Category Archives: Epidemiology

Healthy Intersections Podcast: COVID-19, 4 Years Later

By | March 28, 2024

It’s been 4 years this month since the World Health Organization declared COVID-19 to be a global pandemic. Where are we now? It’s time to take stock of the real impact of the pandemic. Aside from the burden of illness and mortality, the mental health toll, and the strains on the healthcare system, COVID even… Read More »

Making PrEP Accessible to Patients Experiencing Homelessness

By | November 9, 2023

Human Immunodeficiency Virus (HIV) has gone from a deadly infection to a manageable health condition in the last thirty years. Today, we have medications available that can treat those with HIV and prevent HIV in uninfected people. Pre-exposure prophylaxis, also known as PrEP, is a medication given to individuals without HIV to keep them from… Read More »

Healthy Intersections Podcast: June 2023

By | June 19, 2023

Welcome to the June 2023 episode of the Healthy Intersections podcast! This month, we sit down again with Carol Schmitt, Chief Scientist at RTI International, along with Juliet Sheridan, to talk about another of the RTI Rarity interactive state maps. This time, we are looking at North Carolina. We talk about historical redlining, climate change,… Read More »

Healthy Intersections Podcast: April 2023

By | April 24, 2023

Originally published April 6, 2023; updated April 24, 2023 to add audio links. Welcome! April 2023 marks a new milestone for the Healthy Intersections Podcast (HIP), sponsored by the American Public Health Association’s Medical Care Section. I’m taking on the role of the main producer of HIP. We’re also moving to a video AND audio… Read More »

COVID Still Kills, but the Demographics of Its Victims Are Shifting

As California settles into a third year of pandemic, covid-19 continues to pose a serious threat of death. But the number of people dying — and the demographics of those falling victim — has shifted notably from the first two years. Given the collective immunity people have garnered through a combination of mass vaccination and… Read More »

Social Drivers of Cancer Mortality: Part 2

By | September 1, 2022

Measuring and addressing social drivers of health are important in cancer research. Part 1 of this series, published in March 2022, described three commonly used area-level SDoH indices. None are not able to explain much variation in cancer mortality rates. In this post, I share results from a new model that shows promise. Methods in… Read More »

SDoH in Same-Sex Couple Hotspots and Coldspots

By | June 24, 2022

Happy Pride month! In this post, I’d like to share about a research project in progress that is relevant to the LGTBQIA+ community. This post may also be interesting to those of you who care ok about health equity and the social determinants of health (SDoH). I am a member of the queer community myself.… Read More »

Healthy Intersections Podcast: June 2022

By | June 2, 2022

On this month’s episode of the Healthy Intersections Podcast, Samy Anand from the Medical Care Section recaps last month’s blog posts and preview’s June’s issue of the Medical Care journal. Some great articles to check out for your summer reading list. Next, Lisa Lines, co-editor of the blog and podcast, interviews Dr. Pia MacDonald, an… Read More »

Single-arm trials for COVID-19 vaccines

By | May 27, 2021

Randomized control trials are the commonly held gold standard clinical trial design. The randomized controlled trial (RCT) is the gold standard of clinical research. However, researchers are increasingly asking: must they be? Webster-Clark, Jonsson Funk, and Stürmer discussed single-arm trials: administering a drug to an experimental group and using real-world data (RWD) to select an… Read More »

Monitoring EMS data for substance use

The United States is currently experiencing multiple, simultaneous epidemics that claim thousands of lives every week. According to the CDC, over 81,000 drug overdose deaths occurred between June 2019 and May 2020. That’s the highest number of overdose deaths ever recorded in a 12-month period. An estimated 93,000 Americans die annually from alcohol-related causes. Many… Read More »

Racism and Rurality in COVID-19 Burden

The inequitable distribution of COVID-19’s terrible burden has been well documented. There are notable disparities by race and ethnicity. COVID-19 rates, including incidence and fatality rates, are higher among Black, Indigenous, and other Persons of Color (BIPOC). This is structural racism at its worst, in which BIPOC individuals are disproportionately represented among essential workers and… Read More »

