Prevalence and risk factors of low birth weight in the United States: An analysis of 2016-2021 data.

BACKGROUND: Low birthweight (LBW), infants weighing less than 2,500 g, is a global health concern associated with high infant morbidity and mortality rates. This study investigates LBW prevalence and its relation to maternal sociodemographic characteristics and lifestyle behaviors factors in the United States (US). METHODS: This analysis used the National Survey of Children's Health (NSCH) data from 2016 to 2021, including n = 225,443 children aged 0-17 years. 18,131 had LBW (<2,500 g), and 2810 had very LBW (VLBW) (<1,500 g). Logistic regression calculated odds ratios (OR) using LBW as the dependent variable, adjusting for various factors. RESULTS: Between 2016 and 2021 in the United States, LBW prevalence averaged 9.31%, with VLBW at 1.50%. Mothers aged 18-35, White, had the lowest LBW (7.63%) and VLBW (1.17%) rates. Mothers aged ≤18 years, black, had the highest LBW (15.45%) and VLBW infants (4.70%). Maternal age emerged as a significant LBW factor, with an OR of 1.27 for ≤18 and 1.19 for >35. Children in poor health had the highest OR (2.87). Race/ethnicity and other disparities were observed. CONCLUSION: Our study highlights LBW risk among non-White mothers with specific criteria, emphasizing the need for continued exploration of intersectional targets for change that are exacerbating LBW disparities among marginalized populations which may be artificially attributed to biologic determinants and individual-level risk factors. In-depth analysis of repressive structures at the root of inequalities demand continued research on macro levels of influence. Customized healthcare reform holds the greatest potential to disrupt the patterns contributing to poor health outcomes among LBW children, and will ultimately maximize the reach and effectiveness of health promotion strategies and clinical practices aimed to improve universal maternal and infant health.

Using Comorbidity Statistical Modeling to Predict Inpatient Mortality: Insights Into the Burden on Hospitalized Patients.

Background The expenditures of the United States for healthcare are the highest in the world. Assessment of inpatient disease classifications associated with death can provide useful information for risk stratification, outcome prediction, and comparative analyses to understand the most resource-intensive chronic illnesses. This project aims to adapt a comorbidity index model to the National Inpatient Sample (NIS) database of 2020 to predict one-year mortality for patients admitted with select International Classification of Diseases, 10th Edition (ICD-10) codes of diagnoses. Methodology A retrospective cohort study analyzed mortality with comorbidity using the Charlson comorbidity index model (CCI) in a sample population of an estimated 5,533,477 adult inpatients (individuals aged ≥18 years) obtained from the National Inpatient Database for 2020. A multivariate logistic regression model was constructed with in-hospital mortality as the outcome variable and identifying predictor variables as defined by the Clinical Classifications Software Refined Variables (CCSR) codes for selected ICD-10 diagnoses. Descriptive statistics and the base logistic regression analyses were conducted using SAS statistical software version 9.4 (SAS Institute, Cary, NC, USA). To avoid overpowering, a subsample (n = 100,000) was randomly selected from the original dataset. The initial CCI assigned weights to ICD-10 diagnoses based on the associated risk of death, and conditions with the greatest collective weights were included in a subsequent backward stepwise logistic regression model. Results The results of the base CCI regression analysis revealed 16 chronic conditions with P-values <0.20. Anemia (1,567,081, 28.32%), pulmonary disease (asthma, chronic obstructive pulmonary disease [COPD], pneumoconiosis; 1,210,892, 21.88%), and diabetes without complications (1,077,239, 19.47%) were the three most prevalent conditions associated with inpatient mortality. Results of the backward stepwise regression analysis revealed that severe liver disease/hepatic failure (adjusted odds ratio [aOR] 10.50; 95% confidence interval [CI] 10.40-10.59), acute myocardial infarction (aOR 2.85; 95% CI 2.83-2.87) and malnutrition (aOR 2.15, 95% CI 2.14-2.16) were three most important risk factors and had the highest impact on inpatient mortality (P-value <0.0001). The concordance statistic (c-statistic) or the area under the curve (AUC) for the final model was 0.752. Conclusions The CCI model proved to be a valuable approach in categorizing morbidity classifications associated with the greatest risk of death using a national sample of hospitalized patients in 2020. Study findings provide an objective approach to compare patient populations that bear important implications for healthcare system improvements, clinician treatment approaches, and ultimately decision decision-makers poised to influence advanced models of care and prevention strategies that limit disease progression and improve patient outcomes.

