JMIR Public Health and Surveillance

Nurses represent the largest segment of the United States healthcare workforce and played an instrumental role in the countrys response to the COVID-19 pandemic. Yet, little attention has been given to the contribution of this component of the U.S. medical personnel in the nations ability to face public health crisis. We present a cross-sectional, ecological analysis using cumulative annual reports from different national databases to assess the relationship between registered nurse (RN) density...

Increasing human mobility and population connectivity have intensified the risks of global pathogen spread, while concurrent shifts in human demographic patterns, ecological factors, and climatic conditions have altered the global landscape of this risk. Genomic surveillance can serve as a critical tool for early detection of emerging pathogen threats; however, challenges remain in deciding where to monitor, in understanding trade-offs among surveillance modalities, and in translating detections...

BackgroundRecreational cannabis legalization has expanded rapidly across US states. The regulatory approaches states adopt vary widely, with varying implications for public health. This study aimed to characterize heterogeneity in recreational cannabis laws (RCLs) across US states and to identify state-level characteristics associated with these regulatory models. MethodsWe conducted Latent Class Analysis (LCA) of state-year RCL provisions from 2013 to 2024 (n=612) to identify distinct RCL appr...

ObjectiveGiven the potential severity and economic burden of falls, we compared the short-term risk of falls following initiation of sustained-release (SR) tapentadol versus controlled-release (CR) oxycodone in real-world clinical practice. DesignActive comparator, new user retrospective cohort study using routinely collected health data from 2014 to 2020. SettingNew South Wales, Australia. ParticipantsPeople aged [≥]18 years initiating publicly subsidised tapentadol (SR) or oxycodone (CR)...

Daylight Saving Time (DST) remains contentious: some policymakers highlight behavioral benefits, while others emphasize health risks. Existing evidence relies largely on aggregated data and strict modeling assumptions, obscuring individual-level patterns and yielding associational rather than causal insights. We address these limitations using objective, longitudinal Fitbit measures from the NIH All of Us Research Program. Avoiding strict modeling assumptions, we employed a natural difference-in...

ObjectiveTo analyze the impact of telemedicine on emergency department (ED) utilization among University of Virginia (UVA) Health System patients, examining which patient characteristics predict reduced ED usage and whether telemedicine reduces ED utilization. Materials and MethodsWe used UVA Electronic Health Records and public datasets to establish clinical and contextual features including demographics, comorbidities, insurance status, and community characteristics. UVA patient data were lin...

Timely forecasting of dengue hospitalizations is essential for public health preparedness but is frequently limited by delays in official reporting systems. Climatic conditions strongly influence dengue transmission, yet hospitalization data often become available weeks after patient admission, reducing their value for early response. Digital information generated during clinical practice may provide a more timely signal of emerging disease activity. This study evaluates whether integrating cli...

BackgroundUnderstanding the drivers of protective behavior during infectious disease outbreaks is critical for public health policy. App-based experimental epidemic games (epigames) offer a novel method to study these behaviors empirically, but their external validity--how well in-game choices reflect real-life beliefs--still needs to be rigorously tested. MethodsWe conducted a two-week randomized controlled trial (N=567) using the Epigames smartphone app at the American University of Iraq - Ba...

IntroductionOngoing education in HIV care is limited for many healthcare providers working in rural and non-academic settings, which can reduce patients access to high-quality care. To guide targeted tele-mentoring and continuing education, we analyzed questions submitted by clinicians during Extension for Community Healthcare Outcomes (ECHO) sessions to characterize learning needs and thematic trends. MethodsWe reviewed 78 clinical questions submitted during Project ECHO sessions and developed...

BackgroundTuberculosis (TB) remains a major public health challenge in Nepal, with incidence rates substantially higher than global estimates. Accurate forecasting of TB incidence is essential for early warning systems, resource allocation, and targeted interventions. This study aimed to develop and validate a hybrid Seasonal Autoregressive Integrated Moving Average (SARIMA) and Convolutional Neural Network Auto-Regressive (CNNAR) model for TB incidence forecasting in Nepal. MethodsMonthly TB i...

The recent SARS-CoV-2 pandemic has highlighted the growing importance of infectious disease analysis. An accurate and robust model can empower public health leaders to make timely decisions on social distancing and vaccination policies, thereby reducing the number of cases, hospitalizations and deaths. However, the emergence of new variants and subvariants can significantly alter the transmissibility, immune escape capacity and virulence of the pathogen in a short time, making the number of case...

ObjectiveExplore self-reported racial discrimination in healthcare. MethodsRepresentative population sample, Switzerland, repeated cross-sectional data 2016 to 2024 (N=15,525). ResultsContrary to expectation, respondents from the migration-related population (foreign citizens, foreign born, migration background, first/second generation) report less racial discrimination than members of the majority population. Over time, we see an increase in the non migration-related population reporting (rac...

In death certificates Entity Axis reflects reported death causes in their original order, and Record Axis reflects standardized re-classifications processed with expert rules. Additionally, while conventional mortality statistics consider a single underlying cause ignoring multiple contributing conditions, weighting schemes may consider all listed causes. We evaluated the impact of re-classification and weighting schemes across all 56,986,831 US death certificates from 2003-2023. ICD-10 codes we...

Community health workers are crucial to public health efforts in low- and middle-income countries. Despite their contributions to improving health, they encounter numerous barriers in performing their day-to-day work. Artificial intelligence applications may offer a potential solution to some of these barriers. We examined the implementation of smartphone-based artificial intelligence interventions with community health workers in Uganda, Rwanda, and Nigeria, including how the interventions were...

BackgroundThe Epic End of Life Care Index (EOLCI) predicts one-year mortality and was developed to improve serious illness care. However, prior external EOLCI evaluations had limited sample sizes, populations, and equity evaluations. In preparation for a multi-system pragmatic clinical trial, we sought to evaluate the EOLCI performance and equity in the trials two participating health systems. ObjectiveEvaluate EOLCI model performance overall and across key subgroups. Design/Setting/PatientsRe...

ObjectivesTo characterize emergency department (ED) clinician engagement with electronic health record (EHR)-based social drivers of health (SDOH) data; test whether engagement differs in encounters with opioid use disorder (OUD); and, among OUD encounters, assess whether engagement is associated with medications for OUD (MOUD) treatment. Materials and MethodsWe conducted a cross-sectional study of adult ED encounters (January 2023-October 2024). OUD encounters, identified with a structured phe...

ProblemRapid and unplanned urbanization in LMICs exacerbates health inequities, particularly among the urban poor living in slums. In Madhya Pradesh (MP), India, the state government introduced Sanjeevani clinics to provide free, quality healthcare to these populations. This study highlights lessons from digitizing these clinics and making them AI-ready with an open-source AI framework. ApproachA multisectoral collaboration between the state government, implementation, and academic partners led...

Point-of-care (POC) blood testing enables rapid, decentralized diagnostics with transformative promise, yet its innovation landscape remains poorly mapped. To this end, we focused on features that we believe are key to make progress in areas of precision healthcare and predictive medicine, such as longitudinal data collection and data analytics integration. While no review can be complete, this work attempts to address this gap by analyzing 86 POC blood testing devices worldwide and proposing a ...

Public health monitoring traditionally relies on active reporting from diverse data sources, including clinical and administrative data, disease registries, and population-based surveys. Yet these surveillance methods often face challenges such as incomplete reporting, time lags, and variable population coverage. Meanwhile, diagnostic laboratories routinely generate vast volumes of operational data that are currently untapped for public health monitoring. As these data are not collected for scie...

ObjectivesHuman trafficking is a priority concern in the U.S, but few research studies have investigated the nature and extent of its occurrence on U.S. college campuses. The objective of this research was to identify the nature and extent of human trafficking/sexual exploitation among college students in San Diego County and Imperial Valley, California, where some of the highest documented rates of human trafficking occur nationally. MethodsCollege students (n = 971) from 12 campuses in Southe...