Health Policy Commons^™

Identifying Rural Health Clinics Within The Transformed Medicaid Statistical Information System (T-Msis) Analytic Files, Katherine Ahrens Mph, Phd, Zachariah Croll, Yvonne Jonk Phd, John Gale Ms, Heidi O'Connor Ms

Rural Health Clinics

Researchers at the Maine Rural Health Research Center describe a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Background: There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part this is because methods to identify RHC encounters within Medicaid claims data are outdated.

Methods: We used a 100% sample of the 2018 Medicaid Demographic and Eligibility and Other Services Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files for 20 states …

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.

Retrospective Assessment Of A Collaborative Digital Asthma Program For Medicaid-Enrolled Children In Southwest Detroit: Reductions In Short-Acting Beta-Agonist (Saba) Medication Use, Meredith Barrett, Rahul Gondalia, Vy Vuong, Leanne Kaye, Alex B. Hill, Elliot Attisha, Teresa Holtrop

Urban Studies and Planning Faculty Research Publications

Background
Real-world evidence for digitally-supported asthma programs among Medicaid-enrolled children remains limited. Using data from a collaborative quality improvement program, we evaluated the impact of a digital intervention on asthma inhaler use among children in southwest Detroit.

Methods
Children (6–13 years) enrolled with Kids Health Connection (KHC), a program involving home visits with an asthma educator, were invited to participate in a digital self-management asthma program (Propeller Health). Patients were provided with a sensor to capture short-acting beta-agonist (SABA) medication use, and given access to a paired mobile app to track usage. Patients’ healthcare providers and caregivers (“followers”) were invited …

Maternal Healthcare Access And Obstetric Complications: A Cause And Effect Relationship?, Lena Sharara

Independent Study Project (ISP) Collection

Poverty-stricken migrant women, named ‘Kayayei or Kayayo’ because of the nature of their job in the informal sector, have high birth rates and are said to have many barriers affecting their access to maternal health resources. In this study, Kayayei in Madina Market were interviewed and both quantitative and qualitative data were gathered to determine whether a relationship exists between access to maternal health and the obstetric complications and outcomes experienced by Kayayei. A Chi-Squared Test of Independence and a Qualitative Content Analysis were both used to analyze the data. Due to a non-significant p-value, it was found that the …

Inclusión Cultural En Fonasa: Parto Aymara Como Un Estudio De Caso, Madison Singleton

Independent Study Project (ISP) Collection

Los primeros años de la década de 2000s sirven como un período legal transformador en Chile, debido al auge de los grupos de representación indígena y la introducción de la ley 20.584 que asegura un modelo de interculturalidad en los servicios de salud. El objetivo de esta investigación es comprender los factores que impactaron en la priorización de la inclusión cultural en el sistema público de salud (FONASA), utilizando el parto aymara en Arica como un estudio de caso. Esta investigación toma forma en un diseño de investigación cualitativa y exploratoria utilizando 5 entrevistas y 5 observaciones, así como las …

How Has The Opioid Overdose Crisis Affected Child Maltreatment In The U.S.?, Alexander Chapman

Population Health Research Brief Series

This brief summarizes results from a study examining the association between U.S. county-level opioid mortality rates and child maltreatment rates from 2007 to 2017. Places with higher opioid overdose mortality rates have higher rates of child maltreatment. Poverty makes this problem worse - where the proportion of families in poverty increases, the association between fatal opioid overdose rates and child maltreatment also increases. Findings suggest that intervening in opioid use by reducing poverty has the potential to markedly decrease the incidence of child maltreatment.

