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The Plague Of ‘Ghost Workers’: Interrogating Payroll Fraud And Executive-Bureaucratic Conspiracy In Nigeria, Mike Omilusi May 2025

The Plague Of ‘Ghost Workers’: Interrogating Payroll Fraud And Executive-Bureaucratic Conspiracy In Nigeria, Mike Omilusi

Journal of African Policy Studies

Like all forms of corruption, ghost workers present a serious drain on state funds. The Nigerian government has tens of thousands of forged or imaginary names on its payroll. These people inhabit the ranks of Nigeria’s “ghost workers,” who receive pensions from the government without ever working a day. This essay examines the impact of ghost workers on the public wage bill and generally, high cost of governance in Nigeria. It interrogates the renewed efforts of governments at all levels in probing this pattern of fraud, particularly in a period of economic recession. It is submitted in this essay that …


Big Data As Potential Tool For Success In Developing Countries, Jean-Claude Pedjeu, Aurore J. Kamssu, Jeffrey S. Siepke-Sambo May 2025

Big Data As Potential Tool For Success In Developing Countries, Jean-Claude Pedjeu, Aurore J. Kamssu, Jeffrey S. Siepke-Sambo

Journal of African Policy Studies

Big data and the computer technology to analyze it are said to be one of the top 10 revolutions in the coming decade. While the developed world is making strides in the use of big data for decision making purposes, the Low-income countries (LIC) or poor countries and some medium-income countries (MIC) or developing countries are lacking behind in their collection and use of digital data to aid decision making. This is especially the case with many businesses and government agencies that have the potential to benefit in their policy designs and implementations from big data. The purpose of this …


Accounting For The Decline Of Service Delivery In Urban Local Authorities: A Survey Of Zimbabwean Cities And Towns, Wenceslaus Mudyanadzo, Makomborero Y. Nzwatu May 2025

Accounting For The Decline Of Service Delivery In Urban Local Authorities: A Survey Of Zimbabwean Cities And Towns, Wenceslaus Mudyanadzo, Makomborero Y. Nzwatu

Journal of African Policy Studies

This paper presents a review of several factors which account for the decline of service delivery in urban local authorities within Zimbabwe. The study utilised desk research methodology to explore and analyse relevant data which was in government legislation, ministerial statements, public and private media articles, books and journals to come up with the totality of the environment relating directly or indirectly to the decline of service delivery in local authorities (LAs). The evidence cited is based on findings from identified urban local authorities which include Harare, Chitungwiza, Gweru, Mutare, Masvingo and Bulawayo City Councils. Themes surrounding the interference in …


Reinventing E-Governance Policy In Local Governments In Southern Nigeria, Robert A. Dibie, Maryam O. Quadri May 2025

Reinventing E-Governance Policy In Local Governments In Southern Nigeria, Robert A. Dibie, Maryam O. Quadri

Journal of African Policy Studies

This paper examines the extent to which electronic governance policy has contributed to more efficient service delivery in local governments in southern Nigeria. It also explores how e-governance practices has improved the relationship between citizens and local governments in southern Nigeria. It argues that despite the appropriation of funds for the purchase of computers and other electronic equipment in many local governments in the past three decades, the delivery of services in almost all the local governments under study has not improved. The paper uses data derived from questionnaire survey administered to local government staff in southern Nigeria. Two thousand …


Middle-Income Housing Affordability: An Exploration Of The Residual Income Approach In Delaware, Alexis Bryan-Dorsey May 2025

Middle-Income Housing Affordability: An Exploration Of The Residual Income Approach In Delaware, Alexis Bryan-Dorsey

Walden Dissertations and Doctoral Studies

Families with children face challenges finding affordable housing. The research problem addressed through this quantitative group comparison design study was the need for alternative measures of determining housing affordability for families with children. Efforts to determine the best evaluation of housing affordability could help some families that may fall into the gap and lack a substantiated voice in the development of public policy. Researchers have demonstrated issues with housing affordability, such as the rising costs of housing and a shortage of affordable housing units but have not established the significance of using alternative measures to determine affordability and the implementation …


The Effects Of Family Cohesion On The Relationship Between Trauma And State-Level Social Policy Provision In The United States, Brandon Kendall Ross Fielding May 2025

The Effects Of Family Cohesion On The Relationship Between Trauma And State-Level Social Policy Provision In The United States, Brandon Kendall Ross Fielding

