Health Policy Commons^™

The Development Of Health System Resiliency: How Kenya's Experience With Malaria Impacted Its Reaction To The Covid-19 Pandemic, Zoe A. Ward

Baker Scholar Projects

Public health scholars have recently focused on health system resiliency to explain how previous experiences dealing with public health crises impact the healthcare sector, public behavior, and policy response to novel crises. However, it is unclear how resiliency develops. This study contributes by testing whether a health system’s experience with a health emergency and significant interventions impacts the response to a novel crisis. This research asks, “How has Kenya’s experience with malaria impacted its response to COVID-19?” Using the United States Agency for International Development (USAID) Malaria Indicator Survey (MIS), I develop a malaria adherence score to measure county-level compliance …

The Shortfalls Of Vulnerability Indexes For Public Health Decision-Making In The Face Of Emergent Crises: The Case Of Covid-19 Vaccine Uptake In Virginia, Lydia Cleveland Sa, Erika Frydenlund

VMASC Publications

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is …

Experiences With Covid-19 Stress Among Hispanic/Latino Farmworkers, Brenda Berumen-Flucker, Hadiza Galadima, Sylvia Shangani, Michele Kekeh, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: Hispanics/Latinos, particularly those that identify as foreign-born, are overrepresented in the agricultural sector in the U.S. Over the course of the COVID-19 pandemic, this subpopulation of farmworkers was recognized as an invaluable group of essential workers unable to implement COVID-19 protections.

METHODS: Previously validated COVID-19 stress scale measures were identified, adapted, and translated to collect COVID-19 stress data from Hispanic/Latino agricultural workers in two heavily agricultural counties in northeastern North Carolina. Participants were recruited using purposive convenience sampling. Data collection took place from June to November of 2021.

RESULTS: The majority of Hispanic/Latino agricultural workers surveyed reported experiencing worries …

Hiv Viral Load Suppression Before And After Covid-19 In Kinshasa And Haut Katanga, Democratic Republic Of The Congo, Gulzar H. Shah, Gina D. Etheredge, Stacy Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.

Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.

Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.

Results: After controlling for covariates …

Risk Of Transmission Of Respiratory Viruses During Aerosol-Generating Medical Procedures (Agmps) Revisited In The Covid-19 Pandemic: A Systematic Review, Jenine Leal, Brenlea Farkas, Liza Mastikhina, Jordyn Flanagan, Becky Skidmore, Charleen Salmon, Devika Dixit, Stephanie Smith, Stephen Tsekrekos, Bonita Lee, Joseph Vayalumkal, Jessica Dunn, Robyn Harrison, Melody Cordoviz, Roberta Dubois, Uma Chandran, Fiona Clement, Kathryn Bush, John Conly, Oscar Larios

Journal Articles

BACKGROUND: In many jurisdictions healthcare workers (HCWs) are using respirators for aerosol-generating medical procedures (AGMPs) performed on adult and pediatric populations with all suspect/confirmed viral respiratory infections (VRIs). This systematic review assessed the risk of VRIs to HCWs in the presence of AGMPs, the role respirators versus medical/surgical masks have on reducing that risk, and if the risk to HCWs during AGMPs differed when caring for adult or pediatric patient populations.

MAIN TEXT: We searched MEDLINE, EMBASE, Cochrane Central, Cochrane SR, CINAHL, COVID-19 specific resources, and MedRxiv for English and French articles from database inception to September 9, 2021. Independent …

The Value Of Education: School Policy Decisions During The Covid-19 Pandemic, Elika W. Somani

Individually Designed Interdepartmental Major Honors Project

During the COVID-19 pandemic, lacking national U.S. policies, wide variation and conflict over chosen public school policy decisions emerged. What factors and guidelines informed the decision-making process in K-12 public schools during the COVID-19 pandemic and who were the key stakeholders? This study examines three school district types – a large city, medium city, and small-town – across Minnesota as case studies to unpack how policy decisions were made during the pandemic. Stakeholder interviews uncovered that the school decision-making process was a) connected to a district's political opinions, b) made by the superintendent and school board, c) primarily influenced by …

