Health Policy Commons^™

Could It Be That Healthcare Systems Are Putting Profits Before Patients?, Majida Naz

Publications and Research

The escalating costs of healthcare in the United States have led to a significant burden on diverse populations, often resulting in diminished access to quality care. As profit-driven motives increasingly influence healthcare providers and insurers, the affordability and accessibility of healthcare services are adversely affected. This research examines the intricate dynamics between profit motives and healthcare provision, employing a mixed-methods approach to investigate the impact on the diverse groups. By conducting a quantitative and some qualitative examination of healthcare spending data, this study demonstrates a pronounced disparity in the quality of healthcare services provided to populations across different income levels. …

Toward Informatics-Enabled Preparedness For Natural Hazards To Minimize Health Impacts Of Climate Change, Jimmy Phuong, Naomi O. Riches, Luca Calzoni, Gora Datta, Deborah Duran, Asiyah Yu Lin, Ramesh P. Singh, Anthony E. Solomonides, Noreen Y. Whysel, Ramakanth Kavuluru

Publications and Research

Natural hazards (NHs) associated with climate change have been increasing in frequency and intensity. These acute events impact humans both directly and through their effects on social and environmental determinants of health. Rather than relying on a fully reactive incident response disposition, it is crucial to ramp up preparedness initiatives for worsening case scenarios. In this perspective, we review the landscape of NH effects for human health and explore the potential of health informatics to address associated challenges, specifically from a preparedness angle. We outline important components in a health informatics agenda for hazard preparedness involving hazard-disease associations, social determinants …

Factors Associated With Mask Use In New York City Neighborhood Parks During The Covid-19 Pandemic: A Field Audit Study, Lisa Hitch, Marie A. Sillice, Hanish Kodali, Katarzyna E. Wyka, Javier Otero Peña, Terry Tk Huang

Publications and Research

Background: Mask use is a cost-effective measure to decrease COVID-19 transmission. Mask mandates intend to increase mask compliance but are often ambiguous when it comes to public outdoor spaces.

Methods: We used a field audit study to examine mask use in New York City neighborhood parks during COVID-19. 1453 park visitors were observed in 13 parks during July–August 2020 using a modified and validated park use audit tool (System for Observing Play and Recreation in Communities) that included items on general and proper mask use (i.e., mask covering both nose and mouth). Generalized estimating equation regression was used to determine …

The Case For Public Investment In Higher Pay For New York State Home Care Workers: Estimated Costs And Savings, Isaac Jabola-Carolus, Stephanie Luce, Ruth Milkman

Publications and Research

This report explores one potential solution to the mounting home care labor shortage in New York State: substantially raising wages for the state's home care workers. The analysis presents detailed projections, based on the best available data, of the economic effects of such an intervention, estimating the costs and benefits that would result. We find that public funding to raise home care wages would require significant resources, but those costs would be surpassed by the resulting savings, tax revenues, and economic spillover effects. The net economic gain would total at least $3.7 billion. Lifting wages would also help fill nearly …

Framing Inclusion: The Media Treatment Of Irregular Immigrants' Right To Health Care In Spain, Alisa Petroff, Anahí Viladrich, Sònia Parella

Publications and Research

With the passing of Royal Decree-Law 16/2012, Spain’s national health system switched from a model defined by universal and free health care principles, to a private insurance system that excluded large population groups. Based on a qualitative research design, this paper examines the media treatment of undocumented immigrants’ prerogatives to public health care in Spain (2012–2018). The analysis of 234 articles, drawn from three major Spanish newspapers, reveals three frames that underscore the media’s "rhetorics of inclusion," which argue for the extension of free medical services to irregular immigrants a topic traditionally underestimated by the literature. The moralist frame, supported …

Who Pays For Gun Violence? You Do., Edda S. Fransdottir, Jeffrey A. Butts

Publications and Research

The total economic impact of gun violence is unknown. Studies focus on the direct and short-term expenses immediately following a shooting but often exclude the long-term and far-reaching effects of gun violence on the victim, their family, and their community. Available data vastly underestimate the full economic impact of firearm injuries in the United States, including the fact that taxpayers often get the bill.

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 …

High Tech, High Risk: Tech Ethics Lessons For The Covid-19 Pandemic Response, Emanuel Moss, Jacob Metcalf

Publications and Research

The COVID-19 pandemic has, in a matter of a few short months, drastically reshaped society around the world. Because of the growing perception of machine learning as a technology capable of addressing large problems at scale, machine learning applications have been seen as desirable interventions in mitigating the risks of the pandemic disease. However, machine learning, like many tools of technocratic governance, is deeply implicated in the social production and distribution of risk and the role of machine learning in the production of risk must be considered as engineers and other technologists develop tools for the current crisis. This paper …

Snap At The Community Scale: How Neighborhood Characteristics Affect Participation And Food Access, Nevin Cohen

Publications and Research

Cities are spatially diverse, with enclaves of particular demo- graphic groups, clusters of businesses, and pockets of low-income individuals living amid affluence.

This essay presents data from New York City to illustrate the importance of measuring and addressing neighborhood characteristics that affect Sup- plemental Nutrition Assistance Program (SNAP) participation and the purchasing power of SNAP benefits: pockets of “eligible-but-not-enrolled” in- dividuals, proximity between SNAP participants and jobs, and variations in food prices across neighborhoods.

