Health Policy Commons^™

Data Profiles-Rhode Island-West Warick, John C. Brown, Richard A. Ramswak, James R. Gomes

Mosakowski Institute for Public Enterprise

We continue support the Federal Bank of Boston “Working Cities” challenge which aims to support social and economic recovery of underperforming small and mid-sized cities in the New England region. We continue to extend our data profiles of these cities located in Massachusetts, Rhode Island and now Connecticut. It is our hope that these data ‘rich” profiles which includes key indicators on health, population and demographic changes, industrial growth, and educational performance can not only support policy development in these targeted areas, but also help in monitoring the progress these cities make over time.

Data Profiles-Rhode Island-Woonsocket, John C. Brown, Richard A. Ramsawak, James R. Gomes

Mosakowski Institute for Public Enterprise

We continue support the Federal Bank of Boston “Working Cities” challenge which aims to support social and economic recovery of underperforming small and mid-sized cities in the New England region. We continue to extend our data profiles of these cities located in Massachusetts, Rhode Island and now Connecticut. It is our hope that these data ‘rich” profiles which includes key indicators on health, population and demographic changes, industrial growth, and educational performance can not only support policy development in these targeted areas, but also help in monitoring the progress these cities make over time.

In A Bind: The Role Of Transgender Health Care Coverage In Politics, Lucas Johnson

Undergraduate Honors Theses

No abstract provided.

The Health Care Expenditure And Income: A Global Perspective, Badi H. Baltagi, Raffaele Lagravinese, Francesco Moscone, Elisa Tosetti

Center for Policy Research

This paper investigates the long-run economic relationship between health care expenditure and income in the world using data on 167 countries over the period 1995-2012, collected from the World Bank data set. The analysis is carried using panel data methods that allow one to account for unobserved heterogeneity, temporal persistence, and cross-section dependence in the form of either a common factor model or a spatial process. We estimate a global measure of income elasticity using all countries in the sample, and for sub-groups of countries, depending on their geo-political area and income. Our findings suggest that at the global level, …

Does Aco Adoption Change The Health Workforce Configuration In U.S. Hospitals?, Avi Dor, Patricia Pittman, Clese Erikson, Roberto Delhy, Xinxin Han

Health Workforce Research Center Publications

Working with Premier, Inc., this study explored how participation in ACOs affects hospitals’ workforce assignment and configuration. The study 1) describes the differences in workforce characteristics in hospitals adopting versus not adopting an ACO model and 2) determines key changes in workforce before and after a hospital adopts an ACO model. Key Questions

1. Hospitals with what types of workforce configuration are more likely to participate in an ACO?
2. How do hospitals change their workforce after participating in an ACO?
3. Do hospitals not yet participating in ACOs make similar/different changes to workforce as their peers in ACOs?

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

Powerful Words: An Exploration Of Linguistic Hierarchy In Moroccan Hospitals, Ellelan Degife

Independent Study Project (ISP) Collection

Morocco is a country of distinct diversity, which exists as a result of the settling of multiple peoples and European colonization. As a result of this diversity, many languages are employed in different settings and spaces, and of these languages, French represents remnants of colonialism and continual elitism in the country. One of the spheres that French commands in Moroccan society is medicine, which creates a dichotomy between the educated health care providers and the underprivileged patients in public hospitals. The aim of this paper is to explore the effect of French on the doctor-patient relationship in urban, public Moroccan …

“Always A Double-Edged Sword”: How Women And Health Care Providers Navigate Issues Of Contraception In Differing Senegalese Communities, Angelina Strohbach

Independent Study Project (ISP) Collection

This paper examines how women and health care providers in two distinct Senegalese settings—Dakar and Mouit, a village located within the Gandiol region-- navigate contraception as both a social and medical good. Contraception is an invaluable tool in terms of advancing women’s right to reproductive health, but major discrepancies in its usage exist across a variety of social lines in Senegal, including level of education, marital status, occupation, age, and living in a rural versus urban setting. What socially constructed thought processes and lived experiences contribute to these discrepancies? In a cultural context heavily based upon tradition and Islamic faith, …

Exploring Access To Portable Water And Sanitation Practices In A Post-Conflict Environment: The Case Of Gulu District, Northern Uganda, Peyton Going

Independent Study Project (ISP) Collection

Over the course of 30 days of fieldwork in October and November of 2016, data was collected through interviews conducted with local government officials, researchers and academics, and village community members of Gulu District.

