Now showing items 1-20 of 32

    • Trends in cancer incidence rates in Georgia, 1982-2011

      Yoo, Wonsuk; Coughlin, Steven S.; Lillard, James; Georgia Regents University; Emory University; Morehouse College (Georgia Public Health Association, 2015)
      Background: Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidences for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of the trends in incidence of cancer in Georgia. Methods: Incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 9 program, supported by the National Cancer Institute, spanning the years 1982 to 2011. To assess trends over time, age-adjusted cancer incidence rates relative to the 2000 Standard US population and annual percent changes (APCs) were calculated using SEER*Stat software. Results: In Georgia, cancer incidence rates for women increased from 365.1 per 100,000 in 1982 to 404.2 per 100,000 in 2011, with an overall APC of 0.3% (95% confidence interval: 0.2 to 0.4), but, for men, cancer incidence rates showed a slight decline from 528.0 per 100,000 in 1982 to 513.7 per 100,000 in 2011 (APC of 0.2%, 95% CI: -0.6 to 0.1). For Black, White, and Other (Asian/Pacific Islanders/American Indians) females, there were increases in incidence in this period, with APC values of 0.6, 0.4, and 0.3, respectively. For all males and for Black and White males, there were overall decreases in incidence, with APC values of -0.2. For Other males, however, the APC value was -0.9. Conclusions: In Georgia, increases in cancer incidence rates occurred during 1982-2011 among the female population and within various racial groups in this population, but there was relative stability in incidence rates among the male population, except for Other males.
    • Patient-centered outcomes for GoStrong: A self-management diabetes program in Savannah, GA

      Yang, Frances; Roberts, Lizzann; Davis, Bionca; Christianson, Angela (Georgia Public Health Association, 2015)
      Background: To advance the goal of health improvement for diverse populations with diabetes, a patient-centered approach is foundational. Methods: Innovative methods were used to initiate and advance an approach to diabetes engagement and self-management. We began with a strategy to understand how patients with diabetes view and interact with the disease via the medical community and moved to program development through patient-centered design and to the development of strategic partnerships and continuous learning from patients, stakeholders, and academic research partners. Results: The mean age of the participants in the GoStrong™ program (n=106) was 51 ±9.2 (SD) years. There were significant differences in the HbA1c levels over time compared to the Control group (n=100). The mean HbA1c level from baseline to 36 months decreased from 7.49% to 6.89%, with the largest decline (to 6.28%, p<0.01) at 12 months. The mean HbA1c level for the control group increased from 8.38% to 8.49% from baseline to 36 months, with the largest increase (to 8.89%, p<0.01) at 18 months. There were significant differences for total medical costs at 12 months prior to and 12 months after starting the GoStrong program, a difference in total prescription drug costs at 12 months, and differences within the total group in number of emergency room (ER) visits. Claims information showed that GoStrong produced significantly lower total medical costs and ER visits. There was also an increase in total prescription drug costs that may be due to better medication adherence. Conclusions: For diabetics, the GoStrong program results in reduced HbA1c levels, reduced costs, and reduced ER visits.
    • Evaluation results of an innovative pilot program to increase access to fresh fruits and vegetables in Cobb County, GA

