Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-15 (of 15 Records) |
Query Trace: Thacker SB[original query] |
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How I came to write papers for clinicians in the late 1980s about improving the quality of reviews
Thacker SB . J R Soc Med 2022 115 (7) 273-275 I arrived at my interest in systematic reviews and meta-analysis through a circuitous route. In 1976, I joined the Epidemic Intelligence Service (EIS) Programme at the Communicable Disease Center (now Centers for Disease Control and Prevention). The EIS was established in 1951 by Alexander D Langmuir in response to concerns about the threat of biological weapons at the time of the Korean conflict.1 The Service is modelled along the lines of a clinical residency, with the ‘resident’ learning on the job in a mentored experience in applied epidemiology. EIS officers are known as ‘the disease detectives’ because they investigate epidemics of disease, the health effects of disasters, and trends over time of infectious disease, environmental health, chronic disease, violence, and unintentional injuries, as well as maternal and child health.2 I was assigned to the health department in Washington, DC, but spent my first few weeks with a team investigating the epidemic of Legionnaires Disease in Pennsylvania. Subsequently, I led investigations of diverse problems in hospitals, schools, restaurants, nursing homes, an institution for the mentally disabled and communities, including a study of the effects of a severe drought in Haiti. However, it was an investigation of a small cluster of febrile morbidity in a Washington, DC, hospital for women that led to my first systematic review and meta-analysis, although I had heard of neither of those terms at the time. |
Rationale for periodic reporting on the use of selected clinical preventive services to improve the health of infants, children, and adolescents - United States
Yeung LF , Shapira SK , Coates RJ , Shaw FE , Moore CA , Boyle CA , Thacker SB . MMWR Suppl 2014 63 (2) 3-13 This supplement is the second of a series of periodic reports from a CDC initiative to monitor and report on the use of a set of selected clinical preventive services in the U.S. population in the context of recent national initiatives to improve access to and use of such services. Increasing the use of these services can result in substantial reductions in the burden of illness, death, and disability and lower treatment costs. This supplement focuses on services to improve the health of U.S. infants, children, and adolescents. The majority of clinical preventive services for infants, children, and adolescents are provided by the health-care sector. Public health agencies play important roles in increasing the use of these services by identifying and implementing policies that are effective in increasing use of the services and by collaborating with stakeholders to conduct programs to improve use. Recent health-reform initiatives, including efforts to increase the accessibility and affordability of preventive services, fund community prevention programs, and improve the use of health information technologies, offer opportunities to improve use of preventive services. This supplement, which follows a previous report on adult services, provides baseline information on the use of a set of selected clinical preventive services to improve the health of infants, children, and adolescents before implementation of these recent initiatives and discusses opportunities to increase the use of such services. This information can help public health practitioners, in collaboration with other stakeholders that have key roles in improving infant, child, and adolescent health (e.g., parents or guardians and their employers, health plans, health professionals, schools, child care facilities, community groups, and voluntary associations), understand the potential benefits of the recommended services, address the problem of underuse, and identify opportunities to apply effective strategies to improve use and foster accountability among stakeholders. |
Rationale for periodic reporting on the use of adult clinical preventive services of public health priority--United States
Coates RJ , Yoon PW , Zaza S , Ogden L , Thacker SB . MMWR Suppl 2012 61 (2) 3-10 This supplement introduces a CDC initiative to monitor and report periodically on the use of a set of selected clinical preventive services in the U.S. adult population in the context of recent national initiatives to improve access to and use of such services. Increasing the use of these services has the potential to lead to substantial reductions in the burden of illness, death, and disability and to lower treatment costs. The majority of clinical preventive services are provided by the health-care sector, and public health agencies play important roles in helping to support increases in the use of these services (e.g., by identifying and implementing policies that are effective in increasing use of the services and by collaborating with stakeholders to conduct programs to improve use). Recent health reform initiatives, including efforts to increase the accessibility and affordability of preventive services, fund community prevention programs, and improve the use of health information technologies, offer opportunities to enhance use of preventive services. This supplement provides baseline information on a set of selected clinical preventive services before implementation of these recent reforms and discusses opportunities to increase the use of such services. This information can help public health practitioners collaborate with other stakeholders that have key roles to play in improving public health (e.g., employers, health plans, health professionals, and voluntary associations), understand the potential benefits of the recommended services, address the problem of underuse, and identify opportunities to apply effective strategies to improve use and foster accountability among stakeholders. |