Teledermatology: Strengths and Weaknesses for Implementation

By | April 8, 2021

A growing trend in health care, accelerated by the COVID-19 pandemic, is the implementation of telemedicine.  Telemedicine is the delivery of health-related information and services among patients and providers via telecommunication technologies.  An example is the use of video technology by doctors to evaluate, diagnose, or treat a patient instead of having a face-to-face encounter. … Read More »

Treating the Opioid Crisis: Current Trends and What’s Next, Part 2

Last week, we discussed three noteworthy trends from the past decade in treating the opioid crisis. The first was recognizing medication for opioid use disorder (MOUD) as the standard of care. The second was formalizing an addiction medicine specialty. And the third was expanding the availability of MOUD. This week, we’ll consider three additional trends in… Read More »

Treating the Opioid Crisis: Current Trends and What’s Next

Throughout the past decade, the U.S. has seen a dramatic shift in addiction medicine research, clinical practice, and related stigma in seeking care. In a pair of blog posts, we will explore the top six trends related to treating the opioid crisis. And we’ll consider what may be next. The Opioid Epidemic Opioid addiction has… Read More »

Suicide Risk and Prevention Among Women

By | February 2, 2021

We have reached a 30-year high in the rate of suicide in the United States. Suicide risk and prevention efforts among women are the focus of a recent Medical Care supplemental issue. Efforts at prevention and recovery have been especially important for the Departments of Defense and Veterans Affairs. As mentioned in the introduction to… Read More »

Public Health and Medicine Are Essential Partners in Advancing Health

By | November 30, 2020

Historically, public health has served the nation through sanitation, immunization, and other disease-prevention activities (e.g., disease tracking and quarantine). For example, public health developed wastewater treatment programs to help fight typhoid fever during the industrial revolution. It also helped educate the public (and the food industry) on safely preparing and preserving foods. As a result,… Read More »

Rebuilding the Foundation of Rural Community Health after COVID-19

COVID-19 has exposed the cracks in the foundation of America’s rural community health system. These cracks include increased risk of facility closures, loss of services, low investment in public health, maldistribution of health professionals, and payment policies ill-suited to low-volume rural providers. As a result, short-term relief to stabilize rural health systems and long-term strategies… Read More »

Spain, Belgium, and Others Are Releasing Immigrant Detainees During COVID-19. Why the United States Should, Too

May 6 heralded another grim milestone in the United States: the first COVID-19-related death of an Immigration and Customs Enforcement (ICE) detainee, a 57-year-old man from El Salvador. Despite having high blood pressure and possibly diabetes, he had been denied release on bond by a judge. He continued to be held in Otay Mesa Detention… Read More »

COVID-19: Lessons for Climate Change Strategy

By | May 13, 2020

We are in the midst of two global public health catastrophes: the rapid spread of COVID-19 and the more insidious, chronic effects of climate change. The swift spread of COVID-19 has devastated many countries and their economies. But global changes in environmental conditions have been harming communities for decades. The World Health Organization estimates that… Read More »

COVID-19: High risk of severe illness

By | April 13, 2020

There is a lot of attention being paid to the proportions of severe and fatal cases in discussions of COVID-19. Unless you’ve been living under a rock since January, you know that there are groups who are more likely to get very sick or die during this pandemic. In this post, we explore the evidence… Read More »

COVID-19: health and the coming economic recession

By | April 3, 2020

The first reports of COVID-19, the name now used to describe the disease caused by a novel coronavirus, first emerged around New Year’s day of 2020. Since then, the conversation has shifted from containment efforts in Wuhan, China to social distancing and mandatory closures across the U.S., including in New York, California, Illinois [pdf], Massachusetts,… Read More »

Healthcare utilization in the SARS-CoV-2 pandemic

By | April 22, 2020

This post summarizes what we know right now about the SARS-CoV-2 virus and the disease it causes, COVID-19. The information contained in this post may change as the situation changes, or may become obsolete. We will attempt to update if any of this changes substantively.  News and social media outlets have fallen short of useful… Read More »

