Digital Commons Network^™

Integrating Health Equity Into Implementation Science To Advance Chronic Disease Prevention And Control, Callie Walsh-Bailey

Brown School Graduate Student Theses and Dissertations

Marginalized populations are inequitably burdened by chronic diseases such as diabetes, heart disease, obesity, and cancer. The goal of health equity work is to ensure all people have a fair and just opportunity to achieve optimal health. Implementation science has made health equity a greater focus and priority in recent years. There has been a proliferation of guidance on what implementation science needs to do to advance equity. However, the field currently lacks specific, actionable guidance on how to integrate equity. The overarching goal of this dissertation is to synthesize conceptual and theoretical underpinnings regarding health equity and bring them …

Approaches To Charitable Giving And Perceptions Of Organizational Effectiveness Among Midlevel Donors, Cal J. Halvorsen, Johanna Lynch, Sylvia Brown, Melissa L. Mcternan

Harvey A. Friedman Center for Aging

For decades, scholars have devoted attention to identifying the giving habits of charitable donors, yet the behaviors of midlevel donors have not been independently considered. This study examined midlevel donors’ approaches to charitable giving and the extent to which they give to effective organizations. Operationalized as giving between $2,000 and $20,000 annually, we analyzed descriptive statistics and multivariate probit models of 1,260 midlevel donors using a novel study. We found that respondents were least likely to engage in ad-hoc giving and most likely to give to organizations due to personal connections or prior research. However, while caring about a cause …

Measuring The Impacts Of Experiential Legal Education, Robert R. Kuehn, Peter A. Joy

Scholarship@WashULaw

Experiential legal education has become an essential component of the law school curriculum, emphasizing "learning by doing" through practical experiences in law clinics, externships, and simulation courses. This pedagogical approach offers law students the critical skills and professional values required for effective and ethical practice. Despite its recognized importance and parallels with other professional disciplines, legal education still requires minimal experiential education compared to other professions. This reluctance likely stems from lingering skepticism by some legal educators about its value, even though many stakeholders, including other educators, students, recent graduates, and other legal professionals, acknowledge its significance.

This Article is …

Examining The Role Of Urban Policy, Built Environment, And Physical Activity In Mexico City, Eugen Resendiz Bontrud

Brown School Graduate Student Theses and Dissertations

Over the past three decades, Latin America has undergone major demographic, lifestyle, and epidemiological transitions. These rapid transitions are relevant contributors to social and health inequities in the region. Physical inactivity is a known risk factor for several adverse health outcomes, including Type 2 diabetes, coronary heart disease, and site-specific cancers (breast, ovarian, endometrial, and colon). Latin America has the highest prevalence of physical inactivity among all global regions, with one in every three Latin Americans being physically inactive. Research exploring the link between urban policies, built environment characteristics, and physical activity has grown over the past two decades. Nevertheless, …

Exploring The Complex Relationship Between Social Needs And Health, Rachel Catherine Garg

Brown School Graduate Student Theses and Dissertations

Over the past two decades, the healthcare sector has increasingly sought to assess and address patients’ health-related social needs with the dual aim of health improvement and cost reduction. However, evidence for the health impact of social needs interventions is mixed. Most interventions are not guided by theories or conceptual models that specify causal pathways or mechanisms for how unmet social needs impact health. It is also currently unknown how social needs change over time and the timeframe over which social needs impact health outcomes. This dissertation seeks to fill these gaps by (1) critically reviewing existing conceptual models proposing …

Climate Change And Farmer Mental Health: A Participatory And Systems-Based Approach, Christopher Weatherly

Brown School Graduate Student Theses and Dissertations

Because of their closeness to and dependence on the land, climate change will disproportionately impact farmer mental health. Despite local and global reliance on U.S. Midwest farmers' mental health and wellbeing, there are limited studies elucidating the impacts of our changing climate on their mental health. The proposed dissertation addresses this gap by leveraging qualitative data from community stakeholders and applying a systems perspective in two phases to address the research question: How does climate change impact farmer mental health? The study takes place in farming communities in rural southeastern Iowa, which have experienced demonstrated increases in daily average temperature, …

My Alfond Grant Cda: Experience From 10 Years Of Automatic Deposits For All Maine Newborns, Colleen J. Quint, Margaret M. Clancy

Center for Social Development Research

For over a decade, the Alfond Scholarship Foundation has automatically enrolled every Maine-resident newborn into the United States’ first statewide, universal Child Development Account (CDA) by investing $500 on each child’s behalf in the NextGen 529 plan. This Policy Brief provides an overview of My Alfond Grant and tracks the growth of the CDA in the 10 years since it made the major policy-design change to implement automatic enrollment. The Brief also includes insights regarding partnerships and communications that have helped to improve My Alfond Grant’s ability to connect with Maine families.