      Woodruff, C Rebecca; Shipley, Rebecca; Brown, Agnes F.; Coleman, Anne-Marie; Munoz, Jennifer; Honeycutt, Sally; Hermstad, April K; Loh, Lorna; Kegler, Michelle C.; Emory University (Georgia Public Health Association, 2015)
      Background: This abstract describes a public health practice initiative called the Farm Fresh Market (FFM) and presented pilot evaluation results. Methods: The FFM, developed by Cobb and Douglas Public Health, the McCleskey-East Cobb Family YMCA, and Cobb2020, sold low-cost fruits and vegetables to families living in the 30168 zip code of Austell, Georgia. The evaluation focused on documenting to what extent the FFM reached its intended population and increased perceived access to fresh fruits and vegetables among customers. A convenience sample of 100 returning FFM customers completed self-administered, written intercept surveys at the end of the 2014 market season. Results: The market served customers from a range of socioeconomic backgrounds. Most customers strongly agreed that the FFM made it easier (69%) and less expensive (79%) for them to buy fresh fruits and vegetables and easier for them (63%) and their families (64%) to eat a healthy diet. Most customers reported that they ate more vegetables (65%) and fruit (55%) as a result of shopping at the FFM and reported high levels of satisfaction with all aspects of the FFM. Conclusions: The results suggest that the FFM served customers from the local area and that the FFM may have increased perceived access to healthy food options among customers. Community-level interventions to increase access to healthy foods may play an important role in chronic disease prevention.
    • Advocating for pregnant women in prison: Georgia can do better

      Webb, Nancy C.; Gates, Madison L. (Georgia Public Health Association, 2015)
      Background: Women are the fastest growing segment of the U.S. prison populace and approximately 1 in 25 were pregnant when they were incarcerated. However, women, including pregnant women, are receiving unacceptable health care in correctional systems. Further, many correctional systems lack policies to protect the best interest of incarcerated women, mothers and their children. Methods: We reviewed the literature on pregnant women in prison and found that corrections has been slow in making changes and adapting facilities for women, especially related to pregnancy, parenting skills and nurseries. It has been suggested the parent-infant attachment and the involvement incarcerated parents have with their children can help in preventing intergenerational crime. Results: The prison system in the U.S. is not set up to meet the needs of pregnant women prisoners. Many states, including Georgia, do not have policies regarding prenatal care or the use of restraints during labor and delivery. Conclusions: Georgia should rethink its prison-spending model. It would behoove Georgia’s leaders to take a look at what programs exist for pregnant women and mothers and consider adopting a model that would be a good fit for our state. We propose a collaborative approach for stakeholders to improve the care of pregnant offenders and the health of their children.
    • Perceptions of HIV/AIDS testing among urban and rural African American church members

      Walker, Roblena E; Walden University (Georgia Public Health Association, 2015)
      Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members. Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n = 114) in the Southern U.S. Results: The quantitative findings indicated that the urban participants reported significantly higher rates of testing than the rural participants, but the groups had equally high HIV knowledge and positive perceptions of HIV/AIDS testing. In-depth, individual interviews (24 urban; 24 rural) were conducted to gain a better understanding of the factors that contribute to perceptions of HIV/AIDS testing and knowledge of HIV/AIDS. Transcripts were axially coded for a priori themes and then analyzed for emergent categories of responses. These interviews indicated that the participant’s perceptions of HIV/AIDS testing were in general, not influenced by the church and that there were no noticeable distinctions regarding why HIV/AIDS testing was sought. The combined results of this study suggested that the churches surveyed were not promoting HIV/AIDS awareness and that the participants felt that the church should do more as it relates to HIV/AIDS. Conclusions: Since the AA church plays an important role in the lives of many AAs, it potentially can, particularly in rural areas, bring forth social change by advocating HIV/AIDS testing and prevention efforts in order to reduce the rate of HIV infections.
    • Reflections on mental health advocacy across differing ecological levels

      Thompson, J Nancy; McGee, E Robin; Munoz, C Leslie; Walker, R Elizabeth (Georgia Public Health Association, 2015)
      ABSTRACT Background: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Methods: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Results: We have proposed interventions and advocacy effort for each ecological level. Project UPLIFT, a distance-delivered intervention for mental health is presented as an example of an effort that can affect several levels of the social ecology. Conclusions: Advocacy and interventions that make an effort to encompass the levels of the social-ecological model may contribute to greater progress in improving mental health outcomes.
    • Nonprofit hospitals and community health needs assessments

