Equity Work Among Accredited Health Departments in the United States, 2015-2021.

OBJECTIVES: Minimal research has examined the number of health departments conducting work related to equity and/or the kind of work, if any, they are conducting. We examined the relationship between public health accreditation and work related to health equity by analyzing accredited health departments' responses to a prompt in the Public Health Accreditation Board's (PHAB's) annual report. METHODS: We analyzed self-reported responses from accredited health departments to questions about emerging public health issues and innovations in PHAB's annual report. We identified themes using a priori and inductive coding. RESULTS: A total of 316 health departments submitted an annual report from January 2015 through December 2021. Of those health departments, 283 (89.6%) stated in their annual report that they engaged in work related to health equity, 50 (17.7%) of which provided a narrative about this work. Of those 50 health departments, the most common theme reported was community partnership, described by 23 (46.0%) health departments. The next most reported themes were COVID-19 vaccine access for racially or socioeconomically marginalized communities (n = 17, 34.0%) and programs related to health equity (n = 16, 32.0%). CONCLUSIONS: We found that most accredited health departments conduct work related to health equity. Further research is needed to examine characteristics that influence a health department's likelihood of conducting equity work. Models and resources on how health departments, particularly small health departments, can begin equity work would be valuable.

Heterozygous ATP2A2 missense variant identified in a Shih Tzu with Darier disease.

Darier disease is caused by heterozygous loss of function variants in the ATP2A2 gene encoding the endoplasmic/sarcoplasmic reticulum Ca2+ pump ATP2A2. Defective intracellular calcium signaling in the epidermis results in a loss of desmosomal adhesion and the development of characteristic skin lesions. In this study, we investigated a Shih Tzu that developed erythematous papules on the ventrum and, over time, the dorsal neck and a nodule in the right ear canal with secondary ear infection. Histopathologic examination demonstrated discrete foci of acantholysis affecting suprabasal layers of the epidermis. Whole genome sequencing of the affected dog identified a heterozygous missense variant, p.N809H, affecting an evolutionarily conserved amino acid residue of the ATP2A2 protein. The highly characteristic clinical and histopathologic findings together with a plausible variant in the only known functional candidate gene establish the diagnosis of canine Darier disease in the studied dog and highlight the potential of genetic analyses as complementary diagnostic approach in veterinary medicine.

Public Health Department Accreditation and Innovation: A Brief Report of the Approaches Used to Promote Innovation.

To examine the relationship between public health accreditation and innovation, we analyzed accredited health departments' self-reported responses to a prompt within the Public Health Accreditation Board's (PHAB's) Annual Report regarding any approaches to pursuing innovation within their health department. We found that of the 205 health departments examined, 75 (37%) described elements of the health department's approach to fostering innovation. The most common approaches to innovation included partnerships (59% of those health departments that described their innovation approaches) and leadership (27%). Other common elements, mentioned by at least 20% of health departments that provided their innovation approach, include funding, internal collaboration, training, and devoting time to innovation. Both larger health departments and state health departments were more likely than smaller health departments and local health departments to describe elements of their approach in fostering innovation, suggesting that those types of health departments may have access to resources and flexibility in staffing, both integral elements for promoting innovation.

A novel cytological technique for bacterial detection on canine skin.

BACKGROUND: Cytological examination of the skin is an important diagnostic technique in dermatology for disease diagnosis and monitoring of treatment. Impression smear and tape-strip preparation are gold standard cytological techniques. This study introduces a novel cytological method, slurry preparation, in which debris collected from the skin surface is macerated in warm sterile water and dried on the slide. HYPOTHESIS/OBJECTIVES: To compare organism yield between a novel and two standard cytological collection techniques by evaluating bacteria and Malassezia yeast counts. ANIMALS: Thirty client-owned dogs diagnosed with atopic dermatitis and lesions consistent with pyoderma and/or Malassezia dermatitis. MATERIALS AND METHODS: In a prospective, blinded comparison study, dermatological lesions from each dog were sampled using impression smear, tape-strip and slurry preparation methodologies. Ten random reticle fields per lesion, accounting for a total area of 6.25 × 10-3 mm2 (equivalent to ˜5% of a typical ×40 field), were evaluated by light microscopy for each cytological method. Bacterial and Malassezia organisms were measured as counts/sample. The slurry preparation was compared to each of the standard methodologies separately using paired Student's t-tests. RESULTS: The slurry preparation was demonstrated to be more sensitive than gold standard techniques in detecting bacteria, with mean differences of 12.7 and 13.5 additional bacteria per cytological sample, compared to the impression and tape-strip preparations, respectively. The slurry preparation did not differ significantly in detecting Malassezia organisms compared with impression smear preparation. The tape-strip preparation was demonstrated to be more sensitive than the slurry preparation in the detection of Malassezia organisms, finding a mean difference of 0.22 more organisms per sample. CONCLUSION: Slurry preparation presents advantages over the gold standard techniques in the detection of bacteria which can help to manage canine pyoderma more appropriately. Performing a slurry preparation in cases of suspected canine pyoderma could be considered as an alternative to the gold standard techniques.

The Power of Community in Addressing Infant Mortality Inequities.

On opposite ends of North Carolina, collaborations in Buncombe and Chatham counties are tackling infant mortality inequities with innovative strategies. While their strategies differ, both groups use an approach that is driven by authentic community voice and directly contributes to dismantling structural racism. The Mountain Area Health Education Center in Asheville is transitioning their leadership of the Mothering Asheville Coalition to SistasCaring4Sistas, a group of Black doulas with lived experience, and is supporting the doulas' work to become a nonprofit organization that will serve the entire state. Chatham County Health Department leads the Equity for Moms and Babies Realized Across Chatham Coalition, a group that relies on recommendations from birthing individuals with lived experience to continually assess and revise hospital policies and practices to improve birth experiences in addition to birth outcomes. The work of these communities highlights several implications for advancing health equity, including the need to establish and maintain trust with the community served, include those with lived experience and expertise in decision making, guide strategies, take risks, and facilitate organizational culture change.