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Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Other
This episode from the podcast 99 Percent Invisible reflects on how the COVID-19 pandemic exposed the American public to a long-standing problem: the disjointed nature of the U.S. health system. Because state and local health departments largely operate independently and use their own data collection and analysis tools, health systems across the country lack standardized data definitions and systems. These inconsistencies made it nearly impossible to collect and analyze comprehensive, standardized data on COVID-19 cases, deaths, and vaccines administered amid the pandemic. Health experts featured on this episode believe that the pandemic made the need for an overhaul of America’s informatics system very apparent. When rebuilding this system, it’s important to focus on remedying existing inequalities in data collection and classification that in some cases render the health status of certain populations – think Native American communities and other communities of color – completely invisible in the data. By virtue of being small populations, it can be difficult for health departments to collect sufficient and/or statistically significant data on minority communities. Another issue discussed in this episode is the use of broad racial categories like “other,” “multiple races,” or even “Asian American,” which, if not disaggregated, obscures the health status of diverse populations who are grouped under the same category. Without comprehensive and inclusive health data, it’s difficult to identify disparities and implement policies and programming that promote social mobility and health equity.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Systematic Review/Meta-Analysis
This review of state data collection and reporting practices during the COVID-19 pandemic found inconsistencies and gaps in data collected by race and ethnicity. Improved standardization across the U.S.–which may come in the form of a federally-operated centralized database–would address some of the concerns in data representation of all Americans.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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White Paper/Brief
This brief lists interventions to support state public health efforts to address rural disparities and racial discrimination. It emphasizes the importance of localized data on social determinants of health and improving systemic and structural underpinnings of racial disparities. Suggested interventions address data collection and workforce issues, including representativeness and paid family leave.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Summary Report/Recommendations
This article seeks to assess COVID-19 case and mortality rates in non-Hispanic American Indian and Alaska Natives (AI/AN) through an analysis of laboratory-reported COVID-19 data from January 22-July 3, 2020, for 23 U.S. states. The results show that AI/AN individuals are 3.5 times more likely to contract COVID-19 than White individuals, and more accurate race/ethnicity data must be reported by all states to more accurately represent this population.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study examines a cohort of patients testing for COVID-19 in a large healthcare setting spanning California, Oregon, and Washington between March 1 and December 31, 2020. to determine the sociodemographic and clinical characteristics of these patients. Results found that major healthcare disparities were evident, particularly among Hispanics. Hispanic individuals tested positive at a higher rate, required excess hospitalization and mechanical ventilation, and had higher odds of in-hospital mortality despite younger ages. Targeted, culturally responsive interventions and equitable vaccine development and distribution are needed to address the increased risk of poorer COVID-19 outcomes among minority populations.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study develops a microsimulation model of COVID-19 transmission in a homeless shelter and calibrated it to data from surveys conducted during COVID-19 outbreaks in five homeless shelters in three US cities from March 28 to April 10, 2022. The study estimates the probability of averting a COVID-19 outbreak when an exposed individual is introduced into a representative homeless shelter of 250 residents and 50 staff over 30 days under different infection control strategies. The results show that within communities with high COVID-19 community incidence are unable to prevent a large outbreak, despite extensive infection control strategies. This study suggests a need for non-congregate housing in high-risk settings, is needed to avoid outbreaks within these settings.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study examined the sociodemographic characteristics of the residents of Cameron County, Texas, one of the most Hispanic-populated counties in the United States with over 90% of residents identifying as Hispanic. The study analyzed data from March to December 2020, and studied both social determinants of health and COVID-19 mitigation policies, such as the “shelter in place” mandate. The results show that single parents, those living below the poverty level, and those who do not fluently speak English are at a more increased risk of contracting COVID-19. The shelter in place mandate was able to reduce community transmission within three weeks of implementation, but the results of its impact vary greatly by age, sex, and race.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study highlights the geographic differences in COVID-19 positivity rates within Los Angeles county, taking into consideration other socio-structural determinants that impact these rates. The data — testing data from the LAC Department of Public Health and American Community Survey data — was analyzed and mapped to include testing rates, race/ethnicity, poverty, insurance status, education, and population/household density. Results found higher COVID-19 positivity rates in communities with higher proportions of Latinx residents, those living below the federal poverty line, and those with high household densities.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study details an analysis of data from the University of Maryland family medicine and immediate care (UFM) practices to examine an association between COVID-19 infections and demographic and socioeconomic factors. Results found that Black and Hispanic patients were more likely test positive for COVID-19, and those living in areas with a high Area Deprivation Index score experienced higher risks of infections.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study looks at the perceptions, challenges, barriers, and experiences of undocumented immigrants in the U.S. The study used a snowball sampling of 20 undocumented Asian and Latinx men and women and asked them a series of questions about access to health care and their experience during the COVID-19 pandemic. The results found significant barriers in language comprehension, mistrust of public systems, and socioeconomic factors such as employers with little to no sick leave for those affected by COVID-19.