      Stephens, Beth (Georgia Public Health Association, 2015)
      Background: The Patient Protection and Affordable Care Act of 2010 requires all hospitals filing as 501(c)(3) nonprofit organizations to conduct a Community Health Needs Assessment (CHNA) every three years. Many Georgia hospitals published their first CHNAs in 2012 and 2013. The goals of this research and policy project were to assess compliance with the new CHNA requirements for nonprofit hospitals, provide recommendations to hospital administrators and policymakers, and encourage hospitals to engage in meaningful ways with community-based organizations and local public health departments in the next round of CHNAs. Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs. Conclusions: Georgia Watch’s research provides insight on how hospitals can best engage their communities, prioritize local health concerns, initiate valuable partnerships, and develop meaningful, evidence-based strategies to address community health needs.Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs.
    • Community-based participatory research principles for the African American community

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Ansa, Benjamin E.; Coughlin, Steven S.; Blumenthal, Daniel S. (Georgia Public Health Association, 2015)
      Background: Numerous sets of principles have been developed to guide the conduct of community-based participatory research (CBPR). However, they tend to be written in language that is most appropriate for academics and other research professionals; they may not help lay people from the community understand CBPR. Methods: Many community members of the National Black Leadership Initiative on Cancer assisting with the Educational Program to Increase Colorectal Cancer Screening (EPICS) had little understanding of CBPR. We engaged community members in developing culturally-specific principles for conducting academic-community collaborative research. Results: We developed a set of CBPR principles intended to resonate with African-American community members. Conclusions: Applying NBLIC-developed CBPR principles contributed to developing and implementing an intervention to increase colorectal cancer screening among African Americans.
    • Community-based participatory research principles for the African American community

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Ansa, Benjamin E.; Coughlin, Steven S.; Blumenthal, Daniel S.; School of Medicine; Georgia Regents University; University of Massachusetts; Morehouse College (Georgia Public Health Association, 2015)
      Background: Numerous sets of principles have been developed to guide the conduct of community-based participatory research (CBPR). However, they tend to be written in language that is most appropriate for academics and other research professionals; they may not help lay people from the community understand CBPR. Methods: Many community members of the National Black Leadership Initiative on Cancer assisting with the Educational Program to Increase Colorectal Cancer Screening (EPICS) had little understanding of CBPR. We engaged community members in developing culturally-specific principles for conducting academic-community collaborative research. Results: We developed a set of CBPR principles intended to resonate with African-American community members. Conclusions: Applying NBLIC-developed CBPR principles contributed to developing and implementing an intervention to increase colorectal cancer screening among African Americans.
    • 86th Annual Georgia Public Health Association Meeting & Conference Report

