Breast cancer is the most common cancer among women in the United States, and cardiovascular disease (CVD) is a leading cause of death in this population. Understanding CVD-related death among breast cancer survivors is critical to inform policies. Previous studies calculating CVD-related death rates in this population used data from the Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) with the general US female population as the denominator, which may have produced misleading comparisons. For example, age-adjusted CVD-related death rates have appeared lower among women with breast cancer than in the general US female population, despite survivors facing an elevated CVD risk, understating the need for CVD-focused survivorship care. We demonstrated 2 methodologically appropriate approaches for estimating CVD-related death rates among US women with breast cancer from 1999 through 2020, using a denominator restricted to the breast cancer survivor population, derived from Surveillance, Epidemiology, and End Results (SEER) and Projected Prevalence (ProjPrev) data. We found trends in CVD-related death rates that were broadly consistent with previous studies, with an average annual percentage change of -1.8 (95% CI, -2.0 to -1.6). Our estimates were more intuitive than those from previous studies because they correctly reflected an elevated, rather than reduced, risk relative to the general population: the age-adjusted CVD-related death rate per 100 000 women with breast cancer was 1078.1 in 1999 and 733.1 in 2020. These findings suggest that our approaches can be applied to future research on cause-specific mortality among patients with cancer using CDC WONDER data. Future studies may improve generalizability and identify strategies for linking databases to generate more accessible evidence for public health decision-making.

Disease intervention professionals possess the critical skills and competencies necessary to prevent, manage, and control the spread of infectious diseases. However, until recently, no national credential existed to formally recognize their expertise. Through funding from the Centers for Disease Control and Prevention awarded to the Association of Schools and Programs of Public Health, the National Coalition of STD Directors was subawarded to support a national credentialing initiative designed to train and prepare disease intervention professionals for certification and recertification. The National Coalition of STD Directors advanced this initiative through the strategic development of a comprehensive, multimodal training pathway that aligns with the foundational elements of the Certified in Disease Intervention (CDI) program. This training pathway includes a 12-part eLearning module series, supplemental resources such as podcasts and micro-learning videos, a cobranded learning management system portal, and an interactive CDI educational summit. The strategic program plan developed under this initiative is guided by an evaluation framework to assess the reach, quality, and impact of the deliverables. Through the deployment of adult learning theories and insights from the public health field, this strategic training pathway provides disease intervention professionals with accessible, high-quality opportunities to strengthen their knowledge and skills as they prepare for certification and recertification under the CDI program.

Despite the availability of preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) for the prevention of HIV transmission, 30 000 new cases of HIV are reported every year in the United States. Barriers to PrEP and PEP use are multifactorial and include clinician misinformation, stigma, and varied access to ongoing training. To better understand the origin of these barriers, we reviewed recent Centers for Disease Control and Prevention (CDC) clinical guidelines for PrEP and PEP to identify changes, persistent gaps in guidelines, and opportunities for improvement. Our review found that not only do the updated PrEP guidelines still lack clarity on newer preventive medications and recommended screening schedules, but they also continue to rely heavily on risk-based screening frameworks that leave many eligible patients overlooked. Similarly, the PEP guidelines place substantial responsibility on patients to recognize their own exposure and seek treatment within a narrow initiation window, which may contribute to underuse of PEP. Based on these findings, we propose 4 key guideline recommendations: (1) update CDC guidance to clearly incorporate new PrEP and PEP regimens and prescribing practices, (2) emphasize annual screening for all sexually active patients rather than relying solely on risk-based criteria, (3) add PrEP/PEP-focused clinical guidance training in the didactic curriculum of medical and other health profession students, and (4) develop dedicated billing codes to support routine PEP screening and reduce administrative barriers for clinicians.

In 2024, a community-higher education partnership in the Midwest prepared public health and medical students for public health emergencies using an innovative whole-community approach of private-public collaboration. The partnership program consisted of evidence-based, workshop-style training with community resident participation. Researchers posed 2 questions before program initiation: (1) How willing were students to respond to emergencies (on a Likert-type scale of 1 = strongly disagree to 5 = strongly agree) before and after the program? and (2) What was the main challenge to mass-casualty drill planning and implementation for program partners? Twenty-two student participants completed a survey before and after the program, and researchers interviewed the 7 program partners after the program. We used a pretest-posttest design to assess differences in student participant self-efficacy in responding to and willingness to respond to public health emergencies. We found no significant difference from pretest (mean [SD] = 15.64 [1.84]) to posttest (mean [SD] = 16.32 [1.76]; P = .07) in the "self-efficacy in response provision" subscale. We found a significant increase in scores from pretest (mean [SD] = 14.18 [2.82]) to posttest (mean [SD] = 17.18 [2.28]; P < .001) in the "willingness to report to work and treat patients" subscale. We also found a significant positive change in subscale scores for "willingness to participate in all disaster situations" from pretest (mean [SD] = 12.41 [1.68]) to posttest (mean [SD] = 13.68 [1.36]; P = .004). The main challenge to the drill was the need for additional mock victim volunteers. When planning local drills, the whole-community approach can provide the foundation needed for community collaboration and capacity building for disaster preparedness.

