Richard A. Goodman's research while affiliated with Emory University and other places

Publications (129)

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Context: The US government manages a large number of data sets, including federally funded data collection activities that examine infectious and chronic conditions, as well as risk and protective factors for adverse health outcomes. Although there currently is no mature, comprehensive metadata repository of existing data sets, US federal agencies...
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Interventions are control and prevention measures that public health officials select and implement at one or more points in time after initiating a field investigation in response to an acute public health problem. Regardless of the nature of the problem, an immediate need exists to understand what is happening and to recommend and implement contr...
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In response to an outbreak of disease of public health importance, a city, county, or state health department can request field epidemiologic assistance from the next higher level public health agency. In the United States, the highest level public health agency is the Centers for Disease Control and Prevention. To ensure smooth communications, pla...
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Cancer is the second leading cause of morbidity and mortality in the U.S. Although reducing the number of new cancer cases is a national health goal, the continuing growth of the older adult population ensures that the burden of cancer will increase. Despite documentation of the shortage of oncologists to meet the growing need, relatively limited a...
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Introduction: Rapid growth of the older adult population requires greater epidemiologic characterization of dementia. We developed national prevalence estimates of diagnosed dementia and subtypes in the highest risk U.S. Population: Methods: We analyzed Centers for Medicare & Medicaid administrative enrollment and claims data for 100% of Medic...
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Coexistence of multiple chronic conditions (i.e., multimorbidity) is the most common chronic health problem in adults. However, clinical practice guidelines have primarily focused on patients with a single disease, resulting in uncertainty about the care of patients with multimorbidity. The American Thoracic Society convened a workshop with the goa...
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Landmark articles from the peer-reviewed literature can be used to teach the fundamental principles of geriatric medicine. Three approaches were used in sequential combination to identify landmark articles as a resource for geriatricians and other healthcare practitioners. Candidate articles were identified first through a literature review and exp...
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Cardiovascular disease, the leading cause of death in the United States and worldwide, accounts for substantial suffering and healthcare-related expenditures.1–3 For more than 30 years, the American Heart Association (AHA) and the American College of Cardiology (ACC) have partnered with other organizations to translate the best available scientific...
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This is an invited commentary for a special issue on CPPW. In this invited commentary, we review definition frameworks for community health and examine factors having core relevance to shaping the meaning of this term and growing field. We conclude by suggesting a potential framework for conceptualizing and advancing this field of public health pra...
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With non-communicable conditions accounting for nearly two-thirds of deaths worldwide, the emergence of chronic diseases as the predominant challenge to global health is undisputed. In the USA, chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in...
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Purpose: An isolated focus on 1 disease at a time is insufficient to generate the scientific evidence needed to improve the health of persons living with more than 1 chronic condition. This article explores how to bring context into research efforts to improve the health of persons living with multiple chronic conditions (MCC). Methods: Forty-fi...
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Background: The increasing prevalence of Americans with multiple (2 or more) chronic conditions raises concerns about the appropriateness and applicability of clinical practice guidelines for patient management. Most guidelines clinicians currently rely on have been designed with a single chronic condition in mind, and many such guidelines are ina...
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The objective of this research was to update earlier estimates of prevalence rates of single chronic conditions and multiple (>2) chronic conditions (MCC) among the noninstitutionalized, civilian US adult population. Data from the 2012 National Health Interview Survey (NHIS) were used to generate estimates of MCC for US adults and by select demogra...
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Following the intentional dissemination of B.anthracis through the U.S. Postal Service in 2001, use of the term "naturally occurring" to classify some infectious disease outbreaks has become more evident. However, this term is neither a scientific nor an epidemiologic classification that is helpful in describing either the source or the mode of tra...
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Among the 21st century’s major emerging health issues, one of the most critical is the increasing prevalence of individuals with comorbidities, or multiple chronic conditions (MCCs), and the myriad challenges this poses for public health, healthcare, social services, and other sectors. Given the increasing prevalence of individuals with MCCs and th...
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The prevalence of new cases of diabetes continues to increase, and the health burden for those with diabetes remains high. This is attributable, in part, to low adoption of evidence-based interventions for diabetes prevention and control. Law is a critical tool for health improvement, yet assessments reported in this paper indicate that federal, st...
