Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Ekperi L [original query] |
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The virtual village: A 21st-century challenge for community preparedness
LeBlanc TT , Ekperi L , Kosmos C , Avchen RN . Am J Public Health 2019 109 S258-s259 Communities are societal extensions of family. Since early times, humans banded together for mutual aid, companionship, and protection from threats.1 Communities were forged by people living in the same geographic area with shared attitudes, interests, and goals for cultures, religions, and occupations.1 However, social scientists expressed concerns during the Industrial Revolution about changes observed in the human experience as populations retreated from rural areas and close-knit family units in favor of big cities and life among strangers.1 | | Sometime in the latter part of the 20th century, the way people interacted began to shift dramatically.2 In the United States, a decline in marriage and birthrates changed family dynamics and increased the number of adults living alone.2 In 2018, there were 35.7 million single-person households, composing 28% of all United States households—a significant increase from 13% in 1960.3 Social isolation is becoming more acute, with less community engagement as people rely on advances in technology to feel connected.2 |
The impact of Hurricane Sandy on HIV testing rates: An interrupted time series analysis, January 1, 2011 - December 31, 2013
Ekperi LI , Thomas E , LeBlanc TT , Adams EE , Wilt GE , Molinari NA , Carbone EG . PLoS Curr 2018 10 BACKGROUND: Hurricane Sandy made landfall on the eastern coast of the United States on October 29, 2012 resulting in 117 deaths and 71.4 billion dollars in damage. Persons with undiagnosed HIV infection might experience delays in diagnosis testing, status confirmation, or access to care due to service disruption in storm-affected areas. The objective of this study is to describe the impact of Hurricane Sandy on HIV testing rates in affected areas and estimate the magnitude and duration of disruption in HIV testing associated with storm damage intensity. METHODS: Using MarketScan data from January 2011December 2013, this study examined weekly time series of HIV testing rates among privately insured enrollees not previously diagnosed with HIV; 95 weeks pre- and 58 weeks post-storm. Interrupted time series (ITS) analyses were estimated by storm impact rank (using FEMA's Final Impact Rank mapped to Core Based Statistical Areas) to determine the extent that Hurricane Sandy affected weekly rates of HIV testing immediately and the duration of that effect after the storm. RESULTS: HIV testing rates declined significantly across storm impact rank areas. The mean decline in rates detected ranged between -5% (95% CI: -9.3, -1.5) in low impact areas and -24% (95% CI: -28.5, -18.9) in very high impact areas. We estimated at least 9,736 (95% CI: 7,540, 11,925) testing opportunities were missed among privately insured persons following Hurricane Sandy. Testing rates returned to baseline in low impact areas by 6 weeks post event (December 9, 2012); by 15 weeks post event (February 10, 2013) in moderate impact areas; and by 17 weeks after the event (February 24, 2013) in high and very high impact areas. CONCLUSIONS: Hurricane Sandy resulted in a detectable and immediate decline in HIV testing rates across storm-affected areas. Greater storm damage was associated with greater magnitude and duration of testing disruption. Disruption of basic health services, like HIV testing and treatment, following large natural and man-made disasters is a public health concern. Disruption in testing services availability for any length of time is detrimental to the efforts of the current HIV prevention model, where status confirmation is essential to control disease spread. |
Medical countermeasure actions - a historical perspective
LeBlanc TT , Ekperi L , Avchen RN , Kosmos C . Am J Public Health 2018 108 S175-s176 On March 20, 1995, Sarin gas was released during morning rush hour in the Tokyo, Japan, subway system, killing 13 individuals and causing illness among thousands.1 The event received significant media coverage and signaled a call for action among officials in charge of national security. As a component of preparedness efforts against acts of bioterrorism, then President Clinton launched the first national biological weapons defense initiative, and in 1999, Congress appropriated $50 million dollars for the Department of Health and Humans Services, Centers for Disease Control and Prevention (CDC) to mobilize the public health system for protection against harmful biological agents.2 Ensuring safety of the public’s health led to the development of the National Pharmaceutical Stockpile, a repository of pharmaceuticals and medical supplies available for rapid deployment, and provision of direct support to local, state, and territorial health departments in the event of a large-scale public health emergency.3 |