Dissertations and Theses

This dissertation examines how childhood trauma and family cohesion interact to shape state-level social policy generosity in the United States. The study begins with a multilevel quantitative analysis using data from the National Survey of Children’s Health and the State Safety-Net Generosity Index to assess how individual-level experiences of trauma and family support relate to state-level welfare generosity. Two trauma indices--one focused on adverse childhood experiences and bullying, and the other on food-related hardship--are used to explore how trauma influences attitudes toward public assistance, and whether family cohesion moderates this relationship. Results from marginal effects analyses indicate that family cohesion, …


The Case Against Police Militarization: Stop Turning Police Into Soldiers, Kenia A. Silva Garcia May 2025

The Case Against Police Militarization: Stop Turning Police Into Soldiers, Kenia A. Silva Garcia

Themis: Research Journal of Justice Studies and Forensic Science

This paper will critically explore police militarization in the United States, highlighting its origins, implications, and the urgent need to demilitarize them. The rise of militarized police forces began in the 1960s—the War on Drugs and federal programs that allowed military equipment to be transferred to local police departments made their expansion even more possible. Due to this expansion, this paper discusses that police should not be militarized because it increases violence, disproportionately affects marginalized communities, particularly racial minorities, and ultimately fails to reduce crime. Evidence suggests that militarized police forces foster systemic inequalities that are rooted in historical racism—a …


How Mass Incarceration Has Destroyed African American Communities, Angeliki Karvounis May 2025

How Mass Incarceration Has Destroyed African American Communities, Angeliki Karvounis

Themis: Research Journal of Justice Studies and Forensic Science

Beginning with the “Tough on Crime” movement of the 1970s, policies such as mandatory minimums, the War on Drugs, and the Three Strikes law have reinforced racial disparities in the criminal justice system. Multiple historical and systemic factors have contributed to the disproportionate imprisonment of African American individuals. This paper explores the long-term consequences of incarceration, including the erosion of family structures, the economic marginalization of affected communities, and the perpetuation of poverty and crime. The repercussions of parental incarceration on children and the challenges faced by formerly incarcerated individuals seeking reintegration into society are examples of the long-term consequences …


Prisoner Reentry Into Society Viewed Through The Lens Of Women, Jalak Parekh May 2025

Prisoner Reentry Into Society Viewed Through The Lens Of Women, Jalak Parekh

Themis: Research Journal of Justice Studies and Forensic Science

In the 1970s, President Richard Nixon declared a War on Drugs and initiated a series of policies that were intended to combat the use of illegal drugs by implementing severe sentences for drug-related crimes. As a result, the focus of the criminal justice system veered away from rehabilitation efforts. Today, the U.S. criminal justice system has considerably high rates of recidivism. This paper examines the importance of successful reentry into society for formerly incarcerated women, especially those who must resume a caregiver role to their children. However, a relapse into criminal behavior seems imminent due to societal barriers in obtaining …


The Lasting Effects Of Gun Violence On Victims And Communities, Anthony Do May 2025

The Lasting Effects Of Gun Violence On Victims And Communities, Anthony Do

Themis: Research Journal of Justice Studies and Forensic Science

Gun violence is a pressing public health and criminal justice issue with lasting effects on victims, families, and communities in the United States. The psychological impact of gun violence can contribute to conditions such as post-traumatic stress disorder, anxiety and sleep deprivation. The issues are pronounced within marginalized or disadvantaged neighborhoods. The emergence of 3D-printed “ghost guns” presents further complications in the effort to regulate firearms. The United States stands out for its disproportionately high rates of firearm deaths. The findings in this paper highlight the urgent need for comprehensive prevention strategies that address both the current and future impacts …


"La Vida Es Un Carnaval": An Exploration Of Cuban Identity And Nostalgia Through Dance/Movement Therapy - A Community Engagement Project, Maria Fernanda Mendez Mendoza May 2025

"La Vida Es Un Carnaval": An Exploration Of Cuban Identity And Nostalgia Through Dance/Movement Therapy - A Community Engagement Project, Maria Fernanda Mendez Mendoza

Expressive Therapies Theses

“La Vida Es Un Carnaval” is a community engagement project and thesis that explores how identity and nostalgic resilience show up through dance/movement therapy with Cuban immigrants living in the United States, specifically Massachusetts. This project brought together six Cuban-born participants, ages 26 to 67, each with their own unique migration stories; from the Rafter Balsero Crisis of 1994, to the “Wet-Foot/Dry-Foot” policy, and family reunification. Through a mix of in-person and online sessions, participants explored their experiences using intermodal activities including dance/movement therapy techniques, conversation, journaling, artwork, and music. Themes of cultural pride, “Cubanía” – Cuban-ness, culture shock, and …


Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin May 2025

Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin

Pharmacy and Wellness Review

Antimicrobial resistance is an escalating global threat driven by inappropriate antibiotic use and shaped by socioeconomic disparities. Social determinants of health, including limited healthcare access, poverty, low health literacy, and environmental conditions, contribute to higher rates of resistant infections and poorer treatment outcomes in underserved populations. Barriers such as pharmacy deserts, self-medication, and inadequate stewardship infrastructure amplify these risks. Pharmacists, as accessible and highly trained healthcare professionals, play a critical role in combating antimicrobial resistance by optimizing antibiotic use, delivering culturally competent education, and leading antimicrobial stewardship programs across settings. Community and clinical pharmacists are especially well positioned to bridge …


How The Integration Of Bosnian Refugees In Saint Louis Is A Model For Success For Current Afghan Refugees And Future Resettlements In The U.S., Indira Kar May 2025

How The Integration Of Bosnian Refugees In Saint Louis Is A Model For Success For Current Afghan Refugees And Future Resettlements In The U.S., Indira Kar

Senior Theses

Refugee resettlement and integration are vital in fostering inclusive communities, enriching local economies, and promoting cultural diversity while also offering displaced individuals the opportunity to rebuild their lives in safety. Considering the successful resettlement of Bosnian refugees in St. Louis, Missouri, starting in the 1990s, I explored what factors could be attributed to their positive integration outcomes. I found a combination of (1) policy, (2) social compatibility, and (3) cultural values that can be attributed to their thriving community and applied these factors to the recent resettlement of Afghan refugees in St. Louis. While Afghan refugees have found success in …


Navigating The Future Of Polygenic Risk Scores: Insights From Child And Adolescent Psychiatrists, Page M Trotter, Amanda R Merner, Lauren A Ginn, Abigail C Martinez, Ana L Battaglino, Kaitlynn P Craig, Jason Bach, Katherine J Freedberg, Takahiro Soda, Eric A Storch, Gabriel Lázaro-Muñoz, Stacey Pereira May 2025

Navigating The Future Of Polygenic Risk Scores: Insights From Child And Adolescent Psychiatrists, Page M Trotter, Amanda R Merner, Lauren A Ginn, Abigail C Martinez, Ana L Battaglino, Kaitlynn P Craig, Jason Bach, Katherine J Freedberg, Takahiro Soda, Eric A Storch, Gabriel Lázaro-Muñoz, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Polygenic risk scores (PRS) are a method of calculating genetic risk for polygenic, or multi-gene, disorders. These scores have potential impacts in the realm of child and adolescent psychiatry, given the high prevalence of psychiatric disorders among youth. However, there are concerns about PRS implementation among key stakeholders, namely child and adolescent psychiatrists (CAP). We conducted interviews with 29 U.S.-based CAP to investigate clinician attitudes toward the use of PRS. The data herein correspond to a future scenario we provided CAP in which PRS are accurate and portable to patients of different racial and ethnic backgrounds. We found that CAP …


Enhancing Digital Accessibility For Deaf Or Hard Of Hearing Learners- Innovative Strategies For Inclusive Education, Felicia Rutledge Ph.D. May 2025

Enhancing Digital Accessibility For Deaf Or Hard Of Hearing Learners- Innovative Strategies For Inclusive Education, Felicia Rutledge Ph.D.

Developmental Disabilities Network Journal

This research-to-practice brief explores innovative strategies to enhance digital accessibility for Deaf or Hard of Hearing (D/HH) learners, focusing on practical applications for inclusive K-12 education. Despite advances in digital learning, D/HH learners face unique barriers due to auditory-centered designs. Accessibility legislation such as the ADA, Section 504, and IDEA mandate educational inclusion for these learners. Key strategies include the integration of assistive technologies (e.g., captioning, ASL video interpretation), the application of the Universal Design for Learning (UDL) 3.0 guidelines, and adherence to WCAG 2.1 principles for accessible content design. The research-to-practice brief provides actionable insights for educators, administrators, and …


Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas May 2025

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …


Editorial: Digital Accessibility Practices Guided By Past Models And Modern Research, Cynthia Curry, Jared Smith May 2025

Editorial: Digital Accessibility Practices Guided By Past Models And Modern Research, Cynthia Curry, Jared Smith

Developmental Disabilities Network Journal

No abstract provided.


