The COVID-19 pandemic has been both an opportunity and an accelerator. AJPH has now published two supplements (CEAL, https://ajph.aphapublications.org/toc/ajph/114/S1; RADx-UP, https://ajph.aphapublications.org/toc/ajph/112/S9), and three more are being produced. These five supplements comprise a panorama of the public health research that was funded by federal agencies during the COVID-19 pandemic. At the core of these supplements is the community-engaged research and interventions that are now an invaluable component of the tremendous achievements of public health during the pandemic. Reading these documents helps us to understand the key role of public health in getting millions of people tested and millions of vaccine doses from the industry warehouses into people’s arms. Federal agencies can be commended for having reacted quickly, efficiently, and appropriately. Hopefully, these AJPH supplements will make these achievements also visible to the public at large.
The pandemic surprised us as a society and suddenly upset most of our usual ways of communicating. It also rapidly exacerbated the main dysfunctional aspects of the public health system: minoritized and disenfranchised populations were highly vulnerable to the brutal effects of SARS-CoV-2. Federal agencies opted to fund community-engaged science and interventions targeting the most heavily hit populations. “Unprecedented times combined with striking disparities called for these unprecedented measures” (https://doi.org/10.2105/AJPH.2022.307105), particularly among African American/Black, Hispanic/Latino, American Indian/Alaska Native, Asian, Native Hawaiian, and Pacific Islander populations, as well as socioeconomically disadvantaged populations, underserved rural populations, and sexual and gender minorities.
At the end of the process, some agencies turned to AJPH to publish the research conducted using their funds. These projects had not necessarily been led by teams familiar with scientific publications. The editors of AJPH have been actively identifying the strongest pieces submitted through Calls for Papers or in other ways, making sure that their content was rigorous and met the publication standards of the Journal. Some of our new article formats, such as Notes From the Field, proved to be suitable for capturing local, innovative experiences, in often difficult-to-reach communities. The Journal also established a new format, Qualitative Notes From the Field, to capture voices from local experiences. This format, while not as fully detailed as the traditional research article, provides the information needed for other groups searching for models to know how these were technically performed and to contact the authors for more details. In some cases, the full article may have been published in other, more specialized journals than AJPH.
These supplements, altogether, form a catalogue, a repository, and a bank of best community-engaged practices. From this perspective, AJPH also takes pride in having featured the experience of thousands of public health professionals and community activists. This anthology of real-time experiences during the pandemic will be of great interest for building a postpandemic public health.
RAPID ACCELERATION OF DIAGNOSTICS
The National Institutes of Health, through the National Institute on Minority Health and Health Disparities, the National Institute on Aging, and other institutes, launched the Rapid Acceleration of Diagnostics–Underserved Populations (RADx-UP) in April 2020 to support community-engaged research to increase access and uptake of COVID-19 diagnostic tests in underserved and vulnerable populations. To date, 142 RADx-UP projects are a nationwide community of practice comprising multidisciplinary research teams working directly with 409 979 enrolled participants as of February 22, 2024, and using the NIH RADx-UP Common Data Elements. RADx-UP research has implemented and evaluated interventions to, for example, increase testing uptake, reduce vaccine hesitancy in high-risk groups, and promote universal masking in schools.
COMMUNITY ENGAGEMENT ALLIANCE
The backbone of the Community Engagement Alliance (CEAL) comprises 21 regional research teams geographically dispersed across 21 states, the District of Columbia, and Puerto Rico, and 371 counties, comprising approximately 85 million people. Half of their partners are faith-based, patient advocate, social service, community-based organizations, and other grassroots service-oriented organizations. Their role is to build trust, share science-based knowledge, generate community-engaged mitigation and prevention strategies, and promote participation in COVID-19–related clinical trials.
OUTLINING A VISION
On May 11, 2023, the US COVID-19 public health emergency declaration expired, but the infrastructure and the methods developed by RADx-UP, CEAL, and programs from the National Institute for Occupational Safety and Health, the Centers for Disease Control and Prevention, and other agencies for which supplements are still in production, need to survive. Beyond COVID-19, the often pioneering approaches can be adapted to chronic diseases.
6. Years Ago
The More Things Change, the More Things Stay the Same
Today, it is no longer an issue of being suspected of being a runaway slave; it is just generally being “suspected”—whether while sleeping in a common room in a university dorm, barbequing, walking home while wearing a hoodie, driving, wanting to use the washroom in a coffee shop, and so on. Being non-White is suspect. This reflects and cements a culture in which. . .our chances of being the victim of police homicide are much higher if we are Black or Latino. What can be done? First, better data are critical. . . . If we can document the number of adults who live within a mile of a park and keep counts of workers who get injured or die on the job, we can systematically collect data about injuries and homicides caused by police brutality. We have only recently begun to quantify and qualitatively describe the history of lynching in the United States; we should not wait until we erect monuments decades hence to describe the prevalence of police brutality.
From AJPH, September 2018, p. 1128
37. Years Ago
Murder at Work
OSHA [Occupational Safety and Health Administration] has failed to address the serious problem of occupational homicide. With guns exceeded only by motor vehicles as a source of fatal injury at work, it is extraordinary that there are no OSHA regulations specifically designed to keep workers from being murdered on the job. Many of the work-related homicides occur in small businesses, yet OSHA gives little attention to workplaces with few employees; those with 10 or fewer are neither inspected by OSHA nor included in mortality estimates by the Bureau of Labor Statistics. . . . [T]here is need for a reporting system that will capture all homicides as well as all work deaths of the self-employed, a sizable group of workers whose safety is largely ignored.
From AJPH, October 1987, pp. 1273–1274
Biography