Child Well-Being Policies In Post-Soviet Countries: The Potential Of Child Development Accounts, Aytakin Huseynli, Michael Sherraden

Center for Social Development Research

Following the collapse of the Soviet Union, all post-Soviet countries initiated reforms in child well-being systems. Some have undertaken meaningful changes, and others continue to struggle. This Policy Brief summarizes one portion of an in-depth study on child well-being policies in six post-Soviet countries: Ukraine, Moldova, Azerbaijan, Georgia, Kazakhstan, and Kyrgyzstan. It discusses asset-building policy for children in those countries, an emerging national children’s account policy in Kazakhstan, and the potential for diffusion of Child Development Account policy.

Homegrown Stl 5th Annual Regional Summit On The State Of Opportunity For Black Boys And Young Men: Organizing For Solutions That Unleash The Elite Potential Of Young Black Males, Sean Joe, Maribeth Clifton, Demeisha Carlton-Brown

Center for Social Development Research

Convened annually, HomeGrown StL’s annual regional summit brings together service providers, government officials, private-sector partners, and residents to strengthen, align, and accelerate local collective-impact strategies that support the health, development, and economic mobility of Black boys and young men in St. Louis City and in St. Louis County.

This report summarizes developments from the 5th Regional Summit on the State of Opportunity for Black Boys and Young Men: Organizing for Solutions That Unleash the Elite Potential of Young Black Males, which convened June 9, 2022. In addition to describing Priority Objectives and Key Results developed during the summit, the report …

Prevalence, Sociocultural Risks And Protective Factors Of Suicidal Behaviors: A Cross Sectional Study Of Middle School Students In The Greater Accra Region Of Ghana, Enoch Kordjo Azasu

Brown School Graduate Student Theses and Dissertations

Suicide is a serious public health issue with more deaths worldwide than malaria, and HIV/AIDS in 2019, according to the World Health Organization. Almost nine out of 10 adolescents who died by suicide in 2019 were from low- and middle-income countries. In Ghana non-fatal suicide rates are higher among middle school and high school students yet the data we have is about a decade old. Using a sample of 800 middle school students in the Greater Accra Region and applying a theoretical-driven analytic approach, this dissertation seeks to understand the prevalence, sociocultural correlates, risk, and protective factors of adolescent suicidal …

Parent And Child Wellbeing In A Humanitarian Context By Flora Cohen,, Flora Cohen

Brown School Graduate Student Theses and Dissertations

There are increasingly more children and families affected by conflict and displacement. Conflict and displacement can cause severe mental health challenges and social fragmentation. Programs that support the mental health and wellbeing of communities and families living in humanitarian contexts are vital to improving future outcomes. This dissertation utilizes evidence from a psychosocial support intervention designed to support caregivers living in Kiryandongo refugee settlement, Uganda. Findings from this study highlight the importance of utilizing children’s voices in the development of programs, equipping researchers with instruments that have been tested for reliability and validity in differing contexts, and evaluating differing program …

The Physical Health Of People With Co-Occurring Serious Mental Illness And Substance Use Disorders, Mark R. Hawes

Brown School Graduate Student Theses and Dissertations

People with serious mental illness (SMI; e.g., schizophrenia) die 10–25 years earlier than people in the general population largely due to chronic medical conditions (e.g., cardiovascular disease [CVD]), and having a co-occurring substance use disorder (SUD) increases this risk even further compared to having either disorder alone. This is concerning since 50% of people with SMI will be diagnosed with a co-occurring SUD in their lifetime and 40%-80% are current tobacco smokers. Healthy lifestyle interventions can improve the health of people with SMI by offering a package of services aimed at improving physical activity, dietary habits, and engagement in health …

Examining Immigrant Experiences In Asset Building: Implications For Asset-Based Policies, Yingying Zeng

Brown School Graduate Student Theses and Dissertations

The economic integration of immigrants has long interested researchers and policymakers, with late but now growing attention on their asset- and wealth-building. Current research on immigrants’ asset building has largely focused on their individual-level characteristics, and not much on opportunities and constraints related to policy arrangements. This dissertation addresses the selection, adaptation, and impacts of immigration, with a goal to expand knowledge about asset-based social welfare policy in light of immigrants’ experiences. This investigation leverages two nationally representative datasets, the New Immigrant Survey and the National Longitudinal Survey of Youth (1997), to understand immigrants’ asset accumulation and intergenerational wealth mobility. …

