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Objective To assess national pandemic preparedness and response plans from a health system perspective to determine the extent to which implementation strategies that support health system performance have been included. Methods We systematically mapped pandemic preparedness and response implementation strategies that improve resilience to pandemics onto the Health System Performance Assessment Framework for Universal Health Coverage. Using this framework, we conducted a document analysis of 14 publicly available national influenza pandemic preparedness plans, submitted to the European Centre for Disease Prevention and Control, to assess how well health system functions are accounted for in each plan. Findings Implementation strategies found in national influenza pandemic preparedness plans do not systematically consider all health system functions. Instead, they mostly focus on specific aspects of governance. In contrast, little to no mention is made of implementation strategies that aim to strengthen health financing. There was also a lack of implementation strategies to strengthen the health workforce, ensure availability of medical equipment and infrastructure, govern the generation of resources and ensure delivery of public health services. Conclusion While national influenza pandemic preparedness plans often include provisions to support health system governance, implementation strategies that support other health system functions, namely, resource generation, service delivery, and in particular, financing, are given less attention. These oversights in key planning documents may undermine health system resilience when public health emergencies occur. Objectif Evaluer les plans nationaux de preparation et de reaction aux pandemies du point de vue du systeme de sante afin de determiner le niveau d'inclusion des strategies de mise en oeuvre qui soutiennent la performance du systeme de sante. Methodes Nous avons systematiquement identifie les strategies de mise en oeuvre de la preparation et de la reaction aux pandemies qui ameliorent la resilience dans le cadre devaluation de la performance des systemes de sante pour la couverture sanitaire universelle. Ce cadre nous a servi de base pour proceder a une analyse documentaire de 14 plans nationaux de preparation a une pandemie de grippe accessibles au public. Ces plans ont ete soumis au Centre europeen de prevention et de controle des maladies, afin devaluer la prise en compte des fonctions des systemes de sante dans chaque plan. Resultats Les strategies de mise en oeuvre figurant dans les plans nationaux de preparation aux pandemies de grippe ne prennent pas systematiquement en compte toutes les fonctions des systemes de sante. Elles se concentrent plutot sur des aspects specifiques de la gouvernance. En revanche, les strategies de mise en oeuvre visant a renforcer le financement de la sante ne sont que peu, voire pas, mentionnees. Les strategies de mise en oeuvre visant a renforcer les effectifs du personnel de sante, a garantir la disponibilite des equipements medicaux et des infrastructures, a regir la generation de ressources et a assurer la prestation de services de sante publique font egalement defaut. Conclusion Si les plans nationaux de preparation aux pandemies de grippe comprennent souvent des dispositions visant a soutenir la gouvernance des systemes de sante, les strategies de mise en oeuvre qui soutiennent d'autres fonctions des systemes de sante, notamment la generation de ressources, la prestation de services et, en particulier, le financement, beneficient d'une attention moindre. Ces lacunes dans des documents de planification cles sont de nature a nuire a la resilience du systeme de sante en cas de situation d'urgence liee a la sante publique. Objetivo Evaluar los planes nacionales de preparacion y respuesta ante una pandemia desde la perspectiva del sistema sanitario para determinar en que medida se han incluido estrategias de implementacion que apoyen el rendimiento del sistema sanitario. Metodos Se trazo un mapa sistematico de las estrategias de preparacion y respuesta ante pandemias que mejoran su resiliencia en el Marco de Evaluacion del Rendimiento del Sistema Sanitario para la Cobertura Sanitaria Universal. A partir de este marco, se realizo un analisis documental de 14 planes nacionales de preparacion ante una pandemia de gripe y de acceso publico, presentados al Centro Europeo para la Prevencion y el Control de las Enfermedades, con el fin de evaluar en que medida se tienen en cuenta las funciones del sistema sanitario en cada plan. Resultados Las estrategias de implementacion que se encuentran en los planes nacionales de preparacion ante una pandemia de gripe no consideran sistematicamente todas las funciones del sistema sanitario. En su lugar, se centran sobre todo en aspectos especificos de la gobernanza. Por otro lado, apenas se mencionan las estrategias de aplicacion destinadas a reforzar la financiacion sanitaria. Tambien faltan estrategias de implementacion para reforzar el personal sanitario, garantizar la disponibilidad de equipos medicos e infraestructuras, gobernar la generacion de recursos y garantizar la prestacion de servicios sanitarios publicos. Conclusion Aunque los planes nacionales de preparacion ante una pandemia de gripe suelen incluir disposiciones para apoyar la gobernanza del sistema sanitario, se presta menos atencion a las estrategias de implementacion que apoyan otras funciones del sistema sanitario, en concreto, la generacion de recursos, la prestacion de servicios y, en particular, la financiacion. Estos descuidos en documentos de planificacion clave pueden debilitar la resiliencia del sistema sanitario cuando se producen emergencias de salud publica., Introduction The coronavirus disease 2019 (COVID-19) pandemic profoundly affected health systems as well as economies and societies more broadly. (1,2) As countries grappled with increasing numbers of COVID-19 cases, many [...]

