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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 44 Research Studies DisplayedDecker SL, Zuvekas SH
AHRQ Author: Decker SL, Zuvekas SH
A nationally representative summary of 2020 changes in the use of health care in the United States.
The authors used Medical Expenditure Panel Survey data to summarize changes in all types of health care from 2018 to 2020. The results showed that outpatient and emergency department visits, as well as inpatient admissions each fell ~35% in April 2020; dental visits fell by over 80%, and mammograms 82%. By the end of 2020, specialist physician visits recovered, though primary care and dental visits remained 12% lower than in 2019. Psychiatric visits, however, rose slightly.
AHRQ-authored.
Citation: Decker SL, Zuvekas SH .
A nationally representative summary of 2020 changes in the use of health care in the United States.
J Ambul Care Manage 2024 Apr-Jun; 47(2):64-83. doi: 10.1097/jac.0000000000000488.
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Delivery, Public Health
Bartsch SM, O'Shea KJ, John DC
The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.
This paper’s objective was to develop a modelling study on the potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine to be used in the U.S. The authors used a computational model representing the US population, the spread of SARS-CoV-2, and the various clinical and economic outcomes of COVID-19 such as hospitalizations, deaths, quality-adjusted life years (QALYs) lost, productivity losses, direct medical costs, and total societal costs, to explore the impact of a universal vaccine under different circumstances. They developed and populated this model using data reported by the CDC as well as observational studies conducted during the COVID-19 pandemic. The pan-coronavirus vaccine would be cost-saving as long as its vaccine efficacy is ≥10% and vaccination coverage is ≥10%. They estimated that every 1% increase in efficacy between 10% and 50% could avert an additional 395,000 infections and save $1.0 billion in total societal costs ($45.3 million in productivity losses, $1.1 billion in direct medical costs). Even when a strain-specific coronavirus virus becomes available it would remain cost-saving, as long as it takes at least 2-3 months to develop, test, and bring that more specific vaccine to the market.
AHRQ-funded; R01HS028165.
Citation: Bartsch SM, O'Shea KJ, John DC .
The potential epidemiologic, clinical, and economic value of a universal coronavirus vaccine: a modelling study.
EClinicalMedicine 2024 Feb; 68:102369. doi: 10.1016/j.eclinm.2023.102369..
Keywords: COVID-19, Vaccination, Public Health
Atkinson MK, Biddinger PD, Chughtai MA
Assessing health care leadership and management for resilience and performance during crisis: the HERO-36.
The authors developed a Healthcare Emergency Response Optimization survey to examine health care organizations’ resilience and performance during crisis. The survey was administered to health care administrators and frontline staff involved in hospitals’ emergency response during the COVID-19 pandemic. Eight measures emerged to assess crisis leadership and management; informal practices mattered most for resilience, while formal practices mattered for performance. The authors identified specific practices for resilience and performance. They concluded that organizations using these measures may modify their preparedness and planning approaches to improve management in future crises.
AHRQ-funded; HS028240.
Citation: Atkinson MK, Biddinger PD, Chughtai MA .
Assessing health care leadership and management for resilience and performance during crisis: the HERO-36.
Health Care Manage Rev 2024 Jan-Mar; 49(1):14-22. doi: 10.1097/hmr.0000000000000387..
Keywords: COVID-19, Public Health
Adams DR
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
The goal of this study was to assess the availability of outpatient mental health services for children and adolescents at safety-net health centers in a large metropolitan county. A comprehensive sample of Community Mental Health Centers (CMHCs) and Federally Qualified Health Centers (FQHCs) received a 5-minute survey approximately one year after the beginning of the COVID-19 pandemic. The response indicated that 10% of health centers had closed and 20% reported that they were not offering outpatient mental health services. Reported wait times were longer at CMHCs than FQHCs. The author concluded that these findings suggested that online directories such as the SAMHSA Treatment Locator are often inaccurate or out-of-date.
AHRQ-funded; HS000084.
Citation: Adams DR .
Availability and accessibility of mental health services for youth: a descriptive survey of safety-net health centers during the COVID-19 pandemic.
Community Ment Health J 2024 Jan; 60(1):88-97. doi: 10.1007/s10597-023-01127-9..
Keywords: Children/Adolescents, Behavioral Health, Access to Care, COVID-19, Public Health
Michelson KA, Rees CA, Sarathy J
Interregional transfers for pandemic surges.
Hospital inpatient and intensive care unit (ICU) bed shortfalls may arise due to regional surges in volume. In this study, the investigators sought to determine how interregional transfers could alleviate bed shortfalls during a pandemic, using estimates of past and projected inpatient and ICU cases of coronavirus disease 2019 (COVID-19) from 4 February 2020 to 1 October 2020.
AHRQ-funded; HS026503.
Citation: Michelson KA, Rees CA, Sarathy J .
Interregional transfers for pandemic surges.
Clin Infect Dis 2021 Dec 6;73(11):e4103-e10. doi: 10.1093/cid/ciaa1549..
Keywords: COVID-19, Hospitals, Public Health, Intensive Care Unit (ICU), Critical Care
Pollack CE, Leifheit KM, McGinty EE
Public support for policies to increase housing stability during the COVID-19 pandemic.
The COVID-19 pandemic has exacerbated longstanding housing precarity. This study measured the public support for policies designed to increase housing stability and gauged whether support levels were associated with views about the role of evictions in COVID-19 transmission and the existence of racial inequities in the housing market. The investigators concluded that support for housing stability policies was strong among U.S. adults, particularly among those who agreed that preventing evictions slowed COVID-19 transmission and among those who acknowledged racial inequities in the housing market.
AHRQ-funded; HS000046.
Citation: Pollack CE, Leifheit KM, McGinty EE .
Public support for policies to increase housing stability during the COVID-19 pandemic.
Am J Prev Med 2021 Dec;61(6):919-22. doi: 10.1016/j.amepre.2021.05.006..
Keywords: COVID-19, Policy, Public Health
Jones K, Mantey J, Washer L
When planning meets reality: COVID-19 interpandemic survey of Michigan nursing homes.
This survey examined conditions at Michigan nursing homes (NHs) during the COVID-19 pandemic period. This survey evaluated preparedness, staffing, testing, and adaptations made due to COVID. Of 452 Michigan NHs contacted via email, 145 opened the survey of those,143 responded from May 1-12, 2020. Two-thirds reported shortages of personal protective equipment. Half lacked sufficient testing resources with only 36% able to test residents and staff when needed. A majority (55%) experienced staffing shortages, with 63% experiencing resignations with front-line clinical staff more likely to resign. Facilities showed rapid adaptation, with 78% creating COVID-19 units to care for patients on site. To reduce isolation, most NHs facilitated communication via phone calls, videoconferencing, and window visits. The majority continued to provide normal required therapies (90%).
AHRQ-funded; HS025451.
Citation: Jones K, Mantey J, Washer L .
When planning meets reality: COVID-19 interpandemic survey of Michigan nursing homes.
Am J Infect Control 2021 Nov;49(11):1343-49. doi: 10.1016/j.ajic.2021.03.016..
Keywords: COVID-19, Nursing Homes, Public Health, Emergency Preparedness
Vranas KC, Golden SE, Mathews KS
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
The COVID-19 pandemic resulted in unprecedented adjustments to intensive care unit (ICU) organization and care processes globally. The investigators examined if hospital emergency responses to the COVID-19 pandemic differed depending on hospital setting and explored which strategies worked well to mitigate strain as perceived by intensivists. The investigators concluded that their study demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
AHRQ-funded; HS028038.
Citation: Vranas KC, Golden SE, Mathews KS .
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
Chest 2021 Nov;160(5):1714-28. doi: 10.1016/j.chest.2021.05.041..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Healthcare Delivery, Workforce, Public Health
Santana S, Brach C, Harris L
AHRQ Author: Brach C
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.
The US Department of Health & Human Services (HHS) updates the Healthy People objectives each decade based on the most current science. For the development of HP2030, the HHS drew on recommendations from the Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (Secretary's Advisory Committee), an independent advisory committee of national health experts, to update the 20-year old individual-focused Healthy People definition of health literacy. This paper discusses that process.
AHRQ-authored.
Citation: Santana S, Brach C, Harris L .
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.
J Public Health Manag Pract 2021 Nov-Dec;27(Suppl 6):S258-S64. doi: 10.1097/phh.0000000000001324..
Keywords: Health Literacy, Public Health, Health Promotion
Applebury DE, Robinson EJ, Gold JA
Pilot testing of simulation in the evaluation of a novel, rapidly deployable electronic health record for use in disaster intensive care.
This purpose of this study was to present the application of simulation to assess a quickly scalable hub-and-spoke model for Electronic Health Record (EHR) system deployment and monitoring, utilizing asynchronous training. The researchers modified existing commercial EHR products to function as the entry point from a simulated hospital and a separate system for tele-ICU support and data monitoring. A modular video-based curriculum was developed for asynchronous training of users. The curriculum's effectiveness was evaluated through the completion of standard ICU documentation tasks in a high-fidelity simulation. Additional endpoints included EHR navigation assessment, user satisfaction (Net Promoter), system usability (System Usability Scale-SUS), and cognitive load (NASA-TLX). The study found that 5 participants achieved a 100% task completion rate in all domains, except for ventilator data (91%). The systems demonstrated high satisfaction, satisfactory usability, and acceptable cognitive load, with higher cognitive loads correlating to the number of screens used.
AHRQ-funded; HS023793.
Citation: Applebury DE, Robinson EJ, Gold JA .
Pilot testing of simulation in the evaluation of a novel, rapidly deployable electronic health record for use in disaster intensive care.
Disaster Med Public Health Prep 2021 Oct 22; 17:e51. doi: 10.1017/dmp.2021.302..
Keywords: COVID-19, Emergency Preparedness, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Intensive Care Unit (ICU), Critical Care
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Bartsch SM, Wedlock PT, O'Shea KJ
Lives and costs saved by expanding and expediting coronavirus disease 2019 vaccination.
The authors developed a computational model representing the United States population, COVID-19 coronavirus spread (February 2020-December 2022), and vaccination to determine the impact of increasing coverage and expediting time to achieve coverage. They concluded that their study quantified the potential value of decreasing vaccine hesitancy and increasing vaccination coverage and how this value may decrease with the time it takes to achieve coverage, emphasizing the need to reach high coverage levels as soon as possible, especially before the fall/winter.
AHRQ-funded; HS028165.
Citation: Bartsch SM, Wedlock PT, O'Shea KJ .
Lives and costs saved by expanding and expediting coronavirus disease 2019 vaccination.
J Infect Dis 2021 Sep 17;224(6):938-48. doi: 10.1093/infdis/jiab233..
Keywords: COVID-19, Vaccination, Public Health
Smulowitz PB, O'Malley AJ, Khidir H
National trends In ED visits, hospital admissions, and mortality for Medicare patients during the COVID-19 pandemic.
Concerns about avoidance or delays in seeking emergency care during the COVID-19 pandemic are widespread, but national data on emergency department (ED) visits and subsequent rates of hospitalization and outcomes are lacking. In this study, the investigators examined trends in ED visits and rates of hospitalization and thirty-day mortality conditional on an ED visit for non-COVID-19 conditions during several stages of the pandemic and for areas that were considered COVID-19 hot spots versus those that were not.
AHRQ-funded; HS025408.
Citation: Smulowitz PB, O'Malley AJ, Khidir H .
National trends In ED visits, hospital admissions, and mortality for Medicare patients during the COVID-19 pandemic.
Health Aff 2021 Sep;40(9):1457-64. doi: 10.1377/hlthaff.2021.00561..
Keywords: COVID-19, Public Health, Emergency Department, Hospitalization
Chelen JSC, White DB, Zaza S
US ventilator allocation and patient triage policies in anticipation of the COVID-19 surge.
Researchers assessed policy preparedness and substantive triage criteria within existing policies using a cross-sectional survey distributed to public health personnel and healthcare providers between March 23 and April 23, 2020. They found that their sample of policies reflected organizational strategies of exemplar-based policy development and the use of objective criteria in triage decisions, either before or instead of clinical judgment, to support ethical distribution of resources.
AHRQ-funded; HS024075.
Citation: Chelen JSC, White DB, Zaza S .
US ventilator allocation and patient triage policies in anticipation of the COVID-19 surge.
Health Secur 2021 Sep-Oct;19(5):459-67. doi: 10.1089/hs.2020.0166..
Keywords: COVID-19, Public Health, Emergency Preparedness, Policy
Barbash IJ, Kahn JM
Fostering hospital resilience-lessons from COVID-19.
This article describes how hospitals can foster organizational resistance using lessons from the COVID-19 pandemic. They describe what resilience would look like including: 1) resilient hospitals would respond to a surge in COVID-19 cases in ways that ensure the delivery of high-quality care for patients with the disease; 2) resilient hospitals would response to COVID-19 surges in ways that preserve standards of care for patients without COVID-19; 3) resilient hospitals would preserve access to care for the entire community of patients they serve, including continuing elective surgeries and mitigating effects of health disparities; and 4) resilient hospitals would do all of this while protecting the well-being of frontline staff. Protection of front-line staff includes ensuring adequate personal protective equipment as well as through clear communication from leaders. Factors that foster resilience are described including well-developed, scalable clinical protocols, flexible electronic health records, and a supportive, interdisciplinary working environment in which all team members feel safe to raise concerns and share new ideas. Resilience might also be fostered among hospitals through their interactions.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Kahn JM .
Fostering hospital resilience-lessons from COVID-19.
JAMA 2021 Aug 24; 326(8):693-94. doi: 10.1001/jama.2021.12484..
Keywords: COVID-19, Hospitals, Healthcare Delivery, Public Health
Bartsch SM, Wong KF, Mueller LE
Modeling interventions to reduce the spread of multidrug-resistant organisms between health care facilities in a region.
The objective of this study was to identify a group of target facilities and to assess which multidrug-resistant organism (MDRO) intervention would be best to implement in the Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, a large regional public health collaborative in Orange County, California. Findings suggested that decolonization would be the best strategy for the Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County.
AHRQ-funded; HS023317; HS028165.
Citation: Bartsch SM, Wong KF, Mueller LE .
Modeling interventions to reduce the spread of multidrug-resistant organisms between health care facilities in a region.
JAMA Netw Open 2021 Aug 2;4(8):e2119212. doi: 10.1001/jamanetworkopen.2021.19212..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Public Health
Santos T, Lee SD, East C
Can collaboration between nonprofit hospitals and local health departments influence population health investments by nonprofit hospitals?
The Patient Protection and Affordable Care Act (ACA) sought to improve population health by requiring nonprofit hospitals (NFPs) to conduct triennial community health needs assessments and address the identified needs. In this context, some states have encouraged collaboration between hospitals and local health department (LHD) to increase the focus of community benefit spending onto population health. The aim of the study was to examine whether a 2012 state law that required NFPs to collaborate with LHDs in local health planning influenced hospital population health improvement spending.
AHRQ-funded; HS024959; HS026116.
Citation: Santos T, Lee SD, East C .
Can collaboration between nonprofit hospitals and local health departments influence population health investments by nonprofit hospitals?
Med Care 2021 Aug;59(8):687-93. doi: 10.1097/mlr.0000000000001561..
Keywords: Hospitals, Public Health
Johnson CL, Schwartz H, Greenberg A
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. The investigators concluded that eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.
AHRQ-funded; HS024532.
Citation: Johnson CL, Schwartz H, Greenberg A .
Patient perceptions on barriers and facilitators to accessing low-acuity surgery during COVID-19 pandemic.
J Surg Res 2021 Aug;264:30-36. doi: 10.1016/j.jss.2021.01.028..
Keywords: COVID-19, Surgery, Access to Care, Patient Experience, Public Health
Byhoff E, Paulus JK, Guardado R
Healthcare workers' perspectives on coronavirus testing availability: a cross sectional survey.
This article describes a survey that was conducted during the first wave of the COVID pandemic during March-August 2020 of hospital workers on their perceptions of, access to, and receipt of COVID testing. A survey was given to all hospital employees in a single academic medical center in Boston, Massachusetts. A total of 2543 employees responded to the survey. Respondents were mostly female (76%), white (55%), with the mean age being 40 years. They were nurses (27%), administrators (22%), and patient support roles (22%) of which 56% of respondents wanted COVID testing. Age, full-time status, employment tenure, changes in quality of life, changes in job duties, and worries about enough sick paid leave were associated with testing. Nurses were more likely to want testing than administrators and patient support staff.
AHRQ-funded; HS026008.
Citation: Byhoff E, Paulus JK, Guardado R .
Healthcare workers' perspectives on coronavirus testing availability: a cross sectional survey.
BMC Health Serv Res 2021 Jul 21;21(1):719. doi: 10.1186/s12913-021-06741-5..
Keywords: COVID-19, Diagnostic Safety and Quality, Provider: Health Personnel, Public Health
Dixon BE, Grannis SJ, McAndrews C BE, Grannis SJ, McAndrews C
Leveraging data visualization and a statewide health information exchange to support COVID-19 surveillance and response: application of public health informatics.
Researchers sought to support public health surveillance and response to coronavirus disease 2019 (COVID-19) through rapid development and implementation of novel visualization applications for data amalgamated across sectors. Capitalizing on a statewide health information exchange, in partnership with health system and public health leaders, Regenstrief biomedical informatics experts rapidly developed and deployed informatics tools to support surveillance and response to COVID-19. The authors concluded that the application of public health informatics methods and tools in Indiana holds promise for other states and nations.
AHRQ-funded; HS025502.
Citation: Dixon BE, Grannis SJ, McAndrews C BE, Grannis SJ, McAndrews C .
Leveraging data visualization and a statewide health information exchange to support COVID-19 surveillance and response: application of public health informatics.
J Am Med Inform Assoc 2021 Jul 14;28(7):1363-73. doi: 10.1093/jamia/ocab004..
Keywords: COVID-19, Health Information Exchange (HIE), Health Information Technology (HIT), Public Health
Geanacopoulos AT, Sundheim Greco, KF
Pediatric intern clinical exposure during the COVID-19 pandemic.
Pediatric health care encounters declined during the coronavirus disease 2019 (COVID-19) pandemic, and pediatric residency programs have adapted trainee schedules to meet the needs of this changing clinical environment. In this study, the investigators sought to evaluate the impact of the pandemic on pediatric interns' clinical exposure. The investigators concluded that pediatric interns at the onset of the COVID-19 pandemic were exposed to fewer patients and had reduced clinical schedules.
AHRQ-funded; HS026503.
Citation: Geanacopoulos AT, Sundheim Greco, KF .
Pediatric intern clinical exposure during the COVID-19 pandemic.
Hosp Pediatr 2021 Jul;11(7):e106-e10. doi: 10.1542/hpeds.2021-005899..
Keywords: COVID-19, Provider: Physician, Public Health
Kruse J, Toledo P, Belton TB
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
The internet is a frequently used resource for providing patient education materials (PEMs). The aim of this study was to evaluate the readability, content, and quality of web-based PEMs on COVID-19 from US academic medical centers. Despite availability of web-based PEMs for COVID-19, the readability was significantly higher than the National Institute of Health and US Department of Health and Human Services recommended sixth grade reading level and actionability of PEMs was low.
AHRQ-funded; HS025267; HS026169.
Citation: Kruse J, Toledo P, Belton TB .
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
Am J Infect Control 2021 Jun;49(6):690-93. doi: 10.1016/j.ajic.2020.11.023..
Keywords: COVID-19, Education: Patient and Caregiver, Health Literacy, Public Health, Infectious Diseases
Masonbrink AR, Harris M, Hall M
Safety events in children's hospitals during the COVID-19 pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. The objective of this study was to compare pediatric hospitalization safety events during the pandemic versus previous years. The investigators concluded that postoperative sepsis rates increased among children hospitalized during COVID-19. They suggest that efforts are needed to improve safety of postoperative care for hospitalized children.
AHRQ-funded; HS024554; HS024592.
Citation: Masonbrink AR, Harris M, Hall M .
Safety events in children's hospitals during the COVID-19 pandemic.
Hosp Pediatr 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937..
Keywords: Children/Adolescents, COVID-19, Patient Safety, Sepsis, Adverse Events, Hospitalization, Hospitals, Inpatient Care, Infectious Diseases, Public Health
Wurcel AG, Reyes J, Zubiago J
"I'm not gonna be able to do anything about it, then what's the point?": A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail.
Despite national guidelines promoting hepatitis C virus (HCV) testing in prisons, there is substantial heterogeneity on the implementation of HCV testing in jails. IN this study, the investigators sought to better understand barriers and opportunities for HCV testing by interviewing a broad group of stakeholders involved in HCV testing and treatment policies and procedures in Massachusetts jails.
AHRQ-funded; HS026008.
Citation: Wurcel AG, Reyes J, Zubiago J .
"I'm not gonna be able to do anything about it, then what's the point?": A broad group of stakeholders identify barriers and facilitators to HCV testing in a Massachusetts jail.
PLoS One 2021 May 26;16(5):e0250901. doi: 10.1371/journal.pone.0250901..
Keywords: Hepatitis, Vulnerable Populations, Screening, Prevention, Public Health, Social Stigma
Dickinson-Copeland CM, Immergluck LC, Britez M
Increased risk of sub-clinical blood lead levels in the 20-county metro Atlanta, Georgia area-a laboratory surveillance-based study.
This study looked at the distribution of blood lead levels (BLLs) in children aged 0-72 months and their associations with sociodemographic and area-level variables. Data from the Georgia Department of Public Health’s Healthy Homes for Lead Prevention Program surveillance data was used to describe the distribution of BLLs in metro Atlanta area children from 2010 to 2018. Residential addresses were geocoded and if BLLs were spatially clustered they were defined at “Hotspots”. Geographically defined hotspots for both clinical (≥5 µg/dL) and sub-clinical (2 to <5 µg/dL) BLLs diffused from the city-central area into suburban areas. Predictors of sub-clinical BLL levels from those with lower (<2 µg/dL) or higher ((≥5 µg/dL) BLLs included non-Medicaid insurance, the proportion of renters in a given geographical area, and proportion of individuals with a GED/high school diploma. Over half of the study children had sub-clinical BLL levels, a range that does not currently trigger public health measures but could result in adverse development outcomes if ignored.
AHRQ-funded; HS024338.
Citation: Dickinson-Copeland CM, Immergluck LC, Britez M .
Increased risk of sub-clinical blood lead levels in the 20-county metro Atlanta, Georgia area-a laboratory surveillance-based study.
Int J Environ Res Public Health 2021 May 13;18(10). doi: 10.3390/ijerph18105163..
Keywords: Newborns/Infants, Children/Adolescents, Social Determinants of Health, Public Health, Public Health