Low socioeconomic status (SES) is a barrier for cardiovascular disease (CVD) risk screening and a determinant of poor CVD outcomes. This study examined the associations between access to health-promoting facilities and participation in a CVD risk screening program among populations with low SES residing in public rental flats in Singapore.

Data from Health Mapping Exercises conducted from 2013 to 2015 were obtained, and screening participation rates of 66 blocks were calculated. Negative binomial regression was used to test for associations between distances to four nearest facilities (i.e., subsidized private clinics, healthy eateries, public polyclinics, and parks) and block participation rate in CVD screening. We also investigated potential heterogeneity in the association across regions with an interaction term between distance to each facility and region.

The analysis consisted of 2069 participants. The associations were only evident in the North/North-East region for subsidized private clinic and park. Specifically, increasing distance to the nearest subsidized private clinic and park was significantly associated with lower [incidence rate ratio (IRR) = 0.88, 95% confidence interval (CI): 0.80–0.98] and higher (IRR = 1.93, 95%CI: 1.15–3.25) screening participation rates respectively.

Our findings could potentially inform the planning of future door-to-door screenings in urban settings for optimal prioritization of resources. To increase participation rates in low SES populations, accessibility to subsidized private clinics and parks in a high population density region should be considered.

To assess the health of community residents following a coal fly ash spill at the Tennessee Valley Authority Kingston Fossil Plant in Harriman, Tennessee, on December 22, 2008.

A uniform health assessment was developed by epidemiologists at Oak Ridge Associated Universities and medical toxicologists at Vanderbilt University Medical Center. Residents who believed that their health may have been affected by the coal fly ash spill were invited to participate in the medical screening program.

Among the 214 individuals who participated in the screening program, the most commonly reported symptoms were related to upper airway irritation. No evidence of heavy metal toxicity was found.

This is the first report, to our knowledge, regarding the comprehensive health evaluation of a community after a coal fly ash spill. Because this evaluation was voluntary, the majority of residents screened represented those with a high percentage of symptoms and concerns about the potential for toxic exposure. Based on known toxicity of the constituents present in the coal fly ash, health complaints did not appear to be related to the fly ash. This screening model could be used to assess immediate or baseline toxicity concerns after other disasters. (Disaster Med Public Health Preparedness. 2014;0:1–8)

Many emergency departments (EDs) in the United States experience daily overcrowding, and a rapid influx of evacuees fleeing a disaster area can pose a substantial burden. Some of these evacuees may require ED care. However, others lack an alternative to the ED to address non-emergent medical concerns (prescription refills or outpatient referral).

The objective of this study was to describe a successful multidisciplinary Hurricane Katrina Evacuation Center, explain the services offered, and determine the center's effects on referrals to local EDs.

Data were collected concerning the number of patients utilizing the medical evaluation center and compared to the total number of evacuees to determine the proportion that utilized medical care. The data concerning patients given prescriptions was obtained by the estimation of the two medical directors of the Center, and therefore, is inexact.

During the five weeks the center was operational, 631 of 716 evacuees (88%) requested medical evaluation, and >80% of those had prescriptions written. Only four (<1%) patients were transported to local EDs.

An evacuee evaluation center provides a convenient non-ED alternative for evacuees to address their non-emergent medical concerns and can be used to ease their transition to a new location.