Public health extras: February/March 2021
=========================================

* Kim Krisberg

## Public health models can prevent gun violence

Public health models that successfully reduce smoking deaths and traffic fatalities can also be used to prevent gun violence, according to a new report from the Educational Fund to Stop Gun Violence.

Released in November, the report outlines how effective public health approaches used to curb smoking or improve traffic safety — such as allocating funds to study the problem, creating national safety regulations for manufacturers and ensuring drivers are trained and licensed — could also be applied to gun violence, which kills about 40,000 Americans every year.

“Our national epidemic of gun violence is a preventable public health crisis that could be contained and reduced using the tools right in front of us,” said Josh Horwitz, executive director of the Educational Fund to Stop Gun Violence, in a news release. “The public health approach is simple: define and study the problem, identify risk factors, and then develop and implement prevention strategies.”

For more information on “Public Health Approach to Gun Violence Prevention,” visit [www.efsgv.org](http://www.efsgv.org).

## Low-income Americans sicker than global peers

Compared to peers in other wealthy nations, Americans with low incomes are typically sicker and more likely to struggle to afford health care and other basic needs, according to the 2020 Commonwealth Fund International Health Policy Survey.

Published in December in Health Affairs, the survey is based on the health experiences of low-income adults in 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the U.S.

Conducting the survey between February and May 2020, researchers found that 36% of U.S. adults with low incomes have two or more chronic conditions — a rate much higher than other nations. More than one-quarter of U.S. low-income adults said they worried about affording basic necessities in the past year, such as food and housing. In the other nations, 6% to 22% of people reported such concerns.

Thirty-six percent of low-income U.S. adults reported problems paying medical bills, which was also much higher than rates in the other wealthy countries, where the percentages ranged from 7% to 16%.

For more information, visit [www.commonwealthfund.org](http://www.commonwealthfund.org).

## Study: Medicaid expansion tied to early cancer detection

Medicaid expansion is linked with early cancer detection and reduced late-stage cancer incidence, a study finds.

Published in November in the *American Journal of Preventive Medicine,* the study is based on cancer registry data from hundreds of counties between 2010 and 2016. It found that expanding access to Medicaid to more low-income people was associated with a 9% increase in early-stage cancer diagnosis in its first year, though the effects dissipated in the second and third years following expansion.

Researchers said the change could be due to pent-up demand for screening and diagnostic services in the immediate years following expansion of Medicaid eligibility.

To date, 39 states have expanded their Medicaid programs.

## Study: Health care workers at highest COVID-19 risk

Health care workers — especially nurses — are most at risk for COVID-19 infection, finds a new study.

Published in November in *BMC Infectious Diseases*, the study looked at data on nearly 550 health care workers with direct patient exposure at two hospitals in New Jersey, as well as more than 280 non-health care workers with no direct patient contact. Among all study participants, more than 7% of health care workers tested positive for COVID-19, compared to less than 1% of non-health care workers.

Overall, researchers found those most likely to test positive were nurses, who accounted for more than half of the infected workers. Workers taking care of multiple patients with suspected or confirmed COVID-19 and people who worked in a hospital with a higher proportion of infected patients also had high positivity rates. Black and Hispanic participants were more likely to test positive for COVID-19.

Intensive care unit workers had the lowest rates of infection, the study found, which researchers said could be associated with personal protective equipment.

*   Copyright The Nation’s Health, American Public Health Association