Medicine and Health Sciences Commons^™

Massachusetts Health Care Reform: Is It Working?, Joshua Mcadoo, Julian Irving, Stacie Deslich, Alberto Coustasse

Management Faculty Research

Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion …

Food Insecurity Among Children In Massachusetts, Stephanie Ettinger De Cuba, Deborah A. Frank, Maya Pilgrim, Maria Buitrago, Anna Voremberg, Harris Rollinger, Denise A. Hines

New England Journal of Public Policy

This article focuses on the prevalence among Massachusetts children and families of food insecurity, inadequate access to enough nutritious food for an active and healthy life. It summarizes research findings on the association of food insecurity with less optimal children’s health and development from the prenatal period through adolescence. Food insecurity also correlates with other material hardships, such as housing and energy insecurity. Data show families’ participation in public nutrition and other assistance program is associated with decreased prevalence of food insecurity and with mitigation of its impact on children’s health and well-being. The article concludes with recommendations for policy …

Children And Homelessness In Massachusetts, Donna Haig Friedman, Katherine Calano, Marija Bingulac, Christine Miller, Alisa Zeliger

New England Journal of Public Policy

In Massachusetts, more than half a million children (15% of all children) live in poverty, 30% of all children live with parents who lack secure employment, and 41% live in households with high housing cost burdens. This article examines the root causes of poverty and its links to child homelessness in the state. Though the state has a long-standing progressive political legacy, the well-being of low-income families with children continues to decline. The article offers evidence about the extent of child homelessness and its profound effects on Massachusetts children and youth. The interconnectedness of what are usually thought of as …

Managed Care, Hospice Use, Site Of Death, And Medical Expenditures In The Last Year Of Life, Ezekiel Emanuel, Arlene Ash, Wei Yu, Gail Gazelle, Norman Levinsky, Olga Saynina, Mark Mcclellan, Mark Moskowitz

wei yu

BACKGROUND: We examined deaths of Medicare beneficiaries in Massachusetts and California to evaluate the effect of managed care on the use of hospice and site of death and to determine how hospice affects the expenditures for the last year of life.

METHODS: Medicare data for beneficiaries in Massachusetts (n = 37 933) and California (n = 27 685) who died in 1996 were merged with each state's death certificate files to determine site and cause of death. Expenditure data were Health Care Financing Administration payments and were divided into 30-day periods from the date of death back 12 months.

RESULTS: …

Planning For The Growing Older Population: Conducting Community Needs Assessments, Caitlin Coyle, Hayley Gravette, Jan Mutchler, Gerontology Institute, University Of Massachusetts Boston

Office of Community Partnerships Posters

Goals and Objectives: To describe the aging population of each community; To investigate the needs, interests and opinions of mature residents relating to their aging needs for age-related services in their respective communities; To provide recommendations to community partners and their stakeholders about how to create strong communities for older adults, based on needs assessment results; Generate reports and other documents to be used by the Department of Elder Services, other town offices, organizations that provide services, advocates, and community members.

Healthy Aging In Massachusetts: Reporting Indicators, Identifying Resources & Activating Allies, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Chae Man Lee, Kristina Turk

Office of Community Partnerships Posters

In Massachusetts, a Healthy Aging Collaborative comprised of a diverse group of stakeholders has been formed for multiple purposes: information sharing around healthy aging, idea generation, partnership building and activity mapping.

Apple Juice Improved Non-Cognitive Symptoms In Moderate- To Late-Stage Alzheimer’S Disease In An Open-Label Pilot Study, Ruth Remington, A Chan, A Lepore, E Kotlya, Thomas Shea

Ruth Remington

Preclinical studies demonstrate that apple juice exerts multiple beneficial effects including reduction of central nervous system oxidative damage, suppression of Alzheimer's disease (AD) hallmarks, improved cognitive performance, and organized synaptic signaling. Herein, we initiated an open-label clinical trial in which 21 institutionalized individuals with moderate-to-severe AD consumed 2 4-oz glasses of apple juice daily for 1 month. Participants demonstrated no change in the Dementia Rating Scale, and institutional caregivers reported no change in Alzheimer's Disease Cooperative Study (ADCS)-Activities of Daily Living (ADL) in this brief study. However, caregivers reported an approximate 27% (P < .01) improvement in behavioral and psychotic symptoms associated with dementia as quantified by the Neuropsychiatric Inventory, with the largest changes in anxiety, agitation, and delusion. This pilot study suggests that apple juice may be a useful supplement, perhaps to augment pharmacological approaches, for attenuating the decline in mood that accompanies progression of AD, which may also reduce caregiver burden.

Perceptions Of Evidence-Based Programs Among Community-Based Organizations Tackling Health Disparities: A Qualitative Study, Shoba Ramanadhan, Josephine Crisostomo, Jaclyn Alexander-Molloy, Ediss Gandelman, Milagro Grullon, Vilma Lora, Chrasandra Reeves, Clara Savage, Kasisomayajula Viswanatha, Chyke Doubeni

Chyke A. Doubeni

Dissemination of prevention-focused evidence-based programs (EBPs) from research to community settings may improve population health and reduce health disparities, but such flow has been limited. Academic-community partnerships using community-based participatory research (CBPR) principles may support increased dissemination of EBPs to community-based organizations (CBOs). This qualitative study examined the EBP-related perceptions and needs of CBOs targeting underserved populations. As part of PLANET MassCONECT, a CBPR study, we conducted six key informant interviews with community leaders and four focus groups with CBO staff members in Boston, Worcester and Lawrence, Massachusetts, in 2008. Working definitions of EBPs among CBO staff members varied greatly …