Using Telehealth to Fight the Novel Coronavirus

By | March 10, 2020

COVID-19, the disease caused by the novel coronavirus, is spreading across the US and around the world. Can providers use telehealth to help  identify and manage the novel coronavirus while helping organizations manage capacity and prevent the spread of COVID-19?  Read on to find out more. Because of its airborne person-to-person transmission, coronavirus and related… Read More »

The myth of female hysteria and women’s health disparities

By | March 5, 2020

What role might the myth of “female hysteria” play in women’s health disparities? For thousands of years, women’s health complaints were often diagnosed as “female hysteria” – a catch-all term that basically implied “it’s all in her head.” The condition was sometimes believed to be caused by a wandering uterus and/or sexual frustration. Doctors treated… Read More »

Care experiences among Medicare beneficiaries with cancer: A cross-study overview of published results to date from SEER-CAHPS

Medicare beneficiaries who have cancer are a growing population with unique care needs. Population-based research examining relationships between cancer patient experiences, health care utilization, and subsequent patient health outcomes is lacking. A recently updated data resource called SEER-CAHPS links cancer registry data with Medicare information and patient surveys. It provides a comprehensive, nationally representative source… Read More »

Witnessing and Responding to Homelessness

By | December 11, 2019

Homelessness is both a public health issue and a deeply troubling sign of policy failures in a rich country such as the US. Yet what are the right ways to respond, both in the moment and on a larger scale? In early November, the American Public Health Association (APHA) gathered for our annual meeting at… Read More »

The ICD-10 transition changed the game more than you think

By | July 25, 2019

The codes of the International Classification of Diseases (ICD) serve as the backbone for billing, payment, and surveillance programs across the entire healthcare system – nationally and globally. Recent research published in Medical Care by Alexander Mainor and colleagues from the Dartmouth Institute for Health Policy & Clinical Practice has shown that the transition of… Read More »

Homelessness as a Public Health Issue

By | June 12, 2019

Homelessness and housing are issues of public health significance. This month, we published a Special Commentary about homelessness in Medical Care, informed by the 2017 policy statement we co-authored for the American Public Health Association (APHA) about homelessness and how federal, state, and local authorities can use evidence-based solutions to help bring an end to… Read More »

Veteran Access to Hepatitis C Treatment

By | May 10, 2019

Hepatitis C treatment has gone through a revolution in the last 5 years. Treatment durations have dropped from 48 to 12 weeks, and success rates have improved dramatically. However, treatment costs have sky-rocketed accordingly, and access to care has become a significant issue, particularly for lower socioeconomic individuals and groups. Eligible veterans should have access… Read More »

Stroke risk has declined in the US — for some groups more than others

By | April 18, 2019

The risk of having a stroke has gone down over the past 25 years among older people in the US, according to new research by Yao and colleagues published this month in Medical Care. The study combined data from several different nationally representative data sources, including Medicare claims and survey data from NHANES and MCBS.… Read More »

Hospitalizations of Individuals Experiencing Homelessness Driven by Behavioral Health Concerns

By | February 6, 2019

Individuals experiencing homelessness are among the most medically, socially, economically, and politically vulnerable in our society. Because of this, patterns of service use by these individuals can often serve as indicators of the safety net capacity and overall wellness of the systems of care we have in place – like “canaries in the coal mine.”… Read More »

Big differences in detection rates between different data sources: sky falling or business as usual?

By | January 2, 2019

This post is for the measurement methodologists in the house. Although, the study results have a real impact for anyone reading macro-level studies of health care services and economics. Sure, this is a bit of inside baseball, but it involves a fundamentally important issue at the center of healthcare research and policy that relies on… Read More »

The Link Between Prescription Copayments, Contraceptive Adherence, and Unintended Pregnancy in the United States

By | December 12, 2018

There are approximately 61 million women of reproductive age (15-44 years) in the United States, and at any given time, 70% of them are at risk of unintended pregnancy—that is, they are sexually active but do not want to become pregnant. About 72% of women who currently use contraception use non-permanent methods, such as the… Read More »

