Digital Commons Network^™

The Economic And Employment Consequences Of Repealing Federal Health Reform: A 50 State Analysis, Leighton Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Health Policy and Management Issue Briefs

Donald Trump and Congressional leaders have stated their intent to repeal the Patient Protection and Affordable Care Act (ACA or Obamacare). This report examines the consequences of repealing two key elements: (1) federal premium tax credits that help low and middle income Americans afford insurance policies bought through the Health Insurance Marketplaces (exchanges) and (2) federal payments to states for expansions of Medicaid eligibility for low-income adults. Congress passed similar legislation (H.R. 3762) in late 2015, which President Obama vetoed.

This report analyzes how the repeal of these policies could affect state-level employment, economies and fiscal conditions. If tax credits …

Implementation Science To Accelerate Clean Cooking For Public Health., Joshua Rosenthal, Kalpana Balakrishnan, Nigel Bruce, David Chambers, Jay Graham, Darby Jack, Lydia Kline, Omar Masera, Sumi Mehta, Ilse Ruiz Mercado, Gila Neta, Subhrendu Pattanayak, Elisa Puzzolo, Helen Petach, Antonello Punturieri, Adolfo Rubinstein, Michael Sage, Rachel Sturke, Anita Shankar, Kenny Sherr, Kirk Smith, Gautam Yadama

Environmental and Occupational Health Faculty Publications

Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the …

Health Reform Repeal Could Cause 3 Million People To Lose Jobs And Trigger Broad Economic Disruption, Leighton Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans.

Goal: To determine the state-by-state effect of repeal on employment and economic activity.

Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal …

Burundi : Water Scarcity, Isabel Salas

Global Public Health

Burundi is located near the African great lakes region of East Africa. This country is one of the poorest and hungriest countries throughout the world because of this they are facing multiple problems with communicable disease. These families are seeing a reduction in the amount of water available to them and based on this they are receiving water from external sources such as wells and lakes. Most of the water throughout Burundi is contaminated with Phytoplankton which increase cholera outbreaks in this area. It has also been shown that uranium impacts the water throughout the wells and lakes. Both of …

The Perceptions Of Key Stakeholders Of The Roles Of Specialist And Advanced Nursing And Midwifery Practitioners, Mary Casey, Laserina O'Connor, Emma Nicholson, Rita Smith, Denise O'Brien, Denise O'Leary, Gerard Fealy, Martin Mcnamara, Diarmuid Stokes, Claire Egan

Articles

Aim: To explore the perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners. Background: There is evidence that the contribution of these roles to patient care is poorly understood. Design: This research took place over 2 months in 2015 and is part of a larger study involving a rapid review to inform policy development on the specialist and advanced nursing and midwifery practice in Ireland. As an added value, a qualitative element involving thematic analysis was undertaken with key stakeholders. Methods: A phenomenological qualitative study was conducted incorporating semistructured interviews …

Evaluation Of The Volunteer Doula Program At Brookings Health System, Jenn Anderson, Rebecca A. Kuehl

Communication Studies Publications

The 12-month research project included interviews and focus groups with key stakeholders, as well as an evaluation of promotional materials. An interdisciplinary team of researchers from South Dakota State University (SDSU) partnered with OB and PR/Marketing staff at Brookings Health System (BHS) to evaluate the volunteer doula program. The team collaboratively recruited participants and developed interview questions for key stakeholders, including: OB nurses and doctors, volunteer doulas, expectant parents, and mothers. Promotional materials were also evaluated by a persuasion expert. Our findings are drawn from interviews with 15 BHS staff, 9 doulas,

Screening Families For Unmet Social Needs In A Pediatric Clinic, Elizabeth Evans Peterson

Master of Public Health Program Student Publications

Background: Previous research indicates that at least 60% of preventable deaths are caused by modifiable factors. Children, especially those under the age of five, are the most at-risk population for negative social determinants of health. Identifying and mitigating these factors could break the poverty impact cycle and promote wellness into adulthood, improving community health outcomes.

