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President Carol L. Folt delivers her 2022 State of the University address at the Health Sciences Campus. (USC Photo/Gus Ruelas)

Campaign aims to double Health Sciences Campus’ footprint, research portfolio, President Folt says

In her second 2022 State of the University speech, the president reiterated her priorities of expanding the scope and scale of Keck Medicine of USC, while highlighting the accomplishments of the university’s health sciences community.

USC is poised for significant growth in health sciences — including a targeted philanthropic campaign to support a major research hub, boost interdisciplinary collaboration across the university and raise funds for student debt relief and faculty retention, President Carol L. Folt said Wednesday in the second of two State of the University speeches.

Folt shared details with health sciences employees, who represent almost half of the overall university’s people and resources, while also praising their tireless dedication.

“We are back — although I say that knowing that many of you have never left,” Folt said from the Broad Lawn at the Health Sciences Campus. “We all turned on a dime to implement policies to protect the health and safety of our people.”

Folt highlighted the accomplishments of USC employees and students who administered many of the COVID-19 vaccines in Los Angeles. She also cited teams that quickly deployed technologies to support screening and safety, telehealth and clinical training.

As a result, she said, COVID-19 cases were “remarkably low” on both campuses.

These successes and collective resilience have set the stage for USC to roll out four substantial “moonshot” goals — including an expansion in health sciences — that Folt first announced last week.

Campaign to grow, evolve Health Sciences Campus with expansion

Folt spoke about the coming USC Campaign for Health — an effort to raise philanthropic support to double the university’s overall research portfolio and increase the scale of Keck Medicine of USC.

“Size makes a difference in health care and health sciences,” Folt said.

Low-interest capital loans obtained during the pandemic will allow the expansion,  which includes building new research space, hiring new faculty and reducing debt for students, to launch quickly.

The campaign will focus on strengthening collaboration between USC’s five health-related schools, representing 55% of the university’s total research, and with other schools across the university.

By further involving USC experts in fields such as engineering and media, “we can … address the giant health challenges that we face so that we can truly expand our research,” Folt said.

State of the University: Record-setting research

During the pandemic, USC researchers published 275 studies on the impact of the virus, Folt said. She praised those working under tight deadlines to advance public health in unprecedented times.

“Our researchers kept pushing their scholarship and their creative enterprises, even under the most trying conditions,” Folt said.

Among other research highlights:

• 43% of funds sought by USC researchers have been awarded.
• The university is now recognized as a top 20 awardee for federal research dollars.
• For the first time, the university joined the “billion-dollar club” for external research funding.

Folt also congratulated 24 Health Sciences Campus junior faculty who received National Institutes of Health Early-Stage Investigator Awards, and she recognized USC faculty selected to serve on President Joe Biden’s National Cancer Advisory Board.

New faces of leadership across USC

Folt outlined recent changes at the highest organizational levels, including the creation of the new Health System Board and the hiring of Steve Shapiro , who began in March 2021 as the first senior vice president for health affairs of USC.

Folt also recognized Rod Hanners , who was named CEO of Keck Medicine and president and CEO of the USC Health System in September 2021: “We are all so thankful for Rod,” Folt said. “His sense of calm and competence were greatly needed during those pretty tough and uncertain times.”

Folt warmly welcomed new Keck School of Medicine Dean Carolyn Meltzer , who began her position in March. Three other new deans were also noted: Emily Roxworthy of the USC School of Dramatic Arts; Thanassis Rikakis of the USC Jimmy Iovine and Andre Young Academy; and Dana Goldman of the USC Price School of Public Policy.

Folt congratulated Sarah Van Orman, who was recently awarded the Presidential Medallion for her leadership with USC Student Health and for increasing the availability of mental health services.

And she offered deep appreciation for departing leaders Laura Mosqueda, former dean of the Keck School of Medicine, and former interim Dean Narsing Rao.

Folt closed the speech by emphasizing that advancing health sciences is a collective effort.

“I believe the true measure of our worth will always be in how well we take care of each other and our planet for this brief time that we are here,” Folt said. “Maybe most importantly right now, how we leave it for the multitudes who will follow us.”

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Health Research

Our researchers examine communication processes and effects at different scales to design interventions that can help constitute healthy societies and achieve health equity. 

We seek to improve the health of our communities, including those that are underserved, resource-restricted, by developing methods for communicating medical and scientific information promptly, truthfully and effectively.

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Health research in action

Using narratives to convey health information

Sheila Murphy created a study to test ways to motivate women to get screening for cervical cancer.

Professor Lindsay Young’s research helps communities in need

Lindsay Young studies the effectiveness of HIV-prevention engagement in online communities of color.

They were homeless, now they’re dead

Researchers and reporters at USC Annenberg’s Crosstown explore the link between healthcare and homelessness.

Faculty researching in the field of Health

Associated centers

Center for Health Journalism

The Center for Health Journalism partners with newsrooms across America and helps journalists and community storytellers innovate, investigate and illuminate health challenges in their communities, serving as a catalyst for change.

Health Equity and Media Lab

The Health and Equity Media Collaborative conducts community-engaged research, leverages communication science, new media and technology to address pernicious public health challenges.

Hollywood, Health and Society

Hollywood, Health and Society provides entertainment industry professionals with accurate and timely information for storylines on health, safety and national security.

Center for Health Financing, Policy, and Management

Summer Research Associates

Kelvin nguyen.

Kelvin Nguyen is a junior on the Pre-Medicine Track studying Health and Human Sciences with a minor in Public Health. With an interest in healthcare issues that affect marginalized populations, he performs research to help neglected groups by analyzing the socioeconomic factors contributing towards inequality. Kelvin is also Director of Finance for the USC Emergency Medical Services organization (EMSC) and is Assistant Director of Trojan Health Volunteers (THV), and has contributed more than 900 hours of service to non-profit organizations within the Dallas-Fort Worth Metroplex as an Americorps Alumni.

Pratik Thakur

Pratik Thakur is a Junior studying Biological Sciences with minors in Health Policy and Economics. He is interested in understanding how forces such as economics, policymaking, and sociology all impact health outcomes. Aside from conducting research about health care systems and disparities, Pratik is committed to supporting underserved communities through his volunteer work both in his hometown of Kansas City and Los Angeles.

Kara Ushijima

Charles garcia.

Charles Garcia is a junior pursuing a B.A. in Communication with a minor in Health Administration. He is currently the External Vice President for Troy Philippines, the only Pilipinx-American organization at USC, which cultivates cultural celebration and advocacy-related initiatives to better serve the Pilipinx and AAPI community. He is also the Communication Chair for USC’s American Red Cross chapter, often using his expertise in health communication in his programming. Interested in the field of health and communication, Charles plans to utilize the knowledge he learns in the classroom and hands-on experience to work in healthcare, ultimately using communication as a driving force to increase accessibility within health in underserved communities, particularly in nonprofit organizations.

Min Kyoung Kim is a junior attending Pomona College, and is from San Jose, California. She is pursuing a Bachelors of Arts in Economics and is on the Pre-Med track. On campus, she spends her time as a Residential Advisor, Pre-health Mentor, and volunteering at local community health centers. Min is interested in becoming a physician and combining her interest in economic policies and healthcare to help bring higher quality healthcare to underserved communities.

Amanda Shen

Amanda is a recent graduate of the University of Southern California with a degree in Health and Human Sciences. She will be pursuing a M.S. in Bioethics this coming year at Columbia University. Amanda aspires to go to medical school and eventually work in clinical settings with vulnerable or underserved populations who are often in need of advocates, specifically within pediatrics or OB/GYN. Simultaneously, she hopes to involve herself with education and policy efforts to better provide equitable healthcare, as she strongly believes top-down decision-making dictates the quality of clinical care and health outcomes in patients.

