% lower hazard (HR, 0.32; 95% CI, 0.16-0.62) of death from despair in NHSII and a 33% lower hazard (HR, 0.67; 95% CI, 0.48-0.94) of death from despair in HPFS. Conclusions and Relevance The findings suggest that religious service attendance is associated with a lower risk of death from despair among health care professionals. These results may be important in understanding trends in deaths from despair in the general population.
- Published
- 2020
27. Measles as Metaphor-What Resurgence Means for the Future of Immunization
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Howard K. Koh and Bruce G. Gellin
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medicine.medical_specialty ,Measles-Mumps-Rubella Vaccine ,Metaphor ,media_common.quotation_subject ,Measles Vaccine ,MEDLINE ,Measles ,Mass Vaccination ,Disease Outbreaks ,Medicine ,Humans ,Child ,Health policy ,media_common ,business.industry ,State government ,General Medicine ,medicine.disease ,United States ,Immunization ,Family medicine ,Child, Preschool ,Measles vaccine ,business ,Social Media ,State Government - Published
- 2020
28. Impact of the Affordable Care Act on Colorectal Cancer Outcomes: A Systematic Review
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Donna Spiegelman, Michelle R. Xu, Lawrence H. Kushi, Howard K. Koh, Mary E. Reed, and Amanda M.B. Kelly
- Subjects
medicine.medical_specialty ,Epidemiology ,Colorectal cancer ,Context (language use) ,01 natural sciences ,Article ,Health Services Accessibility ,Insurance Coverage ,03 medical and health sciences ,0302 clinical medicine ,Cancer Survivors ,Health care ,Patient Protection and Affordable Care Act ,medicine ,Humans ,030212 general & internal medicine ,0101 mathematics ,Healthcare Disparities ,Intensive care medicine ,Early Detection of Cancer ,business.industry ,Medicaid ,Mortality rate ,Incidence (epidemiology) ,010102 general mathematics ,Public Health, Environmental and Occupational Health ,medicine.disease ,United States ,Cost sharing ,business ,Colorectal Neoplasms - Abstract
Context The Patient Protection and Affordable Care Act increases healthcare access and includes provisions that directly impact access to and cost of evidence-based colorectal cancer screening. The Affordable Care Act's removal of cost sharing for colorectal cancer screening as well as Medicaid expansion have been hypothesized to increase screening and improve other health outcomes. However, since its passage in 2010, there is little consensus on the Affordable Care Act's impact. Evidence acquisition Data from March 2010 to June 2019 were reviewed and 21 relevant studies were identified; 19 studies examined colorectal cancer screening with most finding increased screening rates. Evidence synthesis Eleven studies found significant increases, 5 found nonsignificant increases, 3 found nonsignificant decreases, and 1 study found a significant decrease in colorectal cancer screening. Three studies examined the impact on colorectal cancer incidence and stage of diagnosis, where a significant 2.4% increase in early diagnosis was found in one and a nonsignificant increase in incidence in another. However, survival improved after Medicaid expansion. Conclusions Free preventive colorectal cancer screening and Medicaid expansion because of passage of the Affordable Care Act have been, in general, positively associated with modest improvements in screening rates across the country. Future studies are needed that investigate the longer-term impact of the Affordable Care Act on colorectal cancer morbidity and mortality rates, as screening is only the first step in treatment of cancerous and precancerous lesions, preventing them from progressing. Moreover, more studies examining subpopulations are needed to better assess where gaps in care remain.
- Published
- 2020
29. Medicaid And Private Insurance Coverage For Low-Income Asian Americans, Native Hawaiians, And Pacific Islanders, 2010-16
- Author
-
Sarah Humble, Howard K. Koh, Arnold M. Epstein, John J. Park, Graham A. Colditz, and Benjamin D. Sommers
- Subjects
Adult ,Male ,Native Hawaiian or Other Pacific Islander ,Databases, Factual ,common ,Population ,Ethnic group ,Insurance Coverage ,03 medical and health sciences ,0302 clinical medicine ,Asian americans ,Native Hawaiians ,Humans ,030212 general & internal medicine ,education ,Poverty ,Health policy ,education.field_of_study ,Insurance, Health ,Asian ,Medicaid ,030503 health policy & services ,Health Policy ,Patient Protection and Affordable Care Act ,common.demographic_type ,Health equity ,United States ,Indians, North American ,Pacific islanders ,Demographic economics ,Female ,Private Sector ,Business ,0305 other medical science - Abstract
To determine how low-income Asian American, Native Hawaiian, and Pacific Islander (AANHPI) adults gained health insurance coverage-specifically, via Medicaid or private insurance-under the Affordable Care Act, we used a difference-in-differences approach to compare uninsurance rates in 2010-13 and 2015-16. In Medicaid expansion states, adjusted Medicaid coverage gains were 9.67 percentage points larger than in nonexpansion states; however, adjusted private coverage gains in expansion states were 10.19 percentage points lower. These results indicate that, in contrast to the case for other racial/ethnic groups, for AANHPI the Medicaid coverage increases in expansion states were of similar magnitude to the private insurance coverage increases in nonexpansion states. Reasons for this may include differences in willingness to enroll in public versus private coverage, barriers related to language or citizenship status, or other factors. Future studies are needed to understand these patterns and promote health equity for this population.