Abortion Decisions As Humanizing Acts: The Application Of Ambivalent Sexism And Objectification To Women-Centered Anti-Abortion Rhetoric, Rachel L. Dyer, Olivia R. Checkalski, Sarah Gervais

Department of Psychology: Faculty Publications

Women-centered anti-abortion rhetoric, grounded in ostensibly positive beliefs that pregnant people are precious objects who must be protected from having abortions, has proliferated anti-abortion activism and legislation. However, abortion stigma, marked by negative perceptions of people who terminate pregnancies, is the most widely used theoretical tool for understanding the social and psychological implications of abortion. In this article, we first integrate these two seemingly contradictory perspectives on abortion through the lens of ambivalent sexism theory. We then argue that ambivalent sexism paves the way for objectifying perceptions and treatment of pregnant people; specifically, our typology of reproductive objectification provides a …

Births In The Mountain West, 2016-2020, Corryn Richardson, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines state-level data on births and health indicators from the National Center for Health Statistics (NCHS), a government health statistics unit of the Center for Disease Control and Prevention (CDC). This fact sheet presents data related to births in the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah.

Influenza Vaccination Coverage Among An Urban Pediatric Asthma Population: Implications For Population Health, Sarah J. Parker, Amy M. Delaroche, Alex B. Hill, Rajan Arora, Julie Gleason-Comstock

Urban Studies and Planning Faculty Research Publications

Introduction
Asthma is the most common chronic disease in children. Children with asthma are at high risk for complications from influenza; however annual influenza vaccination rates for this population are suboptimal. The overall aim of this study was to describe the characteristics of a high-risk population of children with asthma presenting to an urban pediatric emergency department according to influenza vaccination status.

Methods
The study was a retrospective chart review of 4355 patients aged 2 to 18 years evaluated in a Michigan pediatric emergency department (PED) between November 1, 2017 and April 30, 2018 with an ICD-10-CM code for asthma …

Rural Resiliency: The Cause And Effect Of Minnesota's Maternal Health Crisis, Annabel Traudie Gregg

Geography Honors Projects

The United States is experiencing a maternal health crisis that disproportionately affects those who give birth in rural communities. Rural birthing people have higher maternal mortality rates, increased risk of postpartum hemorrhage, non-indicated cesarean sections, and other adverse health outcomes. Despite the enhanced risks of rural birth, rural communities are losing access to hospital-based obstetric care at an unprecedented rate. Minnesota has vast rural territory, with one-fourth of its population living outside the urban sphere ­– making it a strategic area of study. As of July, 2021, 31% of Minnesota’s 91 rural hospitals were at risk of closing. The repercussions …

Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell

Independent Study Project (ISP) Collection

Research Question: What are the psychological and social effects of teen pregnancy facing teen mothers in 2021 and how do they impact their lives? Objective: The general objective is to describe the psychosocial implications produced by teen pregnancy. Background: Teen pregnancy rates of Latin America and the Caribbean are second in the world, second only to the region of Subsaharan-Africa. Within Latin America, Ecuador has the highest rates of adolescent pregnancy, surpassed only by Venezuela. Recently, the taboo surrounding reproductive health has been challenged, with the matter of abortion being brought to the supreme court. In conjunction with the matter …

Evidence On Child Nutrition Recommendations And Challenges In Crisis Settings: A Scoping Review, Aniqa Islam Marshall, Gideon Lasco, Mathudara Phaiyarom, Nattanicha Pangkariya, Phetdavanh Leuangvilay, Pigunkaew Sinam, Rapeepong Suphanchaimat, Sataporn Julchoo, Watinee Kunpeuk, Yunting Zhang

Development Studies Faculty Publications

Adequate child nutrition is critical to child development, yet child malnutrition is prevalent in crisis settings. However, the intersection of malnutrition and disasters is sparse. This study reviews existing evidence on nutrition responses and outcomes for infants and young children during times of crisis. The scoping review was conducted via two approaches: a systematic search and a purposive search. For the systematic search, two key online databases, PubMed and Science Direct, were utilized. In total, data from 32 studies were extracted and included in the data extraction form. Additionally, seven guidelines and policy documents were included, based on relevance to …