Covid-19 Vaccination Rates In Nevada Counties, December 2021, Kristian Thymianos, Olivia K. Cheche, William E. Brown Jr., Caitlin J. Saladino

Health

This fact sheet presents vaccination rates in Nevada counties as originally reported by the Data Strategy and Execution Workgroup in the Joint Coordination Cell, under the White House COVID-19 Team in the December 30th “COVID-19 Community Profile Report.” Data on one-dose and full vaccination rates are presented.

Health Workers On The Political Frontlines, Gideon Lasco

Development Studies Faculty Publications

No abstract provided.

Politicians Polarize And Experts Depolarize Public Support For Covid-19 Management Policies Across Countries, A. Flores, J.C. Cole, S. Dickert, Kimin Eom, G.M. Jiga-Boy, T. Kogut, R. Loria, M. Mayorga, E.J. Pedersen, B. Pereira, E. Rubaltelli, D.K. Sherman, P. Slovic, D. Vastfjall, L. Van Boven

Research Collection School of Social Sciences

Political polarization impeded public support for policies to reduce the spread of COVID-19, much as polarization hinders responses to other contemporary challenges. Unlike previous theory and research that focused on the United States, the present research examined the effects of political elite cues and affective polarization on support for policies to manage the COVID-19 pandemic in seven countries (n = 12,955): Brazil, Israel, Italy, South Korea, Sweden, the United Kingdom, and the United States. Across countries, cues from political elites polarized public attitudes toward COVID-19 policies. Liberal and conservative respondents supported policies proposed by ingroup politicians and parties more than …

Vaccine Hesitancy Within Nevada Counties, June 2021, Kelliann Beavers, Madison Frazee-Bench, William E. Brown Jr.

Health

This fact sheet highlights estimated rates of vaccine hesitancy, vaccination rates, the index of social vulnerability, and the level of concern for 17 Nevada counties as of June, 2021. The data are reported in the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) estimates.

The Impact Of Covid-19 On Church Gatherings In The Philippines: A Policy Analysis, Grace Zurielle Malolos, Joseph Christian Obnial, Rena Mallillin, Pamela Bianca Pasco, Erika Ong, Arianne Andes, Faith Ann Apat, Emma Teresa Carmela Aportadera, Rafael Valencia, Don Eliseo Lucero-Prisno Iii

Ateneo School of Medicine and Public Health Publications

The Philippines is the largest Christian-majority country in Asia. With church gatherings playing a vital role in the nature of Christianity in the Filipino culture, the advent of the coronavirus disease (COVID-19) pandemic in the Philippines posed challenges to public religious practices amid efforts to mitigate COVID-19 community transmission. Various policy pronouncements from both the government-led Inter-Agency Task Force (IATF) on Emerging Diseases and the church-led Catholic Bishops’ Conference of the Philippines (CBCP) were issued. These guidelines were implemented in order to address the two-pronged problem on healthcare and religious obligations. While these guidelines were initially contributory to the mitigation …

Promising Flex Program Initiatives To Support Critical Access Hospitals During The Covid-19 Pandemic, Celia Jewell Rn, Mph, Sara Kahn-Troster Mph, John Gale Ms

Rural Hospitals (Flex Program)

This brief reports on promising State Flex Program (SFP) strategies to support Critical Access Hospitals during the COVID-19 pandemic. SFPs adapted existing initiatives and implemented new activities to address the emerging needs of CAHs during the pandemic. With approval from the Federal Office of Rural Health, the SFPs redirected funds and activities to address the evolving COVID-19 needs of CAHs while maintaining fidelity to Flex Program goals. Based on qualitative interviews with seven SFPs, the authors, members of the Flex Monitoring Team, discuss initiatives such as resiliency training for frontline staff; packaging and dissemination of COVID-19 information; public health messaging; …