      Smith, Selina A.; Abbott, Regina; Sims, Christy; Medical College of Georgia, Georgia Public Health Association (Georgia Public Health Association, 2015)
      The 86th annual meeting of the Georgia Public Health Association (GPHA) and joint conference with the Southern Health Association was held in Atlanta, Georgia, on April 13-14, 2015, with pre-conference (April 12th) and post-conference (April 14th) Executive Board meetings. As Georgia’s leading forum for public health researchers, practitioners, and students, the annual meeting of the GPHA brings together participants from across the state to explore recent developments in the field and to exchange techniques, tools, and experiences. Historically, the GPHA conference has been held in Savannah (n=24); Jekyll Island (n=20); Atlanta (n=16); Augusta (n=4); and Gainesville (n=1). There was no annual meeting during the early years (1929-1936); during World War II (1941-1943 and 1945); and for four years during the 1980s. Between 2006 and 2010, GPHA held one-day annual meetings and business sessions with educational workshops. Several new initiatives were highlighted as part of this year’s conference. These included a “move and groove” physical activity lounge, registration scholarships for students with a dedicated meet-and-greet reception, an expanded exhibit hall, presentation and approval of three resolutions (related to healthy foods at official activities and events; weapons at official activities and events; and memorials), and approval of the 2015 legislative policy positions and amended association bylaws. The theme for the conference was Advocacy in Action for Public Health. Specifically, the program addressed ensuring access to care; protecting funding for core programs, services, and infrastructure; eliminating health disparities; and addressing key public health issues important to the state of Georgia. One hundred and nine (109) abstracts were submitted for peer review; 36 were accepted for poster and 40 for workshop presentations. Four plenary sessions with keynote speakers covered the intersection between advocacy and policy, Georgia’s response to the Ebola crisis, palliative care, and essentials of advocacy in action for public health. Concurrent workshops focused on Board of Health training, public health accreditation, capacity building, collaboration, patient-centered outcomes, synthetic cannabinoid use, the HIV care continuum, use of data for informed decision making, environmental threats, organizational development, epidemiology, policy, and regulation. Thirty-two (32) awards were presented, including Lawmaker of the Year Award to Governor Nathan and First Lady Sandra Deal for their active and engaged role in promoting public health in Georgia; and the Sellers-McCroan Award to Commissioner Brenda Fitzgerald, Georgia Department of Public Health (DPH) State Health Officer, for her leadership of the Georgia Ebola Response Team and leadership of the newly formed department. The conference attracted 569 registrants primarily through pre-registration (n=561) with limited onsite registration (n=8). For this year’s conference, there was a significant increase in attendance (36%) and exhibitors (33%) relative to 2014. Of registrants reporting GPHA section participation, representation included: academic (5%); administration (10%); boards of health (13%); career development (15%); emergency preparedness (2%); epidemiology (5%); health education and promotion (2%); information technology (2%); maternal and child health (3%); medical/dental (3%); nursing (10%); nutrition (<1%); and other/no record (15%). There was 100% participation in the conference from the state’s 18 public health districts. The conference evaluation completed by a representative sample of registrants indicated areas of potential improvement as: starting sessions on time, using electronic and social media for the conference agenda/syllabus, and decreasing workshop sessions to 45 minutes. Most rated the conference as “good” or “excellent.”
    • Spiritual health: The often-overlooked dimension of health

      Riley, Clarence; Imoyera, Peter; Samples, Oreta; Green, Gregory; Fort Valley State University (Georgia Public Health Association, 2015)
      Background: Spiritual health, one of the six dimensions of health (physical, social, intellectual, emotional, environmental, and spiritual), is often overlooked and has become less prominent in the literature and in public forums. This once-touted dimension of health is now seldom considered. Methods: A review revealed that literature on spiritual health is sparse and, when found, is dated. Results: The existing literature indicates that spiritual health relates to various aspects of well-being, including medical/physical health, mental/psychological health, and educational/intellectual health. It is likely that the decline of consideration of spiritual health is due to the decrease in public discussion of spiritual matters and to the tendency of our society to focus on “political correctness.” Conclusions: Although the fear of alienating others by political incorrectness is foremost in the minds of many, this does not negate the fact that spiritual health is of benefit and can lead many to experiencing a better standard of health. It is our contention that spiritual health is often overlooked but has benefits that need not be concealed by political correctness. Spiritual health should be returned to the mainstream of public health, where its benefits can be enjoyed by those who choose to use them.
    • Impact of 1918 Spanish influenza pandemic on mortality rates in Savannah, GA, and implications for future epidemic prevention

      Plasphol, Sara; Dixon, Betty; Armstrong State University (Georgia Public Health Association, 2015)
      Background: The Spanish Influenza pandemic struck the United States in waves from September 1918 through March 1919. This study investigates the impact of the Spanish Influenza on Savannah and Chatham County, Georgia. Methods: Primary death records from the Chatham County Health Department were examined and analyzed for the years of 1917, 1918, and 1919. Historical mortality rates in the Savannah area were compared to those for other parts of the United States and world. Results: Mortality rates attributed to the Spanish Influenza within Savannah closely paralleled similar flu-related mortality rates for comparison populations in New York, London, and Madrid. Conclusions: These local primary data enable Savannah public health officials to understand the historical trends of communicable disease mortality in relation to other parts of the world, and have the potential to serve as a reference when channeling future resources into epidemic prevention in Chatham County.
    • The state of accreditation readiness in Georgia: A case study

