Abstract:
:A 5-tier pyramid best describes the impact of different types of public health interventions and provides a framework to improve health. At the base of this pyramid, indicating interventions with the greatest potential impact, are efforts to address socioeconomic determinants of health. In ascending order are interventions that change the context to make individuals' default decisions healthy, clinical interventions that require limited contact but confer long-term protection, ongoing direct clinical care, and health education and counseling. Interventions focusing on lower levels of the pyramid tend to be more effective because they reach broader segments of society and require less individual effort. Implementing interventions at each of the levels can achieve the maximum possible sustained public health benefit.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Frieden TRdoi
10.2105/AJPH.2009.185652subject
Has Abstractpub_date
2010-04-01 00:00:00pages
590-5issue
4eissn
0090-0036issn
1541-0048pii
AJPH.2009.185652journal_volume
100pub_type
杂志文章abstract::Occupational lead poisoning and environmental contamination were evaluated at a lead scrap smelter. Thirty of 37 employees (81 per cent) has blood lead levels of greater than or equal to 80 mug/100 ml, indicating unacceptable absorption, and 35 had free erythrocyte protoporphyrin (FEP) levels greater than 60mug/100ml ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.66.6.548
更新日期:1976-06-01 00:00:00
abstract::A survey of deer brought to tagging stations at 24 sites in Main revealed the presence of the deer tick, Ixodes dammini, on 5.1 percent of deer. Ticks were found almost exclusively on deer from southwest coastal sites in the state. The potential for endemic Lyme disease in coastal Maine merits further study. ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.80.3.333
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVES:Suffering from waning demand, poor quality, and reform efforts enabling veterans to "vote with their feet" and leave, the Veterans Health Administration (VA) health care system transformed itself through a series of substantive changes. We examined the evolution of primary care changes underlying VA's transf...
journal_title:American journal of public health
pub_type: 杂志文章,多中心研究
doi:10.2105/AJPH.2007.115709
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:We examined factors associated with completing, initiating, or intending to pursue voluntary national accreditation among local health departments (LHDs). METHODS:We examined National Association of County and City Health Officials 2010 and 2013 profile data in a pooled cross-sectional design with bivariate...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302503
更新日期:2015-08-01 00:00:00
abstract::This paper presents a comparison of prescribing habits for patients hospitalized in medical wards of university hospitals in America and Scotland. American patients received almost twice as many drugs both during and prior to hospitalization than did comparable Scots. The differences between the countries were consist...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.66.7.644
更新日期:1976-07-01 00:00:00
abstract::We investigated links between police brutality and poor health outcomes among Blacks and identified five intersecting pathways: (1) fatal injuries that increase population-specific mortality rates; (2) adverse physiological responses that increase morbidity; (3) racist public reactions that cause stress; (4) arrests, ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2017.303691
更新日期:2017-05-01 00:00:00
abstract::Growing evidence indicates that women in prison are particularly vulnerable to many negative health outcomes, including cervical cancer. The Papanicolaou (Pap) test is an effective tool to screen for this disease. To determine what is and is not working with the Pap test and follow-up treatment, we performed qualitati...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.063677
更新日期:2005-10-01 00:00:00
abstract::We have summarized the evolution of the Nurses' Health Study (NHS), a prospective cohort study of 121 700 married registered nurses launched in 1976; NHS II, which began in 1989 and enrolled 116 430 nurses; and NHS3, which began in 2010 and has ongoing enrollment. Over 40 years, these studies have generated long-term,...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2016.303338
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:We investigated environmental lead pollution and its impact on children's blood lead levels (BLLs) in a rural area of China. METHODS:In 2007, we studied 379 children younger than 15 years living in 7 villages near lead mines and processing plants, along with a control group of 61 children from another villa...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2010.193656
更新日期:2011-05-01 00:00:00
abstract::Researchers have a responsibility to cause no harm, but research has been a source of distress for indigenous people because of inappropriate methods and practices. The way researchers acquire knowledge in indigenous communities may be as critical for eliminating health disparities as the actual knowledge that is gain...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2006.093641
更新日期:2008-01-01 00:00:00
abstract::Historically Black colleges and universities (HBCUs) continue to be overlooked as a resource to address health care workforce shortages and growing needs for a diverse health workforce, despite our commitment as a nation to health equity and eliminating health disparities. Health workforce graduation rates help illum...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.300726
更新日期:2013-03-01 00:00:00
abstract::Improving oral health is a leading population health goal; however, curricula preparing health professionals have a dearth of oral health content and clinical experiences. We detail an educational and clinical innovation transitioning the traditional head, ears, eyes, nose, and throat (HEENT) examination to the additi...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302495
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:Syphilis in the United States is focally distributed, with high incidence rates in the South and in metropolitan areas nationwide. In this study an ecological analysis, using the county as the unit of analysis, was performed to generate hypotheses about community-level determinants of syphilis rates. METHOD...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.87.12.1937
更新日期:1997-12-01 00:00:00
abstract::The Italian death rates and years of potential life lost (YPLL) for all causes and for 12 selected aggregations of causes are reported for 1979 and 1983, with the latter compared to United States data. Cancer is the leading cause of YPLL in Italy (23.8 per cent of total YPLL), followed by unintentional injuries (16.3 ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.78.9.1202
