Jonathan E Fielding

Jonathan E Fielding
University of California, Los Angeles | UCLA · Executive Office

About

133
Publications
47,826
Reads
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8,139
Citations
Citations since 2016
19 Research Items
3971 Citations
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20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600

Publications

Publications (133)
Article
Landmark reports from reputable sources have concluded that the United States wastes hundreds of billions of dollars every year on medical care that does not improve health outcomes. While there is widespread agreement over how wasteful medical care spending is defined, there is no consensus on its magnitude or categories. A shared understanding of...
Article
Full-text available
Objectives. To quantify changes in US health care spending required to reach parity with high-resource nations by 2030 or 2040 and identify historical precedents for these changes. Methods. We analyzed multiple sources of historical and projected spending from 1970 through 2040. Parity was defined as the Organisation for Economic Co-operation and D...
Article
Full-text available
Context: Poor physical and mental health and substance use disorder can be causes and consequences of homelessness. Approximately 2.1 million persons per year in the United States experience homelessness. People experiencing homelessness have high rates of emergency department use, hospitalization, substance use treatment, social services use, arr...
Article
Objective: To improve the understanding of local health departments' (LHDs') capacity for and perceived barriers to using quantitative/economic modeling information to inform policy and program decisions. Design: We developed, tested, and deployed a novel survey to examine this topic. Setting: The study's sample frame included the 200 largest...
Technical Report
The Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (“the Committee”) has been charged by the Secretary of HHS to make recommendations for developing health objectives for the nation to be achieved by the year 2030. This work was started in late 2016 and has produced several reports that have g...
Article
Full-text available
Students may lose knowledge and skills achieved in the school year during the summer break, with losses greatest for students from low-income families. Community Guide systematic review methods were used to summarize evaluations (published 1965-2015) of the effectiveness of year-round school calendars (YRSCs) on academic achievement, a determinant...
Article
Expanded in-school instructional time (EISIT) may reduce racial/ethnic educational achievement gaps, leading to improved employment, and decreased social and health risks. When targeted to low-income and racial/ethnic minority populations, EISIT may thus promote health equity. Community Guide systematic review methods were used to search for qualif...
Article
Objectives: We explored the definition of health equity being used by public health departments and the extent of engagement of public health departments in activities to improve health equity, as well as facilitators and barriers to this work. Design: We conducted 25 semistructured qualitative interviews with lead public health officials (n = 2...
Article
Full-text available
Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based int...
Article
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Two contrasting reviews (authored by Abrams et al. and Glanz & Bareham) in this volume have reached opposing conclusions on the effects of electronic cigarettes in a debate that is dividing the scientific and professional communities that have devoted careers to controlling the manufacture, advertising, sale, and use of combustible cigarettes. The...
Article
Context: Excessive drinking is responsible for one in ten deaths among working-age adults in the U.S. annually. Alcohol screening and brief intervention is an effective but underutilized intervention for reducing excessive drinking among adults. Electronic screening and brief intervention (e-SBI) uses electronic devices to deliver key elements of...
Article
Full-text available
Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision a...
Article
Context: Children in low-income and racial and ethnic minority families often experience delays in development by 3 years of age and may benefit from center-based early childhood education. Design: A meta-analysis on the effects of early childhood education by Kay and Pennucci best met Community Guide criteria and forms the basis of this review....
Article
Context: Few studies have described the range and health impacts of obesity prevention strategies in local communities supported by the Communities Putting Prevention to Work program. Objective: To address this gap, we reviewed implemented strategies in Los Angeles County (LAC) for 3 program focus areas: physical activity-promotion, health marke...
Article
Tobacco use is a leading cause of preventable death in the U.S. and around the world. Increasing tobacco price through higher taxes is an effective intervention both to reduce tobacco use in the population and generate government revenues. The goal of this paper is to review evidence on the economic impact of tobacco price increases through taxatio...
Article
Full-text available
Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority famili...
Article
OBJECTIVES We examined whether the interactions between primarily speaking English at home and community-level measures (median household income and immigrant composition) are associated with physical inactivity and obesity. METHODS We pooled the 2005 and 2007 Los Angeles County Health Survey data to construct a multilevel data set, with community-...
