Impact of Collegiate Football Games on Emergency Response Intervals: A Case Study of College Station, Texas (USA).

OBJECTIVES: Little is known about how mass gatherings affect emergency response intervals. Previous research suggests that college football games increase ambulance transport intervals, but their impact on emergency response intervals is unexplored. This study examines how collegiate home football games in College Station, Texas (USA) affect emergency vehicle response intervals. METHODS: The study determined the impact of collegiate football games on emergency response intervals using incident data provided by the College Station Fire Department (CSFD). Home games during the 2021-2023 Texas A&M University (TAMU) football seasons were the period of interest. Responses for a 72-hour period (Friday-Sunday) on home game weekends (HGWs) and non-home game weekends (NHGWs) were included (n = 5,095). RESULTS: Response intervals on football HGWs were an average of 30 seconds faster than on NHGWs. Emergency vehicles were 16.5% less likely to respond from fire station locations on HGWs compared to NHGWs. There was also a 12.1% increase in the number of calls to campus locations and a 9.7% increase in calls to the local entertainment district on HGWs compared to NHGWs. CONCLUSIONS: Home collegiate football games do not delay response intervals for emergency response vehicles. Further research is needed to determine if these findings can be reproduced in other communities.

An exploration of barriers to access to healthcare in Hancock County, Tennessee: A qualitative study.

OBJECTIVE: Explore barriers to healthcare access in Hancock County, Tennessee using a conceptual framework for access to healthcare. METHODS: We collected data from 30 participants in Hancock County during 1 week in April 2023 using a combination of network and purposive sampling. We analyzed the data using thematic analysis and the conceptual framework of healthcare access. RESULTS: All dimensions of the conceptual framework of healthcare access presented barriers to healthcare access for participants of the study. A lack of acceptability of local healthcare among participants manifested in a perceived lack of availability of healthcare. This resulted in participants travelling or considering it necessary to travel long distances for care, even in a life-threatening emergency, despite the local availability of a hospital with an emergency department. CONCLUSIONS: A lack of acceptability can create healthcare access barriers similar to a lack of availability of healthcare facilities. PATIENT OR PUBLIC CONTRIBUTION: The research team met several times with the leader of a local community organization to discuss this research in Hancock County. These conversations helped to inform the study design and provided necessary background to conduct in-depth interviews. Members of the community organization helped identify individuals to interview and provide access to Remote Area Medical clinic patients. The research team discussed the final themes with the primary community collaborator.

Examining the Impacts of Title 42 in the Rio Grande Valley, Texas: Perceptions From Stakeholders in Immigrant Health and Wellbeing.

During the initial weeks of the COVID-19 pandemic in the United States, the Department of Health and Human Services implemented a little-known public health law, referred to as "Title 42." The law immediately received criticism from public health professionals and pandemic response experts around the country. Years after its initial implementation, however, the policy has been consistently maintained through numerous court decisions as necessary to prevent COVID-19. This article explores the perceived impact of Title 42 on COVID-19 containment and overall health security in the Rio Grande Valley, Texas, based on interviews conducted with public health professionals, medical professionals, nonprofit staff, and social workers. Our findings show that Title 42 was not perceived to prevent the spread of COVID-19 and likely decreased overall health security in this region.

The lingering impact of Hurricane Katrina: Examining the physical health, mental health, and racial equity impacts of disaster response.

PURPOSE: The purpose of the research discussed in this paper is to better understand the negative health outcomes resulting from Hurricane Katrina and the disaster response that followed. This understanding can inform future disaster response. DESIGN: We conducted 10 in-depth interviews with individuals who lived in New Orleans at the time of Hurricane Katrina. We conducted thematic analysis on the interview content and identified patterns across all 10 interviews. FINDINGS: Four primary patterns emerged across all interviews. These were: (1) Federal Emergency Management Agency's (FEMA) response to the crisis created greater physical and mental health hazards for interviewees; (2) Hurricane Katrina led to long-term mental health issues for interviewees, even those who evacuated before the storm; (3) displacement from homes following the storm typically resulted in overcrowded living conditions, which increased interviewees' risk of infectious disease; and (4) the discrimination faced by interviewees in the months and years following Hurricane Katrina had a profound and lasting impact on their well-being. ORIGINALITY: Numerous studies have been conducted to understand the mental health impacts of disaster and a limited number have looked at the physical health impacts or the threat of infectious disease. This study is unique because it incorporates both mental and physical health impacts, but also examines how disaster response itself plays a role in health outcomes for survivors. Additionally, this paper also incorporates the role of racial inequities in disaster response and how those inequities impact survivor health.

Anti-Immigrant Rhetoric, Deteriorating Health Access, and COVID-19 in the Rio Grande Valley, Texas.

The Rio Grande Valley of Texas has an exceptionally high number of COVID-19 cases and case fatality rate. The region makes up only 3% of the Texas population but, as of April 2021, accounted for 9% of the state's COVID-19 deaths. Additionally, during the summer of 2020, the Rio Grande Valley had one of the highest per capita infection rates in the United States. This paper explores the social-ecological elements that impact health-seeking behaviors in this community using interviews conducted with healthcare personnel and nonprofit leaders in the Rio Grande Valley between 2019 and 2020. Using this data, we found that anti-immigrant rhetoric has increased levels of fear among immigrants and mixed-status families, which has made them less willing to access healthcare. Additionally, we found that changes in the public charge rule has led to a decreasing number of children accessing government-provided health insurance. Our findings suggest that these outcomes likely contributed to the severity of the COVID-19 outbreak in the Rio Grande Valley.

