Examining the impact of federally-funded syphilis elimination activities in the USA

Chesson, Harrell W.; Owusu-Edusei, Kwame

doi:10.1016/j.socscimed.2008.09.049

Cited by 25 publications

(40 citation statements)

References 8 publications

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“…33 Eradication of syphilis as proposed in the National Plan to Eliminate Syphilis will require not just parallel action but active collaboration. 34,35 …”

Section: Discussionmentioning

confidence: 99%

Triangulating on Success: Innovation, Public Health, Medical Care, and Cause-Specific US Mortality Rates Over a Half Century (1950–2000)

et al. 2010

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To identify successes in improving America’s health, we identified disease categories that appeared on vital statistics lists of leading causes of death in the US adult population in either 1950 or 2000, and that experienced at least a 50% reduction in age-adjusted death rates from their peak level to their lowest point between 1950 and 2000. Of the 9 cause-of-death categories that achieved this 50% reduction, literature review suggests that 7 clearly required diffusion of new innovations through both public health and medical care channels. Our nation’s health success stories are consistent with a triangulation model of innovation plus public health plus medical care, even when the 3 sectors have worked more in parallel than in partnership.

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“…33 Eradication of syphilis as proposed in the National Plan to Eliminate Syphilis will require not just parallel action but active collaboration. 34,35 …”

Section: Discussionmentioning

confidence: 99%

Triangulating on Success: Innovation, Public Health, Medical Care, and Cause-Specific US Mortality Rates Over a Half Century (1950–2000)

et al. 2010

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“…Theoretical work by Geoffard and Philipson analyzed the difficulties of achieving disease eradication through vaccination using various types of incentives, highlighting that increased coverage levels reduce the incentive of those not yet vaccinated because they are less at risk of contracting the disease [54]. Chesson et al found that greater amounts of state-level funding for syphilis elimination had a notable impact in lowering syphilis rates in subsequent years within the context of a national elimination plan in the US [55]. …”

Section: Resultsmentioning

confidence: 99%

Can Economic Analysis Contribute to Disease Elimination and Eradication? A Systematic Review

Evans¹,

Tediosi²

2015

PLoS ONE

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BackgroundInfectious diseases elimination and eradication have become important areas of focus for global health and countries. Due to the substantial up-front investments required to eliminate and eradicate, and the overall shortage of resources for health, economic analysis can inform decision making on whether elimination/eradication makes economic sense and on the costs and benefits of alternative strategies. In order to draw lessons for current and future initiatives, we review the economic literature that has addressed questions related to the elimination and eradication of infectious diseases focusing on: why, how and for whom?MethodsA systematic review was performed by searching economic literature (cost-benefit, cost-effectiveness and economic impact analyses) on elimination/eradication of infectious diseases published from 1980 to 2013 from three large bibliographic databases: one general (SCOPUS), one bio-medical (MEDLINE/PUBMED) and one economic (IDEAS/REPEC).ResultsA total of 690 non-duplicate papers were identified from which only 43 met the inclusion criteria. In addition, only one paper focusing on equity issues, the “for whom?” question, was found. The literature relating to “why?” is the largest, much of it focusing on how much it would cost. A more limited literature estimates the benefits in terms of impact on economic growth with mixed results. The question of how to eradicate or eliminate was informed by an economic literature highlighting that there will be opportunities for individuals and countries to free-ride and that forms of incentives and/or disincentives will be needed. This requires government involvement at country level and global coordination. While there is little doubt that eliminating infectious diseases will eventually improve equity, it will only happen if active steps to promote equity are followed on the path to elimination and eradication.ConclusionThe largest part of the literature has focused on costs and economic benefits of elimination/eradication. To a lesser extent, challenges associated with achieving elimination/eradication and ensuring equity have also been explored. Although elimination and eradication are, for some diseases, good investments compared with control, countries’ incentives to eliminate do not always align with the global good and the most efficient elimination strategies may not prioritize the poorest populations. For any infectious disease, policy-makers will need to consider realigning contrasting incentives between the individual countries and the global community and to assure that the process towards elimination/eradication considers equity.

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“…(6) Second, as previously highlighted, lower federal budget levels for STD have been associated with future increases in the number of STDs. (9–11) Thus, it is possible that local budget cuts in FY2011–12 may have an impact on future STD rates. Research that examines funding for public STD clinical services and STD rates in subsequent years may be useful.…”

Section: Discussionmentioning

confidence: 99%

“…(10) A similar analysis also found that syphilis rates decreased in years following syphilis elimination funding. (11) Yet, public funding for public health has been declining and is expected to continue to do so through 2023. (12) The full impact of this decline is unknown; however, a 2009 survey of STD services offered by health departments found reductions in budget, staffing and the closures of clinics providing STD services, including STD and family planning clinics.…”

mentioning

confidence: 99%

US Public Sexually Transmitted Disease Clinical Services in an Era of Declining Public Health Funding: 2013–14

et al. 2017

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Background We examined the infrastructure for United States (U.S.) public STD clinical services. Methods In 2013–14, we surveyed 331 of 1,225 local health departments (LHDs) who either reported providing STD testing/treatment in the 2010 National Profile of Local Health Departments survey or were the 50 local areas with the highest STD cases or rates. The sample was stratified by jurisdiction population size. We examined the primary referral clinics for STDs, the services offered and the impact of budget cuts (limited to government funding only). Data were analyzed using SAS and analyses were weighted for non-response. Results Twenty-two percent of LHDs cited a specialty STD clinic as their primary referral for STD services; this increased to 53.5% of LHDs when combination STD-family planning clinics were included. The majority of LHDs (62.8%) referred to clinics providing same-day services. STD clinics more frequently offered extra-genital testing for chlamydia and/or gonorrhea (74.7%) and gonorrhea culture (68.5%) than other clinics (52.9%, 46.2%, respectively; p<0.05). The majority of LHDs (61.5%) reported recent budget cuts. Of those with decreased budgets, the most common impacts were fewer clinic hours (42.8%; 95%CI, 24.4–61.2), reduced routine screening (40.2%; 95%CI, 21.7–58.8) and reductions in partner services (42.1%; 95%CI, 23.6–60.7). One-quarter of those with reduced STD budgets increased fees or copays for clients. Conclusions Findings demonstrate gaps and reductions in U.S. public STD services including clinical services that play an important role in reducing disease transmission. Furthermore, STD clinics tended to offer more specialized STD services than other public clinics.

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Examining the impact of federally-funded syphilis elimination activities in the USA

Cited by 25 publications

References 8 publications

Triangulating on Success: Innovation, Public Health, Medical Care, and Cause-Specific US Mortality Rates Over a Half Century (1950–2000)

Triangulating on Success: Innovation, Public Health, Medical Care, and Cause-Specific US Mortality Rates Over a Half Century (1950–2000)

Can Economic Analysis Contribute to Disease Elimination and Eradication? A Systematic Review

US Public Sexually Transmitted Disease Clinical Services in an Era of Declining Public Health Funding: 2013–14

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