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At least 19 records
All sourcesNASA NTRSDOE OSTI
DOE OSTI2023

The Field Epidemiology Training Program’s Contribution to Essential Public Health Functions in Seven National Public Health Institutes

Objective: This study explores how Field Epidemiology Training Programs (FETP) whose National Public Health Institutes (NPHI) are supported by U.S. Centers for Disease Control and Prevention (CDC) have contributed to strengthening essential public health functions. Methods: We conducted 96 semi-structured interviews with public health experts including NPHI staff, non-NPHI government staff, and staff from non-governmental and international organizations in Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda, and Zambia. We managed data using MAXQDA and employed direct content analysis to derive themes. Results: Three overarching themes emerged in relation to FETPs’ role within the NPHIs’ public health functions. These themes included contribution to improving country surveillance systems, role in providing leadership in outbreak responses, and strengthening countries’ and the NPHIs’ surveillance workforce capacity. Participants also shared challenges around FETPs’ implementation and suggestions for improvement. Conclusion: The results demonstrate the value of FETPs in strengthening public health systems through building workforce capacity and improving surveillance systems. By identifying the successes of FETPs in contributing to essential public health functions, our findings might inform current and future FETP implementation and its integration into NPHIs.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

How Management and Leadership Training Can Impact a Health System: Evaluation Findings From a Public Health Management Training Program in Cambodia

In 2017, the National Institute of Public Health in Cambodia collaborated with the U.S. Centers for Disease Control and Prevention to provide management and leadership training for 20 managers and senior staff from 10 health centers. We conducted a mixed methods evaluation of the program's outcomes and impact on the graduates and health centers. From June 2018 (baseline) to January 2019 (endpoint), we collected data from a competency assessment, observational visits, and interviews. From baseline to endpoint, all 20 participants reported increased competence in seven management areas. Comparing baseline and endpoint observational visits, we found improvements in leadership and governance, health workforce, water, sanitation, and hygiene, and health centers' use of medical products and technologies. When evaluating the improvements made by participants against the World Health Organization's key components of a well-functioning health system, the program positively contributed toward building four of the six components—leadership and governance, health information systems, human resources for health, and service delivery. While these findings are specific to the context of Cambodian health centers, we hope this evaluation adds to the growing body of research around the impact of skilled public health management on health systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

The impacts of COVID-19 on clean energy labor markets: Evidence from multifaceted analysis of public health interventions and COVID-health factors

COVID-19 pandemic has affected clean energy labor market. Using real-time job vacancy data, this study analyzes the impacts of the pandemic on the U.S. clean energy labor market in 2020, including biomass, energy efficiency (EE), electric vehicle (EV), power/microgrid, solar, and wind industries. This study identifies how COVID-health factors and public health interventions influence clean energy job availability during the early COVID pandemic. Overall, California had the most energy jobs and experienced a significant decrease in April 2020. EV and solar had the highest percentages of job vacancies during the pandemic in general. Still, lockdowns had the most severe influence on EE and wind jobs. Stay-at-home orders negatively affected clean energy job vacancies in biomass, EV, power/microgrid, and wind. Social-gathering restrictions, however, did not have much influence. Increased COVID tests at the state level had the strongest and most positive influence on clean energy job postings, indicating the importance of a state's ability to manage public health infrastructure or crisis issues. COVID hospitalizations negatively influenced the job vacancies in biomass and wind but did not affect the other four sectors; conversely, as COVID death numbers increased, the number of jobs in biomass, EV, power grid, solar, and wind decreased, but not in EE jobs.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2025

Including frameworks of public health ethics in computational modelling of infectious disease interventions

Decisions on public health interventions to control infectious diseases are often informed by computational models. Interpreting the predicted outcomes of a public health decision requires not only high-quality modelling but also an ethical framework for assessing the benefits and harms associated with different options. The design and specification of ethical frameworks matured independently of computational modelling, so many values recognized as important for ethical decision-making are missing from computational models. We demonstrate a proof-of-concept approach to incorporate multiple public health values into the evaluation of a simple computational model for vaccination against a pathogen such as SARS-CoV-2. By examining a bounded space of alternative prioritizations of three values relevant to public health ethics (aggregate clinical burden, equity in clinical burden, equity in adverse effects from vaccination), we identify value trade-offs, where the outcomes of optimal strategies differ depending on the ethical framework. This work demonstrates an approach to incorporating diverse values into decision criteria used to evaluate outcomes of models of infectious disease interventions.