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Individuals with multiple (>2) chronic conditions (MCC) present many challenges to the health care system, such as effective coordination of care and cost containment. To assist health policy makers and to fill research gaps on MCC, we describe state-level variation of MCC among Medicare beneficiaries, with a focus on those with six or more conditi...
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Current trends in US population growth, age distribution, and disease dynamics foretell rises in the prevalence of chronic diseases and other chronic conditions. These trends include the rapidly growing population of older adults, the increasing life expectancy associated with advances in public health and clinical medicine, the persistently high p...
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Public health and clinical strategies for meeting the emerging challenges of multiple chronic conditions must address the high prevalence of lifestyle-related causes. Our objective was to assess prevalence and trends in the chronic conditions that are leading causes of disease and death among adults in the United States that are amenable to prevent...
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Public health readiness has increased at all jurisdictional levels because of increased sensitivity to threats. Since 2001, with billions of dollars invested to bolster the public health system’s capacity, the public expects that public health will identify the etiology of and respond to events more rapidly. However, when etiologies are unknown at...
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Never before has the global population included as many older adults as it does today. Over the past century in the United States alone, the proportion of persons aged 65 years or older increased more than threefold, from 4.1% to 12.9%. This issue of the Journal devoted to “Healthy Aging” opens a dialogue for examining innovative roles for public h...
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To the Editor: The meta-analysis by Mr Umpierre and colleagues1 provided further evidence of the beneficial effects of structured exercise and physical activity advice for glycemic control in those with type 2 diabetes mellitus. However, considering the meta-analysis and the accompanying Editorial by Dr Pahor2 together raises 2 important issues for...
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The escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge, associated with suboptimal health outcomes and rising health-care expenses. Despite this problem's growth, the delivery of health services has continued to employ outmoded “siloed” approaches that focus on individual chron...
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The escalating problem of multiple chronic conditions (MCC) among Americans is now a major public health and medical challenge, associated with suboptimal health outcomes and rising health-care expenses. Despite this problem's growth, the delivery of health services has continued to employ outmoded "siloed" approaches that focus on individual chron...
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This chapter provides an overview of the legal issues relating to public health surveillance. It discusses the general legal authorities for public health surveillance set forth in constitutional, statutory, and regulatory laws; legal milestones in the evolution of public health surveillance and disease control in the United States; and legal issue...
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The Centers for Disease Control and Prevention and the Association of State and Territorial Health Officials selected 17 state and large local jurisdictions on the basis of their proximity to federal quarantine stations and collaborated with their state health department legal counsel to conduct formulaic self-assessments of social distancing legal...
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According to many experts, a public health emergency arising from an influenza pandemic, bioterrorism attack, or natural disaster is likely to develop in the next few years. Meeting the public health and medical response needs created by such an emergency will likely involve volunteers, health care professionals, public and private hospitals and cl...
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We thank Goodman and Buehler for their comments about our recent article drawing attention to linkages among neglected swimming pools, vector mosquito production, and West Nile virus (WNV) transmission (1). We agree with their comment that our “study could not directly assess the putative link between disease and exposures to WNV-infected mosquitoe...
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This chapter discusses decision-making regarding the implementation of interventions during the course of epidemiologic field investigations. It first outlines principles that public health officials should take into account when considering interventions. It examines key determinants often involved in making such decisions about interventions, inc...
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This book has a mission of describing the application of basic epidemiologic principles in real time, place, and person to solve problems of an urgent or emergency nature. Based on decades of experience in both infectious and non-infectious diseases at the Centers for Disease Control and Prevention, this book describes the distinct approach, tasks,...
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This chapter provides an overview of the legal issues relating to public health surveillance and field epidemiology. It discusses the general legal authorities for surveillance and public health investigations provided by the U.S. Constitution and by state laws; legal milestones in the evolution of public health surveillance, outbreak investigation...
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This chapter discusses descriptive epidemiology. Field epidemiologists will either collect, or be presented with data from outbreak investigations, surveillance systems, vital statistics, or other sources of information for appropriate analysis. One of the fundamental tasks will be to orient and organize these data to construct useful and relevant...
