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Social and Behavioral Sciences Commons™
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Articles 1 - 30 of 51
Full-Text Articles in Social and Behavioral Sciences
The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays
The Economics Of Implementing Population Health Strategies: Progress In Public Health Services & Systems Research, Glen P. Mays
Health Management and Policy Presentations
Successful strategies to scale up and spread complex community-level interventions require an understanding of the resources required for implementation, how best to distribute them among supporting institutions, and how resource consumption and distribution varies across settings. This session reviews methods and early findings from the RWJF’s Public Health Delivery and Cost Studies (DACS) Initiative, which includes 12 inter-related studies examining the causes and consequences of variation in the costs of delivering complex community-level prevention strategies across more than 300 community settings in 12 states. Findings from these studies highlight the value of studying the economics of implementation, the measurement and …
The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays
The Dynamics Of Medicaid & Public Health Spending: Implications For Aca Implementation, Glen P. Mays
Health Management and Policy Presentations
We estimate the dynamics and interactions of governmental spending on Medicaid and other public health services in all 50 states over a 15 year period. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.
Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays
Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays
Health Management and Policy Presentations
In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.
Cost Estimates Of Foundational Public Health Services: Results From Piloting An Expert Consensus Methodology, C. B. Mamaril, Glen P. Mays
Cost Estimates Of Foundational Public Health Services: Results From Piloting An Expert Consensus Methodology, C. B. Mamaril, Glen P. Mays
Health Management and Policy Presentations
We review preliminary estimates from pilot testing a cost estimation methodology developed to identify the resources required to implement a set of Foundational Public Health Services as recommended by the Institute of Medicine and defined by the Public Health Leadership Forum.
Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays
Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays
Health Management and Policy Presentations
OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …
Cost Estimates Of Foundational Public Health Services: Results From Piloting The Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays
Cost Estimates Of Foundational Public Health Services: Results From Piloting The Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays
Health Management and Policy Presentations
We developed a methodology for estimating the resources required to deliver a set of foundational public health capabilities as recommended in the 2012 Institute of Medicine report on public health financing. The capabilities are based on IOM recommendations and defined by a national expert panel convened as part of the Public Health Leadership Forum. This paper presents preliminary estimates from a pilot test of the cost estimation methodology in Kentucky, and outlines plans for the national estimation strategy.
Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays
Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays
Health Management and Policy Presentations
This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .
Reassessing The Effects Of Unemployment Insurance Generosity On Search Intensity: New Evidence From Earnings Histories, Lewis Warren
Reassessing The Effects Of Unemployment Insurance Generosity On Search Intensity: New Evidence From Earnings Histories, Lewis Warren
University of Kentucky Center for Poverty Research Discussion Paper Series
This paper provides the first nationally representative estimates of how unemployment insurance (UI) generosity in the United States affects the search intensity of unemployed individuals using individual level variation in UI generosity. The paper expands the current literature through fully simulating monetary eligibility and entitlement to unemployment insurance at the individual level where past studies have been unable to examine monetary eligibility and have relied on state variations in the maximum weekly benefit amount which can differ significantly from an individual’s actual benefit amount. To simulate monetary eligibility and entitlement, work histories of unemployed respondents were obtained through fully matching …
Value And Cost-Effectivess Of Chw Programs: Implications For Home Care Workers, Glen P. Mays
Value And Cost-Effectivess Of Chw Programs: Implications For Home Care Workers, Glen P. Mays
Health Management and Policy Presentations
This presentation reviews studies on the health and economic value of strategies to improve the coordination of medical care, public health, and social support services for high-need and high-risk populations. Community health worker (CHW) programs feature prominently in these strategies, particularly for rural and low-resource community settings. Home care workers have the potential to function as CHWs in many settings, and as such present powerful opportunities for scaling up CHW programs that connect medical care, public health, and social services delivery.
Cost Estimates Of Foundational Public Health Capabilities: Pilot Test Results Of An Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays
Cost Estimates Of Foundational Public Health Capabilities: Pilot Test Results Of An Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays
Health Management and Policy Presentations
The Institute of Medicine's 2012 report on U.S. public health financing recommended research to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be made available in every U.S. community. We present results from pilot testing of a proposed methodology for estimating the costs and resource requirements for a set of foundational public health capabilities identified by the Public Health Leadership Forum. Using pilot data from Kentucky public health settings, we estimate both current and projected costs under a range of assumptions about the resources required to fully implement the capabilities at …
How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays
How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays
Health Management and Policy Presentations
Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.