Summer Research Associate

HELIN YILMAZ

Helin Yilmaz is a Junior double majoring in Human Biology and Data Science. Helin has volunteered at both local hospitals in California and hospitals in Turkey to observe healthcare differences and challenges in diverse settings. Helin is also a Subcommittee Representative for the clinic team at Harm Reduction Los Angeles, an organization working to mitigate the effects of drug use for individuals on Skid Row. Furthermore, she has served as Co-President of the Save the Children club and is a member of USC’s Trojan Health Volunteers. In order to improve the quality of healthcare, Helin’s research focuses on increasing healthcare affordability and access. She uses her passion for data analytical tools and computer programming to draw meaningful insights and visualizations.

AVISHKA JAYASEKARA

KENNETH NGUYEN

mHealth Collaboratory

The USC mHealth (mobile health) Collaboratory brings together researchers and partners from across USC and beyond to lead advances in research, well-being and health care through mobile strategies. ​ They are, above all, transdisciplinary and include social scientists, engineers, economists, physicians, psychologists, filmmakers, storytellers, digital designers, information technology experts. They are linked by a common goal: to harness and develop the most astonishing and useful mobile and connected technologies to improve health outcomes and reduce healthcare costs. Led by Donna Spruijt-Metz and William Swartout.

WHAT ARE YOU LOOKING FOR?

Key searches, centers and institutes, allayee lab.

The Allayee Lab's research interests are to use multi-disciplinary genetics to understand cardiovascular, metabolic, and inflammatory diseases. Current projects involve large-scale population studies in humans, gene-environment interactions, and functional experiments in model organisms.

Aung Research Team

The Aung Research Team is a translational environmental health science laboratory at the University of Southern California. Its mission is to utilize interdisciplinary science to accelerate the translation of research to inform policy and interventions and advance environmental justice.

CaRE2 Center

The Florida-California Cancer Research, Education and Engagement (CaRE2) Health Equity Center, funded by the National Cancer Institute, unites Florida A&M University (FAMU), the University of Florida (UF) Cancer Center, and the University of Southern California Norris Comprehensive Cancer Center (USC-NCCC) in a bi-coastal effort to address cancer health disparities through research, education, and engagement.

Center for Applied Network Analysis

The Center for Applied Network Analysis (CANA) at USC hosts bi-monthly lab meetings where members present ongoing research in social network analysis. Workshops on analytical tools like R, STATNET, ERGM, and SIENA are also offered to aid members in mastering advanced techniques.

Center for Genetic Epidemiology

The Center for Genetic Epidemiology focuses on genetic epidemiology, aiming to understand genetic factors in diseases, gene-environment interactions, and the evolutionary impacts on health. Emphasizing diversity, they study varied populations to address disparities in disease risk and advance genomic medicine's translational impact, while recruiting faculty to support genome research and precision medicine initiatives.

Center for Health Equity in the Americas (CenHealth)

The Center for Health Equity in the Americas (CenHealth) aims to address health disparities across the Americas through research, collaborations, and interventions. Supported by the Keck School of Medicine Dean's office at USC, CenHealth focuses on closing health equity gaps in vulnerable populations through national and international initiatives housed within the Department of Population and Public Health Sciences.

Center for Population Health

The Center for Population Health (CPH) at USC provides expertise and resources for population health projects, specializing in community-based research and understanding health disparities. With over 20 years of collective experience, our goal is to support the success of your project through our rich history in health behavior research.

Center for Statistical Genomics

Our focus is on advancing cancer genetic epidemiology amidst the challenges posed by big data and complexity. We strive to develop innovative statistical methods to aid in discovery, characterization, and prediction in cancer studies, integrating biological knowledge with epidemiological or clinical data. Ultimately, our aim is to provide tools for assessing the impact of preventive or therapeutic interventions based on modifiable risk factors.

Center for Translational Research on Environmental Health

The Center applies novel, multidisciplinary approaches in epidemiology, data science, multiomics, biology, community engaged research and environmental engineering to address key environmental health issues using a team science approach.

Center for Young Adult Cancer Survivorship Research

The Southern California Center for Young Adult Cancer Survivorship Research, a collaborative effort between USC and UC Irvine, conducts interdisciplinary research on population health, health services, wellbeing, and medical outcomes among young cancer survivors up to middle age.

The Chinag Lab is a team of geneticists and computational biologists using advanced tools to explore the overlap of human medical and population genetics. Such findings will be pivotal for future medical studies and personalized medicine.

Children’s Cancer Research Laboratory

The Children’s Cancer Research Laboratory focuses on understanding childhood cancer causes, including genetic, environmental, and infectious factors, aiming to prevent the disease. Recent findings highlight links between inherited genetics, tobacco exposure, prenatal infections, altered immune development, and leukemia in children, while offering postdoc opportunities.

The Conti Lab performs research in genetic and environmental epidemiology. This includes development of statistical methods and applied collaborations. Methodological research aims to integrate multiple omic measurements, biological knowledge, and external prior information in statistical modeling, primarily focusing on the use of Bayesian hierarchical models. Current applied work involves collaborative projects in prostate, breast and pancreatic cancers, liver disease, and diabetes-related endpoints. These studies investigate mutliple omic layers, including the genome, exposome and metabolome.

COVID-19 Pandemic Research Center (CPRC)

The COVID-19 Pandemic Research Center aims to understand and address the impact of COVID-19 on diverse populations, especially in Los Angeles and beyond, focusing on health disparities. Through collaborative efforts, the CPRC conducts epidemiological research, identifies risk factors, assesses policy impacts, and develops prevention strategies, leveraging existing population-based studies and external funding to facilitate multidisciplinary research initiatives.

Drug Use and Behavior Lab

The Drug Use & Behavior (DUB) lab investigates the normalcy of drug use throughout history, aiming to understand both positive and negative effects of drugs on individuals and society. Employing behavioral pharmacology, Ecological Momentary Assessment, and surveys, the lab examines how social influences shape drug use patterns, with a focus on informing evidence-based drug policies, harm reduction strategies, and effective treatments for those experiencing drug-related problems.

Environmental Influences on Child Health Outcomes (ECHO)

The ECHO Program aims to enroll over 50,000 children in observational studies, encompassing diverse demographics to investigate the impacts of environmental factors on child health and development over time. Researchers utilize the wealth of data gathered from the cohort, which includes ongoing data collection, ensuring comprehensive insights into early environmental influences on children's health. Study sites across the United States and Puerto Rico collect data uniformly to facilitate collaboration and utilization of information by researchers.

Epidemiology of Substance Use (EOS) Research Group

The Epidemiology of Substance Use (EOS) Research Group is a team of faculty, staff, and students who are broadly interested in patterns of tobacco, cannabis, and other substance use in adolescence and early adulthood. We have a number of ongoing observational research studies aimed at addressing critical research questions relating to the public health impact of new and emerging products.

The Gazal Lab develops and applies statistical methods to understand the genetic basis of human disease, with expertise in combining population genetics, genetic epidemiology and functional genomics approaches.

Gene Ontology Consortium

The mission of the Gene Ontology Consortium is to develop a comprehensive, computational model of biological systems, ranging from the molecular to the organism level, across the multiplicity of species in the tree of life. The GO knowledgebase is the world’s largest source of information on the functions of genes. This knowledge is both human-readable and machine-readable, and is a foundation for computational analysis of large-scale molecular biology and genetics experiments in biomedical research.

Global Research, Implementation, and Training Lab (GRIT LAB)

The USC GRIT Lab is dedicated to carrying out research, programming, and training aimed at building sustainable, community-based public health programming around the world. Our lab is powered by USC students, faculty, and partners dedicated to our shared vision of decolonized, collaborative, global health practice.

