American Journal of Public Health
Volume 106, Issue 1 (January 2016)
http://ajph.aphapublications.org/toc/ajph/current

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Increasing the Incidence and Influence of Systematic Reviews on Health Policy and Practice
Iain Chalmers, DSc, and Daniel M. Fox, PhD
Iain Chalmers is a co-founder of the Cochrane Collaboration (www.cochrane.org) and the James Lind Initiative, Oxford, UK. Daniel Fox is president emeritus of the Milbank Memorial Fund, New York, NY.
Abstract
Why do people make practice and policy decisions in health care and public health without reference to relevant research, or only to biased samples of relevant research evidence? This illogical behavior doesn’t serve the interests of health service users or the public, yet it remains usual. One reason is that most reports of research do not help. Even very prestigious journals publish reports of new studies without acknowledging that readers need to know what the new evidence has added to the totality of trustworthy evidence relevant to the questions addressed.1
Waste in the conduct and reporting of research is a scientific, ethical, and economic scandal, especially because half of the potentially relevant research does not even get reported (see, for example, http://www.alltrials.net). Nevertheless, it is important that systematic use is made of those reports of research that are accessible. In this editorial we consider the increased availability of systematic reviews of research, some of their positive effects on policy and practice, and limitations in the current use of systematic reviews. We end by offering suggestions for enhancing the effectiveness of systematic reviews.

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The Health of the Newest Americans: How US Public Health Systems Can Support Syrian Refugees
Clea A. McNeely, DrPH, MALyn Morland, MSW, MA
Clea A. McNeely is with the Center for the Study of Youth and Political Conflict and the Department of Public Health, University of Tennessee, Knoxville. Lyn Morland is with the Division of Innovation, Policy, and Research, Bank Street College of Education, New York, NY.
ABSTRACT
The statistics are stunning: 1.9 million Syrian refugees in Turkey, 1.7 million in Lebanon, 630 000 in Jordan, 506 000 in the European Union, and 1883 in the United States.1–3 The United States will admit an additional 10 000 Syrian refugees during the next fiscal year, at which point Syrians will constitute approximately 18% of the total refugee population admitted in 2016.4 But this is not a public health emergency in the United States.
The media attention and national concern about Syrian refugees does provide an opportunity, however, to improve our public health system’s capacity to serve all refugees. With commitment and grit, several communities have increased refugees’ access to quality health services that span the full spectrum from preventive screening to management of complex chronic conditions. These promising practices demonstrate the feasibility of providing efficient, accessible and effective health services for even the most linguistically and economically marginalized members of our communities. As Beth Farmer, the director of International Counseling and Community Services in Washington State put it: “If we fix the healthcare system for refugees—make it understandable and easily accessible—we fix it for everyone” (telephone communication, October 2015).

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Sociodemographic Predictors of Vaccination Exemptions on the Basis of Personal Belief in California
American Journal of Public Health: January 2016, Vol. 106, No. 1: 172–177.
Michelle M. Mello, Y. Tony Yang, Paul L. Delamater, Timothy F. Leslie,
Abstract
Objectives. We examined the variability in the percentage of students with personal belief exemptions (PBEs) from mandatory vaccinations in California schools and communities according to income, education, race, and school characteristics.
Methods. We used spatial lag models to analyze 2007–2013 PBE data from the California Department of Public Health. The analyses included school- and regional-level models, and separately examined the percentage of students with exemptions in 2013 and the change in percentages over time.
Results. The percentage of students with PBEs doubled from 2007 to 2013, from 1.54% to 3.06%. Across all models, higher median household income and higher percentage of White race in the population, but not educational attainment, significantly predicted higher percentages of students with PBEs in 2013. Higher income, White population, and private school type significantly predicted greater increases in exemptions from 2007 to 2013, whereas higher educational attainment was associated with smaller increases.
Conclusions. Personal belief exemptions are more common in areas with a higher percentage of White race and higher income.