- Published
- 2019
30. The San Francisco Ban and the Future of e-Cigarettes
- Author
-
Howard K. Koh and Clifford E Douglas
- Subjects
business.industry ,Law ,Medicine ,General Medicine ,business - Published
- 2019
31. Healing and Health Equity for Asian American, Native Hawaiian, and Pacific Islander Populations—Reply
- Author
-
Howard K. Koh, Juliet K. Choi, and Jeffrey B. Caballero
- Subjects
General Medicine - Published
- 2021
32. Fully Alive
- Author
-
Howard K Koh
- Subjects
General Medicine - Published
- 2018
33. Coordinating Community Planning for Transportation and Health
- Author
-
Howard K. Koh and Jenny T. Rosenberg
- Subjects
business.industry ,MEDLINE ,Transportation ,General Medicine ,Community health planning ,Community Health Planning ,Health Services Accessibility ,United States ,Social planning ,Community planning ,Medicine ,Humans ,Social Planning ,business ,Environmental planning - Published
- 2019
34. National declines in the percentages of uninsured among adults aged 18-64 years with active epilepsy, 2010 and 2013 to 2015 and 2017-U.S. National Health Interview Survey
- Author
-
Matthew M. Zack, Rosemarie Kobau, Sanjeeb Sapkota, and Howard K. Koh
- Subjects
Adult ,Male ,Chronic condition ,Adolescent ,Population ,Health Services Accessibility ,Insurance Coverage ,Article ,03 medical and health sciences ,Behavioral Neuroscience ,Epilepsy ,Young Adult ,0302 clinical medicine ,Environmental health ,Surveys and Questionnaires ,Health care ,medicine ,Health insurance ,National Health Interview Survey ,Humans ,030212 general & internal medicine ,education ,education.field_of_study ,Medically Uninsured ,business.industry ,Middle Aged ,medicine.disease ,Confidence interval ,United States ,Neurology ,Insurance status ,Income ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Epilepsy is more common among children and adults living in households at lowest incomes. Like those living with any complex chronic condition, people with epilepsy need quality healthcare to improve their health and social outcomes. The purpose of this study was to use the latest national data to provide updated estimates of the percentages of adults aged 18–64 years with active epilepsy who were uninsured in 2010, 2013, 2015, and 2017 and to examine changes in health insurance coverage during these years. We analyzed nationally representative samples of adults (aged 18–64 years) from the 2010, 2013, 2015, and 2017 National Health Interview Survey (NHIS). We used a validated epilepsy surveillance case definition to classify adults as having active epilepsy during 2010 and 2013 (n = 507) and during 2015 and 2017 (n = 582). We used the NHIS recode variables available in each year that account for a series of questions posed to respondents to confirm coverage and that ultimately classify respondents with different healthcare coverage types. Overall, the percentage of uninsured adults among respondents aged 18–64 years with active epilepsy decreased by more than half (59%), from 17.7% (95% confidence interval [CI] = 13.6%–22.7%) in 2010 and 2013 to 7.3% (95% CI = 4.8%–10.7%) in 2015 and 2017. The decrease in the percentage of uninsured adults with active epilepsy after 2010 and 2013 was balanced by a similar increase in public insurance coverage and private insurance coverage in 2015 and 2017. Epilepsy stakeholders can ensure that all uninsured adults with epilepsy obtain access to health insurance coverage. National Health Interview Survey data on epilepsy, when available, can be used to monitor trends in insurance status in the new decade.
