Social and Behavioral Sciences Commons^™

States’ Covid-19 Restrictions Were Associated With Increases In Drug Overdose Deaths In 2020, Douglas A. Wolf, Shannon M. Monnat, Jennifer Karas Montez, Emily E. Wiemers, Elyse Grossman

Center for Policy Research

Drug overdoses surged in the U.S. during the COVID-19 pandemic. Public health experts raised concerns in the pandemic’s early months about how the pandemic and the policies enacted to stem it might increase overdose risk. This brief summarizes the findings of a paper that used national data to identify how states’ COVID-19 policies affected drug overdose rates among U.S. adults ages 25-64 during the first year of the pandemic. Results show that counties located in states that adopted more aggressive in-person activity restrictions experienced larger increases in 2020 than counties located in states with fewer limitations. State economic support policies …

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 …

Health Policy, Equity, And The Lead Poisoning Crisis: A Conversation With Dr. Mona Hanna-Attisha, Mona Hanna-Attisha

Center for Policy Research

Dr. Mona Hanna-Attisha delivered the 33rd Annual Herbert Lourie Memorial Lecture on Health Policy on Thursday, September 23, 2021. This year's lecture was titled, "Health Policy, Equity, and the Lead Poisoning Crisis: A Conversation with Dr. Mona Hanna-Attisha"

Mona Hanna-Attisha, MD, MPH, FAAP, is founder and director of the Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative, an innovative and model public health program in Flint, Michigan.

A pediatrician, scientist, activist, and author, Dr. Hanna-Attisha has testified three times before the United States Congress and was awarded the Freedom of Expression Courage Award by PEN America. She …

Health Have, Health Have Nots In A Time Of Covid-19, Sandro Galea

Center for Policy Research

In this brief, my goal is to talk about something which has animated a lot of my thinking and writing in the past decade. It is how our health is fundamentally socially patterned and reflects the world around us. This has been true for decades in this country, and one could also argue, globally, however this brief will focus on this topic at the national level. As you will see, I will talk mostly of health haves and health have nots in general, but as we progress, show how COVID-19 has made this evermore apparent.

Marijuana Legalization: Beyond Yes Or No., Keith Humphreys

Center for Policy Research

This paper will first go over some basic terms and concepts, then discuss what’s going on in the world around cannabis with a focus on the United States. I will then offer some policy options to consider if New York chooses to legalize recreational cannabis.

Unequal Hopes, Lives, And Lifespans In The Usa: Lessons From The New Science Of Well-Being, Carol Graham

Center for Policy Research

Given that we have had historic increases in inequality, as well as stagnant poverty levels for several decades, I will tell the story of poverty and inequality in the U.S. from the perspective of the metrics of happiness and well-being. My research—and the book that resulted—found that inequality is part of this story, but not the only part. The story was much more complicated than I anticipated. One of the most interesting parts of the story includes different levels of hope and resilience across races and places. Poverty and inequality play a big role, but there is much more to …

The Opioid Epidemic: A Practice And Policy Perspective, Gail D'Onofrio

Center for Policy Research

I will be talking about the escalating opioid epidemic and some innovative solutions my colleagues and I at Yale University and throughout the state of Connecticut, are working on to mitigate the consequences of this public health crisis.

Pregnancy Medicaid Expansions And Fertility: Differentiating Between The Intensive And Extensive Margins, Lincoln H. Groves, Sarah Hamersma, Leonard M. Lopoo

Center for Policy Research

The theoretical and empirical links between public health insurance access and fertility in the United States remain unclear. Utilizing a demographic cell-based estimation approach with panel data (1987-1997), we revisit the large-scale Medicaid expansions to pregnant women during the 1980s to estimate the heterogeneous impacts of public health insurance access on childbirth. While the decision to become a parent (i.e., the extensive margin) appears to be unaffected by increased access to Medicaid, we find that increased access to public health insurance positively influenced the number of high parity births (i.e., the intensive margin) for select groups of women. In particular, …