更新日期:1988-09-01 00:00:00
abstract::Epidemiologists have expressed concern about constraints upon the conduct of epidemiological research imposed by Institutional Review Boards (IRBs), attorneys, and both institutional and individual health services providers. The epidemiologists assert that these constraints, not necessarily required by law or sound po...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.72.10.1155
更新日期:1982-10-01 00:00:00
abstract::The State-Wide Rural Well-Water Survey was conducted between April 1988 and June 1989. About 18% of Iowa's private, rural drinking-water wells contain nitrate above the recommended health advisory level (levels of NO3-N greater than 10 mg/L); 37% of the wells have levels greater than 3 mg/L, typically considered indic...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.83.2.270
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVES:We examined risk factors for injuries to nursing assistants from assaults by nursing home residents at both the individual and the organizational level. METHODS:We analyzed data from the 2004 National Nursing Assistant Survey that were linked to facility information from the 2004 National Nursing Home Surve...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2009.185421
更新日期:2010-10-01 00:00:00
abstract::We investigated enforcement of mental health benefits provided by California Medicaid's Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Enforcement, compelled by a consumer-driven lawsuit, resulted in an almost 4-fold funding increase over a 5-year period. We evaluated the impact of enforcement on ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2006.094771
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:To examine trends and socioeconomic disparities for preventable dental-related emergency department (ED) visits in Nevada. METHODS:We pooled retrospective data containing 66 267 ED visits involving dental conditions from Nevada hospital ED databases from 2009 to 2015. The dependent variable was nontraumatic...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2017.304242
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:We analyzed how ease of geographic access to emergency departments (EDs), defined as driving time to the closest ED, changed between 2001 and 2005, and whether access deterioration was more likely to occur in vulnerable communities. METHODS:We classified communities on the basis of American Hospital Associa...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2009.175828
更新日期:2010-08-01 00:00:00
abstract::Historical work on cancer has suggested that a range of political, social, and medical concerns stimulated the emergence of cancer as a public health problem in the early 20th century.I argue that anxiety about cervical cancer mortality was instrumental in establishing cancer as a major focus of concern for the Britis...
journal_title:American journal of public health
pub_type: 历史文章,杂志文章
doi:10.2105/AJPH.2004.046458
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVES:We examined the relationship between quality improvement (QI) maturity and accreditation attributes of US local health departments (LHDs), specifically those in Nebraska. METHODS:Using 2011 Nebraska LHD QI survey data, we conducted Spearman correlation analyses between QI maturity domains and accreditation ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.302278
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of precursor chemical regulation aimed at reducing cocaine production on cocaine-related maternal and newborn hospital stays in the United States. METHODS:We analyzed monthly counts of maternal and neonatal stays from January 2002 through December 2013 by using a quasi-experimenta...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2017.303708
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:We examined differences in substance abuse treatment outcomes between American Indians and their non-American Indian counterparts in California, during 2000 to 2002. METHODS:A total of 368 American Indians and a matched sample of 368 non-American Indians from 39 substance abuse treatment programs in 13 Cali...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2004.055871
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVES:We examined recent public-sector trends in childhood vaccine costs and estimated future costs. METHODS:We used public-sector price data to calculate vaccine purchase cost per child for children aged 0 to 6 years from 1975 to 2001. We fit a linear regression model to historical data and then used it to proje...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.92.12.1982
更新日期:2002-12-01 00:00:00
abstract::Research suggests that greater ethnic density correlates with worse health among African Americans but better health among Hispanic Americans. These conflicting patterns may arise from Hispanic American samples being older than African American samples. We found that among 2367 Mexican American and 2790 African Americ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.300787
更新日期:2012-12-01 00:00:00
abstract::The health risks from low-dose sparsely ionizing (low-LET) radiation have been the subject of continued debate. At present, quantitative estimates of risk are extremely uncertain due to the controversy surrounding both the dosimetry for A-bomb survivor data and the choice of mathematical models for extrapolating risk ...
journal_title:American journal of public health
pub_type: 杂志文章,评审
doi:10.2105/ajph.72.6.585
更新日期:1982-06-01 00:00:00
abstract::Twenty-eight states have laws that limit payments in malpractice cases, and several studies indicate that these laws reduce the frequency and severity of malpractice claims and lower premiums. Moreover, proponents believe that such laws reduce health care expenditures by reducing the practice of defensive medicine. Ho...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.077883
更新日期:2006-08-01 00:00:00
abstract::The authors measured polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in maternal serum, cord blood, placenta, and serial samples of breast milk from 868 women. Almost all samples of breast milk showed detectable levels of both chemicals. Overall, values for DDE in this study are within the r...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.76.2.172
更新日期:1986-02-01 00:00:00
abstract::Programs and contraceptive use continuation rates were obtained for a rural Georgia family planning clinic. Program continuation is a measurement of maintenance of clinic attendance, while use continuation is related to actual use of effective contraceptives regardless of clinic activity status. Program continuation r...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.65.7.693
更新日期:1975-07-01 00:00:00