The Association of Public Health Laboratories, the Centers for Disease Control and Prevention, and Quest Diagnostic Laboratories collaborated to implement a scalable, extensible model for public health reporting that increased electronic laboratory reporting (ELR) for Quest from 3 million reports in 2015 to 17.5 million reports in 2023. This volume represented a 15% increase in US ELR coverage, from 75% to 90% nationwide from 2015 to 2023. As of early 2026, Quest had sent >200 million ELR messages through the Association of Public Health Laboratories Informatics Messaging Services (AIMS) platform. AIMS is a public health data exchange intermediary that performs shared services, translation, and transformation and maintains connections with state public health agencies (PHAs) and public health laboratories. Using the AIMS platform to validate and route ELR messages reduced the point-to-point connections that Quest must maintain and the onboarding time to connect to each PHA. By using a single messaging standard to exchange data with >50 PHAs, Quest can maintain these feeds with minimal overhead. In 2020, Quest leveraged this existing connection with AIMS to quickly add COVID-19 to the data feed; as a result, Quest became one of the first private laboratories to send COVID-19 data to state PHAs, the Centers for Disease Control and Prevention, and the US Department of Health and Human Services. We describe this crucial milestone in ELR and the lessons learned through the early stages of the project. This successful public-private partnership has been replicated for other use cases and establishes AIMS as the centralized health information exchange network for public health.

Excessive alcohol use is a leading cause of preventable morbidity and mortality in the United States, causing 117 000 deaths from chronic causes and 61 000 deaths from acute causes each year. Local health departments may find it challenging to assess the local impacts of excessive alcohol use, limiting their ability to mount an effective public health response to mitigate related harms. We leveraged the Centers for Disease Control and Prevention's Alcohol-Related Disease Impact (ARDI) application (app) to estimate the average annual number of alcohol-attributable deaths (AADs) and resulting years of potential life lost (YPLL) by age group, sex, and race and ethnicity in Franklin County, Ohio, from 2022 through 2024. The ARDI app allows users to create and upload custom prevalence and mortality datasets to estimate local alcohol-attributable fractions, AADs, and YPLL for 58 underlying causes of death related to excessive alcohol use. On average, there were 680 deaths and 17 597 YPLL per year in Franklin County from 2022 through 2024. The average annual mortality rate per 100 000 residents for AADs was 50.7, which was similar to the mortality rate for drug overdoses in Franklin County in 2023 (51.6). These findings provide important context for local public health professionals and policymakers and provide a foundation for further assessment and public health response. Our use of the ARDI app at the local level may also be of interest to other local health departments that wish to study the impact of excessive alcohol use in their jurisdictions.

Despite curative hepatitis C virus (HCV) treatments, only one-third of cases receive treatment nationally. To evaluate how demographic and clinical characteristics were associated with HCV test result awareness and treatment completion, we analyzed programmatic data of a linkage-to-care program in Los Angeles County. Among 512 respondents, 433 (85%) were aware of their positive test result; of those, 138 (32%) received treatment. Black or African American people were less likely (adjusted prevalence odds ratio [APOR] = 0.43; 95% CI, 0.20-0.92) to be aware of their positive test result than White people. Among those aware of their test results, treatment completion was more likely when a specialist physician ordered the HCV test (APOR = 2.13; 95% CI, 1.03-4.41) than when a primary care provider ordered it, and people with symptoms of liver disease were less likely to complete treatment (APOR = 0.16; 95% CI, 0.08-0.35) than people without symptoms. Clinical and community notification and linkage programs, with a focus on racial and ethnic minority populations, will be necessary to bridge the gap between awareness and treatment initiation among Los Angeles County residents.

Cardiovascular disease (CVD) contributes to substantial health and economic burdens. In the United States, nearly half of the adult population (127.9 million in 2020) has 1 or more CVD-related conditions. Effective evidence-based approaches to prevent and treat CVD exist, yet it can take several years to incorporate scientific findings into practice. As a result, many practitioners are unaware of these public health and clinical strategies. To address this gap and reduce the lag between science and practice, the Centers for Disease Control and Prevention launched the Best Practices Clearinghouse for Heart Disease and Stroke Prevention and Management (BPC). The BPC facilitates the widespread implementation of 18 effective strategies for heart disease and stroke prevention and management, and the platform remains flexible and responsive to new evidence as it emerges. To demonstrate the functionality of the BPC and highlight key features of the platform, we present content from 2 strategies as examples: (1) Lifestyle Modification Programs to Control Hypertension, which helps patients increase healthy behaviors and reduce the risk of further complications or declining cardiovascular health, and (2) Cardiac Rehabilitation to Support Recovery From Cardiac Events, which combines physical activity, health education, and counseling to help patients recover after a cardiac event. The BPC uses a unique approach that supports CVD prevention and management by summarizing evidence for strategy effectiveness, policy and law considerations for strategy implementation, the ability to foster user engagement and information sharing through forms to submit feedback and resources, and clear examples of all 18 strategies in action.