      Peden, Angela; Shah, H Gulzar; Toal, Russell; Alexander, Dayna S.; Wright, Alesha; Anderson, Ashton; Marshall, A Nandi; Uhlich, Scott; Jones, Jeffery; Georgia Department of Public Health; et al. (Georgia Public Health Association, 2015)
      Background: Georgia’s public health districts first began exploring the idea of national public health accreditation in 2008 when Cobb & Douglas Public Health included accreditation in their strategic plan. In May 2015, Cobb & Douglas Public Health was the first Georgia public health district to achieve national accreditation status. This article discusses the current state of accreditation readiness in Georgia and explores strengths and barriers to accreditation. Methods: This study utilized a case study approach in order to examine PHAB accreditation efforts in Georgia within a real-life context. Data came from three sources: nine Accreditation Readiness Assessments, a PHAB Pre-Application Technical Assistance Survey, and state-wide Accreditation Readiness Survey. Results: The Accreditation Readiness Assessments resulted in several lessons learned about common strengths and barriers to accreditation. Strengths included a dedicated staff and supportive Boards of Health. Barriers included accreditation fees and a lack of personnel time. The PHAB Pre-application TA Survey revealed that the majority of those surveyed would recommend TA to other agencies pursuing PHAB accreditation (91%). The Accreditation Readiness Survey revealed that 14 of 18 GA public health districts are either PHAB accredited (1 district), actively pursuing PHAB accreditation (2 districts), or planning to apply (11 districts). This includes 116 of the 159 Georgia counties (73%). Conclusions: The results of this case study show that 72% of Georgia’s public health districts are engaged in accreditation-related activities. This includes activities such as accreditation readiness assessment, community health assessment, QI council and plan development, strategic planning, and policy review.
    • A multisite evaluation of pediatric asthma-related treatment in accordance to the 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines

      Oraka, Emeka; Robinson, Brittani; Ousley, Trevor; Lopez, Francesca; Graham, LeRoy (Georgia Public Health Association, 2016-08-18)
      Background: To determine if Georgia-based healthcare providers who received continuing education on pediatric asthma as described by 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines demonstrated improvements in asthma-related treatment. Methods: We used a multi-site, cross-sectional design. Data were collected via surveys administered to healthcare providers and via randomized medical chart abstractions. Chart abstraction occurred at 12 months prior to intervention (n = 149); one-month post-intervention (n = 208); and three months post-intervention (n = 123). Results: Substantial improvements were observed among the providers who used pre/post bronchodilator spirometry (5% at baseline, 12% at one month, and 19% at three months), and there was a significant increase in the number of patients being advised to improve conditions at home or school to avoid asthma triggers (9% at baseline, 43% at one month, and 37% at three months). However, prescription of preventive medications and patients being taught proper medication/spacer technique by providers decreased from baseline to three-months (69% vs 55% and 41% vs 27%, respectively). Providers’ self-reported barriers and patient load were consistently associated with poorer treatment outcomes. Healthcare providers who received continuing education on NHLBI - EPR 3 guidelines demonstrated an increase in spirometry use and in advising patients on improving home and school conditions. While these findings are useful, provider-reported barriers such as time, organizational, and insurance barriers prevent providers from effectively systematically incorporating all of the EPR 3 guidelines. Conclusions: Internal efforts to address clinical barriers combined with continued education may result in improvements in pediatric asthma-related treatment outcomes.
    • Understanding the role of social norms in organ donation decision making among African American adults