Habre Exposure Analytics Lab

The Exposure Analytics Lab uses advanced methods to study human exposure to environmental contaminants, emphasizing precision environmental health in areas such as air quality, health disparities, and climate change. The lab employs big data, sensors, and modeling tools to analyze exposures at both individual and population levels, exploring the cumulative impact on vulnerable populations' health and well-being.

Herting Neuroimaging Lab

The Herting Neuroimaging Lab uses advance neuroimaging techniques to investigate how the brain develops during childhood and adolescence. Our research focuses on both internal and external risk factors, like hormones, air pollution, and physical activity on brain outcomes like structure, function, cognition, and mental health.

Initiative for California American Indian Health Research and Evaluation (I-CAIHRE) 

I-CAIHRE strives to improve the health and well-being of California's American Indian and Alaska Native (AIAN) communities through community-informed research. We prioritize gathering data that reflects community needs and perspectives to drive sustainable improvements in health outcomes.

Institute for Addiction Science

The USC Institute for Addiction Science (IAS) was founded in 2018 to harness the expertise of addiction scholars across disciplines, with support from various sources including the USC Office of Research Collaboration Fund and philanthropic donations. Under the leadership of Adam Leventhal and John Clapp, the Institute has grown rapidly, now comprising over 80 faculty members from diverse backgrounds and making significant strides in addiction research, training, and community engagement.

Institute for Health Promotion and Disease Prevention

Established in 1980, the USC Institute for Health Promotion & Disease Prevention Research (IPR) is a renowned hub for interdisciplinary research and education, dedicated to improving public health globally. With a track record of prolific scholarship and innovative programs, including the longest-running National Cancer Institute T32 research training program, IPR is recognized as a leader in epidemiology and prevention science.

Institute on Inequalities in Global Health

USC's Institute on Inequalities in Global Health addresses global health disparities through interdisciplinary research, education, and policy action.

Klausner Research Group

The Klausner Research Group focuses on the prevention, diagnosis, management and treatment of infectious diseases of global health importance like HIV/AIDS, syphilis, chlamydia, gonorrhea and infections in pregnancy that lead to preterm birth.

Los Angeles Cancer Surveillance Program

The Los Angeles Cancer Surveillance Program is a state-designated population-based cancer registry for Los Angeles County. The program routinely collects information on all newly diagnosed cancer cases, monitors cancer trends and patterns, and provides high quality data for advancing knowledge to reduce cancer burden and improve cancer care in all populations.

MADRES Center for Environmental Health Disparities

The MADRES Center investigates how environmental factors impact health during vulnerable life stages like pregnancy, infancy, and childhood. It focuses on understanding the connection between these factors and early cardiometabolic disease risk in marginalized populations.

Mancuso Lab

The Mancuso Lab pioneers computational and statistical methods to uncover the genetic basis of complex diseases. They integrate molecular phenotypes with genome-wide association studies, distinguishing between rare and common variations. The lab also quantifies natural selection's influence on specific alleles' impact.

Maternal Cannabis Lab

The Maternal Cannabis Lab at USC, funded by NIH and USC Institutes, investigates cannabis use during pregnancy and associated health disparities. Through qualitative and mixed-methods research, we delve into individual, interpersonal, and societal factors. Our studies analyze patient care, cannabis use patterns, beliefs, and opportunities for maternal health improvement. Our aim is to enhance understanding of cannabis use in pregnancy for healthier and more equitable experiences.

Psychosocialbiology of Women’s Health and Emotional Research (POWER) Lab

The Psychosocialbiology Of Women’s health & Emotion Research (POWER) Lab is led by Dr. Raina Pang. The POWER Lab work focuses on empowering women to improve their health through research and community based educational outreach about factors underlying women’s emotional and physical health. Current projects utilize Ecological Momentary Assessment (EMA) and behavioral pharmacology to investigate sex/gender differences and women-specific factors in consequences and mechanisms underlying tobacco addiction.

Real Time Eating Activity and Children’s Health (REACH) Lab

The REACH Lab at USC uses Intensive Longitudinal Data (ILD) methods to study the short-term processes influencing physical activity and eating behaviors in children, young people, and families.

The Shu lab is a computational genetics research group on mental and behavioral disorders in the Center of Genetic Epidemiology and the Department of Population and Public Health Sciences at Keck School of Medicine of USC. The lab aims to understand the genetic etiology and epidemiology of mental and behavioral disorders through machine learning and statistical approaches.

Southern California Center for Children’s Environmental Health Research Translation

The Southern California Center for Children’s Environmental Health Translational Research seeks to reduce childhood air pollution-related diseases, especially in environmental justice communities, through collaborative engagement and innovative solutions. With a focus on Urbanism, Air Pollution, Children’s Health, and Environmental Justice, the Center utilizes youth engagement, community science, urban design, policy solutions, and communication to address the issue.

Southern California Center for Latino Health (SCCLH)

The Southern California Center for Latino Health (SCCLH) aims to improve the well-being of Latino children and families. Some chronic diseases disproportionately affect Latino communities. We research the causes of these health disparities and develop solutions to improve Latino health.

Southern California Environmental Health Sciences Center

The Southern California Environmental Health Sciences Center (SCEHSC) is dedicated to reducing diseases and disabilities caused by environmental impacts by fostering multidisciplinary research partnerships and innovative approaches. With a focus on Environmental Exposures, Host Factors, and Human Disease across the Lifecourse, the center catalyzes research, supports academic development, engages with communities, and translates research findings to policymakers and the public.

Southern California Evidence Review Center

The Southern California Evidence Review Center conducts comprehensive literature reviews for federal agencies and professional organizations, producing various evidence synthesis products to inform healthcare decisions. Endorsed by the Agency for Healthcare Research and Quality (AHRQ) as an Evidence-based Practice Center (EPC), our team collaborates with experts from USC, RAND, UCLA, and the VA to advance evidence synthesis methods and provide evidence reports to support informed healthcare decisions.

Tobacco Center of Regulatory Science (TCORS)

The Tobacco Center of Regulatory Science is dedicated to generating scientific data to guide regulatory decisions at the FDA's Center for Tobacco Products and to train future tobacco regulatory scientists. Focused on the theme of Intersections of Products with Diverse Populations, our research examines the use and health impacts of specific e-cigarette products across different demographic groups, aiming to inform regulations that protect youth from tobacco product use while minimizing impacts on adult smokers.

The Wilson Lab studies genetic causes of pregnancy complications like preeclampsia and HELLP Syndrome. We also survey survivors and their families to understand their decisions about future pregnancies and assess the risk for fathers of preeclamptic pregnancies.

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Industry Research

• Advertising
• Aerospace & Defense
• Apparel & Footwear
• Biotechnology
• Electronics & Technology
• Film, Television & Theater
• Financial Services
• Foods & Beverages
• Grocery & Supermarkets
• Hospitality, Hotels & Restaurants
• Management & Consulting
• Real Estate
• Transportation
• Travel & Tourism
• Venture Capital & Private Equity
• Key Resources
• Trade Publications
• Associations

This webpage features resources that will assist physicians and dentists in clinical practice management, as well as aid students conducting basic health care industry research. To access all USC medical resources, please refer to the  Norris Medical Library . 

Below are some of the top resources for finding market and industry research:

For general overviews and market research reports search on terms like:

• Healthcare OR health care OR medical care
• Health AND wellness
• Healthcare information OR technology

For more specific research, consider adding terms like:

• Diagnostics
• Remote monitoring
• Telemedicine

Listed below are links to trade publications and relevant industry news:

Note: A trade publication (often a magazine) is an information source that is intended for a very specific audience and will have content that appeals to that audience. The content may come directly from people within the industry, or it may come from freelance or staff writers that have vast experiences writing for that particular trade.

