Social and Behavioral Sciences Commons^™

The Relationship Between Eviction, Rent Burden, And Poor Births In Kalamazoo County, Michigan, Joseph Agati

Masters Theses

Millions of Americans get evicted every year, with thousands coming from Kalamazoo County, Michigan alone. Additionally, many more live with rent burden, paying over 30% of their monthly income on rent. Both eviction and rent burden have been linked to adverse health effects, such as depression and anxiety, and negative coping mechanisms, such as alcoholism and smoking. This study asks if eviction and rent burden are correlated with poor births in Kalamazoo County as there are hundreds of poor births in the county every year, as well as which social vulnerability themes are most predictive of eviction and poor births. …

The Birth Of Development: The Social, Economic And Environmental Advantages To Contraceptive Use On A Global Scale, Linda Hanes

Honors Theses

For many women around the world, pregnancy is a miraculous, exciting stage in life. But for others pregnancy means financial burden, having to stay in an abusive relationship, or giving up a career. What many people forget is that motherhood is not the default position for women. As a result of the traditional views of acceptable roles regarding women, in most, if not all cultures, there is a stigma placed on family planning and abortion. To talk about contraceptive use is to admit that sex is a natural part of life for all genders. Many cultures are not prepared to …

National Quality Awards In Healthcare And Actual Quality In U.S. Hospitals, Beth M. Beaudin-Seiler

Dissertations

This study examined performance outcome data from the Medicare Compare Hospital database for differences in performance between national award-winning hospitals and non-national award-winning hospitals. Specific variables examined were related to clinical care and were identified in literature as well as professional medical associations and societies as being quality indicators. National award-winning hospitals were defined as those having received the Malcolm Baldrige Quality Award in Healthcare or the Healthgrades Distinguished Hospital for Clinical Excellence. The characteristics of highly reliable organizations were also used to align the indicators of excellence for Malcolm Baldrige and Healthgrades recipients. Finally, a closer examination of data …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …

A Study On Generic Prescription Substitution Policy As A Cost Containment Approach For Michigan’S Medicaid System, Khandaker Nayeemul Islam

Dissertations

Increasing health care costs have made management of Medicaid services to provide low-income families through Medicaid programs critical in the recent times. The number of Medicaid beneficiaries in Michigan has increased over the years mainly due to the downsizing of auto sectors. Currently, states spend almost 16% of their budget for Medicaid, making it the second largest item in the budget for most (Kaiser Foundation, 2010). Prescription drugs are a significant part of Michigan’s Medicaid costs. Higher costs caused a tremendous fiscal burden on Michigan in administering the program and providing prescription drugs for its patients. Michigan has implemented several …

Mass Shootings And Mental Health Policy, Jessica Rosenberg

The Journal of Sociology & Social Welfare

Research suggests that mass shootings can increase mental health stigma, reinforce stereotypes that people with mental illness are violent, and influence public policy. This article examines mental health policy initiatives resulting from the mass shootings in Sandy Hook, Connecticut and Aurora, Colorado within the context of existing research about mental illness, suicide, substance abuse and gun violence. Previous legislation that restricts access to firearms among persons with mental illness is reviewed. The article suggests that gun control legislation that focuses on persons with mental illness is not supported by research, may create barriers to treatment, and may have limited efficacy …

Health Inequalities And The Welfare State In European Families, Simone Sarti, Marco Alberio, Marco Terraneo

The Journal of Sociology & Social Welfare

Using EU-Silc data from 2005, our aim in this article is to estimate how self-assessed health and the gradient between education and health vary among individuals in different European countries, considering their contextual socioeconomic vulnerability. In order to do this, we use a hierarchical model with individuals nested in households at the second level, and in various European countries at the third level. Our main research interest is on the modelling variables associated with better health conditions and their improvement or worsening according not only to micro/ individual and macro/national levels but also to the household: a level on which …

Long Term Care Insurance Beyond The Class Program, Amy Restorick Roberts, David B. Miller, Merl C. "Terry" Hokenstad Jr.

