Data released this week by the Centers for Disease Control and Prevention (CDC) show STDs have surged for the fifth consecutive year, reaching an all-time high in the U.S. These dangerous trends in chlamydia, gonorrhea, and syphilis show no sign of slowing and affect millions of lives each year in the United States. Particularly worrisome is the emerging trend of newborn syphilis (congenital syphilis) with a 40 percent increase in one year and the growing number of associated fetal and newborn deaths. Continue reading
By Kim Rodgers, Communications Manager, NACCHO
This story originally ran in NACCHO’s Preparedness Brief
In response to the multistate outbreak of lung injury associated with e-cigarette product use (e.g., devices, liquids, refill pods, and/or cartridges), the Centers for Disease Control and Prevention (CDC) along with other federal, state, and local partners are involved in an on-going investigation. CDC has released a media advisory concerning the situation, and the Lung Injury Response Website has various available resources to educate the public, healthcare providers, and state and local health departments on key facts and recommendations. Continue reading
Erika S. Corle, MPH, Executive Assistant, Providence St. Joseph Health/St. Mary Medical Center
While finishing this blog post, two major earthquakes struck the very area that I am writing about. These earthquakes were the largest to hit Southern California in the past 20 years, striking Kern and San Bernardino counties. Being a member of the affected community, I can attest to the fear, the unknowing, and the hope that the areas hardest hit would not be left behind or forgotten while larger, more able areas were addressed. Continue reading
By Emily Yox, MPH, Global Health Program Analyst, NACCHO
Each month, NACCHO will bring you a new public health book, read and reviewed by NACCHO staff. We hope to provide a well-rounded reading list that you will find enjoyable as well as informative.
Our first recommendation, Dreamland: The True Tale of America’s Opioid Epidemic, by Sam Quinones, was published in 2015 and received many accolades for the way in which the author intertwines the multiple narratives that fit into the U.S. opioid overdose epidemic. He tells stories of epidemiologists, big pharma, entrepreneurial drug dealers, and people in recovery to showcase the different perspectives of the addiction crisis in the United States. It is clear that the book was painstakingly researched but is very well written and hard to put down. Continue reading
By Nicole Miller, MSN, RN; Lela Riherd, BSN, RN, CIC; Zac Doobovsky, BSN, RN, CIC; and Harp Cheema, BSN, RN, Whatcom County Health Department (WA)
The Centers for Disease Control and Prevention (CDC) estimates nearly 2.4 million Americans are living with the hepatitis C virus (HCV), with transmission via injection drug use being the most common mode of HCV acquisition. In Washington State, there has been a 126% increase in newly acquired HCV infections between 2013 and 2017 that is linked to the opioid crisis. In 2018, Whatcom County had approximately 13 acute HCV cases and 306 chronic HCV cases, an increase from 4 acute and 241 chronic in 2017. On July 26, 2019, in response to these increasing numbers, Washington Governor Jay Inslee launched the Hep C Free Washington Plan to Eliminate Hepatitis C in Washington State by 2030, expanding upon a 2018 proclamation calling for a coordinated strategy between state and local public health agencies, tribal governments, and other partners to eliminate hepatitis C.
Expanding prevention and screening services and increasing access to treatment are critical to Washington’s efforts to eliminate hepatitis C, yet many barriers exist for people who inject drugs (PWID) when trying to access care and needed services. Opioid misuse is a complex issue that requires a multifaceted, collaborative approach across disciplines and agencies. The Whatcom County Health Department (WCHD) is working to expand its Syringe Services Program (SSP) and Adult Health Clinic services to address the hepatitis C challenges. By expanding our services, we hope to provide our clients with the resources they need to make informed decisions regarding their health and to encourage testing and treatment for people who are living with hepatitis C.
Syringe Services Program
SSPs are shown to be safe, effective, and play an important role in reducing the transmission of viral hepatitis and other infections. The WCHD SSP is a community-based prevention program that can provide a range of services, including access to clean syringes, safe disposal of syringes, testing for infectious diseases, and linkage to treatment services. Hepatitis A and B vaccines are also available.
The WCHD started its SSP to combat the disease transmission of HCV, HIV, and other infectious diseases among PWID. The number of participants served has increased fourfold since 2009, from 219 unique participants to 881 in 2018.
Participants in our SSP reported stigma as the most common reason for avoiding medical care. We work towards a no-judgment approach to help build a trusting relationship with our clients, which is crucial in the participant’s road to change and healthy outcomes.
The increasing number of unique participants has forced our SSP to change what we ask our clients, how we test, when we test, clinic flow, and how we provide follow up services and referrals. We made changes to our dialogue with clients to facilitate a more engaging conversation and achieve a positive rapport. Our clinic flow is set up to create a safe comfortable space that allows for point of care testing in all of our exchange rooms. Clients often reported time restrictions as a barrier to testing and this change has helped us to provide testing and results in a more timely manner to meet client needs.
A standing order was approved to draw confirmatory HCV RNA testing for any of our clients that are reactive for the point of care HCV antibody test or who have received a reactive test with us in the past with no additional follow up or linkage to care. By providing confirmatory testing we can help clients document chronic HCV and initiate treatment sooner. Clients are more likely to be compliant with care if services can be provided in one centralized location.
SSPs are a tool that can help reduce transmission of viral hepatitis and other infections as well as serve as a bridge to other healthcare or treatment services. Program participants have reported that our services decrease needle reuse and sharing. This in turn helps to reduce disease transmission in our community.
Linkage to Care
Follow-up testing and linkage to care is essential for clients with a new diagnosis, but understanding the next steps for follow-up can be challenging. Our SSP program staff met with a local community health clinic about the potential to expedite referrals that screen reactive to HCV at our SSP. We worked on creating a process that ensured the appropriate testing and linkage to care happened in a timely manner. The community health clinic created a flow sheet, standing orders for HCV testing, and signed a Memorandum of Understanding (MOU) for this process. This MOU allows expedited referrals for better client outcomes.
The CHOICES Project at the Prevention Research Center on Nutrition and Physical Activity at the Harvard T.H. Chan School of Public Health will be accepting applications beginning on August 1 for state and local health agencies to apply to participate in the CHOICES Learning Collaborative Partnership (LCP).
Over the past four years, the CHOICES team has fostered Learning Collaborative Partnerships with 15 state and local health agencies throughout the United States, with Philadelphia, Denver, San Antonio, Salt Lake County, Allegheny County, Detroit, and Houston taking part. The CHOICES LCP presents an opportunity for health agencies representing populations of 500,000 or more to receive funding, training, technical assistance, and locally tailored data to help decision-makers understand and use data on health and cost impact to identify best value for money strategies to prevent childhood obesity. Continue reading
By Erin Vinoski Thomas, MPH, CHES, Health and Disability Fellow, NACCHO; and Chloe Vercruysse, MBA
This post originally ran in NACCHO Essential Elements blog.
People experiencing homelessness lack sustainable access to housing and instead turn to emergency shelters, transitional housing, or places not meant for overnight residence. In the Unites States on a single night in January 2018, 552,830 people experienced homelessness; between 2.5 and 3.5 million people experience homelessness over the course of any given year. Housing is an important determinant of health, and those who experience homelessness are at greater risk for health challenges. Continue reading