Publications by authors named "Jonathan Fielding"

Objective: We assessed the impact of key population variables (age, gender, income and education) on perceptions of governmental effectiveness in communicating about COVID-19, helping meet needs for food and shelter, providing physical and mental healthcare services, and allocating dedicated resources to vulnerable populations.

Design: Cross-sectional study carried out in June 2020.

Participants And Setting: 13 426 individuals from 19 countries.

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Article Synopsis
  • The study examines how much the US would need to cut health care spending to match high-resource countries by 2030 or 2040, highlighting the need for significant reductions of 7.0% annually for 2030 and 3.3% for 2040.
  • These cuts are unprecedented in U.S. history and cannot be achieved through traditional methods alone; new strategies to eliminate waste and lower demand for care are critical.
  • Excessive health care spending threatens public health and economic competitiveness, making it essential for public health leaders to get involved in finding solutions.
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Landmark reports from reputable sources have concluded that the United States wastes hundreds of billions of dollars every year on medical care that does not improve health outcomes. While there is widespread agreement over how wasteful medical care spending is defined, there is no consensus on its magnitude or categories. A shared understanding of the magnitude and components of the issue may aid in systematically reducing wasteful spending and creating opportunities for these funds to improve public health.

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Context: Poor physical and mental health and substance use disorder can be causes and consequences of homelessness. Approximately 2.1 million persons per year in the United States experience homelessness.

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Vaccination is one of public health's greatest achievements, responsible for saving billions of lives. Yet, 20% of children worldwide are not fully protected, leading to 1·5 million child deaths annually from vaccine-preventable diseases. Millions more people have severe disabling illnesses, cancers, and disabilities stemming from underimmunisation.

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Immunization represents one of the greatest public health achievements. Vaccines save lives, make communities more productive and strengthen health systems. They are critical to attaining the UN Sustainable Development Goals.

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Objective: To improve the understanding of local health departments' (LHDs') capacity for and perceived barriers to using quantitative/economic modeling information to inform policy and program decisions.

Design: We developed, tested, and deployed a novel survey to examine this topic.

Setting: The study's sample frame included the 200 largest LHDs in terms of size of population served plus all other accredited LHDs (n = 67).

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Objectives: We explored the definition of health equity being used by public health departments and the extent of engagement of public health departments in activities to improve health equity, as well as facilitators and barriers to this work.

Design: We conducted 25 semistructured qualitative interviews with lead public health officials (n = 20) and their designees (n = 5). All interviews were transcribed and thematically analyzed.

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The United States and China both face the question of how to prioritize programmatic resources and policy interventions to make the greatest impact on the health of their populations. I discuss strengths and limitations of the expert panel survey used by Wu et al. in "The 20 Most Important and Most Preventable Health Problems of China: Opinions From Chinese Experts Using a Modified Delphi Process," in this issue of AJPH.

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Students may lose knowledge and skills achieved in the school year during the summer break, with losses greatest for students from low-income families. Community Guide systematic review methods were used to summarize evaluations (published 1965-2015) of the effectiveness of year-round school calendars (YRSCs) on academic achievement, a determinant of long-term health. In single-track YRSCs, all students participate in the same school calendar; summer breaks are replaced by short "intersessions" distributed evenly throughout the year.

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Objectives: We sought the perspectives of lead public health officials working to improve health equity in the USA regarding the drivers of scientific evidence use, the supply of scientific evidence and the gap between their evidentiary needs and the available scientific evidence.

Design: We conducted 25 semistructured qualitative interviews (April 2017 to June 2017) with lead public health officials and their designees. All interviews were transcribed and thematically analysed.

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Article Synopsis
  • Expanded in-school instructional time (EISIT) could help close racial/ethnic educational achievement gaps, potentially improving employment opportunities and reducing health risks in marginalized populations.
  • A systematic review of 11 studies found that schools with EISIT showed a modest improvement in test scores, with a median increase of 0.05 standard deviations, though results varied.
  • Overall, the evidence on the effectiveness of EISIT is limited, with small effect sizes and insufficient data to conclusively determine its impact on academic achievement and health equity.
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