The aim of this study was to determine the extent to which agencies have improved water and sanitation in the region. The case study of Gulu utilized in-depth interviews with key informants, focus groups, and observations, and sought to determine who the local stakeholders in water and sanitation are, the water sources and sanitation facilities available and their uses, the perception local people have about their …

‘Project Spraoi’: A Randomized Control Trial To Improve Nutrition And Physical Activity In School Children, Tara Coppinger, Seán Lacey, Cian O'Neill, Con Burns

Publications

Background

Recent evidence predicts that by 2030, Ireland will have the highest rate of obesity in Europe. Consequently, there are concerns that health problems associated with this condition will present in childhood. Studies have shown that interventions based on increasing physical activity (PA) levels, reducing sedentary lifestyles and improving nutritional habits all pose protective mechanisms against obesity and its related disorders in youth. Yet, to date, there are no interventions being delivered in Ireland that concurrently target PA, nutritional habits and sedentary time amongst school children.

Purpose

The purpose of this study is to implement and evaluate an intervention that …

A Framework For Measurement Error In Self-Reported Health Conditions, Ling Li, Perry Singleton

Center for Policy Research

This study develops and estimates a model of measurement error in self-reported health conditions. The model allows self-reports of a health condition to differ from a contemporaneous medical examination, prior medical records, or both. The model is estimated using a two-sample strategy, which combines survey data linked medical examination results and survey data linked to prior medical records. The study finds substantial inconsistencies between self-reported health, the medical record, and prior medical records. The study proposes alternative estimators for the prevalence of diagnosed and undiagnosed conditions and estimates the bias that arises when using self-reported health conditions as explanatory variables.

So Many Hospitals, So Little Information: How Hospital Value Based Purchasing Is A Game Of Chance, Andrew I. Friedson, William C. Horrace, Allison F. Marier

Center for Policy Research

As part of the Patient Protection and Affordable Care Act, participating Medicare hospitals have part of their Medicare reimbursements withheld and then redistributed based on quality performance. The Hospital Value Based Purchasing reimbursement plan relies partly on ordinal rankings of hospitals to determine how money is distributed. We analyze the quality metric distributions used for payment and show that there is not enough information to reliably differentiate hospitals from one another near the payment cutoffs; and conclude that a large part of the payment formula is driven by sampling variability rather than true quality information. Alternative reimbursement plans are developed.

Issue 10: Global Care Chains: Addressing Unpaid Reproductive Labour In The Philippines, Harrison Ellis

International Migration Research Centre

This brief examines policy options to address the gender disparities of unpaid care work created by the global care chain. Examining the Philippine context, potential responses include equalizing maternity and paternity leave, expanding state childcare services, partnering with money transfer businesses (MTBs), and promoting the recruitment men for care positions. This issue has been recognized by the Sustainable Development Goals (SDGs). Target 5.4 of the SDGs calls for the recognition of the value of “unpaid care labour and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of responsibility within the household and …

Predicting Depression In Older Adults: Community Vs. Nursing Home, Hannah Vitello, Skye Leedahl

Senior Honors Projects

With the population of the United States slowly growing older, the issues surrounding long-term services and supports (LTSS) will become more prevalent. Little research has been done comparing older adults living in nursing homes to older adults living in the community, especially regarding mental health and depression. Depression is a mental illness that affects people emotionally and physically, as well as mentally, which can lead easily into other health complications in the older adult population. This study seeks to determine if factors such as demographics, health, social interaction, and family relationships affect mental health in nursing home residents differently than …

Detroit Health Department: Lead Report 2016, Abdul El-Sayed, Alex B. Hill, Haifa Haroon

Urban Studies and Planning Faculty Research Publications

The Epidemiology team at the Detroit Health Department rigorously stress- tested Detroit’s lead numbers. The findings suggest a true decline in EBLL levels rather than a decrease in lead testing or a change in the characteristics of the children who are being tested.