Purpose: The purpose of this study was to describe trends in unmet social needs of children attending a well-child visit in Dayton, Ohio. Methods: Families attending a hospital-affiliated clinic during a well-child visit were asked to complete a simple, 10-item questionnaire. This cross-sectional study utilized …

Visualizing The Diffusion Of Digital Mammography In New York State, Francis P. Boscoe, Xiuling Zhang

Epidemiology & Biostatistics Faculty Scholarship

Digital mammography saw rapid adoption during the first decade of the 2000s. According to data maintained by the Food and Drug Administration, which regulates mammography machines, fewer than 1 percent of the machines in 2001 were digital. By 2014, this figure had risen to 94%. We were interested in identifying the times and locations where the technology was introduced within the state of New York as a way of illustrating the uneven introduction of this technology. While the diffusion of medical innovation has been well-studied, there have not been many instances where maps or geographic information science methods have been …

Repealing Federal Health Reform: Economic And Employment Consequences For States, Leighton C. Ku, Erika Steinmetz, Erin Brantley, Brian K. Bruen

Health Policy and Management Issue Briefs

Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans.

Goal: To determine the state-by-state effect of repeal on employment and economic activity.

Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal …

Reducing The Rate Of Late Stage Breast Cancer Through Effective Health Communication: An Opinion Piece, Rachele Hendricks-Sturrup

Internet Journal of Allied Health Sciences and Practice

Purpose: Health and illness are traditionally characterized and treated differently across various ethnic groups, which encourages American health systems serving these diverse populations to explore culturally competent and safe ways to effectively reduce illness within such populations. Certain ethnic groups of women in the United States (US) bear greater risk of late stage breast cancer because of various circumstances, which include but are not limited to a lack of insurance or underinsurance and discomfort with and/or resentment toward the US healthcare system. The dominant culture and the social aspects of the modern American health system often and most favorably serve …

Using A Social Ecological Model To Explore Upstream And Downstream Solutions To Rural Food Access For The Elderly, Lauri Andress

Faculty & Staff Scholarship

A social ecological model is applied to the secondary analysis of qualitative data to study the impact of place on rural food access for older adults in West Virginia. The use of a social-ecological model to review the senior’s coded narratives provided a clearer picture of higher impact, upstream levers to address food security for older adults in a rural region. The elderly have restricted access to food in rural West Virginia because of an indirect relationship with place that acts through the social ecological domains of the built environment, macrosocial factors, stressors, the natural environment, and social support. The …

Detroit Food Metrics Report 2017, Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Malignant Melanoma In Kentucky: An Analysis Of The Individual And Social Factors On Disease Stage And Treatment, Virginia Valentin

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In 2016 there will be an estimated 76,380 new cases of malignant melanoma and 10,130 deaths in the United States (US). ¹ Malignant melanoma incidence is increasing faster than any other preventable cancer in the US with an expected 112,000 new cases a year by 2030. ^2,3 This capstone attempts to quantify the association of individual and social factors on melanoma late-stage diagnosis and non-adherence to surgical treatment guidelines for early-stage lesions in Kentucky.

Methods: The analysis combines three datasets: individual level data from the Kentucky Cancer Registry, census tract level data from the US Census and …

Understanding And Promoting Parent-Child Sexual Health Communication, Shannon Phelps

Theses and Dissertations--Education Sciences

Parent-child sexual health communication (PCSHC) can have a positive impact on adolescents’ sexual health choices, outcomes, and capabilities for communicating with others about sexual health. Many parents are hesitant and feel unprepared for and uncomfortable with communicating about sexual health with their children. Other parental factors as well as child factors can impact the quality, frequency, coverage, and effectiveness of PCSHC. Some adolescent sexual health outcomes have improved, however, teen birth rates in the United States are elevated compared to other developed countries and half of all sexually transmitted infection (STI) diagnoses are made to adolescents and emerging adults. This …

Status Of Sexual And Reproductive Health And Rights In Zambia: Contraception And Family Planning, Preventing Unsafe Abortion And Accessing Post Abortion Care, And Maternal Health, Population Council

Reproductive Health

In 1994, the International Conference on Population and Development affirmed that sexual and reproductive health and rights (SRHR) are human rights. The Government of the Republic of Zambia has fully committed to fulfilling the SRHR of all people by ratifying 11 international instruments of law. This brief is Part 1 of a three-part series entitled “Status of Sexual and Reproductive Health and Rights in Zambia,” reporting on progress, gaps, and existing challenges in SRHR. Using a human rights–based approach, the Government of Zambia and collaborators, with technical facilitation by the Population Council, conducted an assessment of the status of SRHR …