Article
Full-text available
In spite of increased focus by public health to engage and work with non-health sector partners to improve the health of the general as well as special populations, only a paucity of studies have described and disseminated emerging lessons and promising practices that can be used to undertake this work. This article describes the process used to co...
Article
Reducing the portion size of food and beverages served at restaurants has emerged as a strategy for addressing the obesity epidemic; however, barriers and facilitators to achieving this goal are not well characterized. In fall 2012, the Los Angeles County Department of Public Health conducted semistructured interviews with restaurant owners to bett...
Article
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During October 23-December 8, 2009, the Los Angeles County Department of Public Health used points of dispensing (PODs) to improve access to and increase the number of vaccinations against influenza A(H1N1)pdm09. We assessed the efficiency of these units and access to vaccines among ethnic groups. An average of 251 persons per hour (SE 65) were vac...
Article
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This study assessed changes in consumption of sugar-sweetened beverages (SSBs) among children (aged ≤17 years) in Los Angeles County. We analyzed children's data from the 2007 (n = 5,595) and 2011 (n = 5,934) Los Angeles County Health Survey. The percentage of children who consumed 1 or more SSB per day decreased from 43.3% in 2007 to 38.3% in 2011...
Article
Full-text available
An emerging approach to public health emergency pre-paredness and response, community resilience encom-passes individual prepared-ness as well as establishing a supportive social context in communities to withstand and recover from disasters. We ex-amine why building commu-nity resilience has become a key component of national policy across multipl...
Article
Since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States’ approach to improving population health. In each decade, a new version of Healthy People is issued, featuring updated goals and identifying topic areas and quantifiable objectives for health improvement during the succeeding ten years, wit...
Article
We use the UCLA Health Forecasting Tool to forecast the 2011-2050 health trends in Milwaukee County. We first simulate a baseline scenario (S-1) that assumes no health behavior change, and compare this with three simulated intervention scenarios: expansion of Quitline reach to enhance smoking cessation (S-2), an increased penetration of diabetes sc...
Article
Journals are full of studies of interventions with results that are statistically “significant” but lack guidance on the real importance of the work (1). We suggest that articles concerning clinical or population-health interventions should be accompanied by structured information about the potential health impact. This information should incorpora...
Article
Despite the many accomplishments of public health, greater attention on evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about 15 years ago. Key components of EBPH include: making decisions based on the best available scientific evidence, using dat...
Article
s of 2010, health care-related expenditures in the U.S. totaled some $2.6 trillion (17.9% of the gross domestic product (GDP)). Year after year, healthcare spending rises at double the rate of overall GDP growth, and total healthcare spending growth con- sistently outpaces overall inflation. This exuberant growth would be welcome if health care wer...
Article
The success of public health has been its ability to understand contemporary health problems, to communicate the needs successfully, to identify solutions, and to implement them through programs and policies. In the past 50 years, those successes can be attributed largely to control of infectious disease, improved maternal and child health, deliver...
Article
Full-text available
Despite years of declining smoking prevalence, tobacco use is still the leading preventable contributor to illness and death in the United States, and the effect of past tobacco-use control efforts has not fully translated into improvements in health outcomes. The objective of this study was to use a life course model with multiple competing causes...
Article
Full-text available
Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms. The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and...
Article
The Los Angeles County Tobacco Control and Prevention Program was significantly restructured in 2004 to improve capacity for local policy adoption. Restructuring included creating a fully staffed and trained policy unit; partnering with state-funded tobacco control organizations to provide high-quality, continuous technical assistance and training;...
Article
For the past three decades, the Healthy People initiative has represented an ambitious yet achievable health promotion and disease prevention agenda for the nation. The recently released fourth version-Healthy People 2020-builds on the foundations of prior iterations while newly embracing and elevating a comprehensive "social determinants" perspect...
Article
Full-text available
Racial/ethnic minority groups have higher risks for disease resulting from obesity. The University of California, Los Angeles, and the Los Angeles County Department of Public Health partnered with community organizations to disseminate culturally targeted physical activity and nutrition-based interventions in worksites. We conducted community dialo...
