10 Years Later : The Impact of the Affordable Care Act on Prevention and Public Health in North Carolina

Brody, William R.; Kimple, Kelly S.; Stanley, Karen; Wood, Joyce; Singletary, Tish; Nelson, Sharon; Kansagra, Susan M.

doi:10.18043/ncm.81.6.377

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…44,45 Ninety-eight of 100 North Carolina counties fund disease prevention. 9 Indicative of gaps in North Carolina LHD resources, a 2018 study 41 found that only 4% of responding LHDs prescribed preexposure prophylaxis (PrEP); just 13% of LHDs refer for PrEP. The reasons for not offering PrEP included not seeing LHD clients as at risk for HIV.…”

Section: Lhdsmentioning

confidence: 99%

“…More than 60 years later, LHDs continue to be critical to southern prevention efforts 44,45 . Ninety-eight of 100 North Carolina counties fund disease prevention 9 . Indicative of gaps in North Carolina LHD resources, a 2018 study 41 found that only 4% of responding LHDs prescribed preexposure prophylaxis (PrEP); just 13% of LHDs refer for PrEP.…”

Section: Lhdsmentioning

confidence: 99%

“…Local health departments (LHDs) offer HCV/HIV screening and testing 9–11 and are a greater source of clinical services in the US South, 12,13 where stigma perpetuates screening and testing gaps 14–18 . People who use drugs (PWUD) are at increased risk for HCV/HIV and healthcare barriers including stigmatizing language 19–22 .…”

mentioning

confidence: 99%

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Hepatitis C and HIV Screening, Testing, and Risk Perceptions among South-Central Appalachian County Health Department Staff

Harless¹,

Lugo²,

Ostrach³

2022

Southern Medical Journal

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Objectives: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are significant public health concerns, especially given the risks for disease interactions. Rates of HCV and HIV are increasing, especially in rural areas. Local health departments (LHDs) play an important role in rural health care, offering screening, testing, and treatment for HCV and HIV. Gaps persist in LHD resources for meeting these demands, especially in Appalachia and the US South.Methods: To explore HCV/HIV screening, testing, and treatment approaches and perspectives in south-central Appalachian North Carolina, structured telephone questionnaires were administered to communicable disease nurses and other health department staff directly involved in screening and testing. Mixed-methods data analyses were conducted and triangulated with stakeholders.Results: Eighteen participants representing 19 counties completed the questionnaire, achieving a saturation sample. Participants reported barriers to screening and testing, including housing insecurity, lack of transportation and insurance, unemployment, and the isolation of living in a rural area. Divergence in perceptions of barriers between public health regions emerged, as did perceptions of who is at risk and use of stigmatizing language about people at risk for HCV/HIV.Conclusions: This study highlights the impact of LHD behaviors and perceptions on screening and testing, and offers recommendations to improve HCV/HIV screening and testing accessibility in south-central Appalachia, a high-risk region.

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Section: Lhdsmentioning

confidence: 99%

Section: Lhdsmentioning

confidence: 99%

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Hepatitis C and HIV Screening, Testing, and Risk Perceptions among South-Central Appalachian County Health Department Staff

Harless¹,

Lugo²,

Ostrach³

2022

Southern Medical Journal

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“…Some of the most expansive work in this area in North Carolina occurred under the Communities Putting Prevention to Work and Community Transformation Grants, which the Centers for Disease Control and Prevention (CDC) established to focus on tobacco, active living, and healthy eating. Through this fund-ing, the North Carolina Division of Public Health and local health departments across the state supported the implementation of an estimated 200 policy and environmental changes to reinforce healthy living, including smoke-free air policies, joint-use agreements for school playgrounds, and healthy food retail changes [4]. This work continues today through the Healthy Communities program.…”

Section: Introductionmentioning

confidence: 99%

The Journey Upstream: Chronic Disease Prevention and Control Over the Years

Kansagra

Isac

2021

North Carolina Medical Journal

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Over the last several decades, the field of public health has moved upstream to better address the roots of chronic disease. From addressing individual risk factors of disease, to addressing social determinants of health, to addressing social and institutional factors that drive inequity, public health's role in addressing chronic disease prevention has required collaboration across many community sectors.

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10 Years Later : The Impact of the Affordable Care Act on Prevention and Public Health in North Carolina

Cited by 2 publications

References 5 publications

Hepatitis C and HIV Screening, Testing, and Risk Perceptions among South-Central Appalachian County Health Department Staff

Hepatitis C and HIV Screening, Testing, and Risk Perceptions among South-Central Appalachian County Health Department Staff

The Journey Upstream: Chronic Disease Prevention and Control Over the Years

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