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The burden and social determinants of asthma for adults in the state of GeorgiaBackground: Asthma is a serious chronic health condition, and social determinants may affect its prevalence. Methods: Data from the Behavioral Risk Factors Surveillance Survey (BRFSS), the Georgia Asthma Call-back Survey (ACBS), and the Georgia hospital and emergency department survey for patients with a diagnosis of asthma were used. All data were from the years 2011 through 2014. SAS and SUDAAN software were used to calculate weighted prevalence estimates and to perform univariate and multivariate analyses of the association between social determinants, other risk factors, and asthma outcomes. Results: The prevalence of asthma was highest among non-Hispanic blacks, women, and persons with less than a high school education, with an annual household income below $25,000, and in rural parts of the state (south and northwest Georgia). Those without insurance for more than three years had a higher prevalence of asthma than those who had insurance or had been uninsured less than 6 months. Although the percentage without insurance declined from 2012 to 2014, more than 1 in 5 adults of working age with asthma still lacked health insurance, and more than half had been without it for more than 3 years. One-third of Georgians with asthma could not see a doctor, at least on one occasion, because of cost, and more than a third were currently paying off medical bills. Approximately one quarter did not report having a personal physician, and a similar percentage reported having more than one year since their last check-up. In multivariate analyses, women (adjusted odds ratio [aOR] 1.61), smokers (aOR 1.54), and persons with a higher BMI (aOR 1.56) were all independently associated with having asthma. Conclusions: For the state of Georgia, there are associations between social determinants, such as education, income, and geography, and the prevalence of asthma, and many patients lack access to care. Addressing social determinants, including having affordable health insurance, is necessary to improve management of asthma.
Context matters: A community-based study of urban minority parents' views on child health.Among children, there are substantial ethno-racial minority disparities across a broad range of health-related behaviors, experiences, and outcomes. Addressing these disparities is important, as childhood and adolescence establish health trajectories that extend throughout life.
Discussion of public health education and training, and the needs of the future public health workforce.Georgia enjoys a wealth of public health capacity ranging from governmental public health to academic programs as well as local, state, and internationally acclaimed organizations. Leadership is evident across public health policy, practice and research. In the closing plenary of the 2017 Annual Meeting-Faces of Public Health, GPHA engages leaders in our field in a spirited conversation on the public health workforce. The esteemed panel representing state, national, and international public health organizations will reflect on the needs of a 21st Century workforce: prepared to respond beyond emergencies and identified threats; able to adapt to an increasing complex technological, political and economic environment; committed to affecting the economic and social determinants of health inequities; and collaborating to advance the knowledge base aligned with core public health functions and essential services. Are professional standards, qualifications and credentials appropriately calibrated for the needs and opportunities ahead? How has the underlying science base for public health practice, leadership and research changed? As stewards of population health, is the workforce equipped to provide thought leadership on health policy and legislation? What’s working and what’s not working in the recruitment, preparation, and retention of Georgia’s large and diverse public health workforce? The audience will be invited to join the panel in this engaging dialogue.