Factors Associated With Chronic Kidney Disease Of Non-Traditional Causes Among Children In Guatemala, Alejandro Cerón, Brooke M. Ramay, Luis Pablo Méndez-Alburez, Randall Lou-Meda

Anthropology: Faculty Scholarship

Objective. To identify factors associated with chronic kidney disease of non-traditional causes among children in Guatemala. Methods. A cross-sectional survey was conducted. The study population was all pediatric patients with stage 5 chronic kidney disease active in FUNDANIER’s pediatric nephrology unit (N = 156). Simple random sampling led to a total of 100 participants. Data collection consisted of a questionnaire addressing individual and household characteristics, access and utilization of health care, and place of residence when the disease began. Chronic kidney disease etiology was obtained from medical records. Municipality-level secondary data were collected. Descriptive statistics were estimated. Logistic regression was …

Cross-National Attitudes About Paid Parental Leave Offerings For Fathers, Qi Li, Chris Knoester, Richard J. Petts

Department of Sociology: Faculty Publications

Using cross-national data from the 2012 International Social Survey Programme (N = 33,273), this study considers institutional, self-interest, and ideational factors in analyzing public opinions about the provision, length, and source of paid parental leave offerings for fathers. We find substantial support for generous leave offerings. Multilevel regression results reveal that being a woman, supporting dual-earning expectations, and realizing more family strains lead to support for more generous leave offerings. Endorsing separate spheres and intensive mothering attitudes reduces support for more generous leave offerings; although, gendered attitudes interact with one another in predicting leave preferences, too. Finally, country-level indicators …

Attitudes About Paid Parental Leave: Cross-National Comparisons And The Significance Of Gendered Expectations, Family Strains, And Extant Leave Offerings, Chris Knoester, Qi Li, Richard J. Petts

Department of Sociology: Faculty Publications

Using data on paid parental leave preferences from 35,488 adults situated within 26 different OECD countries, and multilevel modeling, this study examines public opinions about the provision of paid parental leave, some government funding of leave offerings, and preferred lengths of leave offerings. We consider how attitudes may be similar or different across social contexts and then focus upon the extent to which gender, gendered parenting role attitudes, family strains, and country-level institutionalized leave offerings are associated with leave preferences. The findings indicate that the vast majority of respondents are in favor of rather widespread and generous paid parental leave …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Protocol For A Trial Assessing The Impacts Of School-Based Wash Interventions On Children’S Health Literacy, Handwashing, And Nutrition Status In Low- And Middle-Income Countries, Stephanie O. Sangalang, Shelley Anne J. Medina, Zheina J. Ottong, Allen Lemuel G. Lemence, Donrey Totanes, John Cedrick Valencia, Patricia Andrea A. Singson, Mikaela Olaguera, Nelissa O. Prado, Roezel Mari Z. Ocaña, Rovin James F. Canja, Alfem John T. Benolirao, Shyrill Mae F. Mariano, Jergil Gyle Gavieres, Clarisse P. Aquino, Edison C. Latag, Maria Vianca Jasmin C. Anglo, Christian Borgemeister, Thoomas Kistemann

Development Studies Faculty Publications

Diarrhea, soil-transmitted helminth infection and malnutrition are leading causes of child mortality in low- and middle-income countries (LMICs). To reduce the prevalence of these diseases, effective interventions for adequate water, sanitation, and hygiene (WaSH) should be implemented. This paper describes the design of a cluster-randomized controlled trial that will compare the efficacy of four school-based WaSH interventions for improving children’s health literacy, handwashing, and nutrition. Interventions consisted of (1) WaSH policy reinforcement; (2) low-, medium-, or high-volume health education; (3) hygiene supplies; and (4) WaSH facilities (e.g., toilets, urinals, handwashing basins) improvements. We randomly allocated school clusters from the intervention …