War Against Covid-19: How Is National Identification Linked With The Adoption Of Disease-Preventive Behaviors In China And The United States?, Hoi-Wing Chan, Xue Wang, Shi-Jiang Zuo, Connie Pui-Yee Chiu, Li Liu, Daphne W. Yiu, Ying-Yi Hong

Research Collection Lee Kong Chian School Of Business

Fighting the COVID‐19 pandemic requires large numbers of citizens to adopt disease‐preventive practices. We contend that national identification can mobilize and motivate people to engage in preventive behaviors to protect the collective, which in return would heighten national identification further. To test these reciprocal links, we conducted studies in two countries with diverse national tactics toward curbing the pandemic: (1) a two‐wave longitudinal survey in China (Study 1, N = 1200), where a national goal to fight COVID‐19 was clearly set, and (2) a five‐wave longitudinal survey in the United States (Study 2, N = 1001), where the national leader, …

Consequences Of Covid-19 Crisis For Persons With Hiv: The Impact Of Social Determinants Of Health, Kristie Cason Waterfield, Gulzar H. Shah, Gina D. Etheredge, Osaremhen Ikhile

Department of Health Policy and Community Health Faculty Publications

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher …

Executive Summary- Social Protection In Egypt: Mitigating The Socio-Economic Effects Of The Covid-19 Pandemic On Vulnerable Employment, Dina Makram-Ebeid, Amr Adly, Nadine Sika, Hania M Sholkamy, Samer Atallah

Faculty Journal Articles

This is the executive summary of an interdisciplinary project between the fields of development economics, political economy, labor sociology, development anthropology and public health. It reviews the social protection available to vulnerable employees and their households in Egypt and suggests ways to adapt them in light of the COVID 19 pandemic. The research focuses on four areas a) employment security b) social assistance c) health insurance d) gendered mitigations. The project will map the impact of the crisis on vulnerable employees and their households and propose policy interventions to alleviate the socio-economic effects of the pandemic through the publication of …

Short-Range Forecasting Of Covid-19 During Early Onset At County, Health District, And State Geographic Levels Using Seven Methods: Comparative Forecasting Study, Christopher Lynch, Ross Gore

VMASC Publications

BACKGROUND:

Forecasting methods rely on trends and averages of prior observations to forecast COVID-19 case counts. COVID-19 forecasts have received much media attention, and numerous platforms have been created to inform the public. However, forecasting effectiveness varies by geographic scope and is affected by changing assumptions in behaviors and preventative measures in response to the pandemic. Due to time requirements for developing a COVID-19 vaccine, evidence is needed to inform short-term forecasting method selection at county, health district, and state levels.

OBJECTIVE:

COVID-19 forecasts keep the public informed and contribute to public policy. As such, proper understanding of forecasting purposes …

Health Reform Reconstruction, Lindsay F. Wiley, Elizabeth Y. Mccuskey, Matthew B. Lawrence, Erin C. Fuse Brown

Faculty Articles

This Article connects the failed, inequitable U.S. coronavirus pandemic response to conceptual and structural constraints that have held back U.S health reform for decades and calls for reconstruction. For more than a half-century, a cramped “iron triangle” ethos has constrained health reform conceptually. Reforms aimed to balance individual interests in cost, quality, and access to health care, while marginalizing equity, solidarity, and public health. In the iron triangle era, reforms unquestioningly accommodated four legally and logistically entrenched fixtures — individualism, fiscal fragmentation, privatization, and federalism — that distort and diffuse any reach toward social justice. The profound racial disparities and …

Early Response To Covid-19 In The Philippines, Arianna Maever L. Amit, Veincent Christian F. Pepito, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

Low- and middle-income countries (LMICs) with weak health systems are especially vulnerable during the COVID-19 pandemic. In this paper, we describe the challenges and early response of the Philippine Government, focusing on travel restrictions, community interventions, risk communication and testing, from 30 January 2020 when the first case was reported, to 21 March 2020. Our narrative provides a better understanding of the specific limitations of the Philippines and other LMICs, which could serve as basis for future action to improve national strategies for current and future public health outbreaks and emergencies.

