Medicine and Health Sciences Commons^™

The Federal Government Must Revise Public Housing Policies To Protect Vulnerable Populations From Evictions, Caroline Grabowski

Population Health Research Brief Series

Over 100,000 Americans are now dying from drug overdoses annually, signifying that the goal of the 1986 Anti-Drug Abuse Act (ADAA) to end illicit drug use has not been achieved. What’s more, numerous statutes within the ADAA have created or worsened housing instability among people who use drugs and their families. This is because the ADAA allows public housing officials to use their own discretion when determining evictions and lease refusals and has disproportionately harmed individuals in public housing who did not participate in the drug-related activities that led to their eviction. This brief describes how the ADAA negatively affects …

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.

Serving Those Who Served: Renegotiating Support And Benefits For U.S. Military Veterans With Less Than Honorable Discharges, Mariah Brennan, Emily Graham

Population Health Research Brief Series

Approximately 1 in 7 veterans are discharged from the military under less than “Honorable” conditions. Veterans with less than “Honorable” discharges experience bias and stigma related to their discharge, which can lead to elevated risk for behavioral and mental health challenges and homelessness. This brief summarizes the different military discharge types, explains how less than “Honorable” discharges can affect veteran health, identifies groups of veterans who are at risk of receiving a less than “Honorable” discharge, and makes policy recommendations for the Department of Defense (DoD), civilian employers, and community healthcare providers.

Sexual Minorities Are More Depressed And Anxious Than Heterosexuals In The U.S., Especially Among Women, Joshua Grove

Population Health Research Brief Series

Depression and anxiety are harmful to health. People who suffer from depression or anxiety are more likely to engage in risky health behaviors and have higher risk of various chronic diseases and premature death. This data slice uses data from the 2022 National Wellbeing Survey to explore the prevalence of depression and anxiety among U.S. adults ages 18-64. The results show that sexual minority adults are significantly more likely than those who identify as heterosexual to suffer from depression and anxiety, and differences in prevalence rates between sexual minority and heterosexual women are larger than the differences between men.

Treatment For Mental Health And Substance Use: Spillovers To Police Safety, Monica Deza

Center for Policy Research

We study the effect of community access to mental health and substance use treatment on police officer safety, which we proxy with on-duty assaults on officers. Police officers often serve as first-responders to people experiencing mental health and substance use crises, which can place police officers at risk. Combining agency-level data on police officer on-duty assaults and county-level data on the number of treatment centers that offer mental health and substance use care, we estimate two-way fixed-effects regressions and find that an additional four centers per county (the average annual increase observed in our data) leads to a 1.3% reduction …

Covid-19 Mortality Rates Were Higher In States That Limited Governments From Enacting Public Health Emergency Orders, Xue Zhang, Mildred Warner, Gen Meredith

Center for Policy Research

State and local governments enacted various public health emergency policies during the COVID-19 pandemic that resulted in lower infection and death rates than would have occurred without these policies. However, some states limited emergency public health authority of state executives, state governors, and state and local officials during the pandemic. This brief summarizes the results of a study that used data from the Center for Public Health Law Research and Oxford COVID-19 Government Response Tracker to explore which states passed laws that limited emergency public health authority during the COVID-19 pandemic and the effects of those limitations on COVID-19 death …

Older Adults With A History Of Psychiatric Conditions Experience More Cognitive Decline Than Older Adults Without This History, Maria T. Brown, Miriam Mutambudzi

Population Health Research Brief Series

Having psychiatric conditions (such as bipolar disorder, schizophrenia, and major depressive disorder) throughout one’s life can lead to faster rates of cognitive decline as one ages. This data slice explores the associations between psychiatric history and cognitive function among U.S. White, Black, and Hispanic adults ages 65 and older from 1995-2014. Findings demonstrate that having a history of psychiatric problems is related to lower cognitive functioning and a faster rate of cognitive decline for all three groups, but Black and Hispanic adults experience steeper declines compared with White adults.

Psychosocial Interventions Among Patients With Cancer And Their Family Caregivers In The Sub-Saharan Region: A Systematic Review, Ting Guan, Yousef Qan’Ir, Jamie Conklin, Chifundo Colleta Zimba, Agatha Bula, Wongani Jumbo, Kondwani Wella, Patrick Mapulanga, Samuel A.M. Bingo, Evelyn Chilemba, Jennifer Haley, Nilda Peragallo Montano, Ashley Leak Bryant, Lixin Song

Social Work - All Scholarship

Cancer is becoming a public health issue in the Sub-Saharan Africa (SSA).