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Continually changing health threats, technologies, science, and demographics require that public health professionals have an understanding of law sufficient to address complex new problems as they come into being. This book provides a review of the legal basis and authorities for the core elements of public health practice and solid discussions of...
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This chapter provides an overview of the legal issues relating to public health surveillance and field epidemiology. It discusses the general legal authorities for surveillance and public health investigations provided by the U.S. Constitution and by state laws; outbreak investigations and disease control in the United States; and legal issues rela...
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The perspective presented in this chapter illuminates the central role of law in contemporary public health; distills important themes from the practice of public health law; and projects the heightened role law is likely to play in public health practice in the coming decades. It begins with an overview of the contributions of law to selected publ...
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Systematic reviews are generating valuable scientific knowledge about the impact of public health laws, but this knowledge is not readily accessible to policy makers. We identified 65 systematic reviews of studies on the effectiveness of 52 public health laws: 27 of those laws were found effective, 23 had insufficient evidence to judge effectivenes...
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This chapter describes certain critical operational and management principles that apply before, during, and after the field work. These principles encompass the basic steps of: determining whether additional persons from outside the jurisdiction should be invited in; initiating an invitation; evaluating and responding to an invitation; preparing f...
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Health care providers and their legal counsel play pivotal roles in preparing for and responding to public health emergencies. Lawyers representing hospitals, health systems, and other health care provider components are being called upon to answer complex legal questions regarding public health preparedness issues that most providers have not prev...
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From April 2004 through December 2004, we reviewed the express legal authorities of the 10 most populous US states to restrict the movement of persons to control communicable diseases. All 10 of the states possessed express legal authority to quarantine and isolate individuals, but the laws varied substantially. In the absence of declared emergenci...
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Law influenced every aspect of the public health response to Hurricanes Katrina and Rita, from evacuation orders, to waivers of medical licensing requirements, to the clean-up of public health threats on private property. We used public health surveillance of news reports to identify and characterize legal issues arising during the disaster respons...
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Mutual aid is the sharing of supplies, equipment, personnel, and information across political boundaries. States must have agreements in place to ensure mutual aid to facilitate effective responses to public health emergencies and to detect and control potential infectious disease outbreaks. The 2005 hurricanes triggered activation of the Emergency...
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This chapter examines the structure of law underlying U.S. public health practice by focusing on the statutory basis of the federal and state/local infrastructure of the U.S. public health system, including the creation of federal agencies having public health or related responsibilities and powers under the U.S. Constitution and, similarly, state...
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Public health law is an emerging field in U.S. public health practice. The 20th century proved the indispensability of law to public health, as demonstrated by the contribution of law to each of the century's 10 great public health achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential t...
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This chapter provides a concise overview of the U.S. legal system, methods, and procedures as they might relate to the interests and duties of epidemiologic practitioners, whether they are based in local, state, or federal public health agencies, in academia, or in other settings. It examines U.S. law in relation to two areas of fundamental interes...
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Cardiovascular diseases are major contributors to death, disability, disparities, and reduced quality of life in the United States. Successful prevention and control of these diseases requires a comprehensive approach applied across multiple public health settings and in all life stages. Individual lifestyle and behavior change, as well as the broa...
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In part one of this 2-part series, we reviewed the important roles that laws have played in public health and provided examples of specific laws and their effectiveness in supporting public health interventions (1). We suggested that conceptual legal frameworks for systematically applying law to preventing and controlling chronic diseases have not...
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Recent developments in education have addressed the need to expand and enhance the teaching of statistics and mathematics throughout education (K-16) to improve the statistical literacy and scientific reasoning of students. Nonetheless, many students perceive the statistics instruction contained in mathematics and science courses as unrelated to de...
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Law, which is a fundamental element of effective public health policy and practice, played a crucial role in many of public health's greatest achievements of the 20th century. Still, conceptual legal frameworks for the systematic application of law to chronic disease prevention and control have not been fully recognized and used to address public h...
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Recent developments in education have addressed the need to expand and enhance the teaching of statistics and mathematics throughout education (K-16) to improve the statistical literacy and scientific reasoning of students. Nonetheless, many students perceive the statistics instruction contained in mathematics and science courses as unrelated to de...
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Public health officials and the communities they serve need to: identify priority health problems; formulate effective health policies; respond to public health emergencies; select, implement, and evaluate cost-effective interventions to prevent and control disease and injury; and allocate human and financial resources. Despite agreement that ratio...
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We reviewed evidence regarding risk factors associated with incidence of knee injuries both to assess the effectiveness of prevention strategies, and to offer evidence-based recommendations to physicians, coaches, trainers, athletes, and researchers. We searched electronic data bases without language restriction for the years 1966 - September 1, 20...
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“Public health legal preparedness” is a term born in the ferment, beginning in the late 1990s, that has led to unprecedented recognition of the essential role law plays in public health and, even more recently, in protecting the public from terrorism and other potentially catastrophic health threats. The initial articulation of public health has no...
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Since at least the mid-1970s, public health and law enforcement officials have conducted joint or parallel investigations of both health problems possibly associated with criminal intent and crimes having particular health dimensions. However, the anthrax and other terrorist attacks of fall 2001 have dramatically underscored the needs that public h...
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Cardiovascular diseases, epidemic obesity, and other major public health problems in the United States are strongly associated with physical inactivity and other lifestyle-related risk factors. While efforts to increase leisure-time physical activity have emphasized activities centered around the home and neighborhood, improving public health may r...
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Over two hundred years ago, Thomas Jefferson suggested the need for a broader legal curriculum. As the twenty-first century begins, the practice of law will increasingly demand interdisciplinary knowledge and collaboration — between those trained in law and a broad range of scientific and technical fields, including engineering, biology, genetics,...
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Law is indispensable to the public's health. The twentieth century proved this true as law contributed to each of the century's ten great public health achievements: vaccination, healthier mothers and babies, family planning, safer and healthier foods, fluoridation of drinking water, the control of infectious diseases, the decline in death from hea...
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Applied public health law research is an essential element for improving the legal foundation of public health practice. This article focuses on the proper scope and the methodology related to conducting public health law research. In addition to considering the issue of translating research into practice, the article provides overviews of three cu...
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To assess the published evidence on the effectiveness of various approaches to the prevention of ankle sprains in athletes, we used textbooks, journals, and experts in the field of sports medicine to identify citations. We identified 113 studies reporting the risk of ankle sprains in sports, methods to provide support, the effect of these intervent...
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A variety of infectious diseases can be transmitted during competitive sports. Modes of transmission in athletic settings include person-to-person contact, common-source exposures and airborne/droplet spread. This paper reviews the most commonly reported infectious diseases among athletes and discusses the potential for transmission of bloodborne d...
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Publicity about human immunodeficiency virus (HIV) infection in athletes has focused attention on the potential for transmission of blood-borne pathogens during sports and athletic competitions. Existing information suggests that the potential risk for such transmission is extremely low and that the principal risks athletes have for acquiring HIV a...
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The issues addressed in the concurrent sessions of the conference were worldwide in scope and importance. The knowledge base on infectious disease and injury in the child-care setting is increasing, but investigative work in these areas must continue to further define and reduce these risks. Current knowledge offers tools for both risk reduction an...
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To improve understanding of the epidemiology of fatal violence directed toward physicians and other health care workers (HCWs) in health care settings. Analyses of data for 1980 through 1990 from the National Traumatic Occupational Fatalities surveillance system. Overall occurrence of occupational injury deaths and occurrence of workplace-related h...
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Participation in competitive sports is popular and widely encouraged throughout the United States. Reports of infectious disease outbreaks among competitive athletes and recent publicity regarding infectious disease concerns in sports underscore the need to better characterize the occurrence of these problems. To identify reports of infectious dise...
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To provide pertinent background information on infectious diseases and injury in child day care and outline measures to address these health care needs. We reviewed published English-language literature identified through a MEDLINE bibliographic search, major literature summaries, and bibliographies from identified articles. Child day-care settings...
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Increased provision of health care in outpatient settings and concerns about occupational transmission of infections have focused attention on the risk of transmission of infectious diseases in ambulatory health care settings. In contrast to inpatient nosocomial infections, infections transmitted in outpatient settings are neither systematically mo...
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To assess the usefulness of medical examiner data in describing the relationship between alcohol use and fatal injuries, 1978-84 data from the Office of the Chief Medical Examiner (ME), State of Oklahoma, was examined. In each year in the study period, approximately 1,500 deaths resulted from unintentional injuries (UI) and 800 deaths resulted from...