Article
Full-text available
Dram shop liability holds the owner or server(s) at a bar, restaurant, or other location where a patron, adult or underage, consumed his or her last alcoholic beverage responsible for harms subsequently inflicted by the patron on others. Liability in a state can be established by case law or statute. Overservice laws prohibit the sale of alcoholic...
Article
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Los Angeles County has the largest population of any county in the nation. Population-based estimates of health conditions for Los Angeles County are based primarily on telephone surveys, which are known to underestimate conditions of public health importance. This report presents the prevalence of selected health conditions for civilian noninstitu...
Article
Though what we eat is usually considered a lifestyle choice, research suggests that both the types and amount of food (and beverages) we consume are influenced to a surprisingly large degree by environmental cues and that our food choices are made without much forethought.1 At the community level, the food environment also likely exerts a strong in...
Article
Full-text available
Setting a goal for controlling type 2 diabetes is important for planning health interventions. The purpose of this study was to explore what may be a feasible goal for type 2 diabetes prevention in California. We used the UCLA Health Forecasting Tool, a microsimulation model that simulates individual life courses in the population, to forecast the...
Article
Full-text available
We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions'...
Article
Despite the accomplishments and purported value of the US health system, the United States still lags behind other developed countries in the health outcomes it produces.1 Clinical care consumes 95% of the health dollar but accounts for only about 20% of the determinants of health.2 The other 80% is determined by behaviors and the health of communi...
Article
Medical care reform is a critical piece in achieving a healthy society but needs to be complemented by changes in community programs and policies. While the body of evidence-based clinical and population interventions is increasing, the challenge is to identify and implement those interventions that provide the greatest health benefits and value. A...
Article
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Eliminating health disparities is a Healthy People goal. Given the diverse and sometimes broad definitions of health disparities commonly used, a subcommittee convened by the Secretary's Advisory Committee for Healthy People 2020 proposed an operational definition for use in developing objectives and targets, determining resource allocation priorit...
Article
Comparative effectiveness research to date has focused primarily on the diagnosis and treatment of diseases and injuries in individuals. Yet the greatest drivers of people's overall health are found in their social and physical environments. We recommend that the comparative effectiveness research agenda focus on the public health issues responsibl...
Article
Pandemic preparedness and response (as with all public health actions) occur within a social, cultural, and historical context of preexisting health disparities and, in some populations, underlying mistrust in government. Almost 200,000 people received H1N1 vaccine at 109 free, public mass vaccination clinics operated by the Los Angeles County Depa...
Article
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Human papillomavirus (HPV) vaccines have been shown to be safe and highly effective in young and middle-aged women. This study aimed to assess vaccine awareness and desire for vaccination among adult women aged 18-55 years residing in Los Angeles County CA. This study is nested in the 2007 Los Angeles County Health Survey. Included in the analyses...
Article
Full-text available
Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol...
Article
Full-text available
Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies incl...
Conference Paper
Public health departments can play an important role in improving use of these screening services among those at highest risk for premature mortality. Effective population-based and health care system based services exist which promote screening and understanding of screening ( e.g., reminders, recalls, and education). Yet even with these services...
Conference Paper
Although near-universal health coverage will improve health, coverage does not always equate to high-quality medical care. PPACA enables public health departments to address the social and environmental factors that underlie poor health outcomes. Public health departments must ensure safety net services for the uninsured in a funding milieu that su...
Article
The ability of a local health department to assess and improve employee performance through an effective evaluation process is critical to overall organizational success. A constructive performance evaluation process not only provides meaningful feedback on work performance but also provides opportunities to reinforce work behaviors that support th...
Article
Full-text available
As in other countries, public heath in the United States continues to evolve to ensure healthy families and communities as well as individuals. Great achievements in the control of infectious and chronic disease and injuries will need to be sustained while we face new challenges, including providing universal access to high quality healthcare as we...
