Implementing a Needs Assessment to Advance Health Equity in Overdose Prevention and Surveillance Initiatives.

OBJECTIVES: State, local, and federal agencies have expanded efforts to address the root causes of overdoses, including health inequity and related social determinants of health. As an Overdose Data to Action (OD2A) technical assistance provider, the Association of State and Territorial Health Officials (ASTHO) conducted the first national needs assessment to understand capacity and technical assistance needs of OD2A jurisdictions in advancing health equity. METHODS: ASTHO designed and disseminated the OD2A Recipient Health Equity Needs Assessment (RHENA) to 66 OD2A-funded jurisdictions from February to March 2022. OD2A principal investigators and staff were contacted via email and asked to complete the needs assessment within 6 weeks. One coder manually coded open-ended responses, conducted a thematic analysis on the qualitative data, and performed a simple frequency analysis on the quantitative data. RESULTS: Fifty-two jurisdictions (78.8%) responded, including 36 states, 12 cities/counties, and 2 territories. Most jurisdictions (n = 46; 88.5%) reported having a formal or informal health equity lead in place. Common barriers included a lack of access to data sources (n = 37; 71.2%), lack of partnerships (n = 20; 38.5%), and lack of funding (n = 14; 26.9%). Respondents reported needing more information sharing among jurisdictions and partner organizations, coaching on best practices, and routine discussions such as peer-to-peer learning sessions. CONCLUSION: Findings suggest that gaps remain in programmatic policies and principles to address inequities in overdose prevention. Results are being used to identify additional technical assistance opportunities, jurisdictional capacity, and approaches to advance health equity.

Notes from the Field: Pediatric Death from Meningococcal Disease in a Family of Romani Travelers - Sarasota, Florida, 2015.

On January 31, 2015, the Sarasota County Office of the Medical Examiner notified the on-call epidemiologist at the Florida Department of Health, Bureau of Epidemiology of a possible death from meningococcal disease in a male child aged 17 months. The child was part of a large non-English-speaking Romani family (whose members self-identified as Gypsies), who arrived in Florida after traveling in Texas and Europe during the previous 2 months. The child had no history of prior meningococcal immunization. The family reported that the child had been sick for at least 7 days with an ear infection; however, this diagnosis was not confirmed by a physician. Because of increasing fever and onset of vomiting, emergency medical service (EMS) staff members were contacted and the child was transported to a local emergency department on January 29, 2015. Although he was reportedly interactive and alert during registration, he developed a rash while in the emergency department, his condition rapidly deteriorated, and he died within four hours. An autopsy was performed on January 30, and on January 31, the medical examiner reported Gram-negative diplococci in the cerebrospinal fluid (CSF). The on-call epidemiologist notified the Sarasota County epidemiologist to initiate investigation of the case and identify contacts at risk and needing chemoprophylaxis.

Pneumonia Associated with an Influenza A H3 Outbreak at a Skilled Nursing Facility--Florida, 2014.

In December 2014, the Florida Department of Health, Bureau of Epidemiology, was notified that 18 of 95 (19%) residents at a skilled nursing facility had radiographic evidence of pneumonia and were being treated with antibiotics. Two residents were hospitalized, one of whom died. A second resident died at the facility. The Florida Department of Health conducted an outbreak investigation to ascertain all cases through active case finding, identify the etiology, provide infection control guidance, and recommend treatment or prophylaxis, if indicated.

A polymicrobial outbreak of surgical site infections following cardiac surgery at a community hospital in Florida, 2011-2012.

We describe an outbreak of 22 sternal surgical site infections following cardiac surgery, including 4 Gordonia infections. Possible operation room environmental contamination and suboptimal infection control practices regarding scrub attire may have contributed to the outbreak.