"Mathematical Biology"↗
DOE OSTI2025

The overlooked interaction of emerging contaminants and microbial communities: a threat to ecosystems and public health

Abstract Context and aims Emerging contaminants (ECs) and microbial communities should not be viewed in isolation, but through the One Health perspective. Both ECs and microorganisms lie at the core of this interconnected framework, as they directly influence the health of humans, animals, and the environment. The interactions between ECs and microbial communities can have profound implications for public health, affecting all three domains. However, these ECs-microorganism interactions remain underexplored, potentially leaving significant public health and ecological risks unrecognized. Therefore, this article seeks to alert the scientific community to the overlooked interactions between ECs and microbial communities, emphasizing the pivotal role these interactions may play in the management of ‘One Health.’ Results The most extensively studied interaction between ECs and microbial communities is biodegradation. However, other more complex and concerning interactions demand attention, such as the impact of ECs on microbial ecology (disruptions in ecosystem balance affecting nutrient and energy cycles) and the rise and spread of antimicrobial resistance (a growing global health crisis). Although these ECs-microbial interactions had not been extensively studied, there are scientific evidence that ECs impact on microbial communities may be concerning for public health and ecosystem balance. Conclusions So, this perspective summarizes the impact of ECs through a One Health lens and underscores the urgent need to understand their influence on microbial communities, while highlighting the key challenges researchers must overcome. Tackling these challenges is vital to mitigate potential long-term consequences for both ecosystems and public health.

Gomes, Inês B. (ORCID:0000000207313662)↗
DOE OSTI2025

Ethical considerations in infectious disease modelling for public health policy: the case of school closures

Mathematical models of infectious diseases are frequently used as a tool to support public health policy and decisions around the implementation of interventions such as school closures. However, most publications on policy-relevant modelling lack an ethical framework and do not explicitly consider the ethical implications of the work. This creates a risk that the unintended consequences of interventions are overlooked or that models are used to justify decisions that are inconsistent with public health ethics. In this article, we focus on the case study of school closures as a commonly modelled intervention against pandemic influenza, COVID-19 and other infectious disease threats. We briefly review some of the key concepts in public health ethics and describe approaches to modelling the effects of school closures. We then identify a series of ethical considerations involved in modelling school closures. These include accounting for population heterogeneity and inequalities; including a diversity of viewpoints and expertise in model design; considering the distribution of benefits and harms; and model transparency and contextualization. Furthermore, we conclude with some recommendations to ensure that policy-relevant modelling is consistent with some key ethics values.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2021

A proposed framework for the development and qualitative evaluation of West Nile virus models and their application to local public health decision-making

West Nile virus (WNV) is a globally distributed mosquito-borne virus of great public health concern. The number of WNV human cases and mosquito infection patterns vary in space and time. Many statistical models have been developed to understand and predict WNV geographic and temporal dynamics. However, these modeling efforts have been disjointed with little model comparison and inconsistent validation. In this paper, we describe a framework to unify and standardize WNV modeling efforts nationwide. WNV risk, detection, or warning models for this review were solicited from active research groups working in different regions of the United States. A total of 13 models were selected and described. The spatial and temporal scales of each model were compared to guide the timing and the locations for mosquito and virus surveillance, to support mosquito vector control decisions, and to assist in conducting public health outreach campaigns at multiple scales of decision-making. Our overarching goal is to bridge the existing gap between model development, which is usually conducted as an academic exercise, and practical model applications, which occur at state, tribal, local, or territorial public health and mosquito control agency levels. The proposed model assessment and comparison framework helps clarify the value of individual models for decision-making and identifies the appropriate temporal and spatial scope of each model. This qualitative evaluation clearly identifies gaps in linking models to applied decisions and sets the stage for a quantitative comparison of models. Specifically, whereas many coarse-grained models (county resolution or greater) have been developed, the greatest need is for fine-grained, short-term planning models (m–km, days–weeks) that remain scarce. We further recommend quantifying the value of information for each decision to identify decisions that would benefit most from model input.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2026

