Covid-19 and the Safety Net — Moving from Straining to Sustaining

Knudsen, Janine; Chokshi, Dave A.

doi:10.1056/nejmp2114010

Cited by 15 publications

(13 citation statements)

References 1 publication

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“…Following the onset of the COVID-19 pandemic, communities emphasized rethinking the social services safety net and creating lasting and adaptable change to the new economic, social, and public health challenges [ 19 ]. Thus, an investigation is needed to determine which occupations are of highest priority and which workforce interventions are most needed to fill those gaps, particularly to address the consequences of increasing unemployment and economic disruption due to the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Public Health Workforce Gaps, Impacts, and Improvement Strategies from COVID-19

Kirkland

Oldfield-Tabbert²,

Karnik

et al. 2022

IJERPH

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The public health workforce has been instrumental in protecting residents against population health threats. The COVID-19 pandemic has highlighted the importance of the public health workforce and exposed gaps in the workforce. Public health practitioners nationwide are still coming to understand these gaps, impacts, and lessons learned from the pandemic. This study aimed to explore Minnesota’s local public health practitioners’ perceptions of public health workforce gaps, the impacts of these workforce gaps, and the lessons learned in light of the COVID-19 pandemic. We conducted seven concurrent focus groups with members of the Local Public Health Association of Minnesota (LPHA; n = 55) using a semi-structured focus group guide and a survey of the local agencies (n = 70/72 respondents, 97% response rate). Focus group recordings were transcribed verbatim and analyzed using deductive and inductive coding (in vivo coding, descriptive coding), followed by thematic analysis. The quantitative data were analyzed using descriptive analyses and were integrated with the qualitative data. Participants indicated experiencing many workforce gaps, workforce gaps impacts, and described improvement strategies. Overall, many of the workforce gaps and impacts resulting from COVID-19 discussed by practitioners in Minnesota are observed in other areas across the nation, making the findings relevant to public health workforce nationally.

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Section: Introductionmentioning

confidence: 99%

Public Health Workforce Gaps, Impacts, and Improvement Strategies from COVID-19

Kirkland

Oldfield-Tabbert²,

Karnik

et al. 2022

IJERPH

View full text Add to dashboard Cite

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“…gov/assets/doh/downloads/pdf/boh/racism-publichealth-crisis-resolution.pdf) and supported policy advocacy around safety-net health systems to address inequitable access to care for economically disadvantaged communities and communities of color. 33 This surveillance system has informed and shaped DOHMH's public health communication, practice, and policy during the COVID-19 pandemic by serving as a key mechanism to monitor progress and adjust our work in alignment with the agency's strategic priorities. For example, data are presented periodically to the agency's leadership and additional analyses are performed as required related to unexpected findings such as trend deviations (eg, the change in low-birth-weight trends for API and Black birthing parents described earlier).…”

Section: Discussionmentioning

confidence: 99%

Collateral Impacts of the COVID-19 Pandemic: The New York City Experience

Davies

Gould

et al. 2023

Journal of Public Health Management and Practice

Self Cite

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Objective: To adapt an existing surveillance system to monitor the collateral impacts of the COVID-19 pandemic on health outcomes in New York City across 6 domains: access to care, chronic disease, sexual/reproductive health, food/economic insecurity, mental/behavioral health, and environmental health. Design: Epidemiologic assessment. Public health surveillance system. Setting: New York City. Participants: New York City residents. Main Outcome Measures: We monitored approximately 30 indicators, compiling data from 2006 to 2022. Sources of data include clinic visits, surveillance surveys, vital statistics, emergency department visits, lead and diabetes registries, Medicaid claims, and public benefit enrollment. Results: We observed disruptions across most indicators including more than 50% decrease in emergency department usage early in the pandemic, which rebounded to prepandemic levels by late 2021, changes in reporting levels of probable anxiety and depression, and worsening birth outcomes for mothers who identified as Asian/Pacific Islander or Black. Data are processed in SAS and analyzed using the R Surveillance package to detect possible inflections. Data are updated monthly to an internal Tableau Dashboard and shared with agency leadership. Conclusions: As the COVID-19 pandemic continues into its third year, public health priorities are returning to addressing non–COVID-19-related diseases and conditions, their collateral impacts, and postpandemic recovery needs. Substantial work is needed to return even to a suboptimal baseline across multiple health topic areas. Our surveillance framework offers a valuable starting place to effectively allocate resources, develop interventions, and issue public communications.

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“…Safety net health systems, which provide care regardless of patients’ ability to pay, provide care for a large proportion of the medically underserved population in the US and have become increasingly important during the COVID-19 pandemic (9). The population served by safety net systems predominantly comprises low-income individuals, immigrants, and racial/ethnic minorities (10).…”

Section: Introductionmentioning

confidence: 99%

“…These populations who were experiencing higher rates of cervical cancer and other chronic illnesses prior to the pandemic are now being faced with widening health disparities due to COVID (8). Safety net health systems, which provide care regardless of patients' ability to pay, provide care for a large proportion of the medically underserved population in the US and have become increasingly important during the COVID-19 pandemic (9). The population served by safety net systems predominantly comprises low-income individuals, immigrants, and racial/ethnic minorities (10).…”

Section: Introductionmentioning

confidence: 99%

Perceived barriers to cervical cancer screening and motivators for at-home human papillomavirus self-sampling during the COVID-19 pandemic: Results from a telephone survey

Parker

Deshmukh

Chen

et al. 2022

Preprint

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Background Home-based self-sample human papillomavirus (HPV) testing may be an alternative for women who do not attend clinic-based cervical cancer screening. Methods We assessed barriers to care and motivators to use at-home HPV self-sampling kits during the COVID-19 pandemic as part of a randomized controlled trial evaluating kit effectiveness. Participants were women, aged 30-65 years and underscreened for cervical cancer in a safetynet healthcare system. We conducted telephone surveys in English/Spanish among a subgroup of trial participants, assessed differences between groups and determined statistical significance at p<0.05. Results Over half of 233 survey participants reported clinic-based screening (Pap) is uncomfortable (67.8%), embarrassing (52.4%), and discomfort seeing male providers (63.1%). The latter two factors were significantly more prevalent among Spanish versus English speakers (66.4% vs 30% and 69.9 vs 52.2%, respectively, p<0.01). Most women who completed the kit found Pap more embarrassing (69.3%), stressful (55.6%) and less convenient (55.6%) than the kit. The first factor was more prevalent among Spanish versus English speakers (79.6% vs 53.38%, p<0.05). Conclusions The COVID-19 pandemic influenced most (59.5%) to participate in the trial due to fear of COVID, difficulty making appointments and ease of using kits. HPV self-sampling kits may reduce barriers among underscreened women in a safety-net system. Funding This study is supported by a grant from the National Institute for Minority Health and Health Disparities (NIMHD, R01MD013715, PI: JR Montealegre).

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Covid-19 and the Safety Net — Moving from Straining to Sustaining

Cited by 15 publications

References 1 publication

Public Health Workforce Gaps, Impacts, and Improvement Strategies from COVID-19

Public Health Workforce Gaps, Impacts, and Improvement Strategies from COVID-19

Collateral Impacts of the COVID-19 Pandemic: The New York City Experience

Perceived barriers to cervical cancer screening and motivators for at-home human papillomavirus self-sampling during the COVID-19 pandemic: Results from a telephone survey

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