Professionals often subscribe to trade magazines in order to gather valuable information that will help them achieve something within their industry or field.  Trade publications are a Marketer's secret weapon  and can be helpful for tracking recent industry developments, identifying competitors or uncovering market opportunities. 

• Healthtech Magazine
• Insights Care

Here's a list of important journals:

• Health Affairs
• Health Care Management Review
• Health Management Technology
• Healthcare Executive
• Health Care Analysis
• Healthcare Financial Management
• Hospital Business Week
• Hospitals & Health Networks
• JAMA: Journal of the American Medical Association
• Modern Healthcare
• New England Journal of Medicine Three month embargo for full text articles.

Below are links to key industry associations:

Note: If your industry is not represented here, search Google with your industry name + "association".  Not all content on these websites is free; you may need to be a member to access exclusive reports and data.

In some industries, associations might be referred to as;

• Guild OR federation OR society
• Foundation OR council
• Bureau OR forum
• AAFP - American Academy of Family Physicians
• AAMA - American Association of Medical Assistants
• ACHE - American College of Healthcare Executives
• AAPL - American Association for Physician Leadership
• AHA - American Hospital Association
• AIM - Administrators in Medicine
• American Society of Health System Pharmacists
• American Academy of Physician Assistants
• American Association of Healthcare Administrative Management
• American Association of Physician Specialists
• American College of Physicians In addition to 'members only' material, includes current controversies, quality-of-care issues, and many patient advocacy topics.
• American Health Information Management Association
• American Medical Association Includes access to many AMA publications, patient education information, and a searchable version of the AMA directory.
• American Medical Women's Association A good site for women's health care, especially continuing education materials.
• AMIA - American Medical Informatics Association
• ATA - American Telemedicine Association
• CMA - California Medical Association
• HFMA - Healthcare Financial Management Association
• Los Angeles County Medical Association
• Medical Group Management Association
• Medical Library Association This link provides a guide on how to evaluate Health information on the web, as well as numerous links to all aspects of the healthcare industry: Consumer links, Policy Related, Advocacy, specific diseases, technology, etc.
• National Business Group on Health Nonprofit representing employers' perspectives on national health policy issues.
• National Coalition on Health Care
• Consumer Healthcare Products Association A members-based association of manufacturers and distributors of OTC non-prescription drugs advocating safe and responsible use of these medicines.
• 100 Top Hospitals An annual listing published by Watson Health. Most of the reports are for purchase but some content is free.
• America's Health Insurance Plans
• Accenture - Health Consulting
• Bain & Company - Healthcare
• Booz Allen Hamilton - Health & Life Sciences
• Boston Consulting Group - Healthcare Payers, Providers, Systems & Services
• Deloitte - Life Sciences & Health Care
• Ernst & Young - Health
• International Profiles of Health Care Systems, 2020 A report from the Commonwealth Fund published irregularly.
• KPMG - Healthcare & Life Sciences
• Mathematica Policy Research Search 'Insights' and 'Services & Products' for reports and issue papers.
• McKinsey & Co., Inc. - Insights & Publications: Healthcare Systems & Services
• McKinsey Center for US Health System Reform
• MedScape Portal to medical news, drug identification, continuing medical education, and other health-related information. Registration is free for most content.
• PriceWaterhouseCoopers - Healthcare Industry Links to publications and perspectives on the health care industry.
• The Henry J Kaiser Family Foundation News, reports, surveys and policy analysis on multiple issues.
• State Health Facts Sponsored by the Henry J. Kaiser Family Foundation, this website provides state profiles and comparisons of key health data.
• US News & World Report - Health Use the tabs at the top to find rankings for Hospitals, Doctors, Health Insurance, and Nursing Homes.
• Robert Graham Center Covers policy development and advocacy efforts in healthcare while providing free reports and data.

Information Technology and Healthcare

• 50-State Survey of Telehealth Commercial Insurance Laws
• American Telemedicine Association
• California Telehealth Resource Center
• Family Physicians and Telehealth A 2015 report from the Robert Graham Center.
• Global Innovation Index, 2019: the future of medical innovation A 2019 report from INSEAD and WIPO.
• IBM - Healthcare Technology Links to IBM reports and perspectives on technology and health care.
• Impact Advisors - White Papers Find reports and white papers on emerging healthcare IT trends.
• The Physician's Guide to Telemedicine in 2017 A white paper from Prognocis, including individual state regulation profiles.
• The Promise of Telehealth for Hospitals, Health Systems & Their Communities A 2015 Trend Watch paper from the AMA.
• State of the States - Telemedicine Gaps Analysis Analysis from the American Telemedicine Association; search online after free registration.
• TelaDoc Health - Resource Center
• Telehealth: a quarter-trillion dollar post-COVID-19 reality? A 2021 report from McKinsey & Company
• Telehealth Around the World: a global guide A 2020 report from DLA Piper.
• Triple Tree Investment Bank Access to reports and perspectives; registration required for free downloads.

Find key government data, including reports and statistics using the following resources:

• Agency for Healthcare Research & Quality, Dept. of Health & Human Services Links to reports and data on healthcare issues, reports.
• CDC - Center for Disease Control - FastStats Provides quick data on topics of public health importance.
• CDC - Center for Disease Control - Publications Includes links to Morbidity & Mortality Weekly Report and Emerging Infectious Diseases.
• National Health Interview Survey Survey results from a broad range of health topics.
• Centers for Medicare & Medicaid Services Search 'Research, Statistics, Data & Systems' tab for access to publications, statistics and links on multiple topics.
• Congressional Budget Office (CBO) - Health Care
• HCUP - Health Care Costs & Utilization Project Sponsored by the Agency for Healthcare Research & Quality.
• National Institutes of Health Resources Free online health information from the US Government's medical research agency.
• U.S. Bureau of Labor Statistics - Industries at a Glance Links to Labor Statistics in Healthcare NAICS: 62
• U.S. Census - Statistics Lists Economic Health Care & Social Assistance statistics (search the term HEALTH or EC0762)
• U.S. Census - Statistics of U.S. Businesses Hospitals - NAICS 622
• U.S. Department of Health & Human Services Includes the Healthfinder consumer information system and Office of the Surgeon General.
• National Library of Medicine
• Healthfinder A consumer information system created by the U.S. Health & Human Services Department.
• California - Department of Health Care Services See Data & Statistics TAB for reports, links and statistics.
• Medical Board of California
• State of California - Office of the Patient Advocate Information on Insurance Basics, Quality Report Cards and news.
• MedLine Plus A service of the U.S. National Library of Medicine. Medline Ovid subscription access is also available through the Norris Medical Library.
• Health Services Technology Assessment Texts Provides access to full-text documents for health care decision making. Includes clinical practice guidelines, quick-reference guides for physicians, consumer brochures, and evidence reports from the Agency for Health Care Policy and Research
• National Library of Medicine Public site that includes PubMed with access to 18 million journal citations from MedLine and other core healthcare journals.

Books and Reference Sources

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• Last Updated: May 16, 2024 8:42 AM
• URL: https://libguides.usc.edu/industries

The Department of Preventive Medicine, Division of Health Behavior Research, offers a degree program in preventive medicine (health behavior), leading to attainment of the PhD. The program is designed to train exceptional researchers and scholars in the multidisciplinary field of health behavior research. Students receive a thorough grounding in academic and research experience, encompassing theoretical and methodological training in such allied fields as communication, psychology, preventive medicine, biostatistics, public health and epidemiology. Students receive research experience by participating in projects conducted through the USC Institute for Health Promotion and Disease Prevention Research (IPR). The doctoral program is full-time: students are expected to enroll for fall, spring and summer semesters.

Assistantships

Financial and educational support is provided to qualified doctoral students in health behavior research. Graduate (research and/or teaching) assistantships are half-time (20 hours per week) and provide tuition remission as well as a monthly stipend.

