Engaging Community Health Workers in the Centers for Disease Control and Prevention's COVID-19 Public Health Response to Address Health Disparities and Build Community Resilience.

In 2021, the Centers for Disease Control and Prevention's (CDC) National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) funded community health workers (CHWs) for COVID Response and Resilient Communities (CCR). CCR is a 3-year, $350 million initiative to implement CHW strategies aimed at reducing COVID-19 impacts, building resilience, and improving health equity by addressing health-related social needs. This paper describes the CCR initiative and experiences to date, underscoring CHWs' critical role in CDC's pandemic response.

The Community-Based Health Workforce in Public Health and Health Care Delivery.

Context: The "community-based workforce" is an umbrella term used by a workgroup of U.S. Department of Health and Human Services (HHS) leaders to characterize a variety of job titles and descriptions for positions in the public health, health care delivery, and human service sectors across local communities.

Excess Burden of Poverty and Hypertension, by Race and Ethnicity, on the Prevalence of Cardiovascular Disease.

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the United States. Certain demographic characteristics are associated with disparities in CVD and its risk factors, which may interact with specific social determinants of health (SDOH). We examined the association of a single SDOH (ie, poverty level) with diagnosed CVD morbidity and the joint influence of poverty and hypertension on the prevalence of CVD morbidity among non-Hispanic Black, non-Hispanic White, and Hispanic people aged 30 years or older.

A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative.

Thirty-one state and territorial public health agencies participated in a learning collaborative to improve diagnosis and management of hypertension in clinical and community settings. These health agencies implemented public health and clinical interventions in medical settings and health organizations using a logic model and rapid quality improvement process focused on a framework of 4 systems-change levers: 1) data-driven action, 2) clinical practice standardization, 3) clinical-community linkages, and 4) financing and policy. We provide examples of how public health agencies applied the systems-change framework in all 4 areas to assess and modify population-based interventions to improve control of hypertension.

Reducing Health Inequities in the U.S.: Recommendations From the NHLBI's Health Inequities Think Tank Meeting.

The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) embrace broad and inclusive research themes; 2) develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches.

Trends in the use, sociodemographic correlates, and undertreatment of prescription medications for chronic obstructive pulmonary disease among adults with chronic obstructive pulmonary disease in the United States from 1999 to 2010.

Background: The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010.

Methods: We performed a trend analysis using data from up to 1426 participants aged ≥20 years with self-reported COPD from six national surveys (National Health and Nutrition Examination Survey 1999-2010).

The association of chronic obstructive pulmonary disease, disability, engagement in social activities, and mortality among US adults aged 70 years or older, 1994-2006.

Purpose: To assess associations among chronic obstructive pulmonary disease (COPD), disability as measured by activities of daily living (ADL) and instrumental ADL (IADL), engagement in social activities, and death among elderly noninstitutionalized US residents.

Materials And Methods: A nationally representative sample of 9,415 adults who were aged ≥70 years and responded to the Second Supplement on Aging survey in 1994-1996 and mortality follow-up study through 2006 were assessed. Multiple logistic regression analyses were performed to assess the risk of all-cause mortality in participants with COPD after accounting for age, sex, race/ethnicity, and smoking status.

Pulmonary function, chronic respiratory symptoms, and health-related quality of life among adults in the United States--National Health and Nutrition Examination Survey 2007-2010.

Background: We examined the association of impaired lung function and respiratory symptoms with measures of health status and health-related quality of life (HRQOL) among US adults.

Methods: The sample included 5139 participants aged 40-79 years in the National Health and Nutrition Examination Survey 2007-2010 who underwent spirometric testing and responded to questions about respiratory symptoms, health status, and number of physically unhealthy, mentally unhealthy, or activity limitation days in the prior 30 days.

Results: Among these adults, 7.

Trends in the prevalence of obstructive and restrictive lung function among adults in the United States: findings from the National Health and Nutrition Examination surveys from 1988-1994 to 2007-2010.

Background: National spirometric surveillance data in the United States were last collected during 1988-1994. The objective of this study was to provide current estimates for obstructive and restrictive impairment of lung function and to examine changes since 1988-1994.

Methods: We used data from 14,360 participants aged 20 to 79 years from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and 9,024 participants from NHANES 2007-2010.

Frequent insufficient sleep and anxiety and depressive disorders among U.S. community dwellers in 20 states, 2010.

Objective: This investigation examined the association of anxiety or depressive disorder and frequent insufficient sleep.

Methods: Data were obtained from a 2010 telephone survey of a population-based sample of 113,936 adults in 20 states. Respondents were asked how often they did not get enough rest or sleep and if they had ever received a diagnosis of an anxiety or depressive disorder.