Article
A systematic review of the literature to assess the effectiveness of alcohol tax policy interventions for reducing excessive alcohol consumption and related harms was conducted for the Guide to Community Preventive Services (Community Guide). Seventy-two papers or technical reports, which were published prior to July 2005, met specified quality cri...
Article
Quality improvement in public health is a key element in the movement toward accreditation. Multiple national, state, and local initiatives are under way to define quality in a public health context and to develop tools and promising practices to support quality-improvement efforts in local health departments. Until recently, efforts to improve qua...
Article
Full-text available
The density of alcohol outlets in communities may be regulated to reduce excessive alcohol consumption and related harms. Studies directly assessing the control of outlet density as a means of controlling excessive alcohol consumption and related harms do not exist, but assessments of related phenomena are indicative. To assess the effects of outle...
Conference Paper
Public Health agencies play a critical role in promoting and protecting the health of all Americans. The public health workforce must acquire and retain broad competencies to respond to current and emerging health threats. Los Angeles (LA) County, with a population of over 10 million residents spanning across 4000 square miles and 88 cities, is fac...
Conference Paper
Public health faces the challenge of unlimited opportunities to improve the public's health in an environment that is unavoidably short of resources. This reality requires local health departments to review, analyze, and prioritize among these opportunities. A deliberate, well-conceived method of prioritization would assure the best use of scarce r...
Article
Full-text available
A comprehensive population health-forecasting model has the potential to interject new and valuable information about the future health status of the population based on current conditions, socioeconomic and demographic trends, and potential changes in policies and programs. Our Health Forecasting Model uses a continuous-time microsimulation framew...
Article
Since 1980, Healthy People, a comprehensive set of ten-year national public health objectives, has been used by the public health and healthcare communities to guide health planning and motivate action. The USDHHS began developing Healthy People 2020 in 2007. In 2008, USDHHS convened an external advisory committee composed of 13 experts in the fiel...
Article
Health care and public health professionals in the United States can look at their achievements over the last century with pride. Increasing the life span of Americans by almost one-third of a year each year over an entire century is an enormous and unprecedented accomplishment. The virtual elimination of many childhood illnesses, control of cardio...
Article
We conducted a health impact assessment to quantify the potential impact of a state menu-labeling law on population weight gain in Los Angeles County, California. We utilized published and unpublished data to model consumer response to point-of-purchase calorie postings at large chain restaurants in Los Angeles County. We conducted sensitivity anal...
Article
Full-text available
Despite the many accomplishments of public health, a greater attention to evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about a decade ago. Key components of EBPH include making decisions on the basis of the best available scientific evidence, u...
Conference Paper
During the past 7 years, local health departments have assumed stronger roles in emergency preparedness. Substantial increases in directed funding have been coupled with greater responsibilities and accountabilities to funding agencies and elected official at all levels of government. In Los Angeles, we see positive effects on public health infrast...
Article
Objectives: To investigate the proximity of fast food restaurants to public schools and examine proximity by neighborhood income and school level (elementary, middle, or high school). Methods: Geocoded school and restaurant databases from 2005 and 2003, respectively, were used to determine the percentage of schools with one or more fast food res...
Article
Multiple and diverse preventive strategies in clinical and community settings are necessary to improve health. This paper (1) introduces evidence-based recommendations from the U.S. Preventive Services Task Force sponsored by the Agency for Healthcare Research and Quality and the Community Task Force sponsored by the Centers for Disease Control and...
Article
The essential role of physical activity both as an independent protective factor against numerous common chronic diseases and as a means to maintain a healthy weight is gaining increasing scientific recognition. Although the science of physical activity promotion is advancing rapidly, the practice of promoting physical activity at a population leve...
Article
Health impact assessment (HIA)--a combination of methods to examine formally the potential health effects of a proposed policy, program, or project--has received considerable interest over the past decade internationally as a practical mechanism for collaborating with other sectors to address the environmental determinants of health and to achieve...
Article
Evidence-based approaches (those explicitly linked to the best available scientific evidence and reflecting community preferences and feasibility) are increasingly used to inform health policy decision making on the burden of a disease attributable to particular causes, interventions and policies that might work to confront those causes, and issues...