      Lucido, Briana; Center for Disease Control and Prevention (Georgia Public Health Association, 2016-08-18)
      Background: African Americans (AAs) comprise a disproportionate number of those waiting on the national transplant list and are underrepresented among registered organ donors. While barriers to organ donation are well understood, little research has explored factors that facilitate interest in donation. Because AAs are often characterized by strong extended relationships and shared decision-making, social norms may be an influential factor in donation behavior. Utilizing the Theory of Reasoned Action, this study demonstrated the application of theory to understand the role social norms play in donation decisionmaking, among AAs. Methods: Self-administered questionnaires were completed by 425 AA adults residing in the metropolitan Atlanta area. Social norms were measured using a Likert scale consisting of two items that addressed perceptions of favorability of donation and levels of influence a loved one has over the participant’s donation decision making. Main outcomes assessed were donation intentions and expression of donation intentions via designation on one’s driver’s license. Results: Logistic regression results indicate that a loved one’s level of favorability of donation is associated with both intention (OR=2.14, p≤0.01) and expression (OR=1.71, p≤0.01); however, findings approached significance with the level of influence a loved one has on intentions (OR=1.47, p=0.07) but was not associated with expression (p>0.05). Conclusions: The results suggest that a loved one’s level of favorability has an effect on donation decision making, but, conversely, a loved one’s level of influence does not impact donation decision making. Focusing on social norms and encouraging communication may prove useful for future interventions to improve engagement in donation among AAs.
    • Increased perception of mosquito problems during a stormwater restoration project

      Kelly, Rosmarie; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      In 2008, a plan for improvement of the McDaniel Branch Watershed was prepared for the city of Atlanta, Department of Watershed Management. This included the construction of ponds in a kudzu-covered area at Bowen Circle. There is a perception that wetlands create mosquito problems. In point of fact, most of the vector and nuisance species in Atlanta are either container breeders or floodwater species, and do not breed in ponds. Because there is an average of 5 cases of West Nile virus (WNV) reported in Fulton County per year, most of these near Combined Sewer Overflow streams, county residents are aware of the connection between mosquitoes and WNV. As the McDaniel Branch Watershed Improvement Plan progressed, neighborhood residents became convinced that the changes being implemented in the area were increasing mosquito problems and increasing their risk of WNV infections. In Oct 2013, the Environmental Health Section of the Georgia Department of Public Health was contacted by the City of Atlanta Department of Watershed Management concerning control of mosquitoes in the ponds being created at the Bowen Circle site. It was determined that mosquito surveillance should be implemented in the area to determine if the changes to the watershed area were creating a mosquito problem. At the end of the 2014 mosquito surveillance season, it was established that there was little association between the watershed improvement project, the reported mosquito exposure, and measures of mosquito production within this neighborhood.
    • The care continuum for people living with HIV in Georgia: How can we raise the bar?

      Kelly, Jane; Rane, Deppali; Wortley, Pascale; Drenzek, Cherie; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age. Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage to care within 3 months of HIV diagnosis was lower among young adults (aged 19-24 years) (54%); young Black, non-Hispanic (NH) males (49%); and young Black NH men who have sex with men (MSM) (49%) as compared to those among adolescents (66%, 58%, and 57%). Conclusions: Retention in care and VS decreases with the transition from adolescence to young adulthood, possibly reflecting loss of support systems and competing priorities. At the other end of the age spectrum, health care and social support systems will be confronted with increasing numbers of older PLWH in Georgia. Challenges in HIV treatment and prevention include (a) the need for integrated medical care for aging PLWH with co-morbid conditions, and (b) the changing social environment of young PLWH.
    • Childhood cancer incidence in Georgia: Descriptive epidemiology, geographic trends, and disparities in insurance coverage and health care access

