Social and Behavioral Sciences Commons^™

“The Worst Part About My Pregnancy Was Stuff That Didn’T Have To Do With My Pregnancy”: Medicaid Beneficiaries’ Pregnancy Intentions & Experiences In South Carolina, Andrew Michael Chen

Senior Theses

Low-income women and women of color experience adverse birth outcomes at disproportionately higher rates in the United States than most people who give birth. This thesis examines individual interviews conducted with 30 low-income women whose most recent birth was covered by Medicaid, the United States’ largest means-tested public health insurance program. The aim of this thesis is to examine how the women in the study thought about pregnancy, and how they described their intentions to become or avoid becoming pregnant at various times in their life. While public health researchers often frame pregnancy as an event that is either intended …

Political, Racial, And Household Income Barriers For Access To Healthcare In Illinois Counties, Kennedy Bray '23

Student Publications & Research

Access to health care impacts many people throughout the United States, as it restricts their ability to solve their health concerns. People who have the highest risk of a lack of access include people who are uninsured, people a part of a specific social class, or people belonging to a specific political party. In a particular geographical region, these factors could lead to groups of people suffering because of circumstances that they cannot control in their region. In my project, I determine how better access to healthcare and the percentage of people insured are affected by a measurement of the …

County Social Isolation And Opioid Use Disorder Among Older Adults: A Longitudinal Analysis Of Medicare Data, 2013–2018, Tse-Chuan Yang, Carla Shoff, Seulki Kim, Benjamin A. Shaw

Department of Sociology: Faculty Publications

This study aims to fill three knowledge gaps: (1) unclear role of ecological factors in shaping older adults’ risk of opioid use disorder (OUD), (2) a lack of longitudinal perspective in OUD research among older adults, and (3) underexplored racial/ethnic differences in the determinants of OUD in older populations. This study estimates the effects of county-level social isolation, concentrated disadvantage, and income inequality on older adults’ risk of OUD using longitudinal data analysis. We merged the 2013–2018 Medicare population (aged 65+) data to the American Community Survey 5-year county-level estimates to create a person-year dataset (N = 47,291,217 person-years) and …

Accessing Healthcare In The Intermountain West During The Age Of Precarious Labor, Jordan Hammon

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

This research aims to improve our understanding about the association between precarious employment and healthcare access. Using the framework of neoliberalism and the history of welfare reform in the United States, this thesis investigates the relationship between precarious labor and two outcomes associated with health insurance access, namely Medicaid utilization, and being uninsured. I also examine one potential consequence of Medicaid utilization and lack of insurance, having a usual place of health care in the context of the Intermountain West region of the United States.

Using new survey data and quantitative methodologies, this research shows how economic changes, particularly related …

Disparities In Oral Health: Socioeconomic Status And Policies To Increase Access To Primary Dental Care, Mckenzie Nutter

Theses/Capstones/Creative Projects

Primary dental care is a patient-centered service consisting of routine dental checkups. The oral cavity is the first point of entrance to the body for many harmful pathogens. Therefore, primary dental care is essential to not only prevent and treat conditions in the mouth, but to also reduce the number of systemic diseases in the rest of the body. However, people with higher incomes or wealth have increased access to primary dental care. People with low socioeconomic status have decreased access to primary dental care, at least in part due to difficulties in paying for separate dental insurance. Disparities in …

Rurality Of Medical Provider And Race Of Patient As Risk Factors For Overdose In Opioid Use Disorder Populations, Christopher Vance, Colleen Mulligan, David Von Nordheim, Jodi Heaps-Woodruff Ph.D.

Undergraduate Research Symposium

Title: Rurality of medical provider and race of patient as risk factors for overdose in opioid use disorder populations

Background

This study examines the outcomes of medication assisted treatment (MAT) for opioid use disorders (OUD) based on location of treatment and race of the individual seeking treatment. Opioid use in the United States has been disproportionately rising in the last decade and there is evidence of unequal treatment based on different social disparities, namely rurality and race. Discriminatory distribution of medication and treatment for individuals seeking OUD along the lines of race and rurality is an issue of grave importance …

An Examination Of The Association Between State Medicaid Perinatal Services And Birth Outcomes, Joy Morgan Myers

Honors Theses

This thesis investigated the connection between socioeconomic status, healthcare coverage, and birth outcomes. The research question that was posed specifically looked at twenty perinatal services that states covered under Medicaid to varying degrees to see their association, if any, with premature birth rates and low birthweight rates. State-level and Mississippi county-level data were compiled regarding preterm birth rates, low birthweight rates, presumptive eligibility adoption, and coverage of twenty different perinatal services. Using these data, the correlation between state Medicaid expansion status and birth outcomes was first calculated in order to determine if variation in birth outcomes was associated with expanded …

Health Care Access For Children In Latinx Immigrant Families In The Greater Philadelphia Area, Sophia King

Politics Honors Papers

This work examines the gap that exists in access to health care in the Greater Philadelphia Region for children of Latinx immigrant families in comparison to other children in the nation. It provides a critical analysis of the gap in access to coverage, noting that this exists despite wide support for a human right to health. This study draws on existing scholarly research as well as interviews with staff at two health clinics and one community outreach center that are located in Greater Philadelphia. It demonstrates that Latinx immigrant families are less likely to have health insurance and get primary …

Mhpaea & Marble Cake: Parity & The Forgotten Frame Of Federalism, Taleed El-Sabawi

Dickinson Law Review (2017-Present)

No abstract provided.

