An Innovative Approach to Increase Lead Testing by Pediatricians in Children, United States, 2019-2021.

Opportunities for lead exposure are common in the United States. The American Academy of Pediatrics, in collaboration with the Centers for Disease Control and Prevention, launched the Increasing Capacity for Blood Lead Testing Extension for Community Healthcare Outcomes (ECHO) project to educate pediatricians on the importance of testing children for lead exposure and to assess practice behavior change. We found that two weeks to one month after receiving training, more than 80% of participants reported increased lead testing and practice changes. Our results support use of the ECHO model as a mechanism for practice change. (Am J Public Health. 2022;112(S7):S647-S650. https://doi.org/10.2105/AJPH.2022.307084).

Strengthening Social and Economic, Medical, and Public Health Systems Before Disasters Strike

The authors describe the US blood supply system, its gaps and vulnerabilities, and the impact of the pandemic upon it, all of which have contributed to public health emergency response challenges. [...]life in the 21st century and all that goes with it- changes in rapid transportation availability and world travel, centralized methods for producing and distributing food, political and civil upheavals contributing to mass migrations, proliferation of organized terrorism, and effects of climate change-have expanded the potential for and possibility of largescale, mass public health emergencies affecting thousands of persons per event.1 The long-term, unforeseen consequences of 20th-century medical interventions have contributed to the natural evolution of microorganisms producing hardy pathogenic strains that are resistant to available treatments.2 For the past five decades, global scientists and public health professionals have been concerned about calamitous worldwide disasters similar to the influenza pandemic of 1918, which infected more than one third of Earth's population and resulted in more than 50 million deaths.3 Government and public health agencies in the United States have devoted millions of dollars in resources to constructing response infrastructures and developing structural frameworks or models for mobilizing and coordinating multiple stakeholders across city and state bureaucracies and emergency and health care systems to mount responses.4 After the events of September 11, 2001, public health efforts to prepare for emergencies received renewed focus, energy, and resources5 and stimulated scientists from a plethora of disciplines to study disasters from various perspectives. The internet and its contentious offspring-social media-have become ubiquitous features of everyday life through home computers, workplace computers, and mobile devices, which may obfuscate receipt of accurate messaging.1,7,8 In February 2020, when COVID-19 spread globally, I began to understand that disaster models and structural frameworks developed by public health and social scientists were based on several unwritten assumptions: (1) before a mass emergency, a social structure is assumed to be sound and cohesive, with individuals acting in ways to mutually support the whole;(2) a health care system is assumed to work reasonably well, with most people able to access care;and (3) a society's communication system is efficient for delivering unambiguous, life-saving messages to most of an affected population.