It concludes with 5 exam- ples of how addressing these community-scale issues can increase SNAP participation and food access.

Food Justice In The Trump Age: Priorities For Urban Food Advocates, Nevin Cohen, Janet Poppendieck, Nicholas Freudenberg

Publications and Research

Every constituency – regardless of political ideology – must analyze the effects of the election of Republican majorities in Congress and Donald J. Trump as President of the United States. This is particularly true for advocates involved in eliminating food insecurity and hunger, fighting malnutrition and health inequality, and ensuring sustainable and fair urban food systems with high quality jobs. Anticipating the new administration’s efforts that may undermine food justice enables advocates, researchers, and policy makers to choose priorities and forge strategic partnerships.

The Everyday Food Practices Of Community-Dwelling Lesbian, Gay, Bisexual, And Transgender (Lgbt) Older Adults, Nevin Cohen, Kristen Cribbs

Publications and Research

Malnutrition during old age is a significant public health issue. Prevailing behavioral and structural senior malnutrition interventions have had marginal success, largely failing to reflect the realities of people's daily lives. This novel study employed Social Practice Theory (SPT) to explore the food practices of an under-researched, yet highly vulnerable, segment of the older adult population—Lesbian, Gay, Bisexual, and Transgender (LGBT) seniors. Four focus groups were conducted with 31 older adult clients and volunteers at a national LGBT social service and advocacy organization. Findings revealed that food practices—far from being mere expressions of individuals' choices or immutable habits—are entities composed …

Inquiry Into The Implementation Of Bush’S Executive Order 13211 And The Impact On Environmental And Public Health Regulation, Elizabeth Ann Glass Geltman, Gunwant Gill, Miriam Jovanovic

Publications and Research

Executive Order 13211, promulgated in 2001, requires the federal government to consider the impact of federal action on energy independence as part of the George W. Bush’s National Energy Policy. This law review examines whether EO 13211 was used to curtail environmental protection and natural resource conservation. The article begins with a review of the procedure required of federal agencies under EO 13211 and its associated documents. The paper then examines case law and published federal rulemaking proceedings and examines how federal agencies apply tests to evaluate the potential energy effect. The study concludes that EO 13211 strikes a reasonable …

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 …

Oil & Gas Drilling In National Parks, Elizabeth Ann Glass Geltman

Publications and Research

While a great deal of public attention addresses the Halliburton loophole of the Energy Policy Act of 2005 and Bureau of Land Management efforts to regulate hydraulic fracturing on public lands, less attention has been paid to the National Park Service “9B Regulations,” which provide a national regulatory framework governing the exercise of nonfederal oil and gas rights in national parks. This article begins with a review of law pertaining to oil and gas drilling in national parks. The article examines the tension in striking a balance between environmental protection, conservation of national lands and achieving energy independence, including National …

Beyond Baby Steps An Empirical Study Of The Impact Of Environmental Justice Executive Order 12898, Elizabeth Ann Glass Geltman, Gunwant Gill, Miriam Jovanovic

Publications and Research

This study evaluated the impact of Executive Order (EO) 12898 to advance environmental justice. We conducted a review evaluating the frequency and effective use of EO 12898 since execution with particular focus following President Obama’s Plan EJ 2014. We found that both EO 12898 and Plan EJ 2104 had little, if any, impact on federal regulatory decision making. To the extent federal agencies discussed EO 12898, most did so in boilerplate rhetoric that satisfied compliance but was devoid of detailed thought or analysis. In the 21st year, with the exception of the Environmental Protection Agency, very little federal regulatory activity …

Drilling For Common Ground: How Public Opinion Tracks Experts In The Debate Over Federal Regulation Of Shale Oil & Gas Extraction, Elizabeth Ann Glass Geltman

Publications and Research

Public interest in environmental and health impacts from shale oil and gas extraction (what the public calls “fracking”) is growing. Industry claims the public outcry against the new technology is not grounded in science. In February 2013, Resources for the Future (“RFF”) published a list of high priority “risk pathways” that experts from NGOs, academia, government, and industry all agreed were real concerns about fracking. This article used the risk matrix to evaluate whether public comments in dockets of federal agencies that proposed regulation concerning hydraulic fracturing tracked expert concern. The article found that the public tracked many of the …

La Souffrance Animale À Distance: Des Vétérinaires Dans L’Action Humanitaire, Frédéric Keck, Miriam Ticktin

Publications and Research

Résumé

Cet article étudie le rôle des vétérinaires dans l’humanitaire à partir de deux types de pratique : la défense des animaux contre la cruauté et la surveillance des animaux touchés par les épidémies. En suivant l’extension de l’action humanitaire aux animaux comme nouvelles figures de victimes innocentes, nous cherchons à dépasser l’approche compassionnelle de l’humanitaire pour étudier les nouvelles formes scientifiques impliquant des non-humains, comme la médecine vétérinaire légale, les neurosciences et l’immunologie. Nous soutenons finalement que ces sciences produisent de nouveaux collectifs d’humains et de non-humains.

Abstract

This article traces the role of veterinarians in humanitarian action, focusing …

Adolescent Girls, Human Rights And The Expanding Climate Emergency, Holly G. Atkinson, Judith Bruce

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing.¹ These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent. The authors urge key actors responding to both the threats and opportunities that climate change poses to understand adolescent girls as exceptionally at risk on the one hand, and as exceptionally resilient and …