City Public Health Research Articles

Recovering the Urban Past for Equitable Present and Future Social Recovery

A multitude of determinants influence the urban planning process. Yet, in the contemporary context of an ongoing pandemic causing infirmity and death in more than 1,500 cities, how can examples of urban planning from history, namely ones that sought to boost public health, (re)shape the current urban planning paradigm? Is there a need in the light of the global impact of Covid-19 to re-evaluate the value of past planning models and so, in accordance, rethink present-day urban density management and public space creation? In consequence, this paper puts forward an overview of how city planning and public health have historically interlinked, albeit with reference to 19th century Britain and the establishment of public parks. Used communally by assorted social groups such green spaces were considered to be crucial for physical and mental health. Crucially too, these open areas are still a fundamental element of the 21st century British cityscape and, arguably, as part of the present and future social recovery from Covid-19, will play a vital role in public life and well-being.

The Influence of Public Health Center Management on the Quality Public Health Center Services in Ambon City

Health development is integral and important to national development. Therefore, a variety of comprehensive,tiered and integrated health efforts, both provided by the government and private sector, are organized toachieve the national health development goals. This research aims to look at the influence of public healthcenter management on the quality of public health center services in Ambon City. This research is a type ofquantitative research by conducting observational with the design of Cross Sectional Study. The researchpopulation is the entire head of the public health center and the Head of Business in each of the 22 publichealth centers in ambon city area. Sampling is done by total sampling technique. The sample set out in thisstudy was 44 people at ambon city public health center. Analysis data using chi-square test. The resultsshowed that there was an influence of planning (p= 0,000), supervision, control and assessment (p= 0,000)on the quality of public health center services in ambon city. While there is no effect of strengtheningmobilization and implementation (0,074) on the quality of public health center services in Ambon city. Thusthere is an influence of management on the quality of health services of public health centers in ambon city.It is expected that the head of the public health center improves performance in the preparation of planningby always guided by the previous data

Piloting a city health adaptation typology with data from climate-engaged cities: Toward identification of an urban health adaptation gap

Climate change has important population health impacts, and cities are often on the frontlines. However, health is reported to be less active in climate adaptation than other sectors. To contribute to better understanding urban health adaptation efforts and identifying gaps we developed a City Climate Health Adaptation Typology and tested it with adaptation actions of 106 large world cities (population > 1 million) reported to a major publicly-available adaptation database. We found two-thirds of actions of these ‘active adapter’ cities were health-associated. Half were health information activities (e.g., hazard mapping, early warnings); and nearly one-third addressed climate-relevant health determinants in the urban built environment (e.g., green space). Forty percent of cities were in low- or middle-income countries. Our proposed typology provides a systematic framework for monitoring and comparing city health adaptation actions. Reported city actions are suggestive of increasing depth and breadth of urban health-associated adaptation. However, even among these adaptation-engaged cities, a health adaptation gap was apparent in key climate health services (e.g., mental health), and in climate-related public health governance and capacity building. The COVID-19 pandemic has demonstrated pressing need for strong public health institutions. We recommend better integration of public health agencies into local climate action planning, enhanced modes of collaboration between health and non-health agencies and with non-governmental actors, and strengthening of city public health adaptive capacity including through networking.

A Public-Private Partnership Model to Build a Triage System in Response to a COVID-19 Outbreak in Hanam City, South Korea.

A substantial, immediate healthcare burden for screening of Coronavirus disease 2019 (COVID-19) is created when large-scale outbreaks occur. There have been a series of measures to strengthen the screening process through robust public-private partnerships between Hanam City Public Health Center (PHC), the local medical association, and central/provincial government. A partnership between PHC and the local physician’s group in Hanam City established the Respiratory Clinic. The PHC provided the infrastructure for the Respiratory Clinic including medical facilities, supplies (i.e. personal protective equipment), and administrative support. A total of 11 registered physicians from the local physicians group agreed to participate in clinical service provided at the Respiratory Clinic. Any citizens with COVID-19 suspected respiratory symptoms call the COVID-19 hotline and visit the Respiratory Clinic if required. Responding to COVID-19 outbreaks will be a continual process, and the screening system is essential support to public health interventions, and crucial in the response to a surge in COVID-19 cases.

