Notes

COVID-19 widespread suffers from of parents taking care of children with oesophageal atresia/tracheo-oesophageal fistula.
Laws and policies are critical determinants of health and well-being. They can encourage positive behaviors and discourage harmful behaviors, and they can enhance or worsen health, health equity, health disparities, and health literacy. Recognizing their contribution to conditions in the environments in which people are born, live, learn, work, play, worship, and age, and people's experiences of these conditions, the US Department of Health and Human Services considered the roles of law and policy throughout its development of Healthy People 2030. Laws and policies often interrelate, but they have different purposes. A law is an established procedure, standard, or system of rules that members of a society must follow. A policy is a decision or set of decisions meant to address a long-term purpose or problem. Healthy People 2030 offers an opportunity for stakeholders in diverse sectors and at all levels to use laws and policies to support or inform the initiative's implementation, address health disparities and health inequities, and improve health and well-being in this decade. Introducing new laws and policies or rescinding existing ones to achieve Healthy People 2030 goals offers a chance to rigorously assess outcomes and weigh the balance of good outcomes against unintended consequences.
To promote the health of the Navajo people, the Navajo Nation passed the Healthy Diné Nation Act (HDNA) in 2014. The HDNA included a 2% tax on "minimal-to-no-nutritional-value" foods and waived 5% sales tax on healthy foods, the first such policy in the United States and any sovereign Tribal nation. Uniquely aligned with Tribal government structures, revenue was directly allocated to 110 small local government entities (Chapters) for self-determined wellness projects.

To characterize HDNA-funded wellness projects, test for variation in project type, and funding amount over time by region and community size.

Longitudinal study assessing funded wellness projects from tax inception through 2019.

The Navajo Nation.

One hundred ten Navajo Nation Chapters receiving funding for self-determined wellness projects.

The categories and specific types of wellness projects and funding over 4 years by region and community size.

Of revenue collected in 2015-2018, more than 99.1% was disbursed through 2019 ($4.6nerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions.
Through 2019, more than 99% of HDNA revenue was successfully disbursed to 110 rural, Tribal communities. Communities chose projects related to promoting the built recreational environment, agriculture, and fitness/nutrition education, with smaller communities emphasizing cultural and intergenerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions.Disease investigation and contact tracing are long-standing public health strategies used to control the spread of infectious disease. Throughout the COVID-19 pandemic, health departments across the country have lacked the internal workforce capacity and technology needed to efficiently isolate positive cases and quarantine close contacts to slow the spread of SARS-CoV-2. This article describes an innovative disease investigation and contact tracing program developed through a formalized community partnership between a local county health department and local university. This innovative new program added 108 contact tracers to the county's public health workforce, as well as enabled these contact tracers to work remotely using a call center app and secure cloud-based platform to manage the county's caseload of cases and contacts. An overview of the requirements needed to develop this program (eg, hiring, health data security protocols, data source management), as well as lessons learned is discussed.
Public health is a gendered field. Although a majority of the public health workforce, women encounter an imbalance of power and experience disparate opportunities within the profession.

This article offers a multidimensional critique of gender inequity within the public health workforce through an examination of the literature.

There are three existing disparities between men and women in public health unequal representation in leadership positions; persistence of wage discrimination; and disparities in scholarly publication and citations. Disparities are often more pronounced among women with intersectional identities (eg, race/ethnicity or other identities).

Gender inequity is structural, and solutions must address micro-, interactional, and macro-levels. The changing workforce and practitioners' skills in addressing upstream issues provide the opportunity to address this issue.
Gender inequity is structural, and solutions must address micro-, interactional, and macro-levels. The changing workforce and practitioners' skills in addressing upstream issues provide the opportunity to address this issue.Federally qualified health centers (FQHCs) serve patient populations that commonly have low preventive care utilization rates. Implementation of preventive care interventions (PCIs) may help decrease these care deficiencies. A survey of Kentucky FQHC leaders was conducted in 2019 to determine resources used to learn about PCIs and how leaders decide to implement them. Nineteen of Kentucky's 24 FQHCs completed the survey for a participation rate of 79%. this website Among participating FQHC leadership, the 3 resources that were very or somewhat likely to be used to learn about PCIs were advice or consultation from peers (100%), professional associations (95%), and nonacademic conferences/meetings (90%). The state primary care association and statewide community health center network were listed as the most helpful resources. These results highlight the types of resources used by FQHC leadership to learn about PCIs. Understanding preferred learning methods can help researchers improve outreach to FQHCs and facilitate dissemination of PCIs.
In response to the COVID-19 pandemic, states across the United States implemented various strategies to mitigate transmission of SARS-CoV-2 (the virus that causes COVID-19).