Oral Rehydration Therapies In Senegal, Mali, And Sierra Leone: A Spatial Analysis Of Changes Over Time And Implications For Policy, Kirsten E. Wiens, Lauren E. Schaeffer, Samba O. Sow, Babacar Ndoye, Carrie Jo Cain, Mathew M. Baumann, Kimberly B. Johnson, Paulina A. Lindstedt, Brigette F. Blacker, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Oral rehydration solution (ORS) is a simple intervention that can prevent childhood deaths from severe diarrhea and dehydration. In a previous study, we mapped the use of ORS treatment subnationally and found that ORS coverage increased over time, while the use of home-made alternatives or recommended home fluids (RHF) decreased, in many countries. These patterns were particularly striking within Senegal, Mali, and Sierra Leone. It was unclear, however, whether ORS replaced RHF in these locations or if children were left untreated, and if these patterns were associated with health policy changes.
Methods: We used a Bayesian geostatistical model and …

Child Food Insecurity In Nevada Counties, 2018, Ally Beckwith, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet synthesizes data on the child hunger discrepancies in Nevada counties from the Feeding America 2018 Map the Meal Gap Study. The information focuses on food insecurity experienced by children, and the food budget shortfall in Nevada.

Mapping Geographical Inequalities In Oral Rehydration Therapy Coverage In Low-Income And Middle-Income Countries, 2000–17, Kirsten E. Wiens, Robert C. Reiner Jr, Arianna Maever L. Amit, Veincent Christian F. Pepito, Local Burden Of Disease Diarrhoea Collaborators, 702 Co-Authors

Ateneo School of Medicine and Public Health Publications

Background

Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative …

Using Open Public Meetings And Elections To Promote Inward Transparency And Accountability: Lessons From Zambia, Taryn Vian, Rachel M. Fong, Jeanette L. Kaiser, Viviane Sakanga, Melvin Mwansa, Parker S. Chastain, Thandiwe Ngoma, Nancy Scott

Nursing and Health Professions Faculty Research and Publications

Background
Community-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members.

Methods
We applied a principally qualitative …

Toxic Structures: Speculation And Lead Exposure In Detroit's Single-Family Rental Market, Alexa Eisenberg, Eric Seymour, Alex B. Hill, Joshua Akers

Urban Studies and Planning Faculty Research Publications

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor-landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥ 5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity …

Medical Trust In Pediatric Care In The United States, Talia Feldscher

Independent Study Project (ISP) Collection

Trust is a critical aspect of the patient-provider dynamic, but in the U.S., its importance is overlooked in many medical settings, especially among those from low socio-economic groups. As the disparities in American healthcare are being recognized on a larger scale, it is necessary to further uncover why this is the case, and how to begin to remedy this disparity. This study presents an original qualitative data set of perspectives from four current health/mental health practitioners, based on their experiences with their pediatric patients, and how the concept of trust is critical to their service provision. Supported by literature, this …

Las Perspectivas Y Experiencias De Los Profesionales Del Campo De La Reproducción Asistida En La Ciudad Autónoma De Buenos Aires Y Bahía Blanca En El Año 2020. / The Perspectives And Experiences Of The Professionals In The Field Of Assisted Reproduction In The Autonomous City Of Buenos Aires And Bahía Blanca In 2020., Calder Hollond

Independent Study Project (ISP) Collection

En este informe se realiza una exploración del campo de la reproducción asistida en Argentina en 2020 a través de entrevistas personales con seis profesionales en el campo. Estos profesionales vienen de Capital Federal y Bahía Blanca y ofrecen perspectivas diversas en el estado del campo en este momento, los cambios que han pasado en los últimos años, y una mirada hacia el futuro. Este informe utiliza una metodología cualitativa y exploratoria, y un diseño observacional transversal. Además, emplea una muestra no probabilística y un diseño descriptivo para introducir el tema de reproducción asistida en Argentina y después analizarlo a …