This systematic review aims to synthesise psychosocial interventions and

their effects on the health outcomes of adult cancer patients and their

family caregivers in SSA. We identified eligible publications in English

language from PubMed, Cumulative Index of Nursing and Allied Health

Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and

African Index Medicus databases. We included psychosocial

interventions targeted adult cancer patients/survivors or their family

caregivers in SSA. This review identified five psychosocial interventions

from six studies that support adult cancer patients and their family

caregivers in …

How Has The Opioid Crisis Affected Health, Health Care Use, And Crime In The United States?, Johanna Catherine Maclean, Justine Mallatt, Christopher J. Ruhm, Kosali Simon

Population Health Research Brief Series

The U.S. opioid crisis is the deadliest drug crisis in the nation’s history and is not abating. This brief summarizes what is known about the relationships between opioid misuse, health, healthcare use, and crime. The authors show that the opioid crisis has led to worsening health, increased mortality, increased healthcare use, and modest increases in crime. In addition, the policies designed to curb opioid misuse and its associated harms have had only limited success.

Opioid Treatment Programs Can Reduce Opioid-Related Emergency Department Visits And Foster Care Placements, Lindsey Rose Bullinger, Vivian Wang, Kenneth A. Feder

Population Health Research Brief Series

The U.S. opioid epidemic has led not only to unprecedented increases in opioid overdoses, functional impairment, and deaths among adults but also harmed children. After lifting a long-standing moratorium on drug treatment programs and increasing the number of medication-assisted opioid treatment programs (OTPs), Indiana saw a decrease in emergency overdose treatments and foster care placements. This brief explores the positive effects of medication-assisted treatments on children and their caregivers and the cost savings for foster care agencies.

Which Demographic Groups And Which Places Have The Highest Drug Overdose Rates In The U.S.?, Shannon M. Monnat

Population Health Research Brief Series

Although the drug overdose crisis has affected all demographic groups and places in the United States, overdose rates are much higher in some sub-populations and places than others. This brief describes demographic and geographic differences in fatal drug overdose rates from 1999-2020. Throughout most of this period, fatal drug overdose rates were highest among young and middle-aged adult White and Native American males and middle-aged and older Black males. Rates have been consistently highest in Appalachia, but in recent years have spread throughout several regions in urban and rural areas alike. Although opioids have been the main contributor, cocaine- and …

Federal Medication-Assisted Treatment Expansion Grants Do Not Reduce Homelessness, Andrew Sullivan, Changwe Park

Population Health Research Brief Series

Medication-assisted treatment (MAT) is an evidence-based intervention that, combined with counseling and behavioral therapies, can effectively treat opioid use disorders. However, MAT is underused due to multiple barriers. To increase access to MAT, the U.S. government awarded grants to local governments and nonprofit organizations to increase and retain the number of people receiving MAT. This brief examined differences in homelessness and employment outcomes between places that received a MAT grant and those that did not. They found that these grants did not reduce homelessness or unemployment rates in the places that received funding and concluded that their effectiveness may have …

The Oxycontin® Reformulation In 2010 Increased States’ Food Insecurity Rates, Colleen Heflin, Xiaohan Sun

Population Health Research Brief Series

The massive surge in opioid misuse and overdose over the past three decades has led to major family, economic, and social disruptions in the United States. OxyContin® - a highly potent, extended-release opioid was among the most commonly-abused narcotics throughout the 2000s. After reformulating OxyContin® to make it more difficult to inhale or inject, many people with opioid use disorders switched to using street drugs. The reformulation had many other unanticipated consequences. This brief shows that states with higher initial OxyContin® misuse rates had an increase in food insecurity after OxyContin® reformulation. The authors argue that public policies must consider …

How Has The Opioid Overdose Crisis Affected Child Maltreatment In The U.S.?, Alexander Chapman

Population Health Research Brief Series

This brief summarizes results from a study examining the association between U.S. county-level opioid mortality rates and child maltreatment rates from 2007 to 2017. Places with higher opioid overdose mortality rates have higher rates of child maltreatment. Poverty makes this problem worse - where the proportion of families in poverty increases, the association between fatal opioid overdose rates and child maltreatment also increases. Findings suggest that intervening in opioid use by reducing poverty has the potential to markedly decrease the incidence of child maltreatment.

Over Two-Thirds Of Opioid Overdose Victims In Canada Were Employed Before They Died, Alexander Cheung, Joseph Marchand, Patricia Mark

Population Health Research Brief Series

As in the United States, drug overdose is the leading cause of unnatural death in Canada, with most overdoses involving opioids. The authors of this brief quantify the lost labor productivity from opioid overdoses in Canada. They show that from 2016 to 2019, over two-thirds of opioid overdose victims were working and contributing to the economy before they died, with those employed in construction, trades, and transportation having the highest opioid overdose rates. The authors argue that destigmatizing drug use, ensuring a safe supply, and improving access to medical care and take-home Naloxone kits are critical for reducing overdose deaths.