Administrative Law In A Time Of Crisis: Comparing National Responses To Covid-19, Cary Coglianese, Neysun A. Mahboubi

All Faculty Scholarship

Beginning in early 2020, countries around the world successively and then together faced the same rapidly emerging threats from the COVID-19 virus. The shared experience of this global pandemic affords scholars and policymakers a comparative lens through which to view how differences in countries’ governance structures and administrative responses affected their ability to manage the various crisis posed by the pandemic. This article introduces a special series of essays in the Administrative Law Review written by leading administrative law experts across the globe. Case studies focus on China, Chile, Germany, Italy, New Zealand, South Africa, and the United States, as …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda Kimsey, Charles Owens, Samuel T. Opoku, Angela Peden, William Mase

Department of Health Policy and Community Health Faculty Publications

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

Prisons, Nursing Homes, And Medicaid: A Covid-19 Case Study In Health Injustice, Mary Crossley

Articles

The unevenly distributed pain and suffering from the COVID-19 pandemic present a remarkable case study. Considering why the coronavirus has devastated some groups more than others offers a concrete example of abstract concepts like “structural discrimination” and “institutional racism,” an example measured in lives lost, families shattered, and unremitting anxiety. This essay highlights the experiences of Black people and disabled people, and how societal choices have caused them to experience the brunt of the pandemic. It focuses on prisons and nursing homes—institutions that emerged as COVID-19 hotspots –and on the Medicaid program.

Black and disabled people are disproportionately represented in …

Gender In The Time Of Covid-19: Evaluating National Leadership And Covid-19 Fatalities, Leah C. Windsor, Gina Yannitell Reinhardt, Alistair J. Windsor, Robert Ostergard, Susan Allen, Courtney Burns, Jarod Giger, Reed Wood

Social Work Faculty Publications

In this paper we explore whether countries led by women have fared better during the COVID-19 pandemic than those led by men. Media and public health officials have lauded the perceived gender-related influence on policies and strategies for reducing the deleterious effects of the pandemic. We examine this proposition by analyzing COVID-19-related deaths globally across countries led by men and women. While we find some limited support for lower reported fatality rates in countries led by women, they are not statistically significant. Country cultural values offer more substantive explanation for COVID-19 outcomes. We offer several potential explanations for the pervasive …

Learning Before And During The Covid-19 Outbreak: A Comparative Analysis Of Crisis Learning In South Korea And The Us, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

Learning is imperative in government responses to crises like the COVID-19 pandemic. This study examines the South Korean and United States governments’ responses to COVID-19 from a comparative perspective. The analysis focuses on crisis learning conducted before and during the COVID-19 outbreak, using the conceptual categories of intercrisis/intracrisis learning and single-/double-loop learning. The findings suggest that double-loop, intercrisis learning allows for more effective crisis management by (re)developing a common operating framework. The efficacy of learning is enhanced when double-loop learning is followed by single-loop learning that embeds new structures and operational procedures. The findings also suggest that intercrisis learning facilitates …

Months Into The Covid-19 Pandemic, Community Health Centers Report Signs Of Improvement, But Face Financial Uncertainty, Jessica Sharac, James Hernandez, Feygele Jacobs, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Executive Summary:

This policy brief reports on the COVID-19 experience of the nation’s community health centers over a six-month period, utilizing data from the Health Resources and Services Administration’s (HRSA’s) weekly Health Center COVID-19 Survey from April 3rd, 2020 to October 2nd, 2020. The data demonstrate that community health centers were immediately responsive to the public health crisis, initiating diagnostic testing for the COVID-19 virus, and adapting care such as telehealth to address patient needs. However, with visits down overall and limited financial relief, the pandemic has taken an enormous financial toll on health centers. Cumulative patient revenue losses over …