Ending Failures, Showing Results, Improving Population Health: Insights From Research & Reform In The U.S., Glen P. Mays
Ending Failures, Showing Results, Improving Population Health: Insights From Research & Reform In The U.S., Glen P. Mays
Health Management and Policy Presentations
A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.
Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays
Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays
Health Management and Policy Presentations
Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.
Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays
Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays
Health Management and Policy Presentations
Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.
Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays
Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays
Health Management and Policy Presentations
Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.
Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays
Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays
Health Management and Policy Presentations
Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.
Childhood Stress: A Qualitative Analysis Of The Intergenerational Circumstances Of Child Hunger, Mariana Chilton, Molly Knowles
Childhood Stress: A Qualitative Analysis Of The Intergenerational Circumstances Of Child Hunger, Mariana Chilton, Molly Knowles
University of Kentucky Center for Poverty Research Discussion Paper Series
Adverse Childhood Experiences (ACEs), including abuse, neglect, and household instability, affect lifelong health and economic potential. While relationships between household food insecurity and caregiver’s childhood exposure to abuse and neglect are underexplored, preliminary evidence indicates that caregivers reporting very low food security report traumatic events in their childhoods that lead to poor physical and mental health. Building on this evidence, this study investigates how adverse childhood experiences are associated with the intergenerational transmission of household food insecurity.
Distributional Effects Of Welfare Reform Experiments: A Panel Quantile Regression Examination, Carlos Lamarche, Robert Paul Hartley
Distributional Effects Of Welfare Reform Experiments: A Panel Quantile Regression Examination, Carlos Lamarche, Robert Paul Hartley
University of Kentucky Center for Poverty Research Discussion Paper Series
In an influential article, Bitler, Gelbach and Hoynes (American Economic Re- view, 2006; 96, 988-1012) illustrate the importance of estimating heterogeneous impacts of welfare reform experiments. They find that the mean treatment effect offers an uninfor- mative summary of opposing effects, while the treatment effects are significantly different across quantiles. We replicate their results and evaluate the robustness of their findings to accounting for individual-specific heterogeneity possibly associated with welfare program participation. We find results that are in general similar to Bitler’s et al. findings, although the interpretation of labor supply effects in the upper tail is revised. We find …
A Tale Of Two Cities? The Heterogeneous Impact Of Medicaid Managed Care, James Marton, Aaron Yelowitz, Jeffrey Talbert
A Tale Of Two Cities? The Heterogeneous Impact Of Medicaid Managed Care, James Marton, Aaron Yelowitz, Jeffrey Talbert
Aaron Yelowitz
Evaluating Accountable Care Organizations is difficult because there is a great deal of heterogeneity in terms of their reimbursement incentives and other programmatic features. We examine how variation in reimbursement incentives and administration among two Medicaid managed care plans impacts utilization and spending. We use a quasi-experimental approach exploiting the timing and county-specific implementation of Medicaid managed care mandates in two contiguous regions of Kentucky. We find large differences in the relative success of each plan in reducing utilization and spending that are likely driven by important differences in plan design. The plan that capitated primary care physicians and contracted …
Learning From Networks: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays
Learning From Networks: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays
Health Management and Policy Presentations
Social network analysis methods offer many avenues of inquiry for studying new developments in health policy and health care delivery. The expanding availability of large linkable electronic clinical and administrative data sources allows for novel SNA applications with dependent data structures. Opportunities include the study of delivery patterns within accountable care organizations (ACOs), and other multi-provider networks, price and quality competition within new health insurance exchanges, and population health effects attributable to complex community-level interventions.
Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays
Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays
Health Management and Policy Presentations
Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …
Income, Program Participation, Poverty, And Financial Vulnerability: Research And Data Needs, James P. Ziliak
Income, Program Participation, Poverty, And Financial Vulnerability: Research And Data Needs, James P. Ziliak
University of Kentucky Center for Poverty Research Discussion Paper Series
The aim of this paper is to assess the adequacy of the data infrastructure in the United States to meet future research and policy evaluation needs as it pertains to income, program participation, poverty, and financial vulnerability. I first discuss some major research themes that are likely to dominate policy and scientific discussions in the coming decade. This list includes research on the long-term consequences of income inequality and mobility, issues of transfer-program participation and intergenerational dependence, challenges with poverty measurement and poverty persistence, and material deprivation. I then summarize what information we currently collect in the U.S. that is …
Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays
Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays
Health Management and Policy Presentations
This session reviews progress in the field of public health services & systems research (PHSSR), with a specific focus on findings that can inform the implementation and impact of health reform strategies on the U.S. public health system.
Producing Population Health: Collective Action Requires Infrastructure, Incentives & Evidence, Glen P. Mays
Producing Population Health: Collective Action Requires Infrastructure, Incentives & Evidence, Glen P. Mays
Health Management and Policy Presentations
Population health improvement strategies are collective action problems that require targeted infrastructure, incentives, and information to succeed. Research on collective action problems and solutions in public health and other spheres of practice offer insight for the successful scale and spread of population health innovations.
Effects Of Maternal Depression On Family Food Insecurity, Kelly Noonan, Hope Corman, Nancy E. Reichman
Effects Of Maternal Depression On Family Food Insecurity, Kelly Noonan, Hope Corman, Nancy E. Reichman
University of Kentucky Center for Poverty Research Discussion Paper Series
Theory suggests that adverse life events—such as unemployment or health shocks—can result in food insecurity, which has increased substantially in the U.S. over the past decade alongside the obesity epidemic. We test this proposition by estimating the effects of a specific and salient mental health event—maternal depression during the postpartum year—on child and family food insecurity. Using data from the Early Childhood Longitudinal Study—Birth Cohort, we estimate the effects of maternal depression on food insecurity using both single- and twostage models, and explore potential buffering effects of relevant public assistance programs and supports. We find that moderate to severe maternal …
Health Reform Implementation: Update And Implications For Kentucky, Glen P. Mays
Health Reform Implementation: Update And Implications For Kentucky, Glen P. Mays
Health Management and Policy Presentations
This talk reviews the progress of health reform implementation in Kentucky with a focus on opportunities for aligning systems for medical care, public health, and social support delivery to improve population health.
Unifying Systems For Population Health: Infrastructure, Incentives & Evidence For Collective Action, Glen P. Mays
Unifying Systems For Population Health: Infrastructure, Incentives & Evidence For Collective Action, Glen P. Mays
Health Management and Policy Presentations
This presentation, part of the SBM Presidential Symposium on Aligning Family, Clinical, and Community Systems, reviews the collective action problems that are commonly encountered in implementing multi-sector population health improvement strategies, and examines research on ways of using public health strategies and infrastructure to overcome these problems.
Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays
Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays
Health Management and Policy Presentations
Practice-based research networks (PBRNs) provide powerful mechanisms for implementing research studies that evaluate the health and economic effects of delivery system innovations. This presentation reviews strategies, emerging findings, and lessons learned from PBRNs and related studies conducted in U.S. public health settings. We give special focus to studies that examine multi-organizational and cross-sectoral strategies for population health improvement.
Kentucky Forestry Economic Impact Report 2013-2014, Jeff Stringer, Billy Thomas, Bobby Ammerman, Alison Davis
Kentucky Forestry Economic Impact Report 2013-2014, Jeff Stringer, Billy Thomas, Bobby Ammerman, Alison Davis
Kentucky Forestry Economic Impact Reports
Forests are a valuable part of Kentucky’s landscape providing significant resources and opportunities benefiting the Commonwealth. One important and verifiable benefit is the economic contributions of Kentucky’s forest and wood industries. Analysis of these industries indicated a total economic impact of $12.8 billion and 59,000 jobs in 2013. Kentucky is one of the leading producers of hardwood forest products in the south and exports wood products across the nation and the world. This economic impact was generated from forests located in all 120 counties of the Commonwealth providing resources harvested by over 1,800 logging firms and processed at 703 facilities …
Troubles In Paradise: The United States’ Biggest Challenge In The Carribean, Juan Clar
Troubles In Paradise: The United States’ Biggest Challenge In The Carribean, Juan Clar
Ex-Patt Magazine
As many Caribbean economies grow, and the threat of Cuban communism fades, the challenge in the Caribbean for the US comes from the Commonwealth of Puerto Rico.