Ai Governance In The Gaming Industry: A Proposal For A Use Case Registry, Cesar D. Lozoya Martinez May 2025

Ai Governance In The Gaming Industry: A Proposal For A Use Case Registry, Cesar D. Lozoya Martinez

Student Research

Artificial intelligence (AI) is increasingly integrated into everyday life. From customer service chatbots and marketing strategies to player protection tools and surveillance systems, casino operations are embracing the trend. However, without a systematic framework to track the current and emerging use cases across the industry, concerns about transparency, ethical use, and potential consumer harm continue to grow. Rather than aiming to establish binding regulatory practices for an industry and technology that are both quickly evolving, this policy brief advocates for the creation of an AI-use case registry. The registry would comprehensively track gaming companies that are using AI. The growing …


Legislative Transparency And Self-Government: Nevada And First Amendment Application, Allister Dias May 2025

Legislative Transparency And Self-Government: Nevada And First Amendment Application, Allister Dias

Student Research

With the rise in political tension in the United States, the call for transparency from elected officials has reached an all-time high. While the role of American democracy is to promote a sense of participation from constituents, the lack of information regarding policy decisions has exempted the public from the halls of the legislature. This policy brief examines legislative transparency in Nevada through the concept of self-government theory. Despite a 1994 constitutional amendment to require publicly accessible legislative committee meetings, exemptions from Open Meeting Law and statutory exemptions continue to limit public access and further the divide between the government …


Matthew Kinnard, Matthew A. Kinnard M.S., Ph.D. May 2025

Matthew Kinnard, Matthew A. Kinnard M.S., Ph.D.

We Are NIH Oral History Project

No abstract provided.


Enhancing Water Supply Resilience & Sustainability: Potential Solutions To Address Water Scarcity In Bogotá, Colombia, Sophia Alvarez Wong May 2025

Enhancing Water Supply Resilience & Sustainability: Potential Solutions To Address Water Scarcity In Bogotá, Colombia, Sophia Alvarez Wong

Master's Projects and Capstones

Municipal water utilities are in urgent need of adapting to the intensifying impacts of climate change and population growth—key drivers of urban water scarcity worldwide. In rapidly expanding cities like Bogota, Colombia, these pressures have contributed to a severe water crisis driven by prolonged droughts, ecosystem degradation, increasing water demands, and overdependence on limited water sources. This study explores potential adaptation and management strategies that utilities can implement to sustainably strengthen supply system resilience and enhance water security, in the context of low- to middle-income regions. A series of comparative and case study analyses were conducted to assess the feasibility …


The Connection Between An Unequitable Distribution Of Care Responsibilities And A Widening Gender Nutrition Gap In Latin America, Alexis Nicole Bodlak May 2025

The Connection Between An Unequitable Distribution Of Care Responsibilities And A Widening Gender Nutrition Gap In Latin America, Alexis Nicole Bodlak

Honors Program: Senior Projects (Public)

The notion of care refers to activities that satisfy the basic needs of existence and reproduction. Within rural communities, care work such as the production and preparation of food contributes to food security at the household level. Care work supports the paid workforce, allowing workers to focus on commercial productive activities that generate economic income in rural communities. Women perform 6.3 to 29.5 more hours per week than men in unpaid care work, reducing their time for income-generating activities and personal nutrition management. Affecting their economic independence and ability to access and consume nutritious food. Studies show that in food-insecure …


Pedaling Toward Justice: Exploring The Role Of Community Advocacy In Shaping Bicycle Policy In Oakland., Claire Farrell Lowe May 2025

Pedaling Toward Justice: Exploring The Role Of Community Advocacy In Shaping Bicycle Policy In Oakland., Claire Farrell Lowe

Master's Projects and Capstones

The way people move through a city fundamentally shapes their access to jobs, essential services, and economic and social opportunities. While Oakland’s bicycle infrastructure has improved over the past decade, vehicle-centric planning has historically sidelined cycling, creating mobility inequities. This thesis examines the role of community advocacy in advancing equitable bicycle planning and prioritizing cycling infrastructure as a core element of urban development. This thesis project follows the question: what role do advocacy groups play in addressing the gaps between the Oakland Bicycle Plan and its implementation? Through policy analysis, community engagement, and interviews with key informants from Bike East …