Computer Language Requirement

Sufficient familiarity in computer languages to operate major software packages for data management and analysis is required.

Course Requirements

The doctoral program in health behavior research is structured as a four to five year course of study for students entering with a bachelor’s degree. Time requirements are subject to review and approval by the division’s Graduate Program Committee and the Graduate School.

A total of 60 units of graduate study is required for the PhD in health behavior research. Students are required to complete nine core courses: PM 500   , PM 511a   , PM 511b   , PM 515   , PM 530   , PM 601   , PM 604   , PM 615    and PM 756    (total of 37 units). Other requirements include: two elective PM courses, one not offered by health behavior faculty (minimum of 7 units); and a minimum of 4 units each in PM 590   , PM 690 series ( PM 690a   , PM 690b   , PM 690c   , PM 690d   , PM 690z   ), PM 790    and the PM 794 series ( PM 794a   , PM 794b   , PM 794c   , PM 794d   , PM 794z   ).

For students entering with a bachelor’s degree, one of the directed research projects will be equivalent in scope to a master’s thesis. All research experiences/projects must be completed before registering for the PM 794 Doctoral Dissertation series ( PM 794a   , PM 794b   , PM 794c   , PM 794d   , PM 794z   ).

Screening Procedure

The progress of each student is reviewed at the end of every academic year. At the end of the second year of study, students who have not made satisfactory progress are advised that they will be dropped from the program unless their progress improves during their second year.

Qualifying Exam Committee

Each student’s qualifying exam committee consists of five members, including: no more than three health behavior faculty members; one other member from the Department of Preventive Medicine; and one member from a doctorate-granting program outside the Department of Preventive Medicine, representing the student’s minor field.

Qualifying Examination

Following course work and prior to beginning the dissertation, students must demonstrate written and oral mastery of the general field of health behavior research as well as of their chosen area of specialization. The qualifying process includes a written examination on theory and literature relevant to a selected content area. The examination is administered by the student’s qualifying exam committee.

In addition to the qualifying examination, each student is expected to produce the following as evidence of qualification to conduct dissertation research: an academic dossier consisting of a summary of the student’s academic record, teaching and research experience, and professional presentations and publications; at least one original empirical research paper of publishable quality, produced in connection with one of the student’s courses or research experiences or developed independently; a dissertation proposal; and an oral defense of all the preceding materials.

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New research from the USC Norman Lear Center shows progress on mental health representation: Nuanced depictions of mental health promote help-seeking, reduce stigma

LOS ANGELES , May 29, 2024 -- A new study by the USC Norman Lear Center, in collaboration with SHOWTIME/MTV Entertainment Studios, reveals the significant role entertainment plays in shaping knowledge, public perception, and behaviors related to mental health. Shifting Minds: Understanding the Development, Representation, and Impact of Mental Health Storylines in Entertainment underscores the power of accurate and nuanced portrayals of mental health in reducing stigma and encouraging help-seeking behaviors.

Through interviews with writers and mental health experts, the Norman Lear Center took a look into the creative process around developing mental health storylines. They identified trends in mental health storytelling through an analysis of TV and film scripts, and examined how audiences were impacted by 13 TV storylines that aligned with storytelling best practices or informed by experts. This audience impact study included Basketball Wives (VH1), Bel-Air (Peacock), The Chi (Showtime), Clone High (MAX), Couples Therapy (Showtime), MTV's Following: Bretman Rock (YouTube) , Siesta Key (MTV), The Real World Homecoming: New Orleans (Paramount+), The Summer I Turned Pretty (Prime Video), Teen Mom: The Next Chapter (MTV), UnPrisoned (Hulu and Onyx Collective), Wolf Pack (Paramount+), and The Young and the Restless (CBS).

The research team found:

Increased Emphasis on Responsible Storytelling: Content creators and industry professionals pointed to  an industry-wide shift toward more inclusive and responsible portrayals of mental health. Interviews underlined the importance of robust access to accurate, specific, and culturally sensitive resources to support nuanced storytelling.

Expanded and Improved Mental Health Representation: Using their Script Database, the Norman Lear Center analyzed the frequency of mental health keywords in TV and film scripts from the period before and after the launch of the Mental Health Media Guide in 2021. The research shows a 39% increase in mentions of mental health keywords, as well as a 15% decrease in derogatory language, suggesting a shift toward more respectful and nuanced discussions of mental health. 

Positive Audience Impact: Viewers of mental health storylines that followed best practices, or were informed by experts and those with lived experience, had greater knowledge of mental health topics, reduced stigma toward those receiving treatment, and greater willingness to seek help. Viewers indicated a higher likelihood of pursuing a number of mental health actions including therapy, support groups, reaching out to a friend, and breathwork.

Character Depth and Relatability: Feelings of friendship with TV characters contributed to reduced stigma and willingness to seek help. This was true even with complex characters who had a mix of positive and negative traits.

Recommendations for entertainment creatives based on the research include:

• Showcasing a diverse range of characters facing mental health challenges and receiving support from their communities.
• Realistically depicting the process of seeking mental health support and addressing common barriers.
• Normalizing conversations about mental health and highlighting systemic supports, such as workplace policies.
• Taking advantage of resources, such as mental health experts and individuals with lived experiences, to develop authentic stories. The Mental Health Media Guide and organizations like the Lear Center's Hollywood , Health & Society program can provide a range of services.

"This research validates what we as storytellers have always known: authentic and nuanced storytelling has the power to drive meaningful societal change," said Nina L. Diaz , President of Content and Chief Creative Officer, SHOWTIME/MTV Entertainment Studios and Paramount Media Network. "The Mental Health Storytelling Initiative is empowering creators across all genres to elevate storylines that reflect the full mental health experience, and the results are clear: it's not simply resonating with audiences, it's making a difference in their perceptions, reducing stigma and encouraging them to take steps to support their own mental health and that of those around them."

"This research highlights a dramatic shift in mental health storytelling, away from stigmatizing language and toward more nuanced discussions of specific conditions and treatment options," said Erica Rosenthal , Director of Research at the USC Norman Lear Center. "When viewers see their favorite TV characters seeking help or supporting friends who are struggling, we find they are more likely to take these steps themselves."

Launched in 2021 with support from SHOWTIME / MTV Entertainment Studios and housed at the USC Annenberg Inclusion Initiative, the Mental Health Storytelling Initiative harnesses the power of storytelling to change the narrative on mental health. The initiative is powered by the Mental Health Storytelling Coalition, an unprecedented multi-sector partnership between more than 70 leading entertainment industry partners and mental health expert organizations. The Initiative will build on new research and insights to support a broader range of storytellers and topics – including portrayals of kids' mental health, digital creators, and global storytellers.

For more information on the study, visit  learcenter.org/mentalhealth .

SOURCE SHOWTIME/MTV Entertainment Studios

• Open access
• Published: 24 May 2024

Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic

• Jay B. Lusk 1 , 2 ,
• Pratik Manandhar 3 ,
• Laine E. Thomas 3 &
• Emily C. O’Brien 2 , 3  

BMC Health Services Research volume  24 , Article number:  659 ( 2024 ) Cite this article

213 Accesses

Metrics details

Healthcare facility characteristics, such as ownership, size, and location, have been associated with patient outcomes. However, it is not known whether the outcomes of healthcare workers are associated with the characteristics of their employing healthcare facilities, particularly during the COVID-19 pandemic.

This was an analysis of a nationwide registry of healthcare workers (the Healthcare Worker Exposure Response and Outcomes (HERO) registry). Participants were surveyed on their personal, employment, and medical characteristics, as well as our primary study outcomes of COVID-19 infection, access to personal protective equipment, and burnout. Participants from healthcare sites with at least ten respondents were included, and these sites were linked to American Hospital Association data to extract information about sites, including number of beds, teaching status, urban/rural location, and for-profit status. Generalized estimating equations were used to estimate linear regression models for the unadjusted and adjusted associations between healthcare facility characteristics and outcomes.