Vulnerabilities associated with post-disaster declines in HIV-testing: Decomposing the impact of Hurricane Sandy
Thomas E , Ekperi L , LeBlanc TT , Adams EE , Wilt GE , Molinari NA , Carbone EG . PLoS Curr 2018 10 Introduction: Using Interrupted Time Series Analysis and generalized estimating equations, this study identifies factors that influence the size and significance of Hurricane Sandy's estimated impact on HIV testing in 90 core-based statistical areas from January 1, 2011 to December 31, 2013. Methods: Generalized estimating equations were used to examine the effects of sociodemographic and storm-related variables on relative change in HIV testing resulting from Interrupted Time Series analyses. Results: There is a significant negative relationship between HIV prevalence and the relative change in testing at all time periods. A one unit increase in HIV prevalence corresponds to a 35% decrease in relative testing the week of the storm and a 14% decrease in relative testing at week twelve. Building loss was also negatively associated with relative change for all time points. For example, a one unit increase in building loss at week 0 corresponds with an 8% decrease in the relative change in testing (p=0.0001) and a 2% at week twelve (p=0.001). Discussion: Our results demonstrate that HIV testing can be negatively affected during public health emergencies. Communities with high percentages of building loss and significant HIV disease burden should prioritize resumption of testing to support HIV prevention. |
Research participation among state and local public health emergency preparedness and response programs
Yusuf H , Ekperi L , Groseclose S , Siegfried A , Meit M , Carbone E . Public Health 2018 159 133-136 OBJECTIVES: The objective of our study was to assess whether state and local health staff participated in public health emergency preparedness research activities and what partner organizations they collaborated with on research. STUDY DESIGN: This is a cross-sectional study. METHODS: Data were derived from a 2014 web-based survey of state, territorial, and local health departments conducted by the Centers for Disease Control and Prevention and NORC at the University of Chicago as part of a larger project to assess the public health emergency preparedness and response research priorities of state and local health departments. RESULTS: Overall, 30% of survey respondents indicated that health department staff were involved in public health preparedness and response research-related activities. Thirty-four percent indicated that they were extremely or moderately familiar with emergency preparedness research and literature. Approximately 67% of respondents reported interest in receiving additional information and/or training related to the preparedness research and literature. The most frequently reported partners for collaboration in preparedness research-related activities were schools of public health (34%). CONCLUSIONS: Our findings suggest that there is health department interest in learning more about preparedness and response science and that additional efforts are needed to increase health department participation in public health emergency preparedness and response research-related activities. |
A space time analysis evaluating the impact of Hurricane Sandy on HIV testing rates
Wilt GE , Adams EE , Thomas E , Ekperi L , LeBlanc TT , Dunn I , Molinari NA , Carbone EG . Int J Disaster Risk Reduct 2018 28 839-844 Spatial proximity to infrastructural damage from natural disasters may pose a threat to established HIV testing services and contribute to delays in knowledge of one's disease status. Physical vulnerabilities such as spatial proximity to a level 4 FEMA impact zone, are defined in this study as natural and infrastructural barriers that can impede access to care. We analyzed the storm effects and community characteristics that contributed to the changes in HIV testing rates post Hurricane Sandy. Univariate and bivariate Moran's I tests were conducted to test for spatial autocorrelation. Combined spatial lag and error models accounted for lagged effects and alternatives in error distribution. Bivariate local Moran's I identified many significant clusters of more extreme negative relative change in HIV testing rates in areas with high FEMA impact ranks. Spatial lag and error models highlighted a significant relationship between CBSAs closer to a level 4 FEMA impact zone and the increased effect of Hurricane Sandy on HIV testing. Additionally, as the number of habitable buildings increased, there was significantly less change in HIV testing rates. Physical vulnerability had a significant effect on HIV testing rates. However all findings became less significant over time, highlighting the recovery process. Factors including: increased communication concerning preventative measures prior to the disaster, a prompt response to mitigate infrastructural damage and resumption of HIV testing services, are essential at the government and community levels to mitigate infection risk. |
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