      Kanu, Florence; Robb, Wagner Sara; Corriero, Rosemary; University of Georgia (Georgia Public Health Association, 2015)
      Background: Limited research has been conducted concerning childhood cancer (CC) incidence in Georgia, which is a leading cause of death for children in the US. The purpose of this study was to determine if county-level CC incidence rates differed by geography or race and if health care access disparities exist. Methods: Incidence data were obtained from the Georgia Comprehensive Cancer Registry for 2000-2011. Age-adjusted incidence rates per 100,000 were analyzed by sex, race, and county. Hotspots and coldspots of CC incidence were analyzed using the Getis-Ord GI* statistic. Health care access data for children under 19 were obtained using US Census Bureau’s Small Area Health Insurance Estimates for 2011. Georgia’s three children’s oncology group (COG) treatment facilities with 40-mile buffer zones were geographically overlaid with CC incidence rate maps and health insurance maps using Geographic Information Systems (GIS). Results: For leukemia and central nervous system cancers, incidence rates were significantly different between Whites [7.8, 95% confidence interval (CI) (7.4, 8.2)] and Blacks [5.2, 95% CI (4.8, 5.6)]. Statistical hotspots of CC were observed in north Georgia. A lower percentage of insurance coverage among children was observed in southeast GA. Approximately 25% of Georgia counties that were not within a COG buffer had a higher percentage of children who were uninsured (mean ± SD: 10.28% ± 1.86%). Conclusion: Higher CC incidence rates and disparities in access to care were evident in north Georgia. Future research is needed in these geographies to investigate potential risk factors associated with CC incidence patterns and racial differences in Georgia.
    • Immunization policies for employees of childcare facilities within the North Central Health District of Georgia

      Kamara, Paula; Lian, Brad; Smith, Jimmie; McChargue, Judy; Mercer University, North Central Health District (Georgia Public Health Association, 2015)
      ABSTRACT Background: Since the early 1980s, vaccinations have generally been required for children in licensed daycare and school settings. In these settings, vaccinations have reduced disease rates. Adults occupy these settings as well, and ensuring they are vaccinated should also reduce the potential for disease and disease transmission. Yet, there are few vaccination requirements for adults employed at daycare facilities, although such requirements have been recommended (CDC Adult immunization schedule, 2015; ACIP General Recommendations, 2011). The objective of this study was to examine current vaccination policies among childcare facilities within Georgia’s North Central Health District (District 5-2) and the climate for possible policy directives in the future. Methods: A 10-item questionnaire regarding vaccination requirements and policies and the importance of vaccination education was mailed to administrators of all 271 licensed childcare facilities within the North Central Health District in Georgia. A total of 76 questionnaires were returned, representing a 28% response rate. The district has approximately 530,000 residents and is comprised of 13 counties. Results: Of the childcare facilities, 79% have no vaccination policies in place. However, most facility directors (75%) indicated that such policies should be required, and 93 % stated that vaccination education is important for their staff members. Conclusions: Vaccination requirements can help protect children and their caregivers from communicable diseases. From a policy perspective, the climate may be favorable for the implementation of such requirements, in that most childcare directors recognize the importance of such policies and state that they should be required.
    • Variations in public health governance

      Jones, Jeffery; Bangar, Ankit; Chang, Patrick; Tarasenko, Yelena; Georgia Southern University (Georgia Public Health Association, 2015)
      Background: Studies of public health departments have found mixed results regarding the relevance of governance through local boards of health (LBOHs). Some studies find that LBOHs can be an important component in higher performance by local health departments. Other analyses, however, find no advantage for local health departments having or not having a LBOH. The hypothesis was that a typology of LBOHs nationwide can define different types of LBOHs based on their powers and responsibilities. Methods: Using national profile sample data from the National Association of Local Boards of Health, LBOHs were categorized using 34 variables based on four domains of responsibilities and duties: enforcement powers, regulatory powers, human resource powers, and budgetary powers. Correlations between types of LBOHs defined by this typology were then computed, and whether they shared significant characteristics in terms of the race, ethnicity, sex, and educational demographics of their board members was determined. ArcGIS was used to analyze the data spatially for regional and national patterns. Results: LBOHs vary considerably across the country - from LBOHs with no budgetary, enforcement, regulatory, or human resources authorities to those that have all four. Conclusions: Different types of LBOHs may have different influences on their associated local boards of health. This study provides a typology for future research to allow analysts to distinguish different types of LBOHs nationally.