Computational Approaches to Detect Illicit Drug Ads and Find Vendor Communities Within Social Media Platforms.

The opioid abuse epidemic represents a major public health threat to global populations. The role social media may play in facilitating illicit drug trade is largely unknown due to limited research. However, it is known that social media use among adults in the US is widespread, there is vast capability for online promotion of illegal drugs with delayed or limited deterrence of such messaging, and further, general commercial sale applications provide safeguards for transactions; however, they do not discriminate between legal and illegal sale transactions. These characteristics of the social media environment present challenges to surveillance which is needed for advancing knowledge of online drug markets and the role they play in the drug abuse and overdose deaths. In this paper, we present a computational framework developed to automatically detect illicit drug ads and communities of vendors. The SVM- and CNN- based methods for detecting illicit drug ads, and a matrix factorization based method for discovering overlapping communities have been extensively validated on the large dataset collected from Google+, Flickr and Tumblr. Pilot test results demonstrate that our computational methods can effectively identify illicit drug ads and detect vendor-community with accuracy. These methods hold promise to advance scientific knowledge surrounding the role social media may play in perpetuating the drug abuse epidemic.

A qualitative examination of responses from a survey of pharmacy staff in Georgia regarding access to Narcan®.

Georgia state lawmakers enacted legislation designed to reduce opioid overdose deaths by increasing public access to rescue products, such as Narcan®. This article explores whether pharmacy employees have effectively adopted such changes into pharmacy practice. We analyzed unsolicited remarks noted during a parent telephone survey of 120 Georgia pharmacy staff regarding price, availability and barriers to layperson purchase of Narcan®. Comments regarding dispensing requirements and challenges in obtaining inventory and changes in communication style were recorded. Around 15% were unfamiliar with Narcan® as an opioid overdose reversal agent or were unaware of their pharmacy's policies governing its sale. Nearly half of those contacted did not have Narcan® in stock with some reporting that receiving Narcan® would take several days after placing an order. Over half specified requirements for purchasing Narcan® not required by law. Fewer than 15% had Narcan® available and imposed no unnecessary requirements for its purchase. During approximately 10% of the survey calls, respondents used a tone of voice or made comments suggestive of bias. We conclude that non-compliance with current laws, lack of familiarity with Narcan® and negative communication tendencies that suggest implicit bias and stigmatizing behaviors could ultimately inhibit access to opioid overdose treatment.

Collective insights of public-private partnership impacts and sustainability: A qualitative analysis.

The global Coronavirus or COVID-19 pandemic exposed the weakness of healthcare systems including laboratory systems and is a call to action for unprecedented collaboration and partnerships to deal with the global crisis. The United States (U.S.) President's Emergency Plan for AIDS Relief (PEPFAR) establishes the global HIV/AIDS treatment agenda in alignment with the UNAIDS 90-90-90 treatment targets to achieve epidemic control related to enhanced testing, treatment, and viral suppression. A strategic PEPFAR priority area recognizes that large-scale collective efforts and sharing of resources bear greater potential impact for lasting change than any single organization or entity can achieve alone. An important vehicle utilized within the global public health context is the public-private partnership (PPP) model whereby multiple international organizations forge unified project charters to collectively reach mutually agreed goals. While touted as an ideal mechanism to synthesize resources and maximize gain in numerous applications, little is known from a seasoned stakeholder perspective regarding PPP implementation and sustainability issues. The purpose of this research is to holistically examine perceptions of PPP model sustainability related to inputs and impacts among a collective network of stakeholders experienced with PEPFAR workforce development, laboratory-system strengthening project implementation. Interviews were conducted with frontline stakeholders from public and private sector organizations based in the US and select PEPFAR-supported priority countries. Analysis revealed three dominant themes: PPP impacts, keys of successful collaboration, and logistical challenges and opportunities to enhance sustainability of PPP outcomes in the future.

Atlanto-Occipital Decompression of Vertebral Artery for a Variant of Bow Hunter's Syndrome: 2-Dimensional Operative Video.

Rotational vertebral artery (VA) occlusion syndrome, also known as bow hunter's syndrome, is an uncommon variant of vertebrobasilar insufficiency typically occurring with head rotation.1-3 The most common presenting symptom is dizziness (76.8%), followed by visual abnormalities and syncope (50.4% and 40.4%, respectively).2 Osteophytic compression due to spinal spondylosis has been shown to be the most common etiology (46.2%), with other factors, such as a fibrous band, muscular compression, or spinal instability, being documented.1,2 Treatment is dependent on the level and site of VA compression with anterior, anterolateral, or posterior approaches being described.1,4 We present the case of a 72-yr-old male with osteophytic compression of the V3 segment of the vertebral artery at the occipital-cervical junction. The patient underwent a C1 hemilaminectomy and removal of osteophytic compression from the occipital-cervical joint. The patient had complete resolution of compression of his vertebral artery on postoperative imaging and remained neurologically intact following the procedure. We review the literature on this topic, the technical nuances of the procedure performed, and review the different treatment modalities available for this rare condition.1-11 The patient consented to the procedure and to publication of their image.

Prevalence of HIV testing and factors influencing the attitude of high school students towards HIV testing uptake in U.S. using, Youth Risk Behavior Survey 2017 data.

This study examined associations between the prevalence of HIV testing and factors or behaviors that influence HIV testing in U.S.A. 9th to 12th graders using the 2017 Youth Risk Behavior Surveillance Survey (YRBSS) data. Selection criteria was based on a positive report of sexual debut (Ever had sex? Yes/No). Outcome of interest was having ever tested for HIV. Independent risk factors included age, sex, grade, race, condom use, age at first sexual intercourse, number of lifetime sexual partners, use of contraceptives, use of drug or alcohol before last sexual activity and several other factors. Chi-square and logistic regression analyses were conducted to evaluate factors associated with HIV screening participation. HIV testing prevalence was 20.34%. Females (53.97%) were more likely to participate in HIV screening test than males (67.37% females versus 32.63% males) and had higher odds of testing (OR: 2.229; p < .0001). Those in 11th and 12th grade, aged greater than 16 and with multiple sexual partners had higher rates of HIV testing. Strongest associations with HIV testing were older age at 1st sexual intercourse, odds ratio (OR): 0.413; (p ≤ .0001), having three or more sexual partners (OR: 2.023; p ≤ .0001), being female (OR: 2.021; p ≤ .0001), use of contraceptives (OR: 1.828; p ≤ .0001) and describing grades in school as mostly A's or B's (OR: 0.696; p ≤ .001).

Association between per and polyfluoroalkyl substances and markers of inflammation and oxidative stress.

OBJECTIVES: This study aimed to examine the association of Per and Polyfluoroalkyl substances (PFAS) and markers of chronic inflammation and oxidative stress. METHODS: Using data (n = 6652) from the National Health and Nutrition Examination Survey (NHANES) 2005-2012, generalized linear models were used to examine the association between PFAS and inflammatory (ferritin, alkaline phosphatase, C-reactive protein, absolute neutrophil count and lymphocyte count) and oxidative stress (serum bilirubin, albumin and iron) per unit exposure to PFAS while adjusting for covariates. Study participants were those ≥20 years of age. Outcome variables were markers of chronic inflammation and oxidative stress and exposure variables were PFAS. RESULLTS: Percentage change in Perfluorohexane sulfonic acid (PFHxS), Perfluorononanoic acid (PFNA), Perfluorooctanoic acid (PFOA), Perfluorooctane sulfonic acid (PFOS), and Perfluorodecanoic acid (PFDA) were all significantly associated with percentage increases in lymphocyte counts, beta (95% confidence interval); 0.04(0.02,0.05), 0.04(0.02,0.05), 0.05(0.03, 0.07), 0.04(0.03,0.05), 0.03(0.13,1.23) and with percentage increases in serum iron 0.07(0.05,0.09), 0.04(0.02,0.07), 0.10(0.07,0.12), 0.05(0.03,0.07), 0.04(0.02,0.06) and increased serum albumin 0.02(0.02,0.02), 0.02(0.02,0.03), 0.03(0.03,0.04), 0.02(0.017, 0.025), 0.01 (0.01, 0.05). Only PFHxS, PFNA, PFOA and PFOS were associated with percentage increases in serum total bilirubin 0.04(0.03,0.05), 0.02(0.00,0.03), 0.06(0.04,0.08), 0.03(0.02,0.05). Similar results were obtained for categorical quintile analysis with PFOA showing a significant trend (P < 0.001) with lymphocyte count, serum iron, serum total bilirubin and serum albumin. Trend for neutrophil count was not significant (p = 0.183). CONCLUSION: Per and Polyfluoroalkyl substances are associated with markers of chronic inflammation and oxidative stress. Increased exposure leads to increase in serum concentration of these markers meaning these chemicals are associated with both chronic inflammation and oxidative stress.

State-by-State Examination of Overdose Medical Amnesty Laws.

INTRODUCTION: Timely medical attention could decrease mortality following drug or alcohol overdose events, but overdose victims and witnesses often delay or fail to seek professional help because they fear police involvement. Statutes that provide immunity from criminal action can have an important impact on seeking timely treatment. METHODS: We systematically collected and reviewed medical amnesty laws (MALs; commonly known as "Good Samaritan laws") that are designed to encourage bystanders and others to contact authorities for assistance during overdose emergencies. Each law was coded to analyze (1) who receives statutory protections and under what circumstances; (2) what factors undercut the credibility of statutory protections; and (3) whether statutory language is easily attainable and understandable. RESULTS: Forty-seven states plus the District of Columbia have MALs, but provisions differ widely in their scope of protection. Some laws may be less effective than others in prompting calls for professional assistance because they either lack protections, allow overly broad discretion, or prove difficult to research. CONCLUSIONS: Some statutes may be ineffective in encouraging calls for professional assistance following overdose events. Narrow immunity provisions with complex language may not be easily understood by the general population.

COVID-19 Impact on Stroke Presentations.

BACKGROUND: As Covid-19 evolved into a world-wide pandemic, hospitals reported marked declines in strokes, only to be followed by reports of increased numbers of young people presenting with large-vessel occlusions. We reviewed our patient data-base to determine if similar or other novel trends were present. RESULTS: Our Thrombectomy Stroke Center experienced marked declines in ED visits from 2,349 in early March to 1,178 in late April, stroke alerts dropped from 34 to 14 during the same period. Average monthly stroke admissions dropped from 34 in 2019 to 23 in 2020. Nonetheless, in March, we had 12 patients eligible for tPA, which is twice the typical caseload and was unexpected given the low overall stroke presentations. Although the neurointervention caseload was low, the patients were significantly younger. Of the acute intervention patients in March, 5 of the 12 patients were ≤ 60 years old, and two were in their 30's. These trends are similar to those reported elsewhere but were highly unusual for our center as our catchment area is predominantly Caucasian with 34 % of the population > 65 years of age. CONCLUSIONS: Even in low risk centers Covid-19 will likely impart unique stroke presentations. It will be imperative to determine the mechanisms responsible for these changes so we can institute effective strategies for optimal stroke prevention as well as maintain timely acute interventions.

Chronic pain diagnoses and opioid dispensings among insured individuals with serious mental illness.

BACKGROUND: Individuals with major depressive disorder (MDD) and bipolar disorder (BD) have particularly high rates of chronic non-cancer pain (CNCP) and are also more likely to receive prescription opioids for their pain. However, there have been no known studies published to date that have examined opioid treatment patterns among individuals with schizophrenia. METHODS: Using electronic medical record data across 13 Mental Health Research Network sites, individuals with diagnoses of MDD (N = 65,750), BD (N = 38,117) or schizophrenia or schizoaffective disorder (N = 12,916) were identified and matched on age, sex and Medicare status to controls with no documented mental illness. CNCP diagnoses and prescription opioid medication dispensings were extracted for the matched samples. Multivariate analyses were conducted to evaluate (1) the odds of receiving a pain-related diagnosis and (2) the odds of receiving opioids, by separate mental illness diagnosis category compared with matched controls, controlling for age, sex, Medicare status, race/ethnicity, income, medical comorbidities, healthcare utilization and chronic pain diagnoses. RESULTS: Multivariable models indicated that having a MDD (OR = 1.90; 95% CI = 1.85-1.95) or BD (OR = 1.71; 95% CI = 1.66-1.77) diagnosis was associated with increased odds of a CNCP diagnosis after controlling for age, sex, race, income, medical comorbidities and healthcare utilization. By contrast, having a schizophrenia diagnosis was associated with decreased odds of receiving a chronic pain diagnosis (OR = 0.86; 95% CI = 0.82-0.90). Having a MDD (OR = 2.59; 95% CI = 2.44-2.75) or BD (OR = 2.12; 95% CI = 1.97-2.28) diagnosis was associated with increased odds of receiving chronic opioid medications, even after controlling for age, sex, race, income, medical comorbidities, healthcare utilization and chronic pain diagnosis; having a schizophrenia diagnosis was not associated with receiving chronic opioid medications. CONCLUSIONS: Individuals with serious mental illness, who are most at risk for developing opioid-related problems, continue to be prescribed opioids more often than their peers without mental illness. Mental health clinicians may be particularly well-suited to lead pain assessment and management efforts for these patients. Future research is needed to evaluate the effectiveness of involving mental health clinicians in these efforts.