Large-Scale Carbon Removal Will Create Public Health, Economic, and Climate Tradeoffs

Economy-wide efforts to achieve net-zero emissions offer both climate and air quality-related public health benefits from reducing fossil fuel combustion. We explore the expected costs and benefits if carbon dioxide removal (CDR) is deployed at scale in support of these efforts. Six leading forms of CDR at two levels of deployment are compared to a scenario with no U.S. climate action. We find that heavy reliance on CDR avoids a $2.5-5.8 trillion USD2020 in climate damages, provides $2.8-6.5 trillion USD2020 public health benefits, returns $5-6 trillion USD2020 in CDR revenues, but requires $11-13 trillion USD2020 CO2 mitigation cost, cumulatively by 2050 in the U.S. In contrast, lower reliance on CDR requires much deeper near-term fossil-fuel reductions, which increases mitigation costs by 52% but also creates 26% higher public health benefits from reductions in particulate matter- and ozone-related mortality and morbidity, preventing about 12,600 premature deaths by mid-century in the U.S.

Javadi, Parisa↗
DOE OSTI2024

A modeling pipeline to relate municipal wastewater surveillance and regional public health data

As COVID-19 becomes endemic, public health departments require improved passive indicators, which are independent of voluntary testing data, to estimate the prevalence of COVID-19 in local communities. Quantification of SARS-CoV-2 RNA from wastewater has the potential to be a powerful passive indicator. However, connecting measured SARS-CoV-2 RNA to community prevalence is challenging. We have developed a generalized methodology to improve the predictive power of wastewater measurements and applied it to data collected from treatment plants in the Chicago area. We built and compared a set of multi-linear regression models, which incorporate pepper mild mottle virus (PMMoV) as a population biomarker, Bovine coronavirus (BCoV) as a recovery control, and wastewater system flow rate into a corrected estimate for SARS-CoV-2 RNA concentration. For our data, models with BCoV performed better than those with PMMoV, but all model estimates of prevalence significantly improved correlation compared to doing no correction. We also investigate the utility of RNA measurements in wastewater as a leading indicator of COVID-19 trends. We do this in a rolling manner for corrected wastewater data and for other prevalence indicators, and statistically compare the temporal relationship between new increases in the wastewater data and those in other prevalence indicators. We find that wastewater trends often lead other COVID-19 indicators in predicting new surges.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Cyberbiosecurity and Public Health in the Age of COVID-19

Cyberbiosecurity, the aspect of biosecurity involving the digital representation of biological data, had already been emerging as a matter of public concern even prior to the onset of the COVID-19 pandemic. Key issues of concern include, among others, the privacy of patient data, the security of public health databases, the integrity of diagnostic test data, the integrity of public biological databases, the security implications of automated laboratory systems and the security of proprietary biological engineering advances. With the onset of the COVID-19 pandemic, and the importance of digital resources in combatting it, concern about the potential for cyber attacks by state-based or non-state actors has been elevated. To illuminate the challenges, we focus on the cyber vulnerabilities that need to be addressed in public health activities such as disease surveillance and outbreak management. In particular, we examine cyber issues raised by the accelerated pace of development for COVID mitigations, treatments, and vaccines.

cybersecurity, biosecurity↗
DOE OSTI2022

Integrating Public Health Surveillance and Environmental Data to Model Presence of Histoplasma in the United States

In the United States, the true geographic distribution of the environmental fungus Histoplasma capsulatum remains poorly understood but appears to have changed since it was first characterized. Histoplasmosis is caused by inhalation of the fungus and can range in severity from asymptomatic to life-threatening. Due to limited public health surveillance and under detection of infections, it is challenging to directly use reported case data to characterize spatial risk. Using monthly and yearly county-level public health surveillance data and various environmental and socioeconomic characteristics, we use a spatio-temporal occupancy model to estimate latent, or unobserved, presence of H. capsulatum , accounting for imperfect detection of histoplasmosis cases. We estimate areas with higher probabilities of the presence of H. capsulatum in the East North Central states around the Great Lakes, reflecting a shift of the endemic region to the north from previous estimates. The presence of H. capsulatum was strongly associated with higher soil nitrogen levels. In this investigation, we were able to mitigate challenges related to reporting and illustrate a shift in the endemic region from historical estimates. This work aims to help inform future surveillance needs, clinical awareness, and testing decisions for histoplasmosis.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2024

Air quality and public health co-benefits of 100% renewable electricity adoption and electrification pathways in Los Angeles

To demonstrate how a mega city can lead in decarbonizing beyond legal mandates, the city of Los Angeles (LA) developed science-based, feasible pathways towards utilizing 100% renewable energy for its municipally-owned electric utility. Aside from decarbonization, renewable energy adoption can lead to co-benefits such as improving urban air quality from reductions in combustion-related emissions of oxides of nitrogen (NO x ), primary fine particulate matter (PM 2.5 ) and others. Herein, we quantify changes to air pollutant concentrations and public health from scenarios of 100% renewable electricity adoption in LA in 2045, alongside aggressive electrification of end-use sectors. Our analysis suggests that while ensuring reliable electricity supply, reductions in emissions of air pollutants associated with the 100% renewable electricity scenarios can lead to 8% citywide reductions of PM 2.5 concentration while increasing ozone concentration by 5% relative to a 2012 baseline year, given identical meteorology conditions. The combination of these concentration changes could result in net monetized public health benefits (driven by avoided deaths) of up to $\$$1.4 billion in year 2045 in LA, results potentially replicable for other city-scale decarbonization scenarios.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2023

PCAST: Report to the President on Supporting the U.S. Public Health Workforce

The President’s Council of Advisors on Science and Technology (PCAST) is the sole body of advisors from outside the federal government charged with making science, technology, and innovation policy recommendations to the President and the White House. Established by Executive Order, it is an independent Federal Advisory Committee comprised of distinguished individuals from industry, academia, and non-profit organizations with a range of perspectives and expertise. On May 1, 2023, PCAST sent a report to the President with recommendations for developing and sustaining the robust public health workforce that is essential for the United States to make long-needed, permanent improvements to our nation’s approach to public health.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2023

GeoAI for Public Health

Infectious disease spread within the human population can be conceptualized as a complex system composed of individuals who interact and transmit viruses through spatio-temporal processes that manifest across and between scales. The complexity of this system ultimately means that the spread of infectious diseases is difficult to understand, predict, and respond to effectively. Research interest in GeoAI for public health has been fueled by the increased availability of rich data sources such as human mobility data, OpenStreetMap data, contact tracing data, symptomatic online surveys, retail and commerce data, genomics data, and more. This data availability has resulted in a wide variety of data-driven solutions for infectious disease spread prediction which show potential in enhancing our forecasting capabilities. This chapter (1) motivates the need for AI-based solutions in public health by showing the heterogeneity of human behavior related to health, (2) provides a brief survey of current state-of-the-art solutions using AI for infectious disease spread prediction, (3) describes a use-case of using large-scale human mobility data to inform AI models for the prediction of infectious disease spread in a city, and (4) provides future research directions and ideas.

Zufle, Andreas↗
DOE OSTI2022

The public health exposome and pregnancy-related mortality in the United States: a high-dimensional computational analysis

Racial inequities in maternal mortality in the U.S. continue to be stark. The 2015–2018, 4-year total population, county-level, pregnancy-related mortality ratio (PRM; deaths per 100,000 live births; National Center for Health Statistics (NCHS), restricted use mortality file) was linked with the Public Health Exposome (PHE). Using data reduction techniques, 1591 variables were extracted from over 62,000 variables for use in this analysis, providing information on the relationships between PRM and the social, health and health care, natural, and built environments. Graph theoretical algorithms and Bayesian analysis were applied to PHE/PRM linked data to identify latent networks. PHE variables most strongly correlated with total population PRM were years of potential life lost and overall life expectancy. Population-level indicators of PRM were overall poverty, smoking, lack of exercise, heat, and lack of adequate access to food. In this high-dimensional analysis, overall life expectancy, poverty indicators, and health behaviors were found to be the strongest predictors of pregnancy-related mortality. This provides strong evidence that maternal death is part of a broader constellation of both similar and unique health behaviors, social determinants and environmental exposures as other causes of death.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