Analysis Influence of Characteristics and Knowledge of Health Workers on the Management Public Health Centers in Ambon City of Maluku Province

The knowledge of each individual in the organization is definitely different so the cause of knowledgedoes not develop evenly with in the organizational environment. The purpose of this study is to analyze theinfluence of health workers capacity based on the characteristics and knowledge of health workers on themanagement of public health centers. The type of research used is quantitative research with cross-sectionalstudy design. The population in this study is the entire Head of public health center, Head of Administrativeand Program Manager of public health center in Ambon City year 2020 which numbered 143 people. Thesamples in this study used non-random sampling/non probability sampling techniques, namely purposivesampling, the sample set out in this study amounted to 44 health workers namely the Head of public healthcenter and Head of Governance in Ambon city public health center in 2020. The data analysis techniquesused are univariate analysis and bivariate analysis conducted to look for the influence of each free variablewith variables bound using chi-square test. The results of this study show that Knowledge Based HealthCapacity affects the health management of all public health centers in Ambon City. It is recommendedthat trainees be able to add insight into planning knowledge (P1), implementation (P2), and assessment(P3) of community health center management and develop the implementation of community health centermanagement obtained at the training site

DISTRIBUTION AND SPATIAL PATTERN ANALYSIS ON MALNUTRITION CASES: A CASE STUDY IN PONTIANAK CITY

Based on the Basic Health Research (Riskesdas) in 2018, malnutrition cases in West Kalimantan reached 23.8 percent. In 2015, Pontianak City documented 27 cases of malnutrition. Then, the cases increased in 2016 and 2017 as many as 29 and 41 cases. The utilization of Geographic Information System (GIS) is required as a method for public health surveillance and monitoring. This study aims to analyze the distribution of malnutrition cases based on several clinical and non-clinical factors using GIS between 2016 to 2017. The dependent variable was malnutrition cases and the independent variables included household income level, parent’s educational level, comorbidities factors, and distance to the primary health care service. A total of 65 cases of malnutrition in Pontianak City were collected from six sub-districts in Pontianak City. This research was a cross-sectional study. The results showed that of 65 cases of malnutrition occurred on under 5-year-old children in Pontianak in 2016-2017, malnutrition cases taking place in East Pontianak sub-district were 29 cases (44.6%). In addition, malnutrition with clinical symptoms was reported 63 cases (96.9%), while the distance from home to primary health care less than 1 km was 32 cases (49.23%). The study also revealed that malnutrition with comorbidities were 78,5%. Finally, household income levels with malnutrition were below Pontianak regional minimum wage (Rp 2,515,000/month or $176,88). The mapping of malnutrition cases using Geographic Information Systems can facilitate the nutrition programmer in Pontianak City Health Office and Public Health Centre in intervening the social determinant of health to overcome malnutrition.

Satisfaction and its associated factors of infants’ vaccination service among infant coupled mothers/caregivers at Hawassa city public health centers

ABSTRACT Studies conducted on caregivers’ satisfaction on child vaccination services were very scarce including the study area. Therefore, this study was aimed to assess satisfaction and associated factors in vaccination service among infant coupled mothers/caregivers attending at public health centers. A cross-sectional study was conducted on 404 infant coupled mothers/caregivers from 15 March to 15 April 2018 in the selected health centers of Hawassa city, Southern Ethiopia. A systematic random sampling technique was applied to collect relevant data through exit interview with an interviewer-administered structured questionnaire. The overall proportion of the mothers/caregivers who satisfied with their children immunization service was 76.7%. In addition, 89.7%, 77.1%, 77.2%, 65.8%, and 68.3% were satisfied with conveniences of waiting area, cleanliness of immunization rooms, distance from nearby health center, service providers approach and waiting time to get service, respectively. In addition, caregivers living closer to health centers were 5.9 times more likely to be satisfied than their counterparts, the adjusted odds ratio and 95% confidence interval [AOR and 95%CI : 5.9(1.6–22.4)]. Caregivers who waited for ≤30 minutes to get service were 7.3 times more likely to be satisfied than those waited for >30 minutes [AOR and 95% CI: 7.3(3.9–13.6)]. The study indicated the overall satisfaction of caregivers concerning vaccination service to be suboptimal. Maternal/caregivers satisfaction plays a great role to follow vaccination schedule properly and completeness of immunization service for their infants.

Seizure prevalence in children aged up to 3 years: a longitudinal population-based cohort study in Japan

ObjectiveTo investigate the prevalence of seizures/febrile seizures in children up to 3 years of age and examine the effects of gestational age at birth on the risk for febrile seizures.DesignRetrospective...

The Distribution and Spread of Susceptible and Resistant Neisseria gonorrhoeae Across Demographic Groups in a Major Metropolitan Center.