A total of 8,941 healthcare workers from 97 clinical sites were included in the study. After adjustment for participant demographics, healthcare role, and medical comorbidities, facility for-profit status was associated with greater odds of COVID-19 diagnosis (aOR 1.76, 95% CI 1.02–3.03, p  = .042). Micropolitan location was associated with decreased odds of COVID-19 infection after adjustment (aOR = 0.42, 95% CI 0.24, 0.71, p  = .002. For-profit facility status was associated with decreased odds of burnout after adjustment (aOR = 0.53, 95% CI 0.29–0.98), p  = .044).

Conclusions

For-profit status of employing healthcare facilities was associated with greater odds of COVID-19 diagnosis but decreased odds of burnout after adjustment for demographics, healthcare role, and medical comorbidities. Future research to understand the relationship between facility ownership status and healthcare outcomes is needed to promote wellbeing in the healthcare workforce.

Trial registration

The registry was prospectively registered: ClinicalTrials.gov Identifier (trial registration number) NCT04342806, submitted April 8, 2020.

Peer Review reports

The COVID-19 pandemic added a major stressor to the already overtaxed healthcare system in the United States. Existing trends toward health system consolidation and from independent practice were exacerbated by the financial impact of the pandemic [ 1 , 2 , 3 ]. Prior work has demonstrated a consistent impact of healthcare facility characteristics on care quality, with variation in patient outcomes according to for-profit status, bed size, and teaching status; consolidation of health systems has also been linked with worsened patient outcomes [ 4 , 5 , 6 ].

There is also a robust literature relating health facility characteristics with the experiences of healthcare workers who work in those facilities. Several dimensions of the healthcare workplace are associated with outcomes for healthcare professionals. For example, there is an extensive literature demonstrating that physical environment (comprising items ranging from noise levels to temperature to ergonomics) is associated with workplace satisfaction and healthcare worker wellbeing [ 7 ]. Work environments that promote work engagement and self-efficacy are associated with job satisfaction and decrease turnover; by contrast, poor management, unprofessional behavior from colleagues, and unfavorable clinical work structures are associated with decreased job satisfaction and increased turnover [ 8 , 9 , 10 ]. Other workplace characteristics, such as high patient volumes, working a high burden of night shift work, and having a principally academic practice have been associated with increased burnout [ 11 ].

The operating characteristics of healthcare facilities may have a major influence on their ability to provide positive workplace environments for healthcare workers. For example, a prior study showed that registered nurses working in small hospitals were more likely to report job satisfaction than nurses working in large hospitals [ 12 ]. This same study found no association between employment in an academic hospital or facility location in a high population density area and satisfaction with the work environment, and no association with any of the above features and burnout after adjustment for age, sex, and level of education [ 12 ]. On the converse, a study of physical and occupational therapists found that employment in smaller healthcare facilities was associated with higher job stress and burnout levels [ 13 ]. A systematic review and meta-analysis of burnout by inpatient versus outpatient work environment of physicians found that outpatient physicians reported more emotional exhaustion than inpatient physicians, but otherwise did not find compelling evidence of differences in other psychosocial outcomes [ 14 ].

Despite the robust literature exploring the impact of employing healthcare facilities on outcomes of healthcare workers, this has not been explored in a large, diverse cohort of healthcare workers in the context of the COVID-19 pandemic. Therefore, our objective was to characterize the associations between healthcare facility characteristics and healthcare worker outcomes, including burnout, depression, and COVID-19 exposure and diagnosis, among participants of the Healthcare Worker Exposures, Response, and Outcomes (HERO) registry.

The registry and this analysis (ClinicalTrials.gov Identifier NCT04342806) was funded by the Patient-Centered Outcomes Research Institute (PCORI) and was approved by the WIRB-Copernicus Group Institutional Review Board (WCG IRB). Characteristics of the registry and assessment tools have been described previously [ 15 , 16 ]. Written informed consent was obtained from all participants. This study adhered to the tenets of the Declaration of Helsinki. We presented results according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. We analyzed data from participants enrolled in the HERO registry from April 2020-May 2022. Participants who did not provide information on their employing healthcare facility, or whose employing healthcare facility could not be linked to American Hospital Association database were excluded. Participants from any site with more than 10 healthcare workers (HCWs) enrolled were included, for a final cohort of 8,941 HCWs from 97 clinical sites. Exposures of interest included healthcare facility characteristics, namely bed size, teaching status, urban location, and for-profit status, obtained from American Hospital Association data. We evaluated associations between these characteristics and four outcomes of interest prioritized by HCW participants during the COVID-19 pandemic. These included 1) access to personal protective equipment (PPE) quantified on a summary scale from ten questionnaires asking about various surrogates of access to PPE, 2) COVID-19 diagnosis on at least one survey, 3) burnout (defined as responding to at least three burnout symptoms on a burnout instrument on at least one occasion), and 4) depression (defined as a PROMIS-T score > 60 on at least one survey). Generalized Estimating Equations—to account for within-site clustering— were used to estimate linear regression models for the access to PPE outcome, and to estimate logistic regression models for the other outcomes. Adjusted regression models included covariates for age, gender, race, ethnicity, role in healthcare setting (e.g. nurse), healthcare environment (e.g. outpatient), and self-reported medical comorbidities. Dependent and independent variables used in our study are described in detail in Appendix 1 . Median values were used to impute missing continuous adjustment variables and mode values were used to impute missing categorical adjustment variables. Around 10% of participants were missing information on self-reported medical history, and < 1% of all other variables were missing. The vast majority of missing data on self-reported medical history was missing completely at random due to a version change in the data collection form. Imputation was only performed on missing adjustment variables and not on study endpoints. Unadjusted and adjusted odds ratios with 95% confidence intervals and p-values were estimated.

Characteristics of the study population

Characteristics of included participants are shown in Table  1 . The median age was 40 (IQR 33–51), 77.2% of the participants were female, 86.8% identified as White, 4.3% identified as Black or African American, and 8.9% identified as another race; 6.2% of participants identified as Hispanic ethnicity. Most participants worked in inpatient settings (80.2%); 9.2% worked in outpatient settings, 1.2% in emergency services, skilled nursing, or urgent care, and 9.4% in other healthcare settings. Nurses made up a plurality of the participants (32.3%) followed by physicians (21.9%), administrative staff (7.3%), and physicians assistants or nurse practitioners (6.2%).

Characteristics of the study population stratified by characteristics of employing healthcare facilities

Baseline characteristics of the participants varied according to hospital characteristics. Table 2 shows baseline characteristics stratified by hospital ownership status. In summary, for-profit and not-for-profit sites had a somewhat higher proportion of workers who identified as non-Hispanic compared to government sites; furthermore, a greater share of respondents from not-for-profit hospitals were physicians or physicians in training.

Table 3 shows baseline characteristics of the study population stratified by metropolitan versus micropolitan location; participants employed by facilities in micropolitan locations tended to be older, were more likely to identify as White and less likely to identify as Hispanic, were more likely to report employment in facilities other than hospitals and were more likely to be employed as medical assistants or medical administrators rather than physicians or registered nurses.

Table 4 shows baseline characteristics of the study population stratified by teaching status of the employing healthcare facility. Overall, participants from teaching institutions were younger, were less likely to identify as White and more likely to identify as Hispanic, were more likely to work in inpatient settings, and were more likely to be employed as physicians or nurses.

Table 5 shows baseline characteristics of the study population stratified by number of beds of the affiliated hospital. Overall, participants from smaller hospitals tended to be older, were more likely to identify as White and less likely to identify as Hispanic and were less likely to be employed as physicians compared with participants from larger hospitals.