On alert for Ebola: public health risk assessment of travellers from Uganda to the USA during the 2022 outbreak

Abstract Background On 20 September 2022, the Ugandan Ministry of Health declared an outbreak of Ebola disease caused by Sudan ebolavirus. Methods From 6 October 2022 to 10 January 2023, Centers for Disease Control and Prevention (CDC) staff conducted public health assessments at five US ports of entry for travellers identified as having been in Uganda in the past 21 days. CDC also recommended that state, local and territorial health departments (‘health departments’) conduct post-arrival monitoring of these travellers. CDC provided traveller contact information, daily to 58 health departments, and collected health department data regarding monitoring outcomes. Results Among 11 583 travellers screened, 132 (1%) required additional assessment due to potential exposures or symptoms of concern. Fifty-three (91%) health departments reported receiving traveller data from CDC for 10 114 (87%) travellers, of whom 8499 (84%) were contacted for monitoring, 1547 (15%) could not be contacted and 68 (1%) had no reported outcomes. No travellers with high-risk exposures or Ebola disease were identified. Conclusion Entry risk assessment and post-arrival monitoring of travellers are resource-intensive activities that had low demonstrated yield during this and previous outbreaks. The efficiency of future responses could be improved by incorporating an assessment of risk of importation of disease, accounting for individual travellers’ potential for exposure, and expanded use of methods that reduce burden to federal agencies, health departments, and travellers.

General & Internal Medicine↗
DOE OSTI2022

Epidemic Intelligence Service Alumni in Public Health Leadership Roles

Since 1951, the Epidemic Intelligence Service (EIS) of the U.S. Centers for Disease Control and Prevention (CDC) has trained physicians, nurses, scientists, veterinarians, and other allied health professionals in applied epidemiology. To understand the program’s effect on graduates’ leadership outcomes, we examined the EIS alumni representation in five select leadership positions. These positions were staffed by 353 individuals, of which 185 (52%) were EIS alumni. Among 12 CDC directors, four (33%) were EIS alumni. EIS alumni accounted for 29 (58%) of the 50 CDC center directors, 61 (35%) of the 175 state epidemiologists, 27 (56%) of the 48 Field Epidemiology Training Program resident advisors, and 70 (90%) of the 78 Career Epidemiology Field Officers. Of the 185 EIS alumni in leadership positions, 136 (74%) were physicians, 22 (12%) were scientists, 21 (11%) were veterinarians, 6 (3%) were nurses, and 94 (51%) were assigned to a state or local health department. Among the 61 EIS alumni who served as state epidemiologists, 40 (66%) of them were assigned to a state or local health department during EIS. Our evaluation suggests that epidemiology training programs can serve as a vital resource for the public health workforce, particularly given the capacity strains brought to light by the COVID-19 pandemic.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Money Matters: A Three-Step Process for Using Budget Data in Program Evaluation to Assess the Design and Management of a Novel Public Health Program

We applied a three-step process, abstracting and analyzing program budgets to examine how Colorectal Cancer Control Program (CRCCP) awardees are structuring their programs and to assess the fidelity of program design to the CRCCP public health model. We reviewed 23 state, one tribal organization, and six university awardee budgets. We assessed resource allocations, staffing structures, and contracted partners and their activities. Awardees allocated 83% of all funds to contracts and personnel. Program managers were the most budgeted personnel type across three measures: number of people, full-time equivalency, and personnel costs. Awardees not only contracted with health care systems and clinics (39% of all contracts) but also contracted other partner types. Contractors were mainly funded to implement evidence-based interventions (25%) and conduct evaluation (24%). Program design varied among awardees in the number of staff (0–22), number of full-time equivalencies (0–5.4), and the number of contracts (1–11) budgeted. State awardees budgeted more resources to contracts, compared with university awardees (57% vs. 31%), while universities budgeted more for total personnel costs (41% vs. 30%). We learned that awardees designed their programs with fidelity to the CRCCP model. Although implementation approaches varied, overall results suggest implementation requires a combination of internal capacities and contracted partners. Budgets provide opportunities to use already existing program data to evaluate program design, partnerships, and planned activities.

Uhd, Justin↗