The Opioid Epidemic Has Disrupted Children’S Living Arrangements, Mónica L. Caudillo, Andres Villarreal, Philip N. Cohen

Population Health Research Brief Series

The contemporary drug overdose crisis has had profound impacts on children and families in the United States. This brief summarizes how children’s living arrangements have changed during the opioid epidemic. The authors find that opioid overdose deaths are associated with decreasing shares of children living with two married parents and increases in shares of children living with unmarried but cohabiting parents, single fathers, and adults other than their parents. These changes have been most pronounced among White children.

U.S. Counties With Higher Drug Overdose Rates Have Lower School Test Scores, Rajeev Darolia, Sam Owens, John Tyler

Population Health Research Brief Series

The impacts of the contemporary U.S. drug overdose crisis on child and family wellbeing have been profound. This brief describes the link between county-level opioid overdose rates and children’s test scores, finding that counties with higher overdose rates have lower average 3^rd and 8th-grade test scores than counties with lower overdose rates. The relationship between higher overdose rates and lower test scores is particularly strong in rural counties. The places with the highest overdose rates and lowest test scores tend to be economically-disadvantaged, suggesting that economic investments may be needed to address the issue.

Counties With Higher Prescription Opioid Presence Have Slower Student Learning Rates, Jessica Drescher, Carrie Townley-Flores

Population Health Research Brief Series

The adverse impacts of the U.S. opioid crisis have been documented in many domains, but surprisingly little attention has been directed to understanding how the opioid crisis has affected children’s educational outcomes. This brief shows that students in counties with high levels of opioid prescribing are learning more slowly over time than their peers in counties with low levels of opioid prescribing. In addition to directing more support to schools, the authors advocate for policies that address the underlying social conditions that lead to prescription opioid misuse.

The U.S. Should Increase Access To Medication For Opioid Use Disorder Among Incarcerated Individuals, Cody Nagle

Population Health Research Brief Series

Opioid Use Disorder (OUD) is among the most common medical diagnoses for people in jails and prisons. Those leaving incarceration without substance use treatment are 40 times more likely than the general public to have a fatal overdose, making it the leading cause of death for people recently released. This brief describes the use of Medication for Opioid Use Disorder (MOUD) and Medication Assisted Treatment (MAT) as realistic and legally protected approaches to reducing overdoses upon exiting incarceration. It also calls for federal regulation and guidance on the use of MOUD in prisons, jails, and drug courts to ensure each …

The End Of The “Chemical Imbalance” Theory Of Depression - What Now?, Austin Brown

Population Health Research Brief Series

For decades, those diagnosed with depression have been told they suffer from a “chemical imbalance.” This explanation involves neurotransmitters, such as serotonin, thought to be the main neurochemical responsible for major depressive disorders. Growing research challenges this theory and the need for medication therapies for depressive symptoms. This brief summarizes new findings examining the theory that depression is caused by a chemical imbalance and calls for healthcare professionals and patients to consider the market influences and social structures that impact health.

The Daily Patterns Of Emergency Medical Events, Mary E. Helander, Margaret K. Formica, Dessa K. Bergen-Cico

Social Science - All Scholarship

This study examines population level daily patterns of time-stamped emergency medical service (EMS) dispatches to establish their situational predictability. Using visualization, sinusoidal regression, and statistical tests to compare empirical cumulative distributions, we analyzed 311,848,450 emergency medical call records from the U.S. National Emergency Medical Services Information System (NEMSIS) for years 2010 through 2022. The analysis revealed a robust daily pattern in the hourly distribution of distress calls across 33 major categories of medical emergency dispatch types. Sinusoidal regression coefficients for all types were statistically significant, mostly at the p < 0.0001 level. The coefficient of determination ($R^2$) ranged from 0.84 and 0.99 for all models, with most falling in the 0.94 to 0.99 range. The common sinusoidal pattern, peaking in mid-afternoon, demonstrates that all major categories of medical emergency dispatch types appear to be influenced by an underlying daily rhythm that is aligned with daylight hours and common sleep/wake cycles. A comparison of results with previous landmark studies revealed new and contrasting EMS patterns for several long-established peak occurrence hours--specifically for chest pain, heart problems, stroke, convulsions and seizures, and sudden cardiac arrest/death. Upon closer examination, we also found that heart attacks, diagnosed by paramedics in the field via 12-lead cardiac monitoring, followed the identified common daily pattern of a mid-afternoon peak, departing from prior generally accepted morning tendencies. Extended analysis revealed that the normative pattern prevailed across the NEMSIS data when re-organized to consider monthly, seasonal, daylight-savings vs civil time, and pre-/post- COVID-19 periods. The predictable daily EMS patterns provide impetus for more research that links daily variation with causal risk and protective factors. Our methods are straightforward and presented with detail to provide accessible and replicable implementation for researchers and practitioners.