Migrant Access To Healthcare: A Study Of Undocumented Migrant Access To Sexual Healthcare & Family Planning Services In Switzerland In 2016, Emily Egbert

Independent Study Project (ISP) Collection

The Swiss healthcare system has experienced a significant influx of vulnerable migrants over the past few years. This presents a challenge to providers and policy makers to account for and provide aid to these non-­‐ Swiss citizens, such as undocumented migrants (UDM), whose status and circumstances may impede their access to healthcare. Along with this, various cultural barriers may present further challenges to access to the health system. This paper explores UDM access to health through the lens of sexual healthcare and family planning. In examining sexual health, the issues of sexually transmitted infections (STIs), HIV/AIDS, and sexual violence were …

Exploration Of The State Of Mental Healthcare Services For Youth In Nairobi, Rashiidah Richardson

Independent Study Project (ISP) Collection

This paper is formative research concerning the state of mental health care for youth in Nairobi, Kenya. Using a mixed methods design, the objectives of this study were to identify the most prevalent mental health concerns among youth in Kenya, to explore the availability and acceptability of youth friendly mental health care services, and to explore the quality of and challenges to providing youth friendly mental health care services. Results indicate that substance abuse, conduct disorder, and family conflict may be among the most pressing mental health concerns for young people. Furthermore, while young people may be willing to seek …

The Feminization Of Hiv/Aids In Yunnan, China, Leah Pinckney

Independent Study Project (ISP) Collection

The feminization of HIV is a global phenomenon in which more women are becoming HIV-positive. This not only has tragic consequences for those women but also signifies how HIV transmission in China is changing. Increased sexual transmission has given HIV the ability to move from at-risk groups, such as intravenous drug users and commercial sex workers, to the general population. Despite China’s improved health policies and programs about HIV, this situation poses a serious public health issue allowed to perpetuate because of societal problems surrounding gender. These problems are compounded by socioeconomic inequality brought upon by economic change. While much …

Paediatric Tuberculosis In Bhopal, Madhya Pradesh, India: Dots, Diagnosis, And Determinants, Emma Klein

Independent Study Project (ISP) Collection

Tuberculosis (TB) is one of the world’s largest public health challenges, and it has a disproportionate impact on India. In children, TB is a serious but understudied illness due to the complexity of case-notification and relative lack of public health importance. This study took place over the course of one month in Bhopal, Madhya Pradesh, India. In a mixed method study consisting of 53 quantitative patient interviews and qualitative interviews with healthcare providers, social determinants of TB in this setting were investigated as well as challenges faced at all stages of healthcare delivery. Malnutrition and housing were the most severe …

A Qualitative Investigation On The Effects Of The Uttar Pradesh Population Policy On Women Who Undergo Sterilization In Bahraich, Uttar Pradesh, Anna Wadhwani

Independent Study Project (ISP) Collection

The effectiveness of population policies is widely disputed by the international development community and is under constant scrutiny. While these policies have the potential to positively affect reproductive and child health indicators, they often focus too heavily on macro-demographic family planning goals and fail to acknowledge socioeconomic determinants of fertility indicators, often making for ineffective policy. Furthermore, target-based approaches have the potential to negatively impact women’s family planning choices and the quality of care they receive. This study seeks to analyze how the Uttar Pradesh Population Policy affects the decision-making process and experiences of women who undergo sterilization procedures in …

Women’S Views On The Challenges And Solutions In Preventing The Gendered Spread Of Hiv In Masxha, Cato Manor, Paige Mcmahon

Independent Study Project (ISP) Collection

Despite numerous national prevention efforts, South Africa remains at the epicenter of the HIV/AIDS epidemic. The burden of the epidemic is extremely heterogeneous, with province, race, gender, age, and socioeconomic status serving as key variables in determining HIV prevalence rates. Black African women are disproportionately affected by the epidemic, with those between the ages of 20 and 34 having an HIV prevalence rate of 31.6%, the highest in the country (Shisana et al., 2014). The purpose of this study was to engage with black African women about the challenges they believe women face in protecting themselves against HIV, and potential …

Why Children, Adults And The Elderly Are Living On The Streets In Moroccan Cities And What Morocco Is Doing About It., Nora Charidah

Independent Study Project (ISP) Collection

The aim of this independent study project is to explore the determinants of homelessness in the cities of Morocco, more specifically in Rabat,Casablanca and Salé, and how Non-Governmental Organizations (NGO’s) are working to eradicate this epidemic. Poverty, Dysfunctional Families, Mental Illness and Addiction can all be causes as well as results of homelessness; all of these factors have the potential of seriously affecting individuals throughout the entirety of their life. Children, Adults and the Elderly are all affected by poverty throughout Morocco yet street children and the rural impoverished are the populations of the homeless where most research predominately focuses. …

