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Objective: To evaluate the association of short-term exposure to overall fine particulate matter of <2.5 μm (PM 2.5 ) and wildfire-specific PM 2.5 with emergency department (ED) visits for headache., Background: Studies have reported associations between PM 2.5 exposure and headache risk. As climate change drives longer and more intense wildfire seasons, wildfire PM 2.5 may contribute to more frequent headaches., Methods: Our study included adult Californian members (aged ≥18 years) of a large de-identified commercial and Medicare Advantage claims database from 2006 to 2020. We identified ED visits for primary headache disorders (subtypes: tension-type headache, migraine headache, cluster headache, and "other" primary headache). Claims included member age, sex, and residential zip code. We linked daily overall and wildfire-specific PM 2.5 to residential zip code and conducted a time-stratified case-crossover analysis considering 7-day average PM 2.5 concentrations, first for primary headache disorders combined, and then by headache subtype., Results: Among 9898 unique individuals we identified 13,623 ED encounters for primary headache disorders. Migraine was the most frequently diagnosed headache (N = 5534/13,623 [47.6%]) followed by "other" primary headache (N = 6489/13,623 [40.6%]). For all primary headache ED diagnoses, we observed an association of 7-day average wildfire PM 2.5 (odds ratio [OR] 1.17, 95% confidence interval [CI] 0.95-1.44 per 10 μg/m 3 increase) and by subtype we observed increased odds of ED visits associated with 7-day average wildfire PM 2.5 for tension-type headache (OR 1.42, 95% CI 0.91-2.22), "other" primary headache (OR 1.40, 95% CI 0.96-2.05), and cluster headache (OR 1.29, 95% CI 0.71-2.35), although these findings were not statistically significant under traditional null hypothesis testing. Overall PM 2.5 was associated with tension-type headache (OR 1.29, 95% CI 1.03-1.62), but not migraine, cluster, or "other" primary headaches., Conclusions: Although imprecise, these results suggest short-term wildfire PM 2.5 exposure may be associated with ED visits for headache. Patients, healthcare providers, and systems may need to respond to increased headache-related healthcare needs in the wake of wildfires and on poor air quality days., (© 2023 American Headache Society.)

Objective: To describe the planning, development, pilot testing, fielding, and outcomes of a community health survey in a rural California county pursuing public health accreditation., Design: Community partners helped the local health department develop the community health survey. Extensive English- and Spanish-language pilot testing was conducted over a period of four months. Final survey fielding was conducted online and at 20 community sites., Results: 2189 completed surveys were collected. Total costs for developing and fielding the survey were approximately $25,000. Survey results indicated that alcoholism/drug abuse, breathing problems, and obesity were the primary health concerns of county residents. Benefits of conducting the community survey included strengthening inter-organizational partnerships between community partners, engaging a large and diverse respondent sample, and gathering information on a nuanced set of health indicators. Challenges included an unexpectedly high number of respondents and managing the needs of respondents with disabilities or poor literacy., Conclusion: The information gathered from the community health survey was used in the implementation of a county-wide multi-agency strategic plan to address health priorities identified in the CHA. Engaging a broad set of community partners throughout the survey process was critical for ensuring the project's relevance and long-term regional impact., (Copyright © 2017. Published by Elsevier Ltd.)

Background: Asians are often pooled together when evaluating disparities in health care indicators (access, utilization, and management), though substantial variation may exist across different Asian ethnicities., Objective: The aim of this study was to compare health care indicators among Chinese, Korean, Vietnamese, and non-Hispanic white (NHW) adults with cardiovascular disease and hypertension (CVD/HTN)., Methods: We analyzed health care indicators using multivariable logistic regression in a sample of Asians and NHWs with CVD/HTN from the 2011-2012 California Health Interview Survey (CHIS)., Results: Koreans had the lowest utilization of emergency room (ER) or inpatient hospital services; Vietnamese had the lowest access to a personal doctor; Chinese had the lowest adjusted odds of having seen a doctor in the prior 12 months; and all Asians received fewer written heart disease care plans compared to NHWs. Even when utilization of ER for heart disease appeared to be similar, lack of access to a doctor was a more common reason noted by Asians versus NHWs. However, a lower proportion of Asians reported delays in receiving prescription or care. Accounting for differences across groups did not diminish these disparities., Conclusion: Health care indicators varied by race and across Asian ethnicities even after controlling for sociodemographic factors, insurance coverage, and health status. Future studies should consider oversampling other Asian ethnicities and assessing more in depth the potential impact of ethnicity-related factors on disparities in health care indicators.