Impact Of Simultaneous Exposure To Arboviruses On Infection And Transmission By Aedes Aegypti Mosquitoes, Claudia Rückert, James Weger-Lucarelli, Selene M. Garcia-Luna, Michael C. Young, Alex D. Byas, Reyes A. Murrieta, Joseph R. Fauver, Gregory D. Ebel

Journal Articles: Epidemiology

The recent emergence of both chikungunya and Zika viruses in the Americas has significantly expanded their distribution and has thus increased the possibility that individuals may become infected by more than one Aedes aegypti-borne virus at a time. Recent clinical data support an increase in the frequency of coinfection in human patients, raising the likelihood that mosquitoes could be exposed to multiple arboviruses during one feeding episode. The impact of coinfection on the ability of relevant vector species to transmit any of these viruses (that is, their vector competence) has not been determined. Thus, we here expose Ae. aegypti mosquitoes …

We Like Fried Things: Negotiating Health, Taste And Tradition Among Spanish Caribbean Communities In New York City, Melissa Fuster

Publications and Research

The study was conducted to understand fried-food (FF) consumption among Hispanic Caribbean (HC) communities in New York City. Data were collected through qualitative interviews with 23 adults self-identified as Cuban, Dominican, or Puerto Rican. Most informants considered FFs an important part of their traditional diet. Potential explanations included taste, cost, convenience, and the emotive values attached to FF. FF consumption was contextualized in local foodscapes. Results include strategies to diminish FF consumption and differences across HC groups and migratory generations. The relevance for future nutrition interventions addressing health disparities in this community is discussed

Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar

HIV and AIDS

Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …

Mortality One-Year Post Stroke : What Matters? : An Exploratory Study Of A Cohort In New York State, Zainab Magdon-Ismail

Legacy Theses & Dissertations (2009 - 2024)

Background/Purpose: Stroke is one of the leading causes of mortality and serious long-term disability in the United States. However, there are few studies evaluating factors associated with long-term outcomes among stroke survivors.

The Impact And Cost Of Child Marriage Prevention In Three African Settings, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

Girls in sub-Saharan Africa are disproportionately affected by child marriage; by 2050, half of the girls married during childhood will reside in Africa. The negative consequences of the practice are numerous and powerful, spanning health, welfare, development, and demographic domains. Yet, there is limited evidence on what works to delay child marriage in different cultural contexts and even less information on programmatic cost. This study develops and tests the most effective and minimum basic package approaches to delay marriage among older and younger adolescent girls, and estimates the cost and cost-effectiveness of implementing the different approaches, in Burkina Faso, Ethiopia, …

Exploring Spatial Patterning And The Impact Of Obesogenic Built Environments For Youth Obesity, S. Morgan Hughey

Theses and Dissertations

Youth obesity is a major public health concern due to an array of physical, social, and psychological health consequences. Residential location, often referred to as ‘place’, has continued to emerge as a key health determinant with studies showing that where a child lives impacts their health. Environments where it is easy for individuals to have low levels of physical activity – either by discouraging active behavior or promoting sedentary behavior – and easy for individuals to consume unhealthful foods – either by the limited availability of healthful foods or increased availability of unhealthy foods – have been coined ‘obesogenic’. Additional …

Cadmium Exposure And Residence-To-Road Proximity In Eastern Kentucky, Ellen Flora

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Objectives

Cadmium is a carcinogenic and toxic metal. The general population can be exposed to cadmium from multiple sources. The purpose of this study is to evaluate the association of urinary cadmium and residence distance-to-road by performing landscape analyses in eastern Kentucky, a region where smoking prevalence is high, coal production has been a primary industry, and the landscape is predominantly undeveloped. Composite dust samples were also collected and analyzed for Cadmium (Cd), Manganese (Mn), and Zinc (Zn). The primary objective of this study is to ascertain if there is an association between participants with elevated accumulated cadmium …

The Effects Of Improved Water And Sanitation Access On Under Five Child Diarrhea In Peru, April Ballard

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Significance: Diseases related to poor or lack of access to clean water, sanitation, and hygiene negatively impact health, education, and development worldwide and cause millions of deaths in children each year. Health outcomes associated with lack of access to clean water and sanitation are under-evaluated.

Aim: To assess the effect of improved water and sanitation infrastructure development on child morbidity in Peru by investigating diarrhea in children under five years of age.