BackgroundGenomic epidemiology studies of gonorrhea in the United States have primarily focused on national surveillance for antibiotic resistance, and patterns of local transmission between demographic groups of resistant and susceptible strains are unknown.MethodsWe analyzed a convenience sample of genome sequences, antibiotic susceptibility, and patient data from 897 gonococcal isolates cultured at the New York City (NYC) Public Health Laboratory from NYC Department of Health and Mental Hygiene (DOHMH) Sexual Health Clinic (SHC) patients, primarily in 2012–2013. We reconstructed the gonococcal phylogeny, defined transmission clusters using a 10 nonrecombinant single nucleotide polymorphism threshold, tested for clustering of demographic groups, and placed NYC isolates in a global phylogenetic context.ResultsThe NYC gonococcal phylogeny reflected global diversity with isolates from 22/23 of the prevalent global lineages (96%). Isolates clustered on the phylogeny by patient sexual behavior (P < .001) and race/ethnicity (P < .001). Minimum inhibitory concentrations were higher across antibiotics in isolates from men who have sex with men compared to heterosexuals (P < .001) and white heterosexuals compared to black heterosexuals (P < .01). In our dataset, all large transmission clusters (≥10 samples) of N. gonorrhoeae were susceptible to ciprofloxacin, ceftriaxone, and azithromycin, and comprised isolates from patients across demographic groups.ConclusionsAll large transmission clusters were susceptible to gonorrhea therapies, suggesting that resistance to empiric therapy was not a main driver of spread, even as risk for resistance varied across demographic groups. Further study of local transmission networks is needed to identify drivers of transmission.

Building Governmental Public Health Capacity to Advance Health Equity: Conclusions Based on an Environmental Scan of a Local Public Health System.

Vast health inequities persist in cities across the United States. Although recommendations exist to guide governmental public health institutions seeking to advance population health equity, local contexts are likely to influence how these pursuits take shape. We review recommendations for pursuing equity that were developed from an environmental scan conducted in the city of New Orleans. The recommendations, which are based on perspectives provided by city and state public health leaders, leaders from other city governmental departments, and community-based health department partners, center around the enduring impact of systemic racism, working across sectors, and prioritizing community engagement.

Analysis Health Information Systems Quality on the Effectiveness of Public Health Center Officers in Ambon City

Health information systems play a role in providing data, information and health indicators to support the management process will have an impact on increasing the effectiveness of work. The purpose of this research is to know the quality influence of health information system that is seen from availability, timeliness, and relevance to the effectiveness of employees of public health centers in Ambon City. The type of research used is quantitative with cross sectional study design. The population in this study is all employees of the Ambon City Public Health Center amounting to 586 people, the withdrawal of samples with purposive technique obtained by 50 people. Collection of data through questionnaires. Data is analyzed by chi-square test. The results showed that the health information system of the availability aspect (P = 0.02), timely (P = 0.01) and relevant (P = 0.04) significantly affected the effectiveness of healthcare personnel working in the Public health center in Ambon city. It is hoped that the public health center in Ambon City can improve the existing system so that the information produced is more quality.

The Influence of Individual Characteristics on the Performance of Nutrition Program in Ambon City Public Health Center

Human Development, including education and health, is one of the three pillars that are indicators in the development concept of Sustainabale Development Goals (SDGs). State nutrition status of Indonesia from year to year shows improvements although still faced with various challenges that are quite severe. The purpose of this research is to analyze the influence of individual characteristics (age, gender and education) on the performance of nutrition Program in the Community Health center of Ambon. This type of research is quantitative research with the design of Cross Sectional Study. The population in this study is all the energy Center public Health that works in 22 public health centres as much as 54 people. Sampling techniques in a total sampling way. The results showed that there were no age and gender relations with the performance of the nutrition Program in the Community Health center of Ambon with the value P = 0138 and 0519. However, there is an education relationship with the implementation of nutrition Program in the Public health center of Ambon City with the value P = 0.004. Therefore, the Public health center can apply for a nutritional officer to get a scholarship or provide facilities and to resupply the nutritional officers to pursue higher education in order to make nutrition performance more maximal.

Health Observation App for COVID-19 Symptom Tracking Integrated With Personal Health Records: Proof of Concept and Practical Use Study.