The United Nations Sustainable Development Goals: Achieving The Vision Of Global Health With Justice, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet” (UN General Assembly, 2015, September 25, preamble). So pronounces the 2030 Agenda, the United Nations declaration on the Sustainable Development Goals (SDGs), adopted on September 25, 2015, succeeding the Millennium Development Goals (MDGs). If achieved, the SDGs will secure an improved level of health, development, and global justice. However, if the international community fails to live up to its commitments, an untold number of people will likely perish prematurely, people’s opportunities to thrive will be cut off, social …

Eating In East Harlem: An Assessment Of Changing Foodscapes In Community District 11, 2000-2015, Cuny Urban Food Policy Institute At The Cuny School Of Public Health And Health Policy, Nicholas Freudenberg, Melissa Fuster, Diana Johnson, Marissa Sheldon, Michele Silver, Apoorva Srivastava, Janet Poppendieck, Ashley Rafalow, Nevin Cohen

Publications and Research

The report analyzes changes in five domains -- food retail, food insecurity and food benefits, institutional food, food and nutrition education, and diet-related health conditions -- in East Harlem from before the election of Michael Bloomberg through the first two years of the de Blasio Administration. Its goal is to assess the ways in which food environments in East Harlem have improved, stayed the same, or worsened in this 15-year period in order to inform setting food policy goals for the next 5, 10 or 15 years.

Although East Harlem is blessed with a multitude of organizations and individuals dedicated …

Sustainable Development Goals Worth Sharing, Erika Simpson

Political Science Publications

The international community has agreed upon another set of goals for the next 15 years. On the table are no less than 169 objectives and 17 Sustainable Development Goals (SDGs). The new aspirations are summarized and the merits and demerits of further elaboration and measurement including country-specific deadlines and targets are discussed. The hefty budget to achieve all 17 goals is estimated at more than $4 trillion US a year. North American policy-makers need to be aware of humankind’s shared aspirations as they consider the new and expensive SDGs. Foreign aid is one of the instruments of North American foreign …

Routine Screening For Intimate Partner Violence: A Guide For Trainers, Odongo Odiyo, Chi-Chi Undie, Margaret Mak'anyengo

Reproductive Health

This the first regional document devoted to building the capacity of providers to respond to intimate partner violence (IPV). The training guide is a follow-on initiative to the 6th Best Practices Forum in Health of the East, Central and Southern Africa (ECSA) Health Community, held in August 2012. This Forum brought to the fore research findings from the region centering on the acceptability and feasibility of IPV screening, and culminated in the passage of a resolution by Health Ministers that prescribes the integration of gender-based violence screening into healthcare settings in the ECSA region. This training guide responds to this …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

Utilization Of National Health Insurance For Family Planning And Reproductive Health Services By The Urban Poor In Uttar Pradesh, India, Arupendra Mozumdar, Kumudha Aruldas, Aparna Jain, Laura Reichenbach, Robin Keeley, M.E. Khan

Reproductive Health

In 2008, the Government of India launched the National Health Insurance Scheme, Rashtriya Swasthya Bima Yojana (RSBY), to enable families living below the poverty line in both urban and rural areas to access a range of private health services. The available evidence suggests several limitations and barriers that may affect the utilization of RSBY services and warrants a more in-depth examination of the contexts of family planning/reproductive health (FP/RH) services. The Population Council, under the Evidence project, conducted a study among the urban poor to: 1) determine RSBY awareness and barriers to enrollment; 2) identify barriers and facilitating factors to …

Food Insecurity And Housing Instability In Vulnerable Families, Christian King

Department of Nutrition and Health Sciences: Faculty Publications

Reducing the prevalence of household food insecurity has been a long-standing objective of the federal government. Previous research has found many negative consequences of food insecurity for families and households but has not examined its relationship with housing instability. Using longitudinal data from the Fragile Families and Child Wellbeing Study, difference-in-difference models show that food insecurity is associated with housing instability. The association remains statistically significant after accounting for potential selection and unobserved heterogeneity using propensity score matching and excluding households that experienced prior housing instability from the sample. Examining potential mediating factors, I find that material hardship explains about …