A cross-sectional examination of US gun ownership and support for gun control measures: Sociodemographic, geographic, and political associations explored.

Public opinion regarding gun ownership and control coincide with deep political and sociodemographic divisions in the US population. The study objective was to analyze the prevalence and predictors of gun ownership and support for gun control policy using a national representative sample of US adults. Nationally representative data from the General Social Survey (2010 to 2016) were used to examine sociodemographic, geographic, and attitudinal differences in gun ownership and views towards laws requiring police permits before gun purchases (N = 6184). Prevalence ratios and 95% CIs were calculated using logistic regression models. Among US adults, 22.1% reported owning a gun (n = 1358) and 72.5% favored presale gun permit laws (n = 4445). Adults who were aged 65+, male, non-Hispanic white, and politically conservative; earned $35,000+ annually; and did not reside in the Northeast region of the US were significantly more likely to own guns (p < 0.05). Adults who were aged 65+, female, non-Hispanic blacks/other or Hispanics, college graduates, politically liberal, and resided in the Northeast were significantly more likely to favor presale gun permit laws than their counterparts (p < 0.05). Gun safety and prevention efforts must address political and sociodemographic divisions that have stymied the passage of meaningful legislation.

Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.

Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.

A cross-sectional analysis of the association between marijuana and cigarette smoking with metabolic syndrome among adults in the United States.

AIM: To assess the relationship between marijuana use, cigarette smoking and metabolic syndrome among adults in the United States who reported they use marijuana or cigarettes in comparison to non-marijuana and non-cigarette users. METHOD: We conducted multiple logistic regression analyses using data from the 2011-2012 United States National Health and Nutrition Examination Survey to estimate relationships between cardio-metabolic risk factors and increasing years of smoking cigarette or marijuana use. Statistical adjustments were made for both demographic and endogenous factors related to recreational substance use. RESULTS: Each year increase in marijuana use was significantly associated with increased odds of metabolic syndrome (OR=1.05; 95% CI: 1.01, 1.09), and hypertension (OR=1.04; 95% CI: 1.01, 1.07) adjusting for both demographic and endogenous factors related to recreational substance use. Each year increase in cigarette smoking was significantly associated with increased odds of hypertension (OR=1.03; 95% CI: 1.00, 1.06) and hyperglycemia (OR=1.03; 95% CI: 1.01, 1.05) after adjusting for confounders. CONCLUSION: The results of this investigation suggest that increased years of marijuana or cigarette use are important factors in metabolic health; and consequently calls for the need to consider the potential negative effects of marijuana or cigarette for metabolic syndrome and its associated cardio-metabolic risk components.

Atlanta Streets Alive: A Movement Building a Culture of Health in an Urban Environment.

BACKGROUND: Open Streets are community-based programs that promote the use of public space for physical activity (PA), recreation and socialization by closing streets temporarily to motorized vehicles, allowing access to pedestrians. The city of Atlanta hosted its first Open Streets event, Atlanta Streets Alive (ASA), in May 2010. An evaluation of the first 5 ASA events from May 2010 to May 2012 was conducted. The purpose was to learn about the characteristics of ASA participants, the influence of the event on their PA, and perceptions of safety and neighborhood social capital. METHODS: ASA's evaluation had 2 components: participant counts and a participant survey. Characteristics of participation were compared among the 3 different events in which surveys were conducted using the Pearson χ2 test and F test as appropriate. RESULTS: The estimated participation at ASA increased from nearly 3,500 (ASA 1 to 4) to 12,520 (ASA 5). The number of events increased to 3 per year for a total of 10 events until 2014. Overall, 19.4% of participants met the weekly PA recommendation during 1 event. CONCLUSIONS: The expanding diversity of routes, participants, and sponsorships highlights the potential promise such programming offers in terms of establishing an urban culture of health.