BackgroundAs a counter-cluster measure to prevent the spread of the infectious novel coronavirus disease (COVID-19), an efficient system for health observation outside the hospital is urgently required. Personal health records (PHRs) are suitable for the daily management of physical conditions. Importantly, there are no major differences between the items collected by daily health observation via PHR and the observation of items related to COVID-19. Until now, observations related to COVID-19 have been performed exclusively based on disease-specific items. Therefore, we hypothesize that PHRs would be suitable as a symptom-tracking tool for COVID-19. To this end, we integrated health observation items specific to COVID-19 with an existing PHR-based app.ObjectiveThis study is conducted as a proof-of-concept study in a real-world setting to develop a PHR-based COVID-19 symptom-tracking app and to demonstrate the practical use of health observations for COVID-19 using a smartphone or tablet app integrated with PHRs.MethodsWe applied the PHR-based health observation app within an active epidemiological investigation conducted by Wakayama City Public Health Center. At the public health center, a list is made of individuals who have been in close contact with known infected cases (health observers). Email addresses are used by the app when a health observer sends data to the public health center. Each health observer downloads the app and installs it on their smartphone. Self-observed health data are entered daily into the app. These data are then sent via the app by email at a designated time. Localized epidemiological officers can visualize the collected data using a spreadsheet macro and, thus, monitor the health condition of all health observers.ResultsWe used the app as part of an active epidemiological investigation executed at a public health center. During the investigation, 72 close contacts were discovered. Among them, 57 had adopted the use of the health observation app. Before the introduction of the app, all health observers would have been interviewed by telephone, a slow process that took four epidemiological officers more than 2 hours. After the introduction of the app, a single epidemiological officer can carry out health observations. The app was distributed for free beginning in early March, and by mid-May, it had been used by more than 20,280 users and 400 facilities and organizations across Japan. Currently, health observation of COVID-19 is socially recognized and has become one of the requirements for resuming social activities.ConclusionsHealth observation by PHRs for the purpose of improving health management can also be effectively applied as a measure against large-scale infectious diseases. Individual habits of improving awareness of personal health and the use of PHRs for daily health management are powerful armaments against the rapid spread of infectious diseases. Ultimately, similar actions may help to prevent the spread of COVID-19.

Dissemination of Information About Climate Change by State and Local Public Health Departments: United States, 2019-2020.

Objectives. To determine if and how state and local public health departments present information about climate change on their Web sites, their most public-facing platform.Methods. We collected data from every functioning state (n = 50), county (n = 2090), and city (n = 585) public health department Web site in the United States in 2019 and 2020. We analyzed data for presence and type of climate-related content and to determine whether there existed clear ways to find climate change information. We analyzed Web sites providing original content about climate change for explanatory or attributional language.Results. Fewer than half (40%) of state health department Web sites, and only 1.6% of county and 3.9% of city Web sites, provided clear ways to find climate change information, whether through provision of original content or links to external agencies' Web sites. Among Web sites providing original content, 48% provided no explanation of climate change causes.Conclusions. National and global public health associations have identified climate change as a public health emergency, but most state and local public health departments are not delivering that message. These departments must be better supported to facilitate dissemination of reliable, scientific information about climate change and its effects on health.

Staffing Up For The Surge: Expanding The New York City Public Hospital Workforce During The COVID-19 Pandemic.

Confronted with the coronavirus disease 2019 (COVID-19) pandemic, New York City Health + Hospitals, the city's public health care system, rapidly expanded capacity across its eleven acute care hospitals and three new field hospitals. To meet the unprecedented demand for patient care, NYC Health + Hospitals redeployed staff to the areas of greatest need and redesigned recruiting, onboarding, and training processes. The hospital system engaged private staffing agencies, partnered with the Department of Defense, and recruited volunteers throughout the country. A centralized onboarding team created a single-source portal for medical care providers requiring credentialing and established new staff positions to increase efficiency. Using new educational tools focused on COVID-19 content, the hospital system trained twenty thousand staff members, including nearly nine thousand nurses, within a two-month period. Creation of multidisciplinary teams, frequent enterprisewide communication, willingness to shift direction in response to changing needs, and innovative use of technology were the key factors that enabled the hospital system to meet its goals.

Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic.

New York City has emerged as the global epicenter for the coronavirus disease 2019 (COVID-19) pandemic. The city's public health system, New York City Health + Hospitals, has been key to the city's response because its vulnerable patient population is disproportionately affected by the disease. As the number of cases rose in the city, NYC Health + Hospitals carried out plans to greatly expand critical care capacity. Primary intensive care unit (ICU) spaces were identified and upgraded as needed, and new ICU spaces were created in emergency departments, procedural areas, and other inpatient units. Patients were transferred between hospitals to reduce strain. Critical care staffing was supplemented by temporary recruits, volunteers, and Department of Defense medical personnel. Supplies needed to deliver critical care were monitored closely and replenished to prevent interruptions. An emergency department action team was formed to ensure that the experience of front-line providers was informing network-level decisions. The steps taken by NYC Health + Hospitals greatly expanded its capacity to provide critical care during an unprecedented surge of COVID-19 cases in NYC. These steps, along with lessons learned, could inform preparations for other health systems during a primary or secondary surge of cases.