The Journal of Sociology & Social Welfare

The Community Living Assistance and Supports (CLASS) program, created under the Patient Protection and Affordable Care Act, established a federally-administered, voluntary insurance program that allows for working adults to purchase insurance to cover the cost of long term support services. The CLASS program is the first step towards moving away from a welfare-based system, improving consumer choice, and creating a stable funding source for long term care needs. Enrollees in the CLASS program who meet benefit eligibility requirements and need care assistance will receive a cash benefit to pay for supportive services such as home health care, adult day services, …

A Social Justice Perspective On Medicare Part D In An Age Of Reform: Critical Implications Of Trends In Health Care Policy And Advocacy, Louanne Bakk, Marya R. Sosulski

The Journal of Sociology & Social Welfare

This article examines the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) in its current form and explains why a critical perspective is useful when analyzing the policy and reform efforts. Using this approach, we consider the development of the policy and describe ways that gender and racial differences may hinder equal access to medications for some of the most vulnerable older adults. This article explores the implications of gender and racial disparities under the MMA and ramifications of health care reform efforts that could potentially impede, rather than promote, a social justice agenda. Beyond the political advantage …

The President's Emergency Plan For Aids Relief (Pepfar): A Social Work Ethical Analysis And Recommendations, Robert J. Barney, Stephan L. Buckingham, Judith M. Friedrich, Lisa M. Johnson, Michael A. Robinson, Bibhuti K. Sar

The Journal of Sociology & Social Welfare

The President's Emergency Plan for AIDS Relief (PEPFAR) is the most recent international social program instituted by the U.S. Government to combat HIV/AIDS. Since its inception in 2003, this foreign policy initiative has dedicated $63 billion for HIV/AIDS prevention and treatment in foreign countries. Despite PEPFAR's many accomplishments, it continues to promote controversial prevention strategies. This paper analyzes these prevention strategies, utilizing social work values as described in the NASW Code of Ethics. Policy, practice, and research implications are discussed.

Empirical Essays On The Impact Of Health-Aid On Health Outcomes, Elsy Thomas Kizhakethalackal

Dissertations

This dissertation consists of three essays that empirically explore the impact of multilateral health-aid on health outcomes like infant mortality rate (IMR) and incidences of an infectious disease, Tuberculosis, in developing economies. The first essay uses parametric and semiparametric mean regressions (additive and non-additive specifications) to capture the impact of education and health-aid on the IMR, after controlling for other covariates. Both specifications confirm education as an important factor in reducing IMR. However, the effect of health-aid on IMR is not significant. In our additive model, we do see a threshold level of health-aid after which the impacts of health-aid …

The Development Of An Unequal Social Safety Net: A Case Study Of The Employer-Based Health Insurance (Non) System, H. Luke Shaefer, Elizabeth D. Sammons

The Journal of Sociology & Social Welfare

The U.S. social safety net exacerbates labor market inequalities rather than ameliorating them. This paper traces this theme within an important historical case study: the emergence of the employer-based health insurance system. Employers became the dominant and tax-preferred provider of health insurance in the United States without any federal legislative action. Understanding how this happened may inform current reform efforts. This case study highlights two important factors. The first is path dependency, discussed by Skocpol (1992) and Pierson (2000). They argue that the ambiguous divisions of power and a pluralistic governance framework favor incremental processes of social policy formation in …

Degrees Of Institutionalization: Family Planning Policies And Programs In Senegal, 1980-2005, Yazmine Michelle Watts

Dissertations

Senegal's population growth rate of 2.7% is greater than double that of the world average of 1.16%. The Government of Senegal acknowledges the population problem and has made efforts to address this issue. For over the past two decades the United States Agency for International Development (USAID) has served as the predominant donor in Senegal's health sector and has been a strong supporter of Senegal's family planning program. The evolution of family planning in Senegal cannot be understood without considering the roles of culture, religion, decentralization and funding in the institutionalization process. This research addresses important questions concerning factors that …

Political Economy, Moral Economy And The Medicare Modernization Act Of 2003, Judie Svihula

The Journal of Sociology & Social Welfare

Through the lens of political and moral economy, I examined the dominant values and actors in the legislative process of the Medicare Modernization Act of 2003. In my content analysis of federal hearings, I found that witnesses from government agencies, Congress and think tanks had almost equal presence at the hearings. Witnesses who were invited by Congress to testify at the hearings expressed twice as much support for private interests than for the general Medicare population or low-income beneficiaries. Few expressed concern for the uninsured population. Witnesses offered almost four times as many expressions of support for market rationalism than …

Tracing The History Of Medicare Home Health Care: The Impact Of Policy On Benefit Use, Joan K. Davitt, Sunha Choi

The Journal of Sociology & Social Welfare

We trace key policy changes that affected use of the Medicare home health benefit from the 1980s through the prospective payment system implemented in 2000, analyzing the impact on three measures of home care use: expenditures, users and visits. We demonstrate the impact of policies generated in the legislative, the judicial, and the executive branches of government and the gaming behavior of home health agencies in response to policy changes. Our analysis suggests that the policy itself and the implementation process are critical to understanding benefit use. The incentives in the policies and agency reactions had the potential to generate …

Perceived Organizational Support And Ethical Work Climates As Predictors Of Turnover Intention Of Licensed Nurses In Skilled Nursing Facilities, Anna A. Filipova

Dissertations

The purpose of this study was twofold: (1) to replicate Victor and Cullen's (1987; 1988) studies to confirm whether ethical climates (ECs) arise in skilled nursing facilities (SNFs), and whether organizations and groups within organizations have identifiable ECs; and (2) to test a model that examines the effects of ECs and perceived organizational support (POS) on licensed nurses' turnover intention (TOI) through job satisfaction (JS) and organizational commitment (OC).