To examine the effect of COVID-19-related state closures on consumer spending, business revenue, and employment, while controlling for changes in COVID-19 incidence and death.

The analysis estimated a difference-in-difference model, utilizing temporal and geographic variation in state closure orders to analyze their impact on the economy, while controlling for COVID-19 incidence and death.

State-level data on economic outcomes from the Opportunity Insights data tracker and COVID-19 cases and death data from usafacts.org.

The mitigation strategy analyzed within this study was COVID-19-related state closure orders. Data on these orders were obtained from state government Web sites containing executive or administrative orders.

Outcomes include state-level estimates of consumer spending, business revenue, and employment levels.

Analyses showed that although state closures led to a decrease in consumer spending, business revenue, and employment, they accounted for only a small portion of the observed decreases in these outcomes over the first wave of COVID-19.

The impact of COVID-19 on economic activity likely reflects a combination of factors, in addition to state closures, such as individuals' perceptions of risk related to COVID-19 incidence, which may play significant roles in impacting economic activity.
The impact of COVID-19 on economic activity likely reflects a combination of factors, in addition to state closures, such as individuals' perceptions of risk related to COVID-19 incidence, which may play significant roles in impacting economic activity.A common problem faced by local health departments is engaging cross-sector stakeholders to achieve shared community goals. Community engagement is critical for effective Community Health Improvement Plan (CHIP) development and implementation, while also being a standard for health department accreditation. This case study describes one city-county health department's development of a nonprofit arm to act as a catalyst for connecting community leaders to identify and collaboratively address community health goals. First, we describe our process to develop a nonprofit entity and strategically recruit community members to comprise the founding board of directors. Then, we describe methods employed by the nonprofit to create a community action plan in response to identified community health needs and how we incentivized progress. We evaluated our process using a mixed-methods approach and conclude that a nonprofit arm of a health department can be a novel strategy for effectively engaging community stakeholders to advance community health.
The Good Health & Great Hair program was developed by Kaiser Permanente in partnership with a network of trusted neighborhood barbershops and beauty salons in West Baltimore, Maryland.

The initiative aimed to increase health awareness and knowledge and reduce health disparities by making no-cost health care services available beyond traditional health care settings in predominantly Black, historically redlined neighborhoods in West Baltimore.

This initiative, established by an integrated health care system, is the first to utilize mobile health clinics into a holistic community health outreach program in partnership with barbershops and beauty salons to provide medical and social services to underserved populations. In addition to the mobile health clinics, key features of this program included lay first responder trainings on topics of physical and behavioral health, on-site medical and social services offered by community partners, and culturally relevant mental health programming. The majority of and lessons learned could inform the design of similar programs.
The initiative delivered critical health and social support services through a partnership with an established integrated health care system, community barbershops and beauty salons, a mobile health team, and social supports. This novel program utilized a mobile health clinic to provide extensive clinical services complemented by on-site social services. Patterns of service utilization and lessons learned could inform the design of similar programs.
The aim of this study was to identify patterns of palliative chemotherapy (CTh) and the associated overall survival (OS) in patients with pancreatic cancer, with specific focus on age.

Between May 1, 2011, and April 30, 2016, 4260 patients were registered in the Danish Pancreatic Cancer Database. The 1715 patients receiving palliative CTh were retrieved. Age was grouped into less than 70, 70 to less than 75, and 75 years or more.

Of the 1715 patients receiving first-line CTh, 586 (34%) underwent second-line CTh and 151 (9%) third-line CTh. First-line gemcitabine resulted in a significant worse survival compared with combination CTh, hazard ratio 1.51. For combination CTh, OS differed between the age groups, P < 0.01. The median OS in the less than 70 years (n = 547), 70 to less than 75 years (n = 163), and 75 years or more (n = 67) groups were 9.3, 9.6, and 7.2 months, respectively. No differences in survival were observed among patients receiving first-line gemcitabine (P = 0.35).

Our findings are useful in treatment-related decision making in patients with pancreatic cancer.
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