A Roadmap For Reducing Gun Violence In America, Daniel Webster

Center for Policy Research

How do you reduce gun violence in America? It seems rather daunting. I’m going to take you through some key things I think we can do to have far less gun violence in America

Improving Public Health Safety Nets After An Economic Recession, Sanjay Basu

Center for Policy Research

When we say ‘here’s what’s going on with our nation’s health,’ how do we know the answer? Where is the data coming from? How can we best evaluate our public health system? We’re talking about it every day on CNN given the Ebola scare. What do we mean by our ‘public health system’? I would argue that we should expand our definition to mean something more than hospitals and clinics, or doctors and nurses. In particular, I’ll argue that some of our non-health programs that we have as part of the safety net actually make a bigger health impact than …

Hospital Treatment Rates And Spill-Over Effects: Does Ownership Matter?, Badi H. Baltagi, Yin -Fang Yen

Center for Policy Research

This paper studies the effect of hospital ownership on treatment rates allowing for spatial correlation among hospitals. Competition among hospitals and knowledge spillovers generate significant externalities which we try to capture using the spatial Durbin model. Using a panel of 2342 hospitals in the 48 continental states observed over the period 2005 to 2008, we find significant spatial correlation of medical service treatment rates among hospitals. We also get mixed results on the effect of hospital ownership on treatment rates that depends upon the market structure where the hospital is located and which varies by treatment type.

Health Promotions 2.0: The Future Of Wellness Programs In America, Rajiv Kumar

Center for Policy Research

In no small part because of technology, the way we live and work is being transformed. I believe that those of us who are interested in health policy can play an important role in guiding that transformation. I submit to you that unhealthy living is a social issue; that conditions such as obesity and diabetes are social diseases and that their prevalence is a social problem. If we have a social problem, then we need a social solution. I believe part of that solution can be found in the worksite health promotion and wellness programs that have taken root across …

Medicaid Expansion, Long-Term Care Financing In Retirement States And The Post World War Ii Birth Cohort, Toni P. Miles

Center for Policy Research

This policy brief contains a formal consideration of ideas discussed during a presentation to the 2012 Syracuse Seminar on Aging. Like most briefs, it will appeal to policy makers and academics craving detailed demographic, fiscal and policy data. Before diving into this brief, I would encourage readers to view the presentation video (available at http://www.youtube.com/ watch?v=bsv8K7DdJFY). As you will see, the seminar was informal and the discussion was wide ranging. In contrast, this brief focuses on limitations faced by states as they finance longterm care. It is primarily concerned with the Medicaid expansion and growing need for care as the …

Palliative Care And The Health Care Crisis In The United States: A Candid Conversation With Dr. Diane Meier, Diane E. Meier

Center for Policy Research

This paper is a synthesis of the 2012 Lourie Lecture, framed as a series of questions and responses, and supported by images used in the lecture. I’m going to focus on the growth of this new field called palliative care and will make the connection that the crisis afflicting healthcare in the United States cannot be addressed without widespread scaling and implementation of palliative care across the system. My subject is not end-of-life care, but rather care during serious illness. A serious illness is something a person can live with for many years, such as emphysema, or end-stage renal disease …

Quality Of Life For All Ages, By Design. A Conversation With Patricia Moore, Patricia Moore

Center for Policy Research

On November 3, 2011, Patricia Moore presented the Syracuse Seminar on Aging to a packed audience of over 250 faculty, students, and community members. She delivered an engaging lecture on “Quality of life for all ages, by design”. Afterwards Janet Wilmoth, Director of the Syracuse University Aging Studies Institute, and Patricia Moore had a chance to sit down and talk about her path-breaking career, ability-based design, and aging in America.

Integrating Care: Improving Overall Health By Integrating Behavioral/Mental Health Care Into Primary Care, Macaran A. Baird

Center for Policy Research

Hippocrates noted that the patient must be attended in light of “his” diet, work, home, and community setting. Since that time, we have struggled with the dilemma of how to put the patient’s presenting problems in the context of the patient’s life circumstances. That goal has proven elusive. So how do we sort out where to put the emphasis with our healing arts?

The Effect Of Disability Insurance On Health Investment: Evidence From The Va Disability Compensation Program, Perry Singleton

Center for Policy Research

I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by an amendment to Title 38 that deemed diabetes associated with Agent Orange exposure a compensable disability under the VA’s Disability Compensation program. Since a diagnosis is a requisite for benefit eligibility, and nearly one-third of diabetics remain undiagnosed, the advent of disability insurance may have encouraged the detection of diabetes among the previously undiagnosed population. Evidence from the National Health Interview Survey suggests that the policy increased the prevalence of diabetes by 2.7 percentage points among veterans.

On The Measurment Of Job Risk In Hedonic Wage Models, Dan Black, Thomas J. Kniesner

Center for Policy Research

We examine the incidence, form, and research consequences of measurement error in measure of fatal injury risk in United States workplaces using both BLS and NIOSH data. We find evidence of substantial measurement errors in the fatality risk researchers attach to individual workers when estimating the implicit price of risk and the value of a statistical life. We first examine possible classical attenuation bias in the fatality risk coefficient. However, because we also find non-classical measurement error that differs across multiple risk measures and is not independent of other regressors, more complex statistical procedures than a standard instrumental variables estimator …

Unfinished Business: Inadequate Health Coverage For Privately Insured, Seriously Ill Children, Nancy Swigonski, Eleanor D. Kinney, Deborah A. Freund, Thomas J. Kniesner

Center for Policy Research

During the 1980s and 1990s there were great increases of health insurance coverage for poor children through the Children’s Health Insurance Program (CHIP) and extended Medicaid eligibility. Problems remain for the small number of children with serious medical conditions whose care is a high proportion of total health care expenditures on children. We report on the adequacy of health insurance coverage for a sample of children with serious and rare illnesses treated at the single tertiary care pediatric hospital in Indiana. One-third of privately insured children in our data had inadequate insurance. Compared to families with inadequate health insurance families …

Determinants Of Medical Costs Following A Diagnosis Of Depression, Regina H. Powers, Thomas J. Kniesner, Thomas W. Croghan

Center for Policy Research

Objective: Assess the determinants of medical costs for depressed individuals.

Method: Using medical insurance claims for a population of depressed individuals with employer provided insurance, we estimated multivariate models of the costs for general medical care, exclusive of costs for mental health services, following diagnosis. Explanatory variables included provider choice (psychiatrist or non-physician mental health specialist), treatment choice (medication, psychotherapy, or combination treatment); treatment adequacy as defined by APA guidelines; characteristics of depression symptoms and severity; and other demographic characteristics.

Results: On average, there were increases in the costs for general medical services in the year following diagnosis of a …

Intergenerational Labor Market And Welfare Consequences Of Poor Health, Thomas J. Kniesner, Anthony T. Losasso

Center for Policy Research

Our research provides new econometric evidence concerning partial economic risk sharing between a frail elderly parent and an adult child. We estimate a jointly determined limited dependent variables system explaining the parent’s entry into a nursing home, the adult child’s visits to the parent, and the adult child’s labor supplied. The time allocation of adult sons is unaffected by a parent’s frail health. Adult daughters who visit a frail elderly parent daily decrease their annual labor supplied by about 1,000 hours annually, largely through labor force non-participation. The implied welfare loss to the daughter from a frail elderly parent in …

Antidepressent Treatment For Depression: Total Charges And Therapy Duration, Deborah G. Dobrez, Catherine A. Melfi, Thomas W. Croghan, Thomas J. Kniesner, Robert L. Obenchain

Center for Policy Research

Background: The economic costs of depression are significant, both the direct medical costs of care and the indirect costs of lost productivity. Empirical studies of antidepressant costeffectiveness suggest that the use of selective serotonin reuptake inhibitors (SSRI) may be no more costly than tricyclic antidepressants (TCA), will improve tolerability, and is associated with longer therapy duration. However the success of depression care usually involves multiple factors, including source of care, type of care, and patient characteristics, in addition to drug choice. The cost-effective mix of antidepressant therapy components is unclear.

Aims of the Study: Our study evaluates cost and antidepressant-continuity …