The Politics Of Being Heard: Communication And Power Struggles In Hunters Point Naval Shipyard, Caroline Trejo May 2025

The Politics Of Being Heard: Communication And Power Struggles In Hunters Point Naval Shipyard, Caroline Trejo

Master's Projects and Capstones

The environmental and public health challenges in Bayview-Hunters Point have catalyzed widespread community activism, as residents and advocates respond to the ongoing fallout from radiological contamination at the Hunters Point Naval Shipyard. Communication plays a vital role in bridging the gap between affected communities and government entities throughout the cleanup process. This research asks: how have the communication strategies of advocacy groups influenced government actions and policies during the Bayview-Hunters Point Shipyard cleanup? To explore this question, I conducted semi-structured interviews with three community advocates, two former members of a non-partisan civil jury, one independent researcher, and one government official. …


Having A Home To Come Home To: How Subsidized Housing Impacts Unhoused Pregnant Women, Stephanie O. Porvaznik May 2025

Having A Home To Come Home To: How Subsidized Housing Impacts Unhoused Pregnant Women, Stephanie O. Porvaznik

Master's Projects and Capstones

Community based organizations (CBOs) lead the charge in the fight to end housing insecurity and often must make up where local governments fall short. San Francisco is an example of a municipality that has a long history of addressing instances of housing insecurity for its residents, and where CBOs step in to provide housing support for populations with unique and special circumstances. One CBO that operates in San Francisco that I was interested in studying was the Homeless Prenatal Program (HPP), and the Jelani House, a housing subsidy that is funded and operated by the HPP for pregnant women who …


Measuring What Matters: A Policy Analysis Of Statewide Accountability Systems Through The Lens Of College And Career Readiness, Steven Deandre Shadwick May 2025

Measuring What Matters: A Policy Analysis Of Statewide Accountability Systems Through The Lens Of College And Career Readiness, Steven Deandre Shadwick

Theses and Dissertations

A disconnect exists between statewide accountability systems and college and career readiness (CCR) outcomes measured by the ACT and SAT. The goal of a statewide accountability system is to enable, implement, and support success for all students in areas that demonstrate high academic achievement through federal- and state-mandated metrics. Under the Every Student Succeeds Act (2015), states have been granted flexibility in how to measure CCR via a number of School Quality and Student Success (SQSS) indicators. Through a quantitative correlational design, data were collected from 44 states with ACT and SAT participation rates ≥ 90%, ≤ 10% or closest …


Negotiating Migration In The Mediterranean: A Comparative Study Of Morocco And Italy’S Border Policies And Their Humanitarian Impact On Irregular Migrants, Shennel Ep Henries May 2025

Negotiating Migration In The Mediterranean: A Comparative Study Of Morocco And Italy’S Border Policies And Their Humanitarian Impact On Irregular Migrants, Shennel Ep Henries

Master's Theses

Serving as both a barrier and a bridge that connects Africa and Europe, the Mediterranean is today the focal point of global controversies around migration, where humanitarian interests balance against border policing and meet securitization policies. This thesis examines the questions: How do irregular migrants adapt, interpret, and maneuver around securitized Moroccan and Italian migration policies, and what do their strategies tell us about the relationship between humanitarianism and securitization in Mediterranean bordering processes? Drawing on qualitative evidence, including expert interviews with organization employees and volunteers in Morocco and Italy (Fondazione Solidarietà Caritas, Nosotras Onlus, and Caritas Maroc), field observation, …


Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez May 2025

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.


From Data To Action: An Adaptable Crosstabs Template For Participatory Survey Data Analysis, Natalia Pinzon, Vikram Koundinya, William O'R Dowling, Ryan Galt May 2025

From Data To Action: An Adaptable Crosstabs Template For Participatory Survey Data Analysis, Natalia Pinzon, Vikram Koundinya, William O'R Dowling, Ryan Galt

Journal of Extension

We present a practical and accessible template for quantitative survey data analysis designed for non-academic researchers in order to facilitate engagement from community collaborators. The template, created in Google Sheets, is mainly for computing cross-tabulations, but it also displays frequency distributions and p-values for determining statistical significance. The template allows collaborators to record their observations and questions, promoting an efficient yet interactive review process and fostering a democratic analysis environment. Based on our own experience using this template for a data party, we highlight its effectiveness in promoting collaborative data interpretation, decision-making, and the actionable use of survey findings.


Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins May 2025

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …