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CDC Data Shows U.S. Maternal Death Rate Rose Sharply in 2021

The number of women who died of maternal causes in the U.S. rose to 1,205 in 2021, according to a report from the National Center for Health Statistics, released last week by the CDC. That’s a sharp increase from years earlier: 658 in 2018, 754 in 2019 and 861 in 2020. That means the US maternal death rate for 2021 – the year for which the most recent data is available – was 32.9 deaths per 100,000 live births, compared with rates of 20.1 in 2019 and 23.8 in 2020. The maternal death rate in the U.S. has been steadily climbing over the past three decades, and these increases continued through the COVID-19 pandemic. Experts say women were at increased risk for morbidity and mortality from COVID because of being ventilated in the intensive care unit, preeclampsia and blood clots. Read more from CNN Health here.

Vital Signs: Progress Toward Eliminating HIV as a Global Public Health Threat

A new analysis from the CDC reveals that the number of people receiving lifesaving HIV treatment through President’s Emergency Plan for AIDS Relief (PEPFAR) has increased 300 times in under 20 years, from 2004 to 2022. The number of people receiving HIV antiretroviral therapy (ART) through PEPFAR increased from just 66,500 individuals in 2004, the year after PEPFAR was launched, to more than 20 million people in 2022. These findings are published in a recent Vital Signs report. Under PEPFAR’s current five-year strategy, the U.S. aims to eliminate HIV as a global public health threat by 2030 while strengthening public health systems worldwide. The latest data in this Vital Signs report show that PEPFAR’s programs are placing the world on the path to achieving this goal and validate that efforts over the past 20 years have transformed the global HIV epidemic.

Survey of Big City Health Department Staff Reveals Acute Stress

The Big Cities Health Coalition (BCHC – a forum for the leaders of America’s largest metropolitan health departments) released new survey data last week that found burnout and stress are up sharply among governmental public health workers. Burnout was reported as an issue by 43% of respondents, up from 25% in 2017. Also, 29% of BCHC respondents reported symptoms that indicate probable Post Traumatic Stress Disorder (PTSD) - more than those at state or other local health departments. The survey data comes from the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) and describes workplace perceptions, training needs, COVID-19 efforts, and well-being. Read more from BCHC here.


Public Health and Preparedness — Ohio Train Derailment

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When it comes to public health threats, you never know when a disaster will strike. The threats to public health are myriad—ranging from biological (as evidenced by the COVID-19 pandemic) to environmental, and from manmade (such as the opioid epidemic) to natural disasters. Luckily, the U.S. has response teams in place to act quickly in times of great public health need. In the initial days following an environmental disaster, for instance, public health and preparedness teams often coordinate closely with disaster response teams to help ensure that public safety and health are not jeopardized. 

A good example of this coordination can be seen in the recent train derailment in East Palestine, Ohio, which resulted in the spillage of toxic chemicals and a cascade of events that pose further health threats. 

Here’s what you need to know about the derailment, its potential public health threats, and why public health and protection matters. 

What Happened in East Palestine? 

In early February 2023, a freight train carrying hazardous materials derailed in the town of East Palestine, Ohio. This derailment caused 11 tank cars to ignite, spewing toxic chemicals into the air. Subsequently, officials initiated a controlled detonation of some of the cars involved to try to burn off the toxic chemicals and prevent a larger explosion. Five days later, a tank car was found to be leaking oil and this oil was pooling onto the soil. 

What Public Health Threats Were Posed by the Derailment in East Palestine? 

A number of potential public health threats have been considered as a consequence of February’s derailment. First, the freight trains that derailed were carrying vinyl chloride, which is known to be a human carcinogen. They were also carrying butyl acrylate, ethylhexyl acrylate, and ethylene glycol monobutyl ether, all of which are known irritants and some of which may be potentially carcinogenic. In addition to these listed chemicals, many byproducts were produced by the subsequent controlled detonation and fire. These byproducts may include dioxins, which are notoriously harmful. 

Pediatric Flu Deaths Top 100 & ACIP Immunization Schedule for 2023

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 The flu can be difficult on anyone—young or old. The current season has shown that it can pose a grave threat to children. The U.S. Centers for Disease Control and Prevention (CDC) has reported that as of February, pediatric flu deaths during the current season have reached 106. This figure represents the highest flu-related death rate among children since the start of the COVID pandemic. 