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Supporting Medicaid In Virginia, Scott Burns

Exigence

This report analyzes Medicaid in Virginia, the needs-based social health insurance program providing health coverage to children, pregnant women, working parents, the disabled, and elderly who cannot afford health costs on their own. It supports the value of the Medicaid program to these beneficiaries’ long term health, the healthcare sector, cost control and Virginia’s economy. Additionally, it analyzes healthcare policy looking at what effects the Affordable Care Act has had in improving healthcare access and what effects healthcare reform under president-elect Donald Trump’s administration and the Republican controlled 115^th United States Congress might have targeting healthcare cost. Ultimately this …

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

The Reverberating Risk Of Long-Term Care, Allison K. Hoffman

All Faculty Scholarship

The Fiftieth Anniversary of Medicare and Medicaid offers an opportunity to reflect on how American social policy has conceived of the problem of long-term care. In this essay, based on a longer forthcoming article, I argue that current policies adopt too narrow a conception of long-term care risk, by focusing on the effect of serious illness and disability on people who need care and not on the friends and family who often provide it. I propose a more complete view of long-term care risk that acknowledges how illness and disability reverberates through communities, posing insecurity for people beyond those in …

Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei

Nevada Journal of Public Health

Objective. Nevada women with unfavorable health insurance status may face greater barriers than women in the rest of the nation, since the development of healthcare infrastructure in Nevada is running behind population growth. This study examines the relationship between health insurance status and adverse maternal outcomes in Nevada.

Methods. Hospital discharge information of 33,149 women aged 13 or older who delivered in 2004 was abstracted from the 2004 State Inpatient Data for Nevada. A total of 13 measures of complications associated with pregnancy were identified, including preterm labor, hypertensive disorders of pregnancy, gestational diabetes, ante-partum hemorrhage, membrane disorders, cesarean section, …

African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain

Journal of Health Disparities Research and Practice

North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …

The Percentage Of Beds Designated For Medicaid In American Nursing Homes And Nurse Staffing Ratios, Christopher Donoghue

Department of Sociology Faculty Scholarship and Creative Works

Previous analyses of the inverse relationship between a nursing home's Medicaid census and its quality of care have been based on samples limited to specific geographic regions, for-profit entities, or only skilled care facilities. The present study uses national-level data from the 1999 National Nursing Home Survey to examine the association between the proportion of beds designated for Medicaid residents and nurse staffing ratios. The results indicate that homes which designate a higher proportion of their beds for Medicaid recipients maintain lower ratios of registered nurses and nurse's aides to residents, even when key facility characteristics are controlled. It was …

The Status Of Childhood Lead Poisoning And Prevention In Nevada, Usa, Anne Rothweiler, Elena E. Cabb, Shawn Gerstenberger

Environmental & Occupational Health Faculty Publications

One of the first steps in addressing the problem of childhood lead poisoning is to identify the possible sources of exposure in specific communities and target high-risk populations with appropriate interventions. Due to several factors, such as lack of funding and lack of blood lead reporting, little information exists regarding the occurrence of childhood lead poisoning and the prevalence of potential exposure sources in the state of Nevada. Following the recent establishment of a Nevada-based Lead Poisoning Program, we compiled the most current information available on Nevadans, and use this knowledge to suggest future research objectives and outreach activities for …

Flyer: “Safeguarding And Strengthening Medicare And Medicaid.” President Bill Clinton. Clinton/Gore. August 21, 1996., Clinton/Gore '96 Primary Committee, Inc.

Saffy Collection - All Textual Materials

A Flyer promising that Clinton will maintain and extend Medicare and Medicaid support.

Flyer: “Protecting Our Seniors.” President Bill Clinton. Clinton/Gore. August 21, 1996., Clinton/Gore '96 Primary Committee, Inc

Saffy Collection - All Textual Materials

A Flyer detailing Clinton's policies on protecting Medicare and Medicaid, quality health care, and other issues related to senior citizens' concerns.

Medical Futility And Disability Discrimination, Mary Crossley

Articles

The concept of medical futility, which originally developed in the medical literature as a basis for allocating between physician and patient decisional authority regarding end-of-life treatment, is increasingly appearing in discussions regarding possible methods of containing medical costs by limiting treatment. This use of medical futility as a rationing mechanism, whether by a state Medicaid program or by a hospital, raises concerns regarding its impact on persons with severe disabilities near the end of life. This article considers how the applicability of the Americans with Disabilities Act to cost-conscious futility policies might be analyzed. After developing arguments that proponents and …