A cross-sectional survey design was implemented. Three hundred and fifty nine freestanding SNFs were selected in a midwestern state. While a total of 110 facilities (31%) agreed to participate, responses were …

Review Of The Rise And Fall Of Hmos: An American Health Care Revolution. Jan Gregoire Coombs. Reviewed By Lisa S. Patchner., Lisa S. Patchner

The Journal of Sociology & Social Welfare

Book review of Jan Gregoire Coombs, The Rise and Fall of HMOs: An American Health Care Revolution. Madison, WI: University of Wisconsin Press, 2005. $35.00 hardcover.

Fairness Issues In Law And Mental Health: Directions For Future Social Work Research, Jose B. Ashford, Jane Holschuh

The Journal of Sociology & Social Welfare

Concepts from the procedural justice literature in social psychology are examined that offer useful guidance for social work researchers with interests in investigating informal adjudications, speciality treatment courts, and other areas of the administrative process previously neglected in mental health services research. These theoretical concepts are offered as an alternative to the therapeutic jurisprudence framework being adopted by some social workers in the field of law and mental health. The issues outlined in this paper also draw on the health services and psychotherapy literature to highlight issues involving process and procedure as social justice and their significance for advancing a …

Ethiopian Language Policy And Health Promotion In Oromia, Begna Dugassa

The Journal of Sociology & Social Welfare

In the time of HIV/AIDS, epidemics for which we have no vaccination or cure, public health is bound entirely to depend on the traditional health education strategies to stop or contain this disease. This reality demands that we travel extra miles and thoroughly employ every health promotion tool at our disposal. The Ottawa Charter for health promotion stressed the need for public policy to create supportive social conditions for health. This necessitates a commitment to enduring social conditions for health and raises topics that have been neglected by the traditional public health scholars. A close examination of the colonial language …

Health Care Poverty, Lisa Raiz

The Journal of Sociology & Social Welfare

This paper introduces and describes health care poverty. Underinsurance and its consequences for access to health care are highlighted. Definitions of underinsurance and its prevalence are presented. Groups that experience disproportionate barriers to obtaining medical care are identified. Manifestations of underinsurance are explicated and their relationship to receipt of medical care, such as vaccinations and medications is discussed. A refraining of the health care debate is suggested with emphasis moving from uninsurance to access to health care.

Nongovernmental Program Replication And Implementation: What Can Community-Based Programs To Support The Uninsured Learn From Other Communities?, Raymond J. Higbea

Dissertations

This research study evaluated the replication and implementation of Project Access (a nongovernmental, structured program providing physician and health care services to the working-poor) in Grand Rapids, Michigan. A mixed methodological approach was used and included quantitative and qualitative methodologies. The qualitative method used was a self-administered mailed survey of all Project Access enrollees. This survey evaluated the enrollee's perceived health and lifestyle function, access to physician services, access and adherence to prescribed medication regimen, and barriers to physician services during the year pre- and post-enrollment in Project Access. The survey also evaluated the amount enrollees were able or willing …

Unintended Consequences In Public Policy: Formulation And Implementation Of Michigan’S Safe Delivery Of Newborns Law, Anne Julie Hacker

Dissertations

It is generally believed that social policy is the result of careful research and planning on the part of officials. Yet there often exists a gap between theformulation and implementation of many social policies. This gap brings with it conflict, which in turn may result in unintended consequences. Theseconsequences may be so antithetical to the formulators' original intent as to make the policy implementation paradoxical.

