Assessing Health and Human Services Needs to Support an Plan for Prince George's County, Maryland.

With evolving demographics and a changing health system landscape, the Prince George's County Council, acting as the County Board of Health, is considering its future policy approaches and resource allocations related to health and well-being. To inform this path forward, the authors of this study used primary and secondary data to describe both the health needs of county residents and drivers of health within the county, inclusive of the social, economic, built, natural, and health service environments. This study integrates these findings, an analysis of budget documents, and a review of promising practices from other communities to situate recommendations in a Health in All Policies framework to foster aligned and integrated planning and budgeting across the county to promote health and well-being.

Reflect and Reset: Black Academic Voices Call the Graduate Medical Education Community to Action.

The COVID-19 pandemic highlighted the great achievements that the biomedical community can accomplish, but raised the question: Can the same medical community that developed a complex vaccine in less than a year during a pandemic help to defeat social injustice and ameliorate the epidemic of health inequity? In this article, the authors, a group of Black academics, call on the graduate medical education (GME) community to reset its trajectory toward solutions for achieving diversity, improving inclusion, and combating racism using education as the new vector. Sponsoring institutions, which include universities, academic medical centers, teaching hospitals, and teaching health centers, are the center of the creation and dissemination of scholarship. They are often the main sources of care for many historically marginalized communities.

Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members.

Prescription drug misuse (PDM) is of critical concern for the military because of its potential impact on military readiness, the health and well-being of military personnel, and associated health care costs. The purpose of this study is to summarize insights gleaned from a series of activities that the RAND Corporation undertook for the Deputy Assistant Secretary of Defense for Readiness to address this important health and military readiness issue. The authors completed a review of U.

Improving Hospital Efficiency Through Data-Driven Management: A Case Study of Health First, Florida.

This article presents a case study of how one health system-Health First, in Brevard County, Florida-addressed resource challenges by using Lean thinking enabled by information technology. Examining Health First provides an opportunity to learn about how one hospital system addressed these challenges by making fundamental changes in their operations, in advance of the shift toward accountable care. Three years after Health First embarked on an effort to streamline patient flow and improve throughput, adult transfers within the system have increased by more than 300 percent and emergency department times between admission and inpatient bed occupancy decreased by 37 percent.

Barriers to Enrollment in Health Coverage in Colorado.

As part of the implementation of the Affordable Care Act, Colorado has expanded Medicaid and also now operates its own health insurance exchange for individuals (called Connect for Health Colorado). As of early 2014, more than 300,000 Coloradans have newly enrolled in Medicaid or health insurance through Connect for Health Colorado, but there also continues to be a diverse mix of individuals in Colorado who remain eligible for but not enrolled in either private insurance or Medicaid. The Colorado Health Foundation commissioned the RAND Corporation to conduct a study to better understand why these individuals are not enrolled in health insurance coverage and to develop recommendations for how Colorado can strengthen its outreach and enrollment efforts during the next open enrollment period, which starts in November 2014.

District of Columbia Community Health Needs Assessment.

The District of Columbia Healthy Communities Collaborative (DCHCC) represents a unique collaboration among D.C.-area hospitals and federally qualified health centers.

Oral Health in the District of Columbia: Parental and Provider Perspectives.

Research suggests that there are significant barriers to oral health care for many children in Washington, D.C. This article assesses the perspectives of Washington, D.

The Evolving Role of Emergency Departments in the United States.

The research described in this article was performed to develop a more complete picture of how hospital emergency departments (EDs) contribute to the U.S. health care system, which is currently evolving in response to economic, clinical, and political pressures.

Monitoring Cancer Outcomes Across the Continuum: Data Synthesis and Analysis for the District of Columbia.

This article synthesizes and analyzes available data regarding cancer-related outcomes among District of Columbia residents, highlighting key findings and data gaps across the continuum of cancer prevention, treatment, and outcomes and noting variability across subgroups of District residents. Data sources used in this report include the Behavioral Risk Factor Surveillance System, the National Cancer Database, the Centers for Disease Control and Prevention and National Cancer Institute Wide-Ranging Online Data for Epidemiologic Research database, and the American Community Survey. The findings reveal disparities in cancer-related outcomes between black and white District residents across the continuum.

Behavioral Health in the District of Columbia: Assessing Need and Evaluating the Public System of Care.

This article shares findings from a study of the public behavioral health care system in the District of Columbia, including the prevalence of mental health disorders and substance use, the organization and financing of public behavioral health services, utilization of public behavioral health services, and priorities for improvement. The authors' analyses found that prevalence of mental health conditions resembles patterns nationally, among both adults and youth. Substance use disorders are more prevalent among adults and comparatively lower for the youth population, compared to national patterns.

In their own words: lessons learned from those exposed to anthrax.

Objectives: We evaluated perceptions of workers at the US Postal Service Brentwood Processing and Distribution Center and US Senate employees regarding public health responses to the anthrax mailings of October 2001. We generated recommendations for improving responses to bioterrorism on the basis of the perceptions we recorded.

Methods: Transcripts from focus groups conducted with Brentwood and US Senate employees were examined, and qualitative analysis identified common domains.

A bitter pill to swallow: nonadherence with prophylactic antibiotics during the anthrax attacks and the role of private physicians.

To generate recommendations for improving adherence to public health advice during public health crises, we conducted semi-structured interviews with employees at the Brentwood Road Postal Facility and on Capitol Hill to identify key themes associated with decisions to adhere to recommended antibiotic prophylaxis during the 2001 anthrax attacks. Factors used in deciding to adhere to recommended prophylactic antibiotics and concerns about the official response were similar in Brentwood and Capitol Hill employees, and in adherent and nonadherent participants. All participants used multiple sources of information and support as they weighed the risk from anthrax against the advantages and disadvantages of antibiotics.

Racial and ethnic disparities in health: an emergency medicine perspective.

Significant disparities exist in health care based on race. Even when controlling for socioeconomic factors, minorities still have lower rates of utilization for certain procedures, higher mortality rates, and differences in usual source of care. There are a multitude of causes for these disparities, including differences based on access to care, the patient-doctor relationship, and insurance status.