Methods: The child, family, and household data from the Peruvian Demographic and Health Surveys (DHS) were used to evaluate the association between access to water …

Do Numbers Matter? Comparing Single Homicide Followed By Suicide And Multiple Homicide Followed By Suicide Using The National Violent Death Reporting System, 2003-2012, Courtney Blondino

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction

Homicide-followed-by-suicide or homicide-suicides were examined to understand the dynamics of acting outwardly and inwardly violent in a single incident. The purpose of this study was to identify if specific circumstances had an association with the number of victims per homicidesuicide incident. This study addresses an important public health issue by encouraging an accurate viewpoint of homicide-suicide in order to properly program prevention efforts.

Methods

Using the restricted access data (RAD) from 17 National Violent Death Reporting System (NVDRS) states, we characterized 1904 homicide-suicide incidents through qualitative and quantitative analysis based on victim and suspect demographic information, method of injury, …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Narratives Of Men Living With Systemic Lupus Erythematosus, Kimberly Vandermark Lynch

Walden Dissertations and Doctoral Studies

While systemic lupus erythematosus (SLE) has been traditionally viewed as a woman's disease, SLE impacts men as well. Although most research on SLE has concentrated on how it affected women, little is known about how it impacts men. The purpose of this phenomenological study was to examine how men who live with SLE perceive its psychological impact. Using the lens of the biopsychological theory, common themes were examined pertaining to how men with SLE perceive the impact that SLE has on their cognitive and emotional functioning. Data were collected via interviews with 9 men with SLE, and the data were …

Diagnostic Prevalence Of Diabetes Among Older Adults In Rural Appalachia, Gabriella Hodges

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

The rural, mountainous Appalachian region continuously has poorer health outcomes than the rest of the United States. This is true for many chronic diseases including diabetes: the 7th leading cause of death in the United States. This study assessed differences in the prevalence of diagnosed diabetes between older adults in rural, Appalachian counties and rural, non- Appalachian counties.

Methods

Data for the year 2013 was extracted from the Centers for Medicare and Medicaid Services (CMS) Public Use Files for Medicare beneficiaries (September 2015), which provides county level prevalence for diabetes as well as several other conditions among Medicare fee-for-service …

Knowledge, Perceptions, And Facilitators To Colorectal Cancer Screening Among African American Men In Mobile, Alabama, Ruben Franklin

Walden Dissertations and Doctoral Studies

African American (AA) men in the state of Alabama are affected by colorectal cancer (CRC) more than all other races. The purpose of this phenomenological study was to gain understanding of colorectal cancer screening health benefits in AA men in Mobile, Alabama. The health beliefs model (HBM) developed by Hochum, Rosemstock, and Kegels was used to to explore the barriers and facilitators to CRC screening in AA men with health insurance in Mobile, Alabama. The research questions explored knowledge, perceptions, and facilitators to CRC screening among AA men age 40 to 75. Participants were selected using purposive sampling and data …

Exploring The Association Between Fgm/C And Early/Child Marriage: A Review Of The Evidence, Jamlick Karumbi, David Gathara, Jacinta Muteshi-Strachan

Reproductive Health

Female genital mutilation/cutting (FGM/C) has been frequently linked to marriageability and thought to be associated with child marriage, yet there is remarkably little rigorous research to clarify the relationship between these two practices to inform discussions and responses. Furthermore, trends are also shifting in the timing of FGM/C from adolescence to early childhood, and the implications this might have on the links between early/child marriage and FGM/C are not well understood. This review of current available evidence aims to assess the association between FGM/C and early/child marriage in contexts where both practices are carried out. The social and cultural norms …

Exploring The Association Between Fgm/C And Fistula: A Review Of The Evidence, Pooja Sripad, Charity Ndwiga, Kaji Tamanna Keya

Reproductive Health

Female genital mutilation/cutting (FGM/C) and fistula are both conditions that have a range of health, socioeconomic, and lifestyle causes and consequences for women globally. There have been sparse empirical and conceptual efforts to look at how these two conditions manifest and relate to one another. This rigorous review of the literature aims to fill this research gap by assessing the state of evidence on the association of FGM/C and fistula and conceptually mapping this association within broader social, political, and health-systems contexts. Based on the findings, the authors of this report have developed a conceptual mapping framework to situate the …