This qualitative research study examines the ambiguities, challenges, or boundaries that policy formulators placed on practitioners responsible for implementing Michigan's Safe Delivery of Newborns Act and that ultimately created unintended consequences indicative of a public …

Providing Uninsured Adults With Free Or Low-Cost Primary Care: Does It Influence Their Use Of Hospital Emergency Departments?, Anne G. Zahradnik

Dissertations

This study analyzes one component of the health care safety net to determine whether or not being enrolled in a free or low-cost primary care physician access program subsequently affects emergency room utilization by uninsured adults ages 18 through 64. Those individual decisions are analyzed from both public goods and rational choice schemas. Additionally, physician access programs of different formats (a low-cost physician referral program and a freewalk-in clinic) are analyzed and compared for relative effectiveness. The study is a quantitative analysis of more than 40,000 individual patient records rather than relying on qualitative patient recall or on analyzing broad …

The War On Drugs V. The War On Pain: Do Controlled Prescribing Laws Have A Role?, Susanne F. Homant

Dissertations

The illegal use of prescription drugs and the under-treatment of chronic pain are both considered serious public health issues in this country. Strong medicines classified as controlled substances by the DEA are often used to treat chronic pain conditions and are also known to be diverted to non-medical uses, thus a solution to one problem may happen at the expense o f the other. Prescription Monitoring Programs (PMPs) are public policies that are felt by many to address diversion of controlled substances, and are generally welcomed by law enforcement as an excellent tool in the war against drugs. A number …

Factors Affecting Treatment Program Development In A Mental Health Facility Serving Prisoners, Ruby Miranda Meriweather

Dissertations

There is a paucity of literature on how treatment programs for mentally ill prisoners are developed. Federal mandates require that services to mentally ill prisoners be comparable to what is offered in the community. Planners, therefore, must find ways to provide treatment programs that produce that outcome.

This research identified the most important factors that affect treatment program development and implementation to aid planners in designing treatment programs for mentally ill prisoners. This qualitative study, based on grounded theory, used a structured interview with 61 mental health staff (psychiatrists, nurses, psychologists, social workers, and activity therapists) across three categories (Administrative, …

Management Style, Organizational Climate, And Organizational Performance In A Public Mental Health Agency: An Integral Model, Pamela Sue Meserve Erbisch

Dissertations

This dissertation analyzes and estimates the interactions between domestic investment and each type of capital flow under uncertainty and capital market imperfection in 13 oil-producing countries from 1981 to 2003. First, we discuss the recent development in investment theories under uncertainty, irreversibility, and imperfect capital market. Secondly, decomposing uncertainty into permanent and transitory components--based on C-GARCH--we constructuncertainty measures of broad macroeconomic variables in addition to oil price.

Thirdly, a model of four simultaneous equations is developed to capture dynamic interactions. My contribution is twofold. First, not only do we consider the impact of uncertainty and credit market imperfection on investment, …

The Differences In Performance Between Large And Small Organizations In Mental Health Settings, Randy Parker

Dissertations

The quantitative part of this study examined the relationship between organizational size and staff performance in mental health group home settings.The data from two hundred and sixty-two group homes from small, medium, and large umbrella organizations were examined. The results of independent third party evaluations were compared across these umbrella organizations. Evaluations measured compliance and performance mandated by federal health and safety regulations.

The qualitative part of this study involved on-site interviews with group home staff from various organizations at various professional levels which scored either a low or a high number of errors. A qualitative analysis was conducted to …

The Relationship Between Locus Of Control And Nutrition Health Status Among Adult Wic Participants, Damita Jo Zweiback

Dissertations

The purpose of this study is to examine the relationship between locus of control orientation and the nutrition health status of adult WIC participants in Michigan. The locus of control variable is defined as the degree to which an individual perceives reinforcement or outcomes as contingent upon his or her own behavior. It ranges from internal to external. Internal locus of control is the individual's belief that s/he is an actor and can determine one's fate within limits. External locus of control is the person's belief that s/he is controlled by forces outside of one's self (Lefcourt, 1976; Koger, 1999). …

Demographic Factors Predictive Of Medicaid Enrollment In Michigan Counties, Dale Kennedy Howe

Dissertations

Recent changes in administration of the Medicaid program make it imperative that local agencies improve their ability to forecast demand for Medicaid services. In October of 1998 the State of Michigan redesigned the Medicaid specialty care in Michigan from a fee-for-service system to a capitated system. In a capitated healthcare system, financial risk is a result of unanticipated changes in the population size and mix. Numerous demographic factors, such as crime, population, unemployment, median age, income, and ethnicity may be used to improve the accuracy of predicted changes in enrollment for Medicaid. Using naive ordinary least squares models as the …

The Effects Of Reengineering On Hospital Performance Indicators, Linda Rutgers Albery

Dissertations

Reengineering was a management tactic designed to reduce costs and increase efficiencies in the work place. Although many hospitals reported reengineering efforts were a priority during the latter part of the 1990s, little research has been done to determine the effects of reengineering on cost and quality performance indicators.

This research studied a large regional medical center located in southwest Michigan, which implemented patient-focused care redesign. Within this medical center, ten separate and distinct patient care departments were studied over a 5-year period. These departments included critical care, medical, surgical, obstetric and pediatric areas. During the first year o f …