HJAR May/Jun 2023

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2023 27 that we’re seeing, which are resulting in respiratory illnesses. So, in your environ- ment and your city, it’s important to know what the changes are driving some of these health conditions. This past year it probably was a sur- prise to many of us when we had a case of polio in the U.S. We’re also seeing measles outbreaks. What we’ve tried to do is work closely in communities. When we saw the polio case, we began conducting wastewa- ter investigation to see if there are other circulating polio viruses. And that’s where we know that we need to be vaccinating even more and doing more campaigns. Similarly, with the measles outbreaks, we knew where the communities were, but we needed to work closely with pediatricians, again, as trusted messengers that knew the communities and to have culturally rele- vant materials. Because many of this was either religion-driven or culturally driven, and we needed to make sure that we could have those conversations and meet people where they were, so they understood the benefits of vaccination. Speaking of vaccination, health provid- ers, again, I can’t stress enough, are such trusted messengers; and the decision to get a COVID vaccine is an important one that we should recommend to patients including children, pregnant people, and those with weakened immune systems. Coupling vac- cine confidence, safety, and effectiveness information with communication strate- gies can really help us seize on opportu- nities to increase vaccine uptake. When recommendations are based in safety and effectiveness, patients can feel confident in their decision to get vaccinated. And this has ripple effects that can touch others in their family and the community, really bettering public health for us all. The CDC has a free app available to provide recommended vac- cination schedules. Syndemics are when you have multiple epidemics that have exacerbated things like HIV — you also have hepatitis and drug overdose. These really have adverse out- comes in communities. Some of the things that we are doing are working with our partners to develop new multi-pathogen technology to facilitate testing diagnosis and linkage to prevention or treatment for multiple infections. This includes things like having a hep A and B vaccine or screening for hep B and C and HIV in patients. Really important when somebody is there in your front door at your point of care to be able to address multiple things. What I think is really neat is when we’re doing things like our prep guidelines around HIV, we have found that it lowers sexually transmitted infections because of the increased testing diagnosis and treat- ment that we’re doing and shortening the infectious time period. Also, doing things like co-locating treatment and services — HIV, STI, and viral hepatitis prevention ser- vices — really allows us to maximize health outcomes. We’ve done about 30 years of research at CDC now on syringe service programs. We have seen that they decrease HIV and hep C infections by about 50%. And when you couple that with treatment for opioid use disorder, it decreases transmis- sion by about 60%. These are really impor- tant things that we can be doing. Image 3 Adapted from: Healthy People 2030. “Social Determinants of Health.” https://health.gov/healthypeople/priority-areas/social-determinants-health