¿Es Suficiente La Ley De Parto Respetado? Una Investigación Sobre El Parto Respetado Y La Intervención Médica, A Partir De Las Opiniones De Los Profesionales De La Salud Y Una Organizacion De La Sociedad Civil En La Ciudad Autónoma De Buenos Aires, Argentina / Is The Respected Birth Law Enough? An Investigation On The Respected Birth And Medical Interventions Through The Opinions Of Health Professionals And A Civil Society Organization In The Autonomous City Of Buenos Aires, Argentina, Jennifer Rufino

Independent Study Project (ISP) Collection

A través de los años, la medicalización y los avances en el campo de medicina ha garantizado un nivel de seguridad para el proceso del embarazo y el parto. Sin embargo, la intervención médica también ha producido una discusión sobre el aumento de cesáreas, el significado del parto respetado, y los derechos de la mujer. Esta investigación exploró las opiniones de los profesionales de salud y una organización de la sociedad civil sobre la ejecución del parto respetado y el aumentado de la tasa de cesáreas en la Ciudad Autónoma de Buenos Aires, Argentina. Dada la situación de aislamiento social …

The Social Dimensions Of Reproductive Health: Analyzing Disparities In Morocco Through Health Indicators And Social Determinants, Mila Sicorsky

Independent Study Project (ISP) Collection

This paper explores the social dimensions of reproductive health in Morocco through a look at its health indicators and social determinants. Existing literature discusses reproductive health differences that run on economic, social, and cultural lines. In this paper, I shed light on how best to measure and understand these disparities. The research shows that reproductive health in Morocco is most accurately indicated by maternal mortality rates (MMR), access to prenatal and postnatal visits, and access to adequate family planning. It also finds that location of residence, economic status, and women’s status are key social determinants of reproductive health in Morocco. …

Utilization Of Dental Services Among Medicaid Enrolled Pregnant Women In Virginia, Shillpa Naavaal, Tegwyn Brickhouse, Jonathan W. Yu, Joann Wells

Philips Institute for Oral Health Research Publications

The study evaluated the impact of the Virginia Medicaid dental benefit on dental services utilization among pregnant women enrolled in Medicaid. Data from a total of 10,395 women who had at least one dental claim during the 2015-2017 period were included in the study. The number of dental visits and dental services utilized per person grew from an average of 2.2 visits and 7 services in 2015 to 3.1 visits and 10.5 services in 2017, respectively. In 2017, of all dental services used, 6% were for preventive services and 59% were for treatment services. Continued efforts and targeted interventions are …

Syrian Refugee Mothers In Jordan: Perceived Social Support And Postpartum Depression, Marya Rana

Independent Study Project (ISP) Collection

Many women suffer from postpartum depression; migrant women experience postpartum depression at rates almost triple that of the general population. This study investigated the associations between perceived social support and postpartum depression among Syrian refugee mothers living in Amman, Jordan. Eleven mothers completed a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Interpersonal Support Evaluation List (ISEL) - Shortened Version. Four of those mothers also participated in individual interviews, and four others were included in a focus group. Multiple recurring themes were identified from the interviews and focus group, including: perceived differences in child and social support in …

La Pertinencia Cultural De Los Proyectos Relacionados A La Planificación Familiar De Las Ongs En El Distrito De Acomayo, Sadie Traylor

Independent Study Project (ISP) Collection

Esta investigación identifica y analiza la pertinencia cultural de los esfuerzos de ayuda ambos de una ONG local (Kallpa) y de una ONG internacional (Plan International), examinando específicamente el proyecto de cada ONG vinculado al aumento del acceso y uso de la planificación familiar en el Distrito de Acomayo en la región de Cusco para evaluar cómo opera (o no opera) cada ONG con una pertinencia cultural. Además, esta investigación explora la forma en que las estrategias de cada ONG mantienen un enfoque intercultural, y también analiza las percepciones de los beneficiarios del proyecto como testimonios de cómo este método …

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …