Medicine and Health Sciences Commons^™

Developing A Management And Finance Training For Future Public Health Leaders, Kristy T. Hayes, Harry J. Heiman, Peggy A. Honoré

School of Public Health Faculty Publications

Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, …

Decision-Making Processes For Essential Packages Of Health Services: Experience From Six Countries, Rob Baltussen, Omar Mwalim, Karl Blanchet, Manuel Carballo, Getachew Teshome Eregata, Alemayehu Hailu, Maryam Huda, Mohamed Jama, Kjell Arne Johansson, Teri Reynolds

Community Health Sciences

Many countries around the world strive for universal health coverage, and an essential packages of health services (EPHS) is a central policy instrument for countries to achieve this. It defines the coverage of services that are made available, as well as the proportion of the costs that are covered from different financial schemes and who can receive these services. This paper reports on the development of an analytical framework on the decision-making process of EPHS revision, and the review of practices of six countries (Afghanistan, Ethiopia, Pakistan, Somalia, Sudan and Zanzibar-Tanzania).The analytical framework distinguishes the practical organization, fairness and institutionalization …

Incompatibility Group I1 (Inci1) Plasmids: Their Genetics, Biology, And Public Health Relevance, Steven L. Foley, Pravin R. Kaldhone, Steven C. Ricke, Jing Han

Food and Drug Administration Papers

Bacterial plasmids are extrachromosomal genetic elements that often carry antimicrobial resistance (AMR) genes and genes encoding increased virulence and can be transmissible among bacteria by conjugation. One key group of plasmids is the incompatibility group I1 (IncI1) plasmids, which have been isolated from multiple Enterobacteriaceae of food animal origin and clinically ill human patients. The IncI group of plasmids were initially characterized due to their sensitivity to the filamentous bacteriophage If1. Two prototypical IncI1 plasmids, R64 and pColIb-P9, have been extensively studied, and the plasmids consist of unique regions associated with plasmid replication, plasmid stability/maintenance, transfer machinery apparatus, single-stranded DNA …

Laboratory Techniques In Public Health: Bi-520 Introduction To Public Health Lab Manual, Anuradha Srivastava

Open Educational Resources

This laboratory manual for a foundations course Public Health is unique in the sense that very rarely, a foundations course in the field has a lab component offered with the lecture. This lab manual provides basic laboratory exercises that could be useful to introduce undergraduate students to the basics of public health laboratory practices.

Improving Contact Tracing In Minority Communities By Combating Misinformation And Distrust, Jason G. Randall, Dev Dalal, Aileen Dowden

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

The COVID-19 pandemic continues to challenge the global population as infection rates climb, and officials struggle to balance the need to slow the spread of COVID-19 but also open economies safely. The disproportionate impact of COVID-19 on minority communities has raised questions about the unique experiences of these communities in terms of not only becoming infected with COVID-19, but also mitigating its spread. Although contact tracing has been identified as an invaluable tool for managing community spread and supporting economic reopening, this is contingent, in part, upon compliance with contact tracer requests. In this study, we investigated how misinformation and …

The Current State Of Migrant Health In Morocco: Pre-And Peri-Covid-19 Pandemic, Layla Babahaji

Independent Study Project (ISP) Collection

In the early 21st century, Morocco transitioned from being a predominantly transit migration country into both a transit and destination country for migrants. In 2013, the Moroccan government took significant steps to adapt the healthcare system in better integrating migrants in its policies. The government implemented the National Strategy on Immigration and Asylum that improved access to public health care for migrants. Recently, in March of 2020, Morocco declared a state of medical emergency due to the current COVID-19 pandemic that continues today. This paper addresses the effects of the COVID-19 pandemic on the current state of migrant health in …

Medicaid Work Requirements: State-Based Innovation Or Punitive Policymaking?, Diane Sherwin

Honors Theses

In March 2017, officials appointed to the Center for Medicare and Medicaid Services by President Donald Trump signaled to state governments their intent to support states who would choose to utilize Medicaid’s Section 1115 waiver provision to alter their state’s Medicaid program by introducing a work requirement. As of October 1, 2018, 13 states have heeded this signal and proposed a work requirement component for their Medicaid programs. The purpose of this paper is to determine if Medicaid work requirements are an innovative policy approach to improve independence among Medicaid enrollees, or if these requirements are a punitive, partisan approach …

Palau: Obesity, Tavia Weis

Global Public Health

Located in the heart of the Western Pacific Ocean is a large group of small islands that make up the country of Palau. Known for its growing tourism, beautiful landscapes, and cultural beliefs. Although the country is developing, the current health issue of obesity is a growing concern. With almost half of the population obese and the other half in jeopardy, the rising concerns of the obesity epidemic have taken global news and brought the attention of major countries to try and fix these rising issues. This public health brief will discuss the problems of obesity in Palau and the …

Health Care For All In Ireland? The Consequences Of Politics For Health Policy, Vivienne Byers

Articles

The Irish health-care system is a complicated mix of public and private providers, with inequitable and unclear routes for health-service users to access and navigate the system. In 2011, the Irish Government committed to significant health reform to develop a universal single-tier health system. In line with other European nations this was to be underpinned by the principle of social solidarity, with equitable access based on need rather than ability to pay. The road to this reform and its recent collapse highlights the practical implications of political and policy choices in health care, and has implications for financing and delivery, …

Assessing Efficiency Of Public Health And Medical Care Provision In Oecd Countries After A Decade Of Reform, Yasar A. Ozcan, Jaya Khushalani

Health Administration Publications

The objective of this study was to examine the change in efficiency of health care systems of 34 OECD countries between 2000 and 2012, a period marked by significant health reform in most OECD countries. This paper uses a novel Dynamic Network Data Envelopment Analysis (DNDEA) model to analyze the efficiency of the public health system and the medical care system of these OECD countries independently along with assessing the efficiency of their overall health system. This helps understand the relative priorities for improving the overall health system. The data for this study was obtained from the OECD Health Facts …

Privacy Protection And Aggregate Health Data: A Review Of Tabular Cell Suppression Methods (Not) Employed In Public Health Data Systems, Gregory J. Matthews, Ofer Harel, Robert H. Aseltine Jr.

Mathematics and Statistics: Faculty Publications and Other Works

Public health research often relies on individuals’ confidential medical data. Therefore, data collecting entities, such as states, seek to disseminate this medical data as widely as possible while still maintaining the privacy of the individual for legal and ethical reasons. One common way in which this medical data is released is through the use of Web-based Data Query Systems (WDQS). In this article, we examined WDQS listed in the National Association for Public Health Statistics and Information Systems (NAPHSIS) specifically reviewing them for how they prevent statistical disclosure in queries that produce a tabular response. One of the most common …

Multi-Sector Contributions To Public Health Delivery Systems: Economic, Institutional & Policy Determinants, Glen P. Mays

Health Management and Policy Presentations

The United States faces growing public and policy demands to improve health status on a population-wide basis. This session reviews new research from the Robert Wood Johnson Foundation's Systems for Action research program about the implementation of population health activities in communities across the U.S. Using 16 years of data on a national cohort of metropolitan communities, we show that substantial growth has occurred in the array of organizations and sectors that contribute to population health activities, especially in the years following Affordable Care Act implementation. We also show that this growth has not occurred evenly across the U.S., with …

Aligning Delivery & Financing Systems To Build A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Systems for Action research program uses strong social science methods to discover ways of aligning medical, public health, and social service systems in ways that improve health and wellbeing. This session profiles several of the studies now underway through this new program.

Health Care, Employers And Population Health, Glen P. Mays

Health Management and Policy Presentations

Data from the National Longitudinal Survey of Public Health Systems show that hospital and employer contributions to population health activities vary widely across U.S. communities. As peripheral participants in the organizational networks that support population health activities, these stakeholders bring novel information and resources to multi-sector work. This fact may explain the tendency for population health improvement activities to be more effective when hospitals and employers are involved.

Transforming Public Health Delivery Systems For Population Health Improvement, Glen P. Mays

Health Management and Policy Presentations

A growing body of empirical research documents the health and economic benefits of multi-sector health improvement initiatives. In this session we share research that points to the delivery system features --including institutions, infrastructure, and incentives -- that lead to effective population health improvement strategies.

Comprehensive Public Health Delivery Systems: Using Foundational Capabilities To Achieve Health Impact And Equity, Glen P. Mays

Health Management and Policy Presentations

Achieving health equity requires building more comprehensive systems. Using data from a nationally representative cohort of U.S. communities, this session will explore the characteristics of Comprehensive Public Health Delivery Systems, the structures and processes needed to build such systems, and the health and economic benefits attributable to these systems.

Learning Objectives:

• Compare innovative ways to structure local health departments that maximize resources to enhance service delivery to the community.
• Discuss ways local health departments can build strategic alliances to implement successful collaborations that address health threats in the community.

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays, Rick Ingram

Health Management and Policy Presentations

We review methods for measuring the structure of public health delivery systems using data from the National Longitudinal Survey of Public Health Systems. A growing body of research using these measures demonstrates how multiple sectors contribute to core public health functions, and how these functions influence community health status over time. We end with a summary of how the Comprehensive Public Health System measure will be used in monitoring the impact of the 21st Century Public Health System initiative.

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.

The Emerging Zika Pandemic: Enhancing Preparedness, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The Zika virus (ZIKV), a flavivirus related to yellow fever, dengue, West Nile, and Japanese encephalitis, originated in the Zika forest in Uganda and was discovered in a rhesus monkey in 1947. The disease now has “explosive” pandemic potential, with outbreaks in Africa, Southeast Asia, the Pacific Islands, and the Americas. Since Brazil reported Zika virus in May 2015, infections have occurred in at least 20 countries in the Americas. Puerto Rico reported the first locally transmitted infection in December 2015, but Zika is likely to spread to the United States. The Aedes species mosquito (an aggressive daytime biter) that …

Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Health Management and Policy Presentations

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.

Estimating Patient-Centered And Community-Centered Treatment Effects: Examples From Medical Care And Public Health, Glen P. Mays

Health Management and Policy Presentations

Health services researchers face growing clinical and policy imperatives for estimating how the effectiveness of medical and public health interventions vary across patients, population groups, and community settings. Recent advances in local instrumental variables estimation techniques allow for the estimation of person-specific and community-specific treatment effects in the presence of unobserved heterogeneity. This presentation explores examples from both medicine and public health following the local IV methods developed by Basu et al. (2013).

Foundational Public Health Services And Health System Reform, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on public health financing recommended a national initiative to identify the components and costs of a "minimum package" of public health programs and infrastructure that should be available in every U.S. community. In response, efforts are now underway to reach consensus on a set of "Foundational Public Health Services" for the nation, and to identify resource requirements for implementing these services. This presentation reviews existing research on the current availability of Foundational Public Health Services across the U.S. and the health and economic effects attributable to these services. We also review progress on ongoing …

Fundamentals Of Economic Evaluation For Public Health, Glen P. Mays, Cezar Mamaril

Health Management and Policy Presentations

This workshop provides an overview of the design and implementation of economic evaluation studies of public health programs and policies. Strategies for integrating economic evaluation principles, measurement strategies, analytic approaches, and results into the routine operations of public health agencies are examined.

Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays

Health Management and Policy Presentations

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …

Public Health Metrics: Key Considerations And Criteria For Food Safety Modernization, Glen P. Mays

Health Management and Policy Presentations

Robust measures of public health impact are needed to guide implementation of the U.S. Food Safety Modernization Act. This session describes strategies used in the field of public health services research to specify and select measures based on considerations of relevance, tractability, attribution, precision, and feasibility.

Using Network Analysis To Understand Public Health Delivery Systems & Community Health Initiatives, Glen P. Mays

Health Management and Policy Presentations

The increasingly connected world of health care delivery relies on an expanding frontier of multi-stakeholder structures and processes, from interdisciplinary patient-centered care teams, to virtual accountable care organizations (ACOs), to complex community-level interventions. This session highlights recent advances in applying social network analysis (SNA) methods to study the implementation and impact of these types of innovations. This methods workshop examines the benefits and limits of novel SNA applications based on the expanding availability of large, linkable electronic clinical and administrative data sources with dependent data structures. This paper profiles examples of using SNA principles and methods to study the implementation …

Changes In Public Health System Capital And Long-Run Health And Economic Outcomes: 1998 To 2014, Glen P. Mays, Cezar B. Mamaril

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health “system capital”; and (2) the effects of these changes on preventable mortality and resource use. …

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.