State socioeconomic indicators and self-reported hypertension among US adults, 2011 behavioral risk factor surveillance system.

INTRODUCTION: Hypertension is the leading cause of chronic disease and premature death in the United States. To date, most risk factors for hypertension have been identified at the individual (micro) level. The association of macro-level (area) socioeconomic factors and hypertension prevalence rates in the population has not been studied extensively. METHODS: We used the 2011 Behavioral Risk Factor Surveillance System to examine whether state socioeconomic status (SES) indicators predict the prevalence of self-reported hypertension. Quintiles of state median household income, unemployment rate among the population aged 16 to 64 years, and the proportion of the population under the national poverty line were used as the proxy for state SES. Hypertension status was determined by the question "Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?" Logistic regression was used to assess the relationship between state SES and hypertension with adjustment for individual covariates (demographic and socioeconomic factors and lifestyle behaviors). RESULTS: States with a median household income of $43,225 or less (odds ratio [95% confidence interval] = 1.16 [1.08-1.25]) and states with 18.7% or more of residents living below the poverty line (odds ratio [95% confidence interval] = 1.14 [1.04-1.24]) had a higher prevalence of hypertension than states with the most residents in the most advantageous quintile of the indicators. CONCLUSION: The observed state SES-hypertension association indicates that area SES may contribute to the burden of hypertension in community-dwelling adults.

National survey of training needs reported by public health professionals in chronic disease programs in state, territorial, and local governments.

CONTEXT: In 2009, the National Association of Chronic Disease Directors published desirable competencies for professionals in public health chronic disease programs. Assessing the training needs of these professionals is an important step toward providing appropriate training programs in chronic disease prevention and control competencies. OBJECTIVES: Conduct a survey of the chronic disease workforce in state and local health departments to identify professional training needs. DESIGN: We conducted a cross-sectional survey of state, territorial, and local public health professionals who work in chronic disease programs to identify their self-reported training needs, using the membership lists of 3 professional organizations that included practitioners in chronic disease public health programs. SETTING: The survey was national, used a convenience sample, and was conducted in 2011. PARTICIPANTS: The survey was developed using an algorithm to select anonymous participants from the membership lists of the National Association of Chronic Disease Directors, the Directors for Health Promotion and Education, and the National Association of County & City Health Officials. OUTCOME MEASURES: The survey included questions about professional background, chronic disease activities, confidence about skills, and needs for training. RESULTS: The survey had 567 responses (38% response ratio). The majority of the respondents were female, non-Hispanic white, and 40 years or older. Respondents were not confident of their skills in health economics (38%) and technology and data management (23%). The most requested training topics were assessing the effects of policies, laws, and regulations (70%) and health economics (66%). CONCLUSIONS: This survey included local, territorial, and state public health professionals who work in chronic disease programs. These reported training needs in quantitative measurement methods and policy-related topics suggest key subjects for future training and education curricula.

Screening for Elder Mistreatment among Older Adults Seeking Legal Assistance Services.

INTRODUCTION: The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to elder mistreatment (EM). The purpose of this study was to assess the prevalence and correlates of EM among a sample of older adults using legal assistance services in Atlanta, Georgia. METHODS: Researchers administered surveys to consenting older adults (aged 60+) in 5 metro Atlanta community centers that hosted legal assistance information sessions as part of the Elderly Legal Assistance Program. The surveys screened for risk factors and prevalence of EM risk using valid and reliable measures and included additional questions regarding demographics characteristics and healthcare use behaviors. RESULTS: Surveys were completed by 112 participants. Findings reveal that 32 (28.6%) respondents met the criteria for elder abuse / neglect risk; 17 (15.2%) respondents met criteria for depression; and 105 (93.7%) had visited a healthcare provider during the past 6 months. CONCLUSION: The rates of EM risk in this sample were higher than those previously reported in research. Findings support continued examination of unique risks that may be present among older adults who may be possibly facing legal issues. Additionally, the reported frequency of healthcare visits among participants reveals a promising opportunity to examine development of a more widespread EM screening approach to be conducted in non-emergency settings. Interdisciplinary collaboration is required to inform screening approaches that account for complexities that EM cases present.