Expanded Child Tax Credit Payments Supported Families Raising Children With Disabilities, Allyson Baughman, Laura Brugger, Meg Comeau, Leah Hamilton, Candace Jarzombek, Caroline Parker, Stephen Roll

Social Policy Institute Research

The 2021 expanded Child Tax Credit (CTC) provided temporary enhancements to the existing CTC for the tax years 2021 and 2022. Under the expanded credit, families with children under the age of 18 were eligible to receive a credit of up to $3,000 per child ($3,600 for children under the age of 6).

In addition, half the credit was paid out on a monthly basis rather than as a one-time payment at tax time. This provision was designed to provide more immediate financial support to families with children during the COVID-19 pandemic. However, it also supported families who were at …

“It Helped Us More Than I Could Have Imagined”: How The 2021 Expanded Child Tax Credit Supported Families Raising Children With Disabilities, Laura Brugger, Stephen Roll, Leah Hamilton, Allyson Baughman, Meg Comeau, Candace Jarzombeck, Caroline Parker

Social Policy Institute Research

The 2021 expanded Child Tax Credit (CTC) provided temporary enhancements to the existing CTC for the tax years 2021 and 2022. Under the expanded credit, families with children under the age of 18 were eligible to receive a credit of up to $3,000 per child ($3,600 for children under the age of 6). In addition, half the credit was paid out on a monthly basis rather than as a one-time payment at tax time. This provision was designed to provide more immediate financial support to families with children during the COVID-19 pandemic. However, it also supported families who were at …

Advancing Racial Equity Through Community Land Trusts, Amal Alzhrani, Brittany Kiefer, Da-Yup Kim, Gabby Eissner

Center for Social Development Research

Community land trusts are nonprofit organizations designed to preserve housing affordability. This brief describes the design and operation of such trusts, illustrating the concept by spotlighting the Columbia Community Land Trust of Columbia, Missouri.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event was organized by the Center for Social Development in partnership with Women’s Voices Raised for Social Justice and the Alliance for Interracial Dignity. The contents may also be found in …

Racially Restrictive Covenants: A Story Of Segregation, Disinvestment, And Lingering Implications, Fadya Al Hammam, Janeka Haden, Livi Logan-Wood, Joseph Roeder

Center for Social Development Research

Racially restrictive covenants are agreements, typically embedded in property deeds, that limit the transfer of property to non-white people. The covenants remain common features of property deeds in the St. Louis region, though enforcement of them was outlawed by the U.S. Supreme Court’s Shelley v. Kraemer decision in 1948. This brief discusses the covenants and identifies strategies for communities to deploy in addressing them.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event …

Zoning: Issues And Reform, Olivia Borland, Casey Kohlstruk, Lindsay Owens

Center for Social Development Research

What steps can communities take to broaden equitable access to housing and prevent residential displacement? This brief identifies strategies for reforming zoning policy to advance those goals.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event was organized by the Center for Social Development in partnership with Women’s Voices Raised for Social Justice and the Alliance for Interracial Dignity. The contents may also be found in Welcome Home: A Policy Briefing Book for …

Linkage Fees: A Vehicle For Financing Affordable Housing, Lillian Murphy, Stanford Cooper, Russell Beckham

Center for Social Development Research

A linkage fee is a policy instrument for capturing resources to fund affordable housing development and other public services. This brief describes the instrument and offers recommendations on implementing linkage-fee policies.

The contents of this brief evolved from a presentation given in the Colloquium on Inclusive Housing Policy for the St. Louis Region. Held in the Brown School at Washington University on December 15, 2022, the event was organized by the Center for Social Development in partnership with Women’s Voices Raised for Social Justice and the Alliance for Interracial Dignity. The contents may also be found in Welcome Home: A …

Welcome Home: A Policy Briefing Book For Housing Opportunity In St. Louis County, Molly W. Metzger

Center for Social Development Research

“Equality of opportunity” is a beautiful American ideal, but it stands in stark relief to the history of racist policies in the United States—including policies in the St. Louis region. Edited by Molly Metzger, this briefing book aims to broaden opportunity by offering ideas for housing policy change in the majority-white, inner-ring suburbs of St. Louis. The policy works in this collection were written by masters of social work students at Washington University’s Brown School as part of a social-policy course taught by Metzger in partnership with Mayor Laura Arnold of Webster Groves, Missouri, Webster Groves’ Alliance for Interracial Dignity, …

Comments On Receiving The Distinguished Career Achievement Award Of The Society For Social Work And Research, Michael Sherraden

Center for Social Development Research

This Perspective presents remarks given by Founding Director Michael Sherraden upon receiving the Society for Social Work and Research’s 2023 Distinguished Career Achievement Award in a ceremony at the society’s 2023 annual meeting in Phoenix, Arizona, on January 14, 2023.