Association between healthcare facility characteristics and access to personal protective equipment

There was no association either before or after adjustment (for age, gender, race, ethnicity, role in healthcare setting (e.g. nurse), healthcare environment (e.g. outpatient), and self-reported medical comorbidities) between any healthcare facility characteristic (ownership status, teaching status, number of beds, and metropolitan vs. micropolitan location) and access to personal protective equipment (Table  6 ).

Association between healthcare facility characteristics and COVID-19 diagnosis

Before adjustment, only for-profit ownership of the employing healthcare facility was associated with COVID-19 diagnosis (OR 1.94, 95% CI 1.26–3.01). After adjustment, this association was attenuated but was still significant (aOR 1.76, 95% CI 1.02–3.03). Furthermore, while before adjustment there was no association between micropolitan location of the employing healthcare facility and COVID-19 diagnosis (OR 0.79, 95% CI 0.46–1.38), after adjustment, healthcare workers employed by facilities located in micropolitan areas had lower adjusted odds of COVID-19 diagnosis (aOR 0.42, 95% CI 0.24–0.71). There was no association between number of beds or teaching status and COVID-19 diagnosis either before or after adjustment (Table  6 ).

Associations between healthcare facility characteristics and burnout and depressive symptoms

Before adjustment, no healthcare facility characteristic was associated with burnout. However, after adjustment, for-profit ownership of the employing healthcare facility was associated with decreased odds of burnout (aOR 0.53, 95% CI 0.29–0.98) (Table  6 ). Before adjustment, participants employed by healthcare facilities in micropolitan areas had decreased odds of experiencing depressive symptoms (OR 0.80, 95% CI 0.66–0.98); however, after adjustment this association was no longer observed (aOR 0.67, 95% CI 0.43–1.04).

In this large, nationwide, longitudinal patient-reported outcomes study of nearly 9,000 healthcare workers, we found that working in a for-profit healthcare facility was associated with 76% greater odds of COVID-19 infection but 43% decreased odds of reporting burnout after controlling for demographics, role in the workplace, type of healthcare facility, and comorbid condition burden. We also found that working at a healthcare facility in a micropolitan area vs metropolitan area was associated with 68% decreased odds of COVID-19 infection.

Our study provides important information for public health systems. During infectious disease epidemics, health system resilience (defined as the ability of health systems to resist and adapt to external threats) is of paramount importance, and one critical dimension of health system resilience is having sufficient staffing to effectively run critical health services [ 17 , 18 ]. Healthcare facilities vary substantially in their operational models, particularly in the United States, where the complex patchwork of reimbursement structures and concordant incentives for healthcare facilities results in sometimes dramatic differences in operational approaches [ 19 , 20 , 21 ]. Understanding how these different operational models intersect with experiences of healthcare workers is of paramount importance to developing effective public health approaches to pandemic preparedness [ 22 , 23 , 24 ].

Our study also has important implications for health system performance beyond infectious disease outbreaks. The literature exploring outcomes, especially health and psychosocial outcomes, of healthcare workers and how these outcomes vary according to the operational models of the facility by which they are employed is unfortunately sparse [ 25 , 26 , 27 , 28 ]. Future research is critically needed to understand how healthcare workers’ experiences may be affected by operational strategies used by their employing healthcare facilities. Given the incredibly high rates of burnout among patient facing staff in United States healthcare facilities and workforce shortages that are expected to continue to worsen in coming years, identifying whether particular operational models or workplace structures are particularly associated with adverse psychosocial outcomes for healthcare workers may allow policymakers and hospital administrators to identify the most effective targets for areas of intervention to improve retention and limit burnout among clinical staff [ 29 , 30 ].

There are a broad range of possible explanations for the associations observed in this study. With regard to for-profit versus non-profit status, it is possible that for-profit healthcare facilities were less likely to support healthcare worker adherence to COVID-19 prevention strategies, perhaps related to decreased staffing levels, which prior studies have shown are more common in for-profit medical facilities [ 31 , 32 ]. Furthermore, prior studies have shown that for-profit facilities in the United States experienced greater levels of financial instability than non-profit facilities, which could have resulted in increased strain on facility and staff resources leading to greater COVID-19 infection rates [ 33 , 34 ].

The decreased rate of burnout seen in for-profit facilities is not consistent with prior studies before the COVID-19 pandemic. For example, a study in Sweden showed that burnout levels were the highest at a private, for-profit hospitals compared to a publicly administered hospital [ 35 ]. Furthermore, prior studies in the United States have shown that for-profit nursing homes tended to have worse results with regard to employee wellbeing [ 36 ]. However, these studies were conducted before the COVID-19 pandemic, so it is unclear the impact the pandemic may have had on burnout outcomes. It is also possible that our results are a result of unmeasured selection bias, given that the HERO study advertised participation most prominently in not-for-profit academic medical centers, meaning that participants from for-profit facilities may have been those with the most emotional reserve to participate in survey efforts beyond their work and therefore may have been less likely to report burnout.

Regarding the lower rate of COVID-19 diagnoses observed in healthcare workers employed by facilities located in micropolitan vs. metropolitan environments, it is possible that the underlying spread of COVID-19 during the study period may have been most prominent in metropolitan areas. Prior studies showed that in the first 5 months of the COVID-19 pandemic (during which the HERO study enrolled most participants), the incidence rates of COVID-19 cases were higher in metropolitan areas; incidence rates in non-metropolitan areas overtook incidence rates in metropolitan areas in approximately August 2020 [ 37 ]. Another study demonstrates that a much smaller number of micropolitan counties were classified as COVID-19 hotspots than metropolitan counties, providing further support to this interpretation [ 38 ].

Our study has limitations. One key limitation of our study is its reliance on self-reported data with risk for selection bias. Furthermore, our study only included sites where at least 10 healthcare workers responded to the survey, which systematically excluded the smallest sites, which plausibly could be systematically different than larger sites and could introduce a risk of bias. Furthermore, the HERO registry was coordinated through several large academic medical centers and therefore likely over-represents participants from academic medical centers. Our study also relies on American Hospital Association data to perform linkage, which, while effective at identifying hospitals and health systems, may not be as effective at identifying clinics, especially those that are independent of larger health systems. However, while these limitations may limit the generalizability of our study, our results are nonetheless meaningful for policymakers studying the healthcare facilities where most healthcare workers are employed. Another limitation of our study is our inability to control for local rates of COVID-19 cases at each presenting hospital, which could conceivably be a surrogate for the stress on local health systems. County-level data is insufficient for such a purpose, as the case rates at each presenting healthcare facility may not be closely related to the number of cases in the county the facility is located in. Estimating and evaluating variation in COVID-19 caseload at the level of individual healthcare facilities could be an important direction for future research. Furthermore, there are a variety of causal pathways that could connect our endpoints with each other (e.g. lack of access to PPE leading to COVID-19 infection leading to burnout leading to depression, or burnout leading to COVID-19 infection [through decreased use of appropriate PPE, if available]). Future studies should explicitly evaluate these questions using appropriate causal inference strategies.

Strengths of our study include its particularly large size (the HERO registry is the largest of its kind in the United States), reliance on participant reported outcomes that are directly relevant to healthcare workers, and our ability to adjust for key characteristics of healthcare workers such as their role in the healthcare workplace, age, and self-reported medical comorbidities.

In summary, our work provides important preliminary data assessing the impact of healthcare facility structure and operational characteristics on healthcare worker outcomes during infectious disease pandemics. Future studies to carefully track the outcomes of healthcare workers and the association between these outcomes and operational characteristics of the facilities that employ them are urgently needed to inform health policy. Future analyses of the mechanisms of the association between healthcare facility characteristics and outcomes are needed to inform strategies to promote resilience against future pandemics and to promote stability and limit burnout in the healthcare workforce. Policymakers should be aware of the potential association between health system structure and healthcare facility characteristics and healthcare worker outcomes during an infectious disease pandemic.

Availability of data and materials

The data that support the findings of this study are available from the HERO registry, but restrictions apply to the availability of these data and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the HERO Registry oversight committee. Please contact [email protected] to request access to the data.

Abbreviations

Personal protective equipment

Healthcare worker exposure, response, and outcomes

Healthcare worker

Patient-centered outcomes research institute

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Acknowledgements

The authors acknowledge the participants in the HERO registry and the staff and clinical advisors who have supported the HERO research program.

This study was funded by the Patient Centered Outcomes Research Institute (PCORI). The study sponsor had no role in study design, collection, analysis, or interpretation of data, writing the manuscript, or the decision to submit the work for publication.

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Jay B. Lusk

Department of Population Health Sciences, Duke University, Durham, NC, USA

Jay B. Lusk & Emily C. O’Brien

Duke University Clinical Research Institute, Durham, NC, USA

Pratik Manandhar, Laine E. Thomas & Emily C. O’Brien

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Jay B. Lusk: Conceptualization, investigation, methodology, writing-original draft; Pratik Manandhar: methodology, formal analysis, data curation, writing-review and editing; Laine E. Thomas: methodology, formal analysis, data curation, writing- review and editing; Emily C. O’Brien: conceptualization, data curation, investigation, funding acquisition, supervision, writing-review and editing.

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Correspondence to Jay B. Lusk .

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Ethics approval and consent to participate.

The registry and this analysis (ClinicalTrials.gov Identifier NCT04342806) was funded by the Patient-Centered Outcomes Research Institute (PCORI) and was reviewed by the Duke University Institutional Review Board and approved by the WIRB-Copernicus Group Institutional Review Board (WCG IRB, Pro00105284). Approval by a central institutional review board is the accepted ethical standard for large, multi-site prospective studies such as this one. Written informed consent was obtained from all participants. This study was performed in accordance with relevant guidelines and regulations such as the Declaration of Helsinki.

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Supplementary material 1., dependent and independent variables used in the present study, study tables including frequencies of missing data, stratified by exposures of interest, rights and permissions.

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Lusk, J.B., Manandhar, P., Thomas, L.E. et al. Association between characteristics of employing healthcare facilities and healthcare worker infection rates and psychosocial experiences during the COVID-19 pandemic. BMC Health Serv Res 24 , 659 (2024). https://doi.org/10.1186/s12913-024-11109-6

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Received : 03 December 2023

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Published : 24 May 2024

DOI : https://doi.org/10.1186/s12913-024-11109-6

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Mosaic Brain Aneuploidy in Mental Illnesses: An Association of Low-level Post-zygotic Aneuploidy with Schizophrenia and Comorbid Psychiatric Disorders

Affiliations.

• 1 Mental Health Research Center, Moscow, Russian Federation.
• 2 Separated Structural Unit "Clinical Research Institute of Pediatrics named after Y.E Veltishev", Pirogov Russian National Research Medical University, Moscow, Russian Federation.
• 3 Moscow State University of Psychology and Education, Moscow, Russian Federation.
• 4 Department of Medical Genetics, Russian Medical Academy of Postgraduate Education, Ministry of Health, Moscow, Russian Federation.
• PMID: 29606903
• PMCID: PMC5850504
• DOI: 10.2174/1389202918666170717154340

Background: Postzygotic chromosomal variation in neuronal cells is hypothesized to make a substantial contribution to the etiology and pathogenesis of neuropsychiatric disorders. However, the role of somatic genome instability and mosaic genome variations in common mental illnesses is a matter of conjecture.

Materials and methods: To estimate the pathogenic burden of somatic chromosomal mutations, we determined the frequency of mosaic aneuploidy in autopsy brain tissues of subjects with schizophrenia and other psychiatric disorders (intellectual disability comorbid with autism spectrum disorders). Recently, post-mortem brain tissues of subjects with schizophrenia, intellectual disability and unaffected controls were analyzed by Interphase Multicolor FISH (MFISH), Quantitative Fluorescent in situ Hybridization (QFISH) specially designed to register rare mosaic chromosomal mutations such as lowlevel aneuploidy (whole chromosome mosaic deletion/duplication). The low-level mosaic aneuploidy in the diseased brain demonstrated significant 2-3-fold frequency increase in schizophrenia (p=0.0028) and 4-fold increase in intellectual disability comorbid with autism (p=0.0037) compared to unaffected controls. Strong associations of low-level autosomal/sex chromosome aneuploidy (p=0.001, OR=19.0) and sex chromosome-specific mosaic aneuploidy (p=0.006, OR=9.6) with schizophrenia were revealed.

Conclusion: Reviewing these data and literature supports the hypothesis suggesting that an association of low-level mosaic aneuploidy with common and, probably, overlapping psychiatric disorders does exist. Accordingly, we propose a pathway for common neuropsychiatric disorders involving increased burden of rare de novo somatic chromosomal mutations manifesting as low-level mosaic aneuploidy mediating local and general brain dysfunction.

Keywords: Aging; Aneuploidy; Chromosomal instability; Genome instability; Human brain; Ontogeny; Psychiatric disorders; Somatic genome variations.

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Flouride Exposure Impacts Babies’ Brains, USC Study Finds

F luoride exposure during pregnancy has been linked to an increased risk of childhood behavioral problems, according to research published Monday by the Keck School of Medicine of USC.

Researchers at the university conducted the first U.S.-based study examining the link between prenatal fluoride and childhood social, emotional and behavioral functioning.

Nearly three-quarters of Americans consume drinking water that contains fluoride, a practice that began in 1945 to help prevent tooth decay, according to researchers.

The findings appear in JAMA Network Open, a medical journal published by the American Medical Association.

The study analyzed more than 220 mother-child pairs, collecting data on fluoride levels during pregnancy and child behavior at age 3. The researchers found that a 0.68 milligram per liter increase in fluoride exposure was associated with nearly double the chance of a child showing neurobehavioral problems in a range considered close to or at a level to meet the criteria for clinical diagnosis.

“Women with higher fluoride exposure levels in their bodies during pregnancy tended to rate their 3-year-old children higher on overall neurobehavioral problems and internalizing symptoms, including emotional reactivity, anxiety and somatic complaints,” said Tracy Bastain, an associate professor of clinical population and public health sciences at the Keck School of Medicine.

The findings add to existing evidence from animal studies showing that fluoride can harm neurodevelopment, as well as data from studies conducted in Canada, Mexico and other countries showing that prenatal exposure to fluoride is linked with a lower IQ in early childhood, according to the study.

The researchers said they hope the new findings help convey the risks of fluoride consumption during pregnancy to policymakers, health care providers and the public.

“Our findings are noteworthy, given that the women in this study were exposed to pretty low levels of fluoride — levels that are typical of those living in fluoridated regions within North America,” said Ashley Malin, an assistant professor of epidemiology at the University of Florida’s College of Public Health and Health Professions and College of Medicine.

Malin conducted the research in part as a postdoctoral scholar at the Keck School of Medicine.

Tracking emotions and behavior data for the study came from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities at the Keck School of Medicine. MADRES follows predominantly Hispanic families in Los Angeles from pregnancy throughout childhood.

“The overall goal of MADRES is reducing the effects of environmental contaminants on the health and well-being of marginalized communities,” said Bastain, who co-directs MADRES.

Currently, no official recommendations exist for limiting fluoride consumption during pregnancy. However, the researchers hope the findings can help stimulate change.

“There are no known benefits to the fetus from ingesting fluoride,” Malin said. “And yet now we have several studies conducted in North America suggesting that there may be a pretty significant risk to the developing brain during that time.”