- Published
- 2019
35. Reimagining Health-Flourishing
- Author
-
Tyler J. VanderWeele, Howard K. Koh, and Eileen McNeely
- Subjects
Gerontology ,business.industry ,Flourishing ,media_common.quotation_subject ,Health Status ,MEDLINE ,Physical health ,General Medicine ,Mental health ,Mental Health ,Happiness ,Medicine ,Humans ,business ,Health policy ,media_common - Published
- 2019
36. The Opioid Crisis: A Contextual Framework and Call for Systems Science Research
- Author
-
Rachael C. Hwang, Howard K. Koh, R. Kathryn McHugh, Michael Botticelli, and Mohammad S. Jalali
- Subjects
medicine.medical_specialty ,Leverage (finance) ,business.industry ,Public health ,Psychological intervention ,Opioid use disorder ,Context (language use) ,Interpersonal communication ,Public relations ,medicine.disease ,Interpersonal relationship ,Systems science ,medicine ,Psychology ,business - Abstract
Context: The prevalence of opioid use and misuse has provoked a staggering number of deaths over the past two and a half decades. Much attention has focused on individual risks according to various characteristics and experiences. However, broader social and contextual domains are also essential contributors to the opioid crisis, as interpersonal relationships and the conditions of the community and society people live in. Despite efforts to tackle the issue, the rates of opioid misuse, non-fatal overdose, and overdose death remain high. Many call for a broad public health approach, but articulation of what such a strategy could entail has not been fully realized. Broader systems policies, especially those that emphasize prevention, could more effectively intervene in this crisis. Methods: In order to improve the awareness surrounding opioid misuse, we developed a social-ecological framework that helps conceptualize the multivariable risk factors of opioid misuse and facilitates reviewing them in individual, interpersonal, communal, and societal levels. Findings: Our framework illustrates the multi-layer complexity of the opioid crisis that more completely captures the crisis as a multidimensional issue requiring a broader and integrated approach to prevention and treatment. Conclusions: Future research can elucidate the interconnections among the risk factors as well as leverage systems science tools (e.g., simulation modeling) to uncover the complexities of the crisis, and help evaluate, analyze, and forecast the effectiveness of ongoing and new policy interventions. We explain and call for the need for more systems science approaches in opioid research.
- Published
- 2019
37. Navigating Government Service as a Physician
- Author
-
Howard K. Koh
- Subjects
medicine.medical_specialty ,media_common.quotation_subject ,Health Care Sector ,History, 21st Century ,03 medical and health sciences ,0302 clinical medicine ,Arts and Humanities (miscellaneous) ,Nursing ,State (polity) ,Medicine ,030212 general & internal medicine ,Policy Making ,media_common ,Service (business) ,Government ,Public Sector ,030505 public health ,business.industry ,Health Policy ,Public health ,Public sector ,Public Health, Environmental and Occupational Health ,History, 20th Century ,Public relations ,United States ,Personal development ,United States Dept. of Health and Human Services ,Public service ,0305 other medical science ,business ,Public Health Administration ,Career development - Abstract
Working in government can be a remarkable life experience for anyone but particularly for those who have trained in the worlds of medicine and public health. This article describes some lessons learned from a physician initially based in academic medicine and public health who has since spent more than a decade serving in leadership positions at the state and federal levels. Many of the described themes about policy making can guide health professionals who wish to understand and ultimately contribute to the public sector. Certainly, the challenges and risks are noteworthy. However, for those willing and able to take the leap, government service can offer extraordinary opportunities not only for tremendous personal growth but also for making broader contributions to public health.
- Published
- 2016
38. Strengthening the U.S. Public Health Service Commissioned Corps: A View From The Assistant Secretary for Health
- Author
-
Howard K. Koh
- Subjects
medicine.medical_specialty ,030505 public health ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,General Medicine ,Public relations ,United States ,Military medicine ,Public health service ,Officer ,03 medical and health sciences ,Navy ,United States Public Health Service ,0302 clinical medicine ,Payroll ,Health Care Reform ,Agency (sociology) ,Humans ,Medicine ,Management Audit ,Organizational structure ,030212 general & internal medicine ,0305 other medical science ,business - Abstract
To summarize the results of the major management review of the U.S. Public Health Service Commissioned Corps (2009-2010) and note related outcomes.Narrative from the U.S. Assistant Secretary for Health, who directed and oversaw the management review.The management review led to 46 recommendations, all of which have since been implemented. The subsequent organizational and operational changes have unified reporting structures, streamlined the administrative Corps organizational structure, and transferred support services to providers with expertise in uniformed services to create a new integrated personnel and payroll system. Related processes have also prompted a systematic billet review as well as establishment of explicit criteria for eligibility to become a Corps officer. Corps leaders report improvements in recruiting talented officers, increased selectivity from the candidate pool, and enhanced matching of incoming officers with agency assignments. Furthermore, Corps activity has grown in both traditional and innovative ways.The Corps has enjoyed heightened activity and outcomes in the era of health reform. The management review and its implementation have strengthened the Corps, helping officers to do their job and achieve their mission.
- Published
- 2016
39. Sense of Mission and Subsequent Health and Well-Being Among Young Adults: An Outcome-Wide Analysis
- Author
-
A. Lindsay Frazier, Howard K. Koh, Eric S. Kim, Ying Chen, and Tyler J. VanderWeele
- Subjects
Male ,young adults ,Value of Life ,Epidemiology ,Health Status ,Original Contributions ,Health Behavior ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,well-being ,outcome-wide analysis ,Humans ,Emotional expression ,030212 general & internal medicine ,Longitudinal Studies ,Prospective Studies ,Young adult ,Attendance ,Life satisfaction ,health ,Mental health ,purpose in life ,Editor's Choice ,Mental Health ,Prosocial behavior ,030220 oncology & carcinogenesis ,religion ,Well-being ,Female ,Psychology ,Psychosocial ,Attitude to Health ,sense of mission ,Clinical psychology - Abstract
Purpose in life is potentially a modifiable “health asset” that enhances health and well-being. However, the association between purpose and health in younger populations remains understudied. In this study, we prospectively examined an aspect of purpose in life—specifically having a sense of mission—and a wide range of outcomes related to psychosocial well-being, mental health, health behaviors, and physical health in young adults. Longitudinal data from the Growing Up Today Study (2007–2010 or 2007–2013, depending on outcome; mean baseline age = 22.97 years) were analyzed using generalized estimating equations. Sample sizes ranged from 6,323 to 7,463, depending on outcome. Bonferroni correction was used to correct for multiple testing. All models controlled for sociodemographic characteristics, religious service attendance, maternal attachment, and prior values of the outcome variables. Greater sense of mission was associated with greater psychological well-being (including life satisfaction, positive affect, self-esteem, emotional processing, and emotional expression), greater use of preventive health care, more volunteer activities, and possibly fewer depressive symptoms. However, there was little association with physical health or other behavioral outcomes. The formation of a sense of mission may provide a novel target for promoting multiple facets of psychological well-being, prosocial character, and possibly mental health among young adults.
- Published
- 2018
40. Confronting the Rise and Fall of US Life Expectancy
- Author
-
Howard K. Koh, Anand K. Parekh, and John J. Park
- Subjects
Gerontology ,business.industry ,Life expectancy ,Medicine ,General Medicine ,business - Published
- 2019
41. The Philip Morris International-Funded Foundation for a Smoke-Free World
- Author
-
Alan C. Geller and Howard K. Koh
- Subjects
Smoke ,Biomedical Research ,business.industry ,Conflict of Interest ,010102 general mathematics ,Tobacco control ,Foundation (engineering) ,Tobacco Industry ,General Medicine ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,Law ,Evidence-Based Practice ,Research Support as Topic ,Medicine ,Free world ,Smoking Cessation ,030212 general & internal medicine ,0101 mathematics ,business ,Foundations - Published
- 2018
42. Health Insurance for Asian Americans, Native Hawaiians, and Pacific Islanders Under the Affordable Care Act
- Author
-
Arnold M. Epstein, Benjamin D. Sommers, Sarah Humble, Graham A. Colditz, Howard K. Koh, and John J. Park
- Subjects
Adult ,Male ,CARE Act ,medicine.medical_specialty ,Native Hawaiian or Other Pacific Islander ,Adolescent ,common ,education ,MEDLINE ,Hawaii ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Asian americans ,Native Hawaiians ,Patient Protection and Affordable Care Act ,Internal Medicine ,Health insurance ,medicine ,Humans ,030212 general & internal medicine ,Insurance, Health ,Asian ,business.industry ,030503 health policy & services ,common.demographic_type ,Middle Aged ,United States ,Family medicine ,Indians, North American ,Pacific islanders ,Female ,0305 other medical science ,business ,Cohort study - Abstract
This cohort study analyzed the extent of post–Affordable Care Act (ACA) health insurance coverage gains for Asian Americans, Native Hawaiians, and Pacific Islanders and whether disparities in coverage have narrowed over time.
- Published
- 2018
43. Toward a United States of Health: Implications of Understanding the US Burden of Disease
- Author
-
Anand K. Parekh and Howard K. Koh
- Subjects
Burden of disease ,medicine.medical_specialty ,business.industry ,010102 general mathematics ,MEDLINE ,General Medicine ,Health Care Costs ,01 natural sciences ,United States ,03 medical and health sciences ,0302 clinical medicine ,Cost of Illness ,Family medicine ,medicine ,Cost of illness ,Humans ,030212 general & internal medicine ,0101 mathematics ,business ,Health implications ,Original Investigation - Abstract
In this study, Global Burden of Disease investigators characterize trends in mortality, life expectancy, and prevalence associated with most common diseases and disease and mortality risk factors in the United States between 1990 and 2016.
- Published
- 2018
44. Body and Soul: Health Collaborations With Faith-Based Organizations
- Author
-
Howard K. Koh and Eric Coles
- Subjects
medicine.medical_specialty ,business.industry ,Political science ,Public health ,media_common.quotation_subject ,Faith-Based Organizations ,Public Health, Environmental and Occupational Health ,medicine ,MEDLINE ,Public relations ,business ,Soul ,media_common - Published
- 2019
45. Organ Donation in the Era of the Opioid Crisis: A Clinical Strategy to Maximize Transplantation
- Author
-
Francis L. Delmonico, Alexandra K. Glazier, and Howard K. Koh
- Subjects
medicine.medical_specialty ,MEDLINE ,030204 cardiovascular system & hematology ,030230 surgery ,Risk Assessment ,Donor Selection ,Drug Users ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Cause of Death ,medicine ,Humans ,Organ donation ,Intensive care medicine ,Cause of death ,Transplantation ,Donor selection ,business.industry ,Graft Survival ,Opioid-Related Disorders ,Tissue Donors ,Treatment Outcome ,Opioid ,Patient Safety ,Risk assessment ,business ,medicine.drug - Published
- 2017
46. Community-Based Prevention and Strategies for the Opioid Crisis
- Author
-
Howard K. Koh
- Subjects
medicine.medical_specialty ,MEDLINE ,03 medical and health sciences ,0302 clinical medicine ,Preventive Health Services ,medicine ,Humans ,030212 general & internal medicine ,Community Health Services ,Psychiatry ,Health Education ,Opioid epidemic ,030505 public health ,Community based prevention ,business.industry ,Opioid-Related Disorders ,General Medicine ,medicine.disease ,United States ,Analgesics, Opioid ,Opioid ,Health education ,0305 other medical science ,Addictive behavior ,business ,Opioid analgesics ,medicine.drug - Published
- 2017
47. Honoring Dr. Waun Ki Hong, a cancer pioneer and visionary: On the occasion of his Festschrift, August 14, 2014
- Author
-
Howard K. Koh
- Subjects
Cancer Research ,Oncology ,business.industry ,MEDLINE ,Medicine ,Library science ,Cancer ,Historical Article ,Biography ,business ,medicine.disease - Published
- 2015
48. Improving Health Care for Homeless People
- Author
-
James J. O’Connell and Howard K. Koh
- Subjects
030505 public health ,Quality management ,Insurance, Health ,business.industry ,MEDLINE ,General Medicine ,Quality Improvement ,Vulnerable Populations ,United States ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Patient-Centered Care ,Health care ,Ill-Housed Persons ,Housing ,Medicine ,Humans ,030212 general & internal medicine ,Healthcare Disparities ,0305 other medical science ,business ,Quality of Health Care - Published
- 2016
49. Improving Health and Health Care in the United States: Toward a State of Complete Well-being
- Author
-
Howard K. Koh
- Subjects
medicine.medical_specialty ,HRHIS ,business.industry ,Public health ,010102 general mathematics ,International health ,General Medicine ,01 natural sciences ,Health equity ,United States ,03 medical and health sciences ,0302 clinical medicine ,Health promotion ,Nursing ,Family medicine ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Health care reform ,0101 mathematics ,business ,Delivery of Health Care ,Health policy - Published
- 2016
50. Changing the Language of Addiction
- Author
-
Michael Botticelli and Howard K. Koh
- Subjects
Mental Health Services ,medicine.medical_specialty ,Social stigma ,Attitude of Health Personnel ,Substance-Related Disorders ,media_common.quotation_subject ,030508 substance abuse ,Guidelines as Topic ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Terminology as Topic ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,Addiction treatment ,media_common ,Language ,Stereotyping ,Substance dependence ,business.industry ,Addiction ,General Medicine ,Patient Acceptance of Health Care ,medicine.disease ,0305 other medical science ,business ,Addictive behavior - Published
- 2016
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