A Public Health Approach to Addressing Sexually Transmitted Infections

By | August 30, 2018

Chlamydia and gonorrhea are among the most common sexually transmitted infections (STIs) in the United States, and research shows that 50% of sexually active individuals will contract an STI by 25 years old. Though chlamydia and gonorrhea are often asymptomatic in women, screening is important in order to prevent complications, such as pelvic inflammatory disease… Read More »

What’s Next? The Ongoing Crisis for Children Taken from Families Seeking Asylum at the US-Mexico Border

By | August 3, 2018

This year, we’ve seen more than 2,000 children separated from their parents, who were legally seeking asylum in the US. Most were from Central American countries in which crime and unrest place many at risk for violence. These children were taken from their families by US government employees between April 19 and May 31, 2018,… Read More »

The curious case of fibromyalgia: Overdiagnosed, underdiagnosed, and misunderstood

By | June 21, 2018

Fibromyalgia is a debilitating centralized pain condition experienced by millions of Americans. “Centralized” refers to origination or amplification of pain by a sufferer’s central nervous system. It is, in a true sense, pain that is “in one’s head” — but nevertheless as real and noxious as any other pain. Ultimately, pain is always something experienced… Read More »

Opportunistic Salpingectomy: How is this Not Totally a Thing?

By | September 18, 2019

The name doesn’t exactly help. But before we discuss rebranding, a brief introduction to the concept . . . Salpingectomy refers to surgical removal of one (unilateral) or both (bilateral) fallopian tubes. It is thus a surgical option for female sterilization—but also drastically reduces a woman’s risk of ovarian cancer. This is huge. Ovarian cancer… Read More »

The Social Determinants of Addiction

By | February 15, 2018

Opioid use is a serious concern that the executive branch of the United States government recently declared a public health emergency. Based on data from the Department of Health and Human Services, in 2016, 2.1 million people misused prescription opioids for the first time, and 42,249 people died from overdosing on opioids. Also in 2016, 170,000… Read More »

In the fight against the opioid epidemic, states should update their needle and syringe access laws

By | February 7, 2018

During my time as a community pharmacist in Maryland, I often encountered individuals who would approach the pharmacy in search of syringes. Although they would try to disguise their intentions by stating that they needed it for someone else or for an animal, it was apparent why they were there; they were going to use… Read More »

Addressing addiction at the local level

By | November 9, 2017

As the City of Worcester Commissioner of Health and Human Services, I have developed city-wide initiatives and worked on policy change to address three primary health issues prevalent in our community, those being addiction, mental health, and homelessness, which all tend to occur hand in hand. Addiction is the largest public health and public safety… Read More »

Survey says: Most women don’t know about breast cancer overdiagnosis and overtreatment

By | October 4, 2017

October is here, so along with the fall foliage, prepare yourself for a deluge of pink ribbons, umbrellas, bumper stickers, and billboards: it’s Breast Cancer Awareness Month. Started as a well-intentioned campaign to raise awareness about breast cancer and fundraise for breast cancer research, some have said that the movement commodifies a deadly disease at… Read More »

Using claims to measure disease prevalence

By | August 24, 2017

Bias in claims data with respect to disease status is a problem for health services researchers, because we often rely on administrative claims (billing data) to measure disease status for large cohorts. Misclassification bias may alter the prevalence of given conditions–which is especially problematic for epidemiology and comparative effectiveness research. It may even alter the… Read More »

Patterns of Opioid Use and Risk of Opioid Overdose

By | July 5, 2017

Opiate overdose is now the leading cause of accidental death in the United States, killing more than 50,000 people in 2015. About 20,000 of those deaths were attributed to the use of prescription opiate medications. As a physician, I want to alleviate my patients’ pain, but I have also taken an oath to do my… Read More »

The Childhood Roots of Health Inequity: Part 4 – Dr. Jennifer Manly

By | April 27, 2017

This post is the final one in our 4-part series focusing on presentations that were delivered at a special panel session at APHA16 on the childhood roots of health inequity [part 1, part 2, part 3]. Our fourth presenter, Dr. Jennifer Manly, is Associate Professor of Neuropsychology in Neurology at the Gertrude H. Sergievsky Center and the… Read More »