Search

We report the results of a national survey conducted to help public health officials understand the public's response to community mitigation interventions for a severe outbreak of pandemic influenza. Survey results suggest that if community mitigation measures are instituted, most respondents would comply with recommendations but would be challenged to do so if their income or job were severely compromised. The results also indicate that community mitigation measures could cause problems for persons with lower incomes and for racial and ethnic minorities. Twenty-four percent of respondents said that they would not have anyone available to take care of them if they became sick with pandemic influenza. Given these results, planning and public engagement will be needed to encourage the public to be prepared.

This 2007 Harvard School of Public Health/Robert Wood Johnson Foundation survey of 4,334 randomly selected U.S. adults compared perceptions of the quality of physician care among fourteen racial and ethnic groups with those of whites. On each measure examined, at least five and as many as eleven subgroups perceived their care to be significantly worse than care for whites. In many instances, subgroups were at least fifteen percentage points more negative than whites. This was true for Central/South Americans, Chinese Americans, and Korean Americans on five of seven measures. Many of the differences remained after socioeconomic characteristics and language skills were controlled for.

This 2006 survey of 4,157 randomly selected U.S. adults compared perceptions of health care disparities among fourteen racial and ethnic groups to those of whites. Findings suggest that many ethnic minority groups view their health care situations differently and, often, more negatively than whites. A substantial proportion perceived discrimination in receiving health care, and many felt that they would not receive the best care if they were sick. Most differences remained when socioeconomic characteristics were controlled for. The variety of responses across racial groups demonstrates the importance of examining ethnic subgroups separately rather than combined into a single category.

An important question for physicians in the aftermath of the Terri Schiavo case is whether the effort of elected officials to intervene was a one-time anomaly or signals a future trend of elected officials being involved in cases where patients are in a vegetative or long-term comatose state. To try to answer this question, we used results from 12 national opinion surveys conducted in March and April 2005, when the Schiavo case was being debated. A review of these survey results showed that efforts by elected politicians to intervene in the Schiavo case were opposed by the majority of Americans. However, the public was more divided on the question of whether Schiavo's feeding tube should be removed. Opposition to removing Schiavo's feeding tube was associated with opposition to abortion. The results suggest that issues involved in cases like Schiavo's are not likely to disappear from the political agenda.

Background: The potential for a bioterrorist attack involving smallpox has led to a debate about what national precautions should be taken. What is unclear is the public's knowledge of smallpox and views about precautions., Methods: We conducted a national survey of 1006 adults selected by means of random-digit dialing. Respondents were asked about their knowledge of and beliefs about the smallpox virus and the vaccine, their possible reactions to a bioterrorist attack involving smallpox, and a number of proposed state emergency powers., Results: The majority of the respondents have a number of beliefs about smallpox and smallpox vaccination that are false. The majority believe that there is an effective treatment for smallpox, that there have been cases of smallpox in the past five years, and that there is not enough smallpox vaccine to vaccinate everyone in the United States. Thirty percent believe that vaccination earlier in their lives would protect them from the disease. The majority of respondents said they wanted to be vaccinated; however, only 21 percent would want to be vaccinated if physicians declined vaccination. There was strong support among the respondents for several proposed state emergency powers., Conclusions: Our results suggest the need for public education about smallpox. These data also point to the importance of a discussion in the medical community about the advisability of vaccination of individual physicians at this time., (Copyright 2003 Massachusetts Medical Society)

Background: In response to the report by the Institute of Medicine on medical errors, national groups have recommended actions to reduce the occurrence of preventable medical errors. What is not known is the level of support for these proposed changes among practicing physicians and the public., Methods: We conducted parallel national surveys of 831 practicing physicians, who responded to mailed questionnaires, and 1207 members of the public, who were interviewed by telephone after selection with the use of random-digit dialing. Respondents were asked about the causes of and solutions to the problem of preventable medical errors and, on the basis of a clinical vignette, were asked what the consequences of an error should be., Results: Many physicians (35 percent) and members of the public (42 percent) reported errors in their own or a family member's care, but neither group viewed medical errors as one of the most important problems in health care today. A majority of both groups believed that the number of in-hospital deaths due to preventable errors is lower than that reported by the Institute of Medicine. Physicians and the public disagreed on many of the underlying causes of errors and on effective strategies for reducing errors. Neither group believed that moving patients to high-volume centers would be a very effective strategy. The public and many physicians supported the use of sanctions against individual health professionals perceived as responsible for serious errors., Conclusions: Though substantial proportions of the public and practicing physicians report that they have had personal experience with medical errors, neither group has the sense of urgency expressed by many national organizations. To advance their agenda, national groups need to convince physicians, in particular, that the current proposals for reducing errors will be very effective., (Copyright 2002 Massachusetts Medical Society)

Context: Incidents involving anthrax (Bacillus anthracis) through the mail in 4 metropolitan areas have raised concerns about the public's response nationally and locally., Objective: To examine public response to these incidents and what it reveals about the demand placed on health professionals and public health officials nationally, in affected areas, and by affected people., Design: Random-digit-dialed telephone surveys of samples of households nationally and in 3 specific metropolitan areas where cases of anthrax were reported: the District of Columbia; Trenton/Princeton, New Jersey; and Boca Raton, Florida., Outcome Measure: Respondents were asked a series of questions measuring their level of concern and their behavior in response to threats of anthrax and potential bioterrorist acts., Results: The lives of a large share of people were affected in 3 metropolitan areas where anthrax incidents occurred. Residents of those 3 areas and people there who were affected by the incidents expressed a higher level of concern and took more precautions handling their mail. However, these incidents did not lead to great demands on the health system., Conclusions: The incidents of anthrax created anxieties, especially in areas where incidents occurred. There was some increased demand on the health system, but the demands were not large-scale. In the event of a major outbreak of disease, most Americans will rely heavily on their own physician for advice. Both national and local systems of population-based information gathering about the public's response to bioterrorist attacks are needed.