Excess frequent insufficient sleep in American Indians/Alaska natives.

Objective: Frequent insufficient sleep, defined as ≥14 days/past 30 days in which an adult did not get enough rest or sleep, is associated with adverse mental and physical health outcomes. Little is known about the prevalence of frequent insufficient sleep among American Indians/Alaska Natives (AI/AN).

Methods: We assessed racial/ethnic differences in the prevalence of frequent insufficient sleep from the combined 2009-2010 Behavioral Risk Factor Surveillance Survey among 810,168 respondents who self-identified as non-Hispanic white (NHW, n = 671,448), non-Hispanic black (NHB, n = 67,685), Hispanic (n = 59,528), or AI/AN (n = 11,507).

Association between perceived insufficient sleep, frequent mental distress, obesity and chronic diseases among US adults, 2009 behavioral risk factor surveillance system.

Background: Although evidence suggests that poor sleep is associated with chronic disease, little research has been conducted to assess the relationships between insufficient sleep, frequent mental distress (FMD ≥14 days during the past 30 days), obesity, and chronic disease including diabetes mellitus, coronary heart disease, stroke, high blood pressure, asthma, and arthritis.

Methods: Data from 375,653 US adults aged ≥ 18 years in the 2009 Behavioral Risk Factor Surveillance System were used to assess the relationships between insufficient sleep and chronic disease. The relationships were further examined using a multivariate logistic regression model after controlling for age, sex, race/ethnicity, education, and potential mediators (FMD and obesity).

Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study.

Background: Although adverse childhood experiences (ACEs) have previously been demonstrated to be adversely associated with a variety of health outcomes in adulthood, their specific association with sleep among adults has not been examined. To better address this issue, this study examines the relationship between eight self-reported ACEs and frequent insufficient sleep among community-dwelling adults residing in 5 U.S.

Elevated cardiovascular risk among adults with obstructive and restrictive airway functioning in the United States: a cross-sectional study of the National Health and Nutrition Examination Survey from 2007-2010.

Background: Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States.

Methods: We used data from adults aged 20-79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test.

Relationships between hours of sleep and health-risk behaviors in US adolescent students.

Objective: To examine associations between insufficient sleep (<8h on average school nights) and health-risk behaviors.

Methods: 2007 national Youth Risk Behavior Survey data of U.S.

Geographic disparities in chronic obstructive pulmonary disease (COPD) hospitalization among Medicare beneficiaries in the United States.

Background: Hospitalizations for persons with chronic obstructive pulmonary disease (COPD) result in significant health care resource use and excess expenditures. Despite well-documented sociodemographic disparities in COPD outcomes, no study has characterized geographic variations in COPD hospitalization across the US.

Methods: Almost 3.

Relationship between body mass index and perceived insufficient sleep among U.S. adults: an analysis of 2008 BRFSS data.

Background: Over the past 50 years, the average sleep duration for adults in the United States has decreased while the prevalence of obesity and associated outcomes has increased. The objective of this study was to determine whether perceived insufficient sleep was associated with body mass index (BMI) in a national sample.

Methods: We analyzed data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) survey (N=384,541) in which respondents were asked, "During the past 30 days, for about how many days have you felt you did not get enough rest or sleep?" We divided respondents into six BMI categories and used multivariable linear regression and logistic regression analyses to assess the association between BMI categories and days of insufficient sleep after adjusting for sociodemographic variables, smoking, physical activity, and frequent mental distress.

Prevalence of insufficient, borderline, and optimal hours of sleep among high school students - United States, 2007.

We describe the prevalence of insufficient, borderline, and optimal sleep hours among U.S. high school students on an average school night.

Garnering partnerships to bridge gaps among mental health, health care, and public health.

Integrating mental health and public health chronic disease programs requires partnerships at all government levels. Four examples illustrate this approach: 1) a federal partnership to implement mental health and mental illness modules in the Behavioral Risk Factor Surveillance System; 2) a state partnership to improve diabetes health outcomes for people with mental illness; 3) a community-level example of a partnership with local aging and disability agencies to modify a home health service to reduce depression and improve quality of life among isolated, chronically ill seniors; and 4) a second community-level example of a partnership to promote depression screening and management and secure coverage in primary care settings. Integration of mental health and chronic disease public health programs is a challenging but essential and achievable task in protecting Americans' health.

The role of public health in addressing racial and ethnic disparities in mental health and mental illness.

Racial/ethnic minority populations are underserved in the American mental health care system. Disparity in treatment between whites and African Americans has increased substantially since the 1990s. Racial/ethnic minorities may be disproportionately affected by limited English proficiency, remote geographic settings, stigma, fragmented services, cost, comorbidity of mental illness and chronic diseases, cultural understanding of health care services, and incarceration.