Black women in the United States continue to face multilayered forms of anti-Black gendered oppression leading to severe health disparities and inequities that have a dire impact on their well-being. This paper recognizes the urgency to attend to Black women's health and healing in the pursuit of creating health equity. The authors call for the creation of sacred spaces for Black women to participate in embodied and community-engaged healing, grounded in a gender justice that is inextricably tied to racial justice. This research is inspired by the long, rich line of Black American women activist-healers that have called for the radical healing of Black women. Therefore, the authors root their work in an ethical health justice ethos, honoring the humanity of Black women through a recognition of their sacredness, guided by the principles of justice, truth-telling, love, and respect that emphasizes that Black women's lives matter. Using an interdisciplinary approach, the authors braid together healing narratives from the fields of Public Health, Black Psychology, Africana Studies, and Gender, Women's, and Sexuality Studies. Underscoring the importance of Black women reclaiming their radical healing, this paper at the same time underlines resisting anti-Black gendered racism and interlocking forms of oppression. The authors emphasize gender and racial justice while endorsing collectivistic orientations, grounded in an African-centered worldview, that support Black women's embodied and community-engaged healing. As a result, the authors also draw from healing narratives in their fields that include cultural paradigms, socially engaged spirituality, and generational and gendered wisdom. Connecting historical to present-day medical/mental health encounters, the authors underscore inhumane, racist, and sexist pseudoscience, medical treatment, and research experiments on Black women's bodies. The authors also address social injustices, isolation, and (dis)ease while foregrounding gender and racial justice in the creation of health equity for Black women. Keywords: Black Womanism, Black Feminism, Public health, Black Psychology, Black women, Healing, Health justice, Introduction Rarely, if ever, are any of us healed in isolation. Healing is an act of communion. ~bell hooks, All About Love Due to the current backlash of anti-Black gendered [...]

I am a second-year Epidemic Intelligence Service (EIS) officer assigned to the Centers for Disease Control and Prevention's (CDC's) National Environmental Public Health Tracking Program (Tracking Program). EIS officers, commonly [...]

Objectives. We sought to examine the utilization and impact of enabling services, such as interpretation and eligibility assistance, among underserved Asian American, Native Hawaiian, and other Pacific Islander (AANHOPI) patients served at 4 community health centers. Methods. For this project, we developed a uniform model for collecting data on enabling services and implemented it across 4 health centers that served primarily AANHOPI patients. We also examined differences in patient characteristics between users and nonusers of enabling services. Results. Health center patients used many enabling services, with eligibility assistance being the most used service. In addition, compared with nonusers, users of enabling services were more likely to be older, female, AANHOPI, and uninsured (P Conclusions. For underserved AANHOPI patients at community health centers, enabling services are critical for access to appropriate care. We were the first to examine uniform data on enabling services across multiple health centers serving underserved AANHOPI patients. More data on enabling services and evaluation are needed to develop interventions to improve the quality of care for underserved AANHOPI patients. (Am J Public Health. 2010;100:2199-2205. doi: 10.2105/AJPH.2009.172270)

Objectives. We sought to examine the extent to which children in the child welfare system receive mental health care consistent with national standards. Methods. We used data from 4 waves (3 years of follow-up) of the National Survey of Child and Adolescent Well-Being, the nation's first longitudinal study of children in the child welfare system, and the Area Resource File to examine rates of screening, assessment, and referral to mental health services among 3802 youths presenting to child welfare agencies. Weighted population-averaged logistic regression models were used to identify variables associated with standards-consistent care. Results. Only half of all children in the sample received care consistent with any 1 national standard, and less than one tenth received care consistent with all of them. Older children, those exhibiting externalizing behaviors, and those placed in foster care had, on average, higher odds of receiving care consistent with national standards. Conclusions. Adverse consequences of childhood disadvantage cannot be reduced unless greater collaboration occurs between child welfare and mental health agencies. Current changes to Medicaid regulations that weaken entitlements to screening and assessment may also worsen mental health disparities among these vulnerable children. (Am J Public Health. 2010;100:742-749. doi: 10.2105/AJPH.2008.151472)

Reducing and eliminating disparities in health is a matter of life and death. Each year in the United States, thousands of individuals die unnecessarily from easily preventable diseases and conditions. It is critical that we approach this problem from a broad public health perspective, attacking all of the determinants of health: access to care, behavior, social and physical environments, and overriding policies of universal access to care, physical education in schools, and restricted exposure to toxic substances. We describe the historical background for recognizing and addressing disparities in health, various factors that contribute to disparities, how the public health approach addresses such challenges, and two successful programs that apply the public health approach to reducing disparities in health. Public health leaders must advocate for public health solutions to eliminate disparities in health.

Many infectious diseases are recognized as a public health problem. If one were to apply the criteria for designating an infectious disease as a public health problem to diabetes mellitus, how would diabetes rate? The evidence that justifies referring to diabetes as a public health problem includes the burden on society caused by the number of complications and premature mortality, the growth in the number of people diagnosed with the disease since the early 1990s, and the growing public concern. Because diabetes is a public health problem, it warrants public health solutions. This review examines selected components of a framework that provides a useful way to examine what the public health community is doing to combat this growing epidemic. doi: 10.1016/j.jada.2008.01.023