Learning From The Past: Distributed Cognition And Crisis Management Capabilities For Tackling Covid-19, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

The outbreak of coronavirus disease 2019 (COVID-19) has presented an unprecedented public health crisis across the globe. Governments have developed different approaches to tackle the complex and intractable challenge, showing variations in their effectiveness and results. South Korea has achieved exceptional performance thus far: It has flattened the curve of new infections and brought the outbreak under control without imposing forceful measures such as lockdowns and travel ban. This commentary addresses the South Korean government’s response to COVID-19 and highlights distributed cognition and crisis management capabilities as critical factors. The authors discuss how the South Korean government has cultivated distributed …

Measuring The Impact Of Covid-19 On Older Adults In Massachusetts, Ceara Somerville, Jan Mutchler, Caitlin Coyle

Center for Social and Demographic Research on Aging Publications

The spread of COVID-19 across the United States has affected every facet of life since early 2020. According to the Centers for Disease Control and Prevention (CDC), there are currently over 4 million cases across the nation and over 146,000 deaths from the virus. Massachusetts has been one of the states hit hardest, with over 100,000 confirmed cases and more than 8,000 deaths to date. The Commonwealth currently trails only New York and New Jersey in number of deaths. While cases surge around the country, Massachusetts has seen some leveling out of positive cases since the beginning of July. Though …

Covid-19 And Latinos In Massachusetts, Lorna Rivera, Phillip Granberry, Lorena Estrada-Martínez, Miren Uriarte, Eduardo Siqueira, Ana Rosa Linde-Arias, Gonzalo Bacigalupe

Gastón Institute Publications

This report focuses on the Latino population of Massachusetts and uses 2014–2018 American Community Survey (ACS) demographic data to explore both Latinos’ vulnerability to COVID-19 infection and the key predictive factors. We explore what is known about the social determinants of health previously identified as critical to understanding the spread and differential infection rates of COVID-19 across populations—for example, opportunities for infection due to employment and housing conditions—and how these apply to the Latino population in Massachusetts. We also briefly explore those factors that lead to COVID-19 severe illness and possibly death from the disease, including the age of the …

Covid-19: Hospital And Intensive Care Unit (Icu) Bed Capacity In The Mountain West, Ember Smith, Kaylie Pattni, Caitlin Saladino, William E. Brown

Health

Utilizing the Harvard Global Health Institute’s (HGHI) COVID-19 projections, this fact sheet examines the potential hospital and ICU bed shortages in the Mountain West region: Arizona, Colorado, New Mexico, Nevada, and Utah.

Covid-19’S Effects On New York City’S Food System: Lessons For Public Health Responses, Nevin Cohen, Nicholas Freudenberg

Publications and Research

The COVID-19 pandemic disrupted food availability and affordability and changed the daily food practices of New Yorkers. Eleven surveys of samples of 1,000 New York City adults from March 13 through June 28 illustrate three effects on food access and food insecurity: (1) closing restaurants, schools, and other sources of prepared foods reduced access and changed shopping patterns, food expenditures, and diets; (2) economic disruption exacerbated food insecurity and increased demand for food assistance; and (3) altered food practices affected diets and health. These impacts were disproportionately borne by vulnerable populations. This paper reports survey responses illustrating the effects of …

Leveraging The Power Of Mutual Aid, Coalitions, Leadership, And Advocacy During Covid-19, Daniela Domínguez, Dellanira García, David A. Martínez, Belinda Hernandez-Arriaga

Psychology

The COVID-19 pandemic has shed light on the norms, patterns, and power structures in the United States that privilege certain groups of people over others. This manuscript describes COVID-19 as an unprecedented catalyst for social transformation that underscores the need for multi-level and cross-sectoral solutions to address systemic changes to improve health equity for all. The authors propose that the American Psychological Association and its membership can initiate systemic change, in part, by: (a) supporting mutual aid organizations that prioritize the needs of vulnerable communities; (b) leveraging the efforts and strides APA psychologists have already made within the association, in …