This unfortunate milestone underscores the seriousness of the flu for people of all ages. It can also reinforce the importance of immunization, which can prevent infection and severe illness resulting from the flu. 

What Caused the Rise in Pediatric Flu Deaths? 

In contrast to this season’s 106 pediatric deaths, the 2019-2020 season saw 199, while the 2020-2021 period had only one documented child fatality. Masking, quarantining, and other social distance measures were likely the reasons for the relatively low fatalities in the most recent flu seasons, which occurred at the height of the pandemic. 

According to the CDC, most of the children who died during this flu season were not vaccinated. The CDC also reports that flu immunization among children is about 6% below pre-pandemic rates. 

Among the 106 children who died, 41 were younger than five, and three were less than six months old. The other 65 children were between 5-17 years old. Children under five suffer the most significant risk of hospitalization and serious complications from flu infection. 

Of the 81 children whose vaccination status was known, 90% did not receive flu shots, compared to 80% of children in previous flu seasons. Public health experts estimate that 40 of all the children who died had underlying health conditions, but the actual number has yet to be determined. 

COVID-19 Public Health Emergency Updates

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As of May 11, 2023, healthcare in the U.S. might feel different for many people. In the continuing battle against COVID-19, May 11 signals the end of the declaration of COVID as a national public health emergency (PHE). 

The public health response to the pandemic gave many people in the U.S. a small taste of universal healthcare. Moving forward, Medicaid and Medicare recipients, people with insurance, and others who have relied on COVID vaccinations and boosters may wonder what the end of the PHE will mean. 

Ending the PHE Declaration 

Throughout most of the pandemic, Americans were able to get vaccinated and tested for COVID for free. Individuals who got infected could also get treatment, even if they did not have health insurance. Hospitals bore a heavy burden caring for patients with COVID. However, they received government funding to help them provide essential services and continue their operations through several coronavirus surges. 

On January 23, President Biden announced that the COVID federal (PHE) declaration will end on May 11. This change will halt the COVID-related relief that legislation allowed during the pandemic. Given the long-term health and economic effects of COVID, Congress has extended some of the pandemic-related provisions, which will still run out unless Congress responds promptly. Overall, the ending of the PHE declaration means changes for many Americans. 

Availability of Vaccine and Antiviral Medications 

Anyone needing current doses of vaccines, boosters, or antiviral drugs can still get them at no cost because the U.S. government has already paid for them. Also, the White House has provided extra funding for the updated “bivalent” booster vaccines. However, medications in circulation will likely run out this year, and Congress has not successfully passed legislation that would restock the supply. 

International Women’s Day and Women’s History Month: Celebrating the Past and Focusing on Today

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Women’s contributions have been incremental in shaping our medical and public health journey. To celebrate Women’s History Month and International Women’s Day on March 9, we can pay tribute to the women who have changed the face of medical science and healthcare. We can also use these observances to highlight today's pressing issues affecting women’s health and well-being. 

Women’s Achievements in Medicine and Public Health 

During Women’s History Month, it is fitting to celebrate the significant achievements of women who sparked advancements in physical, social, and emotional health. Here are some of the most noteworthy women who have helped improve the quality of our lives. 

Elizabeth Blackwell, M.D. 

Born in 1821, Dr. Elizabeth Blackwell made history by being the first woman in the U.S. to earn a medical degree. Her work helped pave the way for more women’s participation in the medical field. Later in her life, Dr. Blackwell opened a medical college for women. 

Rosalind Franklin, Ph.D. 

Although history did not acknowledge her contributions until after her death, Dr. Rosalind Franklin was instrumental in discovering the DNA double helix. She used X-ray diffraction imagery to map out DNA’s structure. 

Mattiedna Johnson, R.N. 

Born in 1918, Mattiedna Johnson was a nurse and lab technician. While investigating the nature and application of molds, Johnson discovered a mold strain that would eventually become Terramycin, the first cure for scarlet fever. Unfortunately, Johnson did not get credit for her discovery at the time. 

Henrietta Lacks 

Henrietta Lacks had cells removed from her cervix during a wellness screen, which were replicated and used without her consent. However, Lacks’ cells became known as the origin of the famous HeLa cell line, which has played a role in polio eradication, cancer and AIDS research, and other significant medical advancements. 


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