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The epidemiologic field investigation is an important tool used by the Centers for Disease Control (CDC) to provide assistance to State, local, and international public health agencies. The Epidemic Intelligence Service (EIS) of the CDC is an ongoing program that gives physicians and other health professionals opportunities to learn and practice ep...
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Epidemiologic field investigations are often done in response to acute public health problems. When outbreaks of disease occur, there usually is an urgent need to identify the source and/or cause of the problem as a basis for control. Alternatively, the identification of environmental or occupational hazards frequently demands evaluation of exposed...
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The Epidemic Intelligence Service (EIS) was created at the Centers for Disease Control (CDC) in 1951 as a combined training and service program in the practice of applied epidemiology. Since 1951, more than 1,700 professional have served in this 2-year program of the Public Health Service. In the decade of the 1980s, EIS underwent dramatic changes...
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To characterize mortality associated with injuries and other health problems in Oklahoma, we examined data from the Office of the Chief Medical Examiner of the State of Oklahoma for the years 1978 through 1984. Each year, approximately 1,500 and 800 deaths resulted from unintentional injury (UI) and intentional injury (ie, suicide and homicide), re...
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Although alcohol use has been established as a risk factor for injuries associated with motor vehicle crashes, the role of alcohol for other unintentional and intentional injuries is less defined. A review of 102,401 deaths investigated by North Carolina medical examiners in the period 1973-1983 characterized the temporal patterns of ethyl alcohol...
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Although crude and age-adjusted mortality statistics are frequently used to quantify public health problems, they are heavily influenced by the underlying disease processes of the elderly. Alternative measures have been developed to reflect the mortality experience of younger age groups (i.e., premature mortality). We evaluated four different metho...
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The current understanding of the determinants of homicide derives primarily from studies in which data are aggregated for geopolitical units. Case-control studies and other analytic methods are needed to test causal hypotheses regarding the risk of homicide victimization or perpetration for individuals. Strengths and limitations of the case-control...
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To assess the value of medical examiner (ME) data bases for use in epidemiologic surveillance, we compared data from non-injury deaths that became ME cases to all non-injury deaths occurring in 1984 among Fulton County, Georgia residents. The decedents in the ME series were younger and included a large proportion of Black males. Although not repres...
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To characterize patterns of barbiturate use in homicide victims, we used data from the Los Angeles City Police Department and the Medical Examiner-Coroner's Office to study 4,950 victims of criminal homicide committed in that city in 1970-1979. Barbiturates were detected in 323 (7.9 per cent) of the 4,063 victims who were tested. Detectable levels...
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In 1980-1981, 158 motorcycle-associated fatalities occurred in Georgia, accounting for an estimated 6,113 lost years of productive life. Death ratios were highest for men 20 to 29 years of age, and motorcycle-associated fatalities occurred most frequently during summer months, on weekends, and during afternoon and evening hours. Forty-six percent o...
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To characterize the relationship between alcohol use and homicide victimization, we used data from the Los Angeles City Police Department and the Los Angeles Medical Examiner's Office to study 4,950 victims of criminal homicides in Los Angeles in the period 1970-79. Alcohol was detected in the blood of 1,883 (46 per cent) of the 4,092 victims who w...
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Death certificates were used as a source of information to characterize fatalities associated with farm tractor injuries in Georgia for the period 1971-81. In this period, 202 tractor-associated fatalities occurred among residents of Georgia; 198 of these persons were males. The annual tractor-associated fatality rate for males based on the populat...
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Nosocomial pseudoepidemics may be detected when clustering of pseudoinfections occur or when artificial clusters of real infection are observed. Nontuberculous mycobacteria were reportedly isolated from specimens obtained from seven patients at one hospital from October 1980 to January 1981. Because the patients' clinical illnesses were not uniform...
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Nosocomial pseudoepidemics may be detected when clustering of pseudoinfections occur or when artificial clusters of real infection are observed. Nontuberculous mycobacteria were reportedly isolated from specimens obtained from seven patients at one hospital from October 1980 to January 1981. Because the patients' clinical illnesses were not uniform...