The lingering impact of Hurricane Katrina: Examining the physical health, mental health, and racial equity impacts of disaster response.

PURPOSE: The purpose of the research discussed in this paper is to better understand the negative health outcomes resulting from Hurricane Katrina and the disaster response that followed. This understanding can inform future disaster response. DESIGN: We conducted 10 in-depth interviews with individuals who lived in New Orleans at the time of Hurricane Katrina. We conducted thematic analysis on the interview content and identified patterns across all 10 interviews. FINDINGS: Four primary patterns emerged across all interviews. These were: (1) FEMA's response to the crisis created greater physical and mental health hazards for interviewees; (2) Hurricane Katrina led to long-term mental health issues for interviewees, even those who evacuated before the storm; (3) displacement from homes following the storm typically resulted in overcrowded living conditions, which increased interviewees' risk of infectious disease; and (4) the discrimination faced by interviewees in the months and years following Hurricane Katrina had a profound and lasting impact on their well-being. ORIGINALITY: Numerous studies have been conducted to understand the mental health impacts of disaster and a limited number have looked at the physical health impacts or the threat of infectious disease. This study is unique because it incorporates both mental and physical health impacts, but also examines how disaster response itself plays a role in health outcomes for survivors. Additionally, this paper also incorporates the role of racial inequities in disaster response and how those inequities impact survivor health.

Conflict and Cholera: Yemen's Man-Made Public Health Crisis and the Global Implications of Weaponizing Health.

The cholera epidemic in Yemen, which began in October 2016 and reached its peak in 2017, was the largest disease outbreak in modern history. Suspected cases topped 1 million, and there were more than 2,000 confirmed deaths in the first 8 months of the outbreak. Although cholera is an ancient disease, and there were other countries around the globe experiencing outbreaks at the same time as the outbreak in Yemen, Yemen's outbreak had a number of unique features. The outbreak spread at an unprecedented pace and has been directly linked to the country's ongoing armed conflict. In this article we ask: What does the recent cholera outbreak in Yemen teach us about the relationship between conflict and infectious disease? Is the intentional targeting of infrastructure, as is occurring in Yemen, the new face of modern warfare? And what implications does a strategy of infrastructure destruction have for global health security? To answer these questions, we examined the history of the conflict in Yemen, the relationship between conflict and infectious disease, the intentional destruction of infrastructure throughout Yemen, and the resulting cholera outbreak. We discuss health as a weapon of war and seek to understand whether this indirect form of biological warfare is a new standard war tactic. Lastly, we address what the weaponization of health means for both global health security and US national security.

Parent psychology and the decision to delay childhood vaccination.

OBJECTIVE: The study of vaccine hesitancy identifies parental decisions to delay childhood vaccinations as an important public health issue, with consequences for immunization rates, the pursuit of nonmedical exemptions in states, and disease outbreaks. While prior work has explored the demographic and social underpinnings of parental decisions to delay childhood vaccinations, little is known about how the psychological dispositions of parents are associated with this choice. We analyze public opinion data to assess the role of psychological factors in reported parental decisions to delay childhood vaccination. RATIONALE: We anticipate that parents with certain psychological characteristics will be more likely to delay childhood vaccination. Specifically, we explore the roles of conspiratorial thinking, dispositions towards needle sensitivity, and moral purity; expecting that parents with high levels of any of these characteristics will be more likely to delay vaccinating their children. METHOD: In an original survey of 4010 American parents weighted to population benchmarks, we asked parents about delay-related vaccination behavior, demographic questions, and several psychological batteries. We then developed a vaccination delay scale and modeled delay as a function of conspiratorial thinking, needle sensitivity, moral purity, and relevant demographic controls. We then re-specified our models to look specifically at the predictors of delaying HPV vaccination, which has a low uptake rate in the United States. RESULTS: Controlling for other common predictors of hesitant behavior, we find that parents with high levels of conspiratorial thinking and needle sensitivity are more likely to report pursuing alternative vaccination schedules. When analyzing the specific decision by parents to delay HPV vaccination, we find that tendencies towards moral purity and, in turn, sexual deviance are also associated with vaccine seeking behavior. CONCLUSION: Parental decisions to delay childhood vaccinations are an important public health concern that are associated with conspiratorial thinking and needle sensitivity.

'Greater good' versus civil liberties in the United States: Tuberculosis and Seattle's Firland Sanatorium.

As far back as the late 1700s, peoples in the United States were developing ways to control infectious disease without infringing on Constitutional rights. Despite acknowledgement that an infected person has certain civil liberties, the history of public health law shows that, in many instances, infectious disease isolation and quarantine proved to be scientifically questionable at best. I examine an historical example of such questionable relationship between public health and civil liberties: the locked ward at Firland Sanatorium in Seattle, Washington. Mandatory quarantine at Firland began in the late 1940s and lasted until the facility closed in the early 1970s. Can examining this history enhance understanding of the relationship between "the greater good" and an individual's civil liberties?