Public health surveillance in the United States: evolution and challenges
Thacker SB , Qualters JR , Lee LM . MMWR Suppl 2012 61 (3) 3-9 In its landmark 1988 report, a committee of the Institute of Medicine highlighted assessment as one of the three core functions of public health along with policy development and assurance. The committee recommended that every public health agency regularly and systematically collect, assemble, analyze, and make available information on the health of the community, including statistics on health status, community health needs, and epidemiologic and other studies of health problems. Public health surveillance, often called the cornerstone of public health practice, is an essential element of the assessment function. |
Are we there yet? Seizing the moment to integrate medicine and public health
Scutchfield FD , Michener JL , Thacker SB . Am J Public Health 2012 102 Suppl 3 S312-6 Multiple promising but unsustainable attempts have been made to maintain programs integrating primary care and public health since the middle of the last century. During the 1960s, social justice movements expanded access to primary care and began to integrate primary care with public health concepts both to meet community needs for medical care and to begin to address the social determinants of health. Two decades later, the managed care movement offered opportunities for integration of primary care and public health as many employers and government payers attempted to control health costs and bring disease prevention strategies in line with payment mechanisms. Today, we again have the opportunity to align primary care with public health to improve the community's health. |
The value of public health services and systems research
Arias I , Thacker SB , Monroe JA . Am J Prev Med 2012 42 S82-3 Systems research is not new; it routinely has been used in chemistry, biology, ecology, economics, and epidemiology for many years and has been applied toward understanding the public health system for nearly 2 decades. During that time, the CDC, other operating divisions within the DHHS, and several international organizations have been using systems research to advance the field of public health. The CDC has made major contributions through developing the National Public Health Performance Standards Program, the precursor to accreditation of health departments, and leading the establishment of the first national public health systems research agenda in 2006. The CDC also has funded nine Preparedness and Emergency Response Research Centers that are pursuing a multidisciplinary public health systems research approach to improving preparedness and response. Each of these research centers is yielding important results that are relevant to policy and practice. | Elsewhere in DHHS, systems research is being applied to other public health problems. For instance, the NIH is applying systems research to the complex issue of health literacy, a problem that affects people's access to care, skills in comprehending and acting on health information, and decision making about behavior change such as healthy eating and exercise. (obssr.od.nih.gov/scientific_areas/social_culture_factors_in_health/health_literacy/index.aspx). In June 2011, the Health Resources and Services Administration released a tool kit, based on systems thinking and systems analysis, for mapping state child health care.1 The Administration for Health Research and Quality is also using systems research and design to understand and improve the complex socio-technical system of healthcare delivery in the U.S. (www.ahrq.gov/qual/systemdesign.htm). |
Epidemic assistance by the Centers for Disease Control and Prevention: role of the Epidemic Intelligence Service, 1946-2005
Thacker SB , Stroup DF , Sencer DJ . Am J Epidemiol 2011 174 S4-15 Since 1946, the Centers for Disease Control and Prevention has responded to urgent requests from US states, federal agencies, and international organizations through epidemic-assistance investigations (Epi-Aids). The authors describe the first 60 years of Epi-Aids, breadth of problems addressed, evolution of methodologies, scope of activities, and impact of investigations on population health. They reviewed Epi-Aid reports and EIS Bulletins, contacted current and former Epidemic Intelligence Service staff, and systematically searched the PubMed and Web of Science databases. They abstracted information on dates, location, staff involved, health problems, methods, and impacts of investigations according to a preplanned protocol. They assessed the methods presented as well as the quality of reports. During 1946-2005, a total of 4,484 investigations of health events were initiated by 2,815 Epidemic Intelligence Service officers. In the early years, the majority were in response to infectious agents, although environmental problems emerged. Investigations in subsequent years focused on occupational conditions, birth defects, reproductive health, tobacco use, cancer, violence, legal debate, and terrorism. These Epi-Aids heralded expansion of the agency's mission and presented new methods in statistics and epidemiology. Recommendations from Epi-Aids led to policy implementation, evaluation, or modification. Epi-Aids provide the Centers for Disease Control and Prevention with the agility to respond rapidly to public health crises. |
Evolution of epidemic investigations and field epidemiology during the MMWR era at CDC--1961-2011
Brachman PS , Thacker SB . MMWR Suppl 2011 60 (4) 22-6 Since 1946, CDC has provided rapid assistance to states, federal agencies, international organizations, and ministries of health, often through formal requests for epidemic-assistance investigations (Epi-Aids) (1). The Epi-Aid mechanism provides CDC with the agility to respond rapidly to serious and urgent public health crises. Epi-Aids operationalize the tenets of field epidemiology and are used to provide information, as quickly as possible, on which the processes of selecting and implementing interventions can be based to lessen or prevent illness, injury, or death (2,3). | | A total of 4,997 Epi-Aids have been conducted, of which 4,673 (94%) have occurred since 1960. Of the 556 international investigations, 551 (99%) have occurred since MMWR was transferred to CDC in 1960. Approximately 90% of these investigations have involved the approximately 3,000 Epidemic Intelligence Service officers (EISOs) who have trained at CDC since the program was initiated in 1951; however, only 218 EISOs came to CDC before MMWR arrived. EISOs assigned to state and local health departments conduct additional investigations within the states to which they are assigned. During the past 50 years, EISOs collectively have conducted approximately 5,000 state-based investigations without using the formal Epi-Aid request mechanism. |
The cornerstone of public health practice: public health surveillance, 1961--2011
Lee LM , Thacker SB . MMWR Suppl 2011 60 (4) 15-21 The roots of modern public health surveillance took hold in 17th century Europe (1), but the seed for CDC's role as America's national agency for collecting, analyzing, interpreting, and using data to protect the public's health was firmly planted only in 1961, when the Morbidity and Mortality Weekly Report (MMWR) was transferred to what was then the Communicable Disease Center (CDC; now the Centers for Disease Control and Prevention) (2). The advent of MMWR at CDC marked the beginning of CDC's responsibility for aggregating and publishing data weekly on nationally notifiable diseases and publishing the data annually in MMWR's Summary of Notifiable Diseases, United States. |
Public health then and now: celebrating 50 years of MMWR at CDC. Introduction
Shaw FE , Kohl KS , Lee LM , Thacker SB . MMWR Suppl 2011 60 (4) 2-6 This supplement of MMWR celebrates the 50th anniversary of CDC's first publication of MMWR on January 13, 1961 (Figure 1). MMWR was not new in 1961, but it was new to CDC, an agency that itself had been founded only 15 years earlier, in 1946 (1). The longer history of MMWR traces back to July 13, 1878, when the first predecessor of MMWR, called simply The Bulletin of the Public Health, was inaugurated. The Bulletin was established in accordance with the first National Quarantine Act, passed by Congress 2 months earlier. The Act ordered the Surgeon General of the U.S. Marine-Hospital Service to begin publishing abstracted disease reports collected from U.S. consuls in foreign lands to alert U.S. quarantine officials about what diseases could be expected among passengers arriving on steamships (2,3). In the 83 years from 1878 to 1961, MMWR went through several incarnations. By 1952, the publication had its current name and was being published by the National Office of Vital Statistics, an agency within the U.S. Department of Health, Education and Welfare. In 1960, CDC's renowned chief of epidemiology, Alexander D. Langmuir, decided that MMWR should be transferred to CDC (then known as the Communicable Disease Center). After much discussion, and as Langmuir later said in an interview, "all sorts of pulling out teeth by the roots without anesthesia and all kinds of internal frictions," in 1960, MMWR was transferred to CDC (4). | | In 2009, as the 50th anniversary of MMWR loomed, the MMWR Editor (F.E.S.) began discussions with leaders at CDC and the MMWR Editorial Board about how best to commemorate this date. Members of the Board, editors, and friends of MMWR offered many good ideas. In the end, the most persuasive idea was to celebrate the 50th anniversary simply by doing what MMWR has done best for 5 decades at CDC: publish articles of high value to its readers. The title of the supplement is "Public Health Then and Now: Celebrating 50 Years of MMWR at CDC." The supplement's guest editors (F.E.S., K.S.K., L.M.L., S.B.T.) selected a cadre of expert authors who have long experience in their respective fields of public health---enough to enable them to look back over the past 50 years and trace the most important influences and developments. The guest editors asked the authors to answer three key questions. What was the state of the art in 1961? How did it develop through 50 years into its present form? What does the future hold? Thus, with few exceptions, the 16 articles that make up this supplement are not meant to be about MMWR but instead are meant to trace the development of key areas of public health through the 50-year era of MMWR at CDC. | | The authors took up the challenge admirably. The result is a diverse set of articles that portray public health in 1961 and forward in time to the present and beyond. The articles range from detailed historical review, to analyses of MMWR content, to the more whimsical. They are not meant to be exhaustive, nor can they treat their topics as thoroughly as would a longer text, but they do depict the main events, developments, and innovations that led public health to where it stands today. |
Public health surveillance and knowing about health in the context of growing sources of health data
Lee LM , Thacker SB . Am J Prev Med 2011 41 (6) 636-40 The past decade has brought substantial changes in how data related to a community's health are collected, stored, and used to inform decisions about health interventions. Despite these changes, the purpose of public health surveillance has remained constant for more than a century. Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health-related data with the a priori purpose of preventing or controlling disease or injury, or of identifying unusual events of public health importance, followed by the dissemination and use of information for public health action. Surveillance is an important and necessary contributor to knowledge of a community's health. The public health system is responsible for ensuring that public health surveillance is conducted with appropriate practices and safeguards in order to maintain the public's trust. |