Addressing COVID-19 Among People Experiencing Homelessness: Description, Adaptation, and Early Findings of a Multiagency Response in Boston.

People experiencing homelessness are at high risk for coronavirus disease 2019 (COVID-19). In March 2020, Boston Health Care for the Homeless Program, in partnership with city and state public health agencies, municipal leaders, and homeless service providers, developed and implemented a citywide COVID-19 care model for this vulnerable population. Components included symptom screening at shelter front doors, expedited testing at pop-up sites, isolation and management venues for symptomatic people under investigation and for people with confirmed disease, quarantine venues for asymptomatic exposed people, and contact investigation and tracing. Real-time disease surveillance efforts in a large shelter outbreak of COVID-19 during the third week of operations illustrated the need for several adaptations to the care model to better respond to the local epidemiology of illness among people experiencing homelessness. Symptom screening was de-emphasized given the high number of asymptomatic or minimally symptomatic infections discovered during mass testing; contact tracing and quarantining were phased out under the assumption of universal exposure among the sheltered population; and isolation and management venues were rapidly expanded to accommodate a surge in people with newly diagnosed COVID-19. During the first 6 weeks of operation, 429 of 1297 (33.1%) tested people were positive for COVID-19; of these, 395 people were experiencing homelessness at the time of testing, representing about 10% of the homeless adult population in Boston. Universal testing, as resources permit, is a focal point of ongoing efforts to mitigate the effect of COVID-19 on this vulnerable group of people.

Smart Street Litter Detection and Classification Based on Faster R-CNN and Edge Computing

Cleanliness of city streets has an important impact on city environment and public health. Conventional street cleaning methods involve street sweepers going to many spots and manually confirming if the street needs to be clean. However, this method takes a substantial amount of manual operations for detection and assessment of street’s cleanliness which leads to a high cost for cities. Using pervasive mobile devices and AI technology, it is now possible to develop smart edge-based service system for monitoring and detecting the cleanliness of streets at scale. This paper explores an important aspect of cities — how to automatically analyze street imagery to understand the level of street litter. A vehicle (i.e. trash truck) equipped with smart edge station and cameras is used to collect and process street images in real time. A deep learning model is developed to detect, classify and analyze the diverse types of street litters such as tree branches, leaves, bottles and so on. In addition, two case studies are reported to show its strong potential and effectiveness in smart city systems.

Bridging the gap between research, policy, and practice: Lessons learned from academic-public partnerships in the CTSA network.

A primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Health's (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic-public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic-public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.

Dual contraception method utilization and associated factors among sexually active women on antiretroviral therapy in Gondar City, northwest, Ethiopia: a cross sectional study

BackgroundMother to child transmission is responsible for 90% of child infection with human immune deficiency virus (HIV). Dual contraceptive use is one of the best actions to prevent mother’s human immune deficiency virus transmission to her child and partner. This study aimed at assessing the prevalence and factors associated with dual contraceptive use among sexually active women on antiretroviral therapy in Gondar City, northwest, Ethiopia.MethodsAn institution based cross sectional study was conducted in Gondar City public health facilities from December 1 to 31, 2018. Systematic random sampling technique was utilized to include 563 study participants. Data were collected by interview using a structured questionnaire. Descriptive analysis was made to compute mean, median and proportion. Finally, multivariable logistic regression model was fitted to identify the factors associated with dual contraceptive method utilization. Analysis was performed by using Statistical Package for Social Sciences (SPSS) software version 20.ResultsThe overall prevalence of dual contraceptive method utilization among sexually active women on antiretroviral therapy was 28.8% (95% CI: 24.9, 32.7). Women aged 35–49 years (Adjusted odds ratio (AOR): 6.99; 95% CI: 3.11, 15.71)), who lived in urban areas (AOR: 4.81; 95% CI: 2.04, 11.31), attended secondary and above education (AOR: 4.43; 95% CI: 1.92, 10.22), and disclosed HIV status to sexual partners (AOR: 9.84; 95% CI: 3.48, 27.81) were more likely to use dual contraceptive method.ConclusionIn this study, the proportion of women who utilized dual contraceptive method was low. Age, place of residence, educational status and disclosure of HIV status were factors associated with dual contraceptive use. Therefore, providing education about the advantages of disclosing HIV status to sexual partners and strengthening of counseling about the advantages of dual contraceptive use will be helpful in enhancing the use of dual contraceptive method among sexually active women on antiretroviral therapy.