In Snow's footsteps: commentary on shoe-leather and applied epidemiology
Koo D , Thacker SB . Am J Epidemiol 2010 172 (6) 737-9 The term shoe-leather epidemiology is often synonymous with field epidemiology or intervention epidemiology. All 3 terms imply investigations initiated in response to urgent public health problems and for which the investigative team does much of its work in the field (i.e., outside the office or laboratory). Alexander D. Langmuir is credited with articulating the concept of disease surveillance as it is applied to populations rather than individuals. He also founded the Epidemic Intelligence Service (EIS) Program in 1951, a 2-year training experience in applied epidemiology that places professionals in the field, domestically and internationally, in real-life situations. Today, 70-90 EIS officers are assigned each year to Centers for Disease Control and Prevention programs and to state and local health departments to meet the broad spectrum of challenges in chronic disease, injury prevention, violence, environmental health, occupational safety and health, and maternal and child health, as well as infectious diseases. Throughout their assignments, EIS officers are encouraged to strive for analytic rigor as well as public health consequence, which requires technical competence blended with good judgment and awareness of context. Effective applied epidemiologists must have skills beyond just epidemiology to improve a population's health; the field of applied epidemiology requires multiple team members, all having different but complementary skills, to be effective. |
Perspectives on public health workforce research
Crawford CA , Summerfelt WT , Roy K , Chen ZA , Meltzer DO , Thacker SB . J Public Health Manag Pract 2009 15 S5-S15 The Centers for Disease Control and Prevention Office of Workforce and Career Development is committed to developing a competent, sustainable, and diverse public health workforce through evidence-based training, career and leadership development, and strategic workforce planning to improve population health outcomes. This article reviews the previous efforts in identifying priorities of public health workforce research, which are summarized as eight major research themes. We outline a strategic framework for public health workforce research that includes six functional areas (ie, definition and standards, data, methodology, evaluation, policy, and dissemination and translation). To conceptualize and prioritize development of an actionable public health research agenda, we constructed a matrix of key challenges in workforce analysis by public health workforce categories. Extensive reviews were conducted to identify valuable methods, models, and approaches to public health workforce research. We explore new tools and approaches for addressing priority areas for public health workforce and career development research and assess how tools from multiple disciplines of social sciences can guide the development of a research framework for advancing public health workforce research and policy. |
Factors associated with differences in mortality and self-reported health across states in the United States
Chen Z , Roy K , Haddix AC , Thacker SB . Health Policy 2009 94 (3) 203-10 OBJECTIVE: Recent studies indicate continuing health disparities across geographic units in the US. This paper provides updated estimates of the association between socioeconomic factors and population health using a new state-level dataset and panel econometric methods that account for state-specific effects and autoregressive error structure. METHODS: Data from multiple sources for the 50 US states and the District of Columbia are merged. The dependent variables are age-adjusted all-cause mortality, self-assessed health status, and number of healthy days. Panel econometric models are used to accommodate state-specific unobserved factors and to incorporate autoregressive random disturbances to provide consistent and robust estimates. RESULTS: A 1-unit increase in the number of physicians per 1000 population is associated with a reduction in mortality by 30/100,000. The effects of physician-to-population ratio on self-reported health measures are mixed. Socioeconomic, demographic, as well as the prevalence of smoking and obesity have varying effects on mortality and self-reported measures of health. CONCLUSIONS: The new estimate of the association between physician supply and lower mortality suggests continuing efforts to assess the need for policies and incentives to induce physician labor supply in underserved states. Strategies and policies to reduce health disparities should address social, economic and individual risk factors. |
Guide for applied public health workforce research: an evidence-based approach to workforce development
Thacker SB . J Public Health Manag Pract 2009 15 S109-12 Essential to achievement of the public health mission is a knowledgeable, competent, and prepared workforce; yet, there is little application of science and technical knowledge to ensuring the effectiveness of that workforce, be it governmental or private. In this article, I review the evidence for effective workforce development and argue for an increased emphasis on an evidence-based approach to ensuring an effective workforce by encouraging the generation of the evidence base that is required. To achieve this, I propose the appointment of an independent Task Force on Public Health Workforce Practice to oversee the development of a Guide for Public Health Workforce Research and Practice (Workforce Guide), a process that will generate and bring together the workforce evidence base for use by public health practitioners. |
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