The Cogenerate Innovation Fellowship: Supporting Leaders Of Intergenerational Initiatives, Cal J. Halvorsen, Eunice Lin Nichols, Janet Oh

Harvey A. Friedman Center for Aging

This Case Report provides a detailed overview of the CoGenerate Innovation Fellowship, a 9-month fellowship that supports leaders of intergenerational initiatives developed by the national nonprofit organization, CoGenerate. It describes the Fellowship’s recruitment and cohort development strategies, monthly meetings and community-building efforts, end-of-Fellowship celebration, and post-Fellowship support. It summarizes findings from the two-year pilot’s process and outcomes evaluation and provides recommendations to individuals and organizations seeking to support social sector innovators who are leading intergenerational initiatives.

Double Burden Of Malnutrition Workshop Facilitation Manual: Lima, Peru, Carmen Quinteros-Reyes, Pavarskevi Seferidi, Laura Guzman-Abello, Christopher Millett, Antonio Bernabé-Ortiz, Lindsey Pawlowski, Ellis Ballard

Social System Design Lab

This is a facilitation manual for workshops in Lima, Peru as part of the project “Addressing the double burden of malnutrition in Peru: using a community-based system dynamics approach to improve food systems”. The project is a collaboration between investigators at the Center of Excellence in Chronic Diseases (CRONICAS) at the University of Peruana Cayetano Heredia, Universidad de los Andes in Bogota, Peru, the Social System Design Lab at Washington University in St. Louis, USA and Imperial College London funded by the Biotechnology and Biological Science Research Council (Grant Ref: BB/T009004/1). It is a supplemental document associated with the paper …

Double Burden Of Malnutrition Workshop Facilitation Manual: Iquitos, Peru, Carmen Quinteros-Reyes, Paraskevi Seferidi, Laura Guzman-Abello, Christopher Millett, Antonio Bernabé-Ortiz, Lindsey Pawloski, Ellis Ballard

Social System Design Lab

This is a facilitation manual for workshops in Lima, Peru as part of the project “Addressing the double burden of malnutrition in Peru: using a community-based system dynamics approach to improve food systems”. The project is a collaboration between investigators at the Center of Excellence in Chronic Diseases (CRONICAS) at the University of Peruana Cayetano Heredia, Universidad de los Andes in Bogota, Peru, the Social System Design Lab at Washington University in St. Louis, USA and Imperial College London funded by the Biotechnology and Biological Science Research Council (Grant Ref: BB/T009004/1). It is a supplemental document associated with the paper …

The Enemy Within: An Investigation Of The Intracellular Bacteria In Urinary Tract Infections, Jennie Elizabeth Hazen

Arts & Sciences Graduate Student Theses and Dissertations

Urinary tract infections (UTIs) are common diseases that are associated with significant morbidities. Multiple studies have indicated that multiple species of uropathogenesis bacteria invade and persist within bladder epithelial cells as a necessary step of uropathogenesis. Interestingly, many of these species are not canonically associated with intracellular infections. Although the first study describing bacteria within the urothelium was published two decades ago, this critical step of uropathogenesis remains relatively understudied.I established a murine model of community-acquired A. baumannii UTI, a previously unstudied manifestation of the disease. While immunocompetent mice resolved their infections quickly, immunocompromised mice displayed high bacterial burdens throughout …

Effectiveness Of Community Development Organizations In The St. Louis Metropolitan Area, Kyle Pitzer

Brown School Graduate Student Theses and Dissertations

Concentrated poverty has been a core issue in urban America for close to half of a century. The consequences of living in these neighborhoods are also dire. These "neighborhood effects" are defined as the effects of living in concentrated poverty over and above individual circumstances, which have been tied to a number of important life outcomes. One approach to addressing these issues is community development, and perhaps the most salient vehicle of community development is the community development corporation (CDC). This current study sought to address three aims: 1), understand the effects of CDCs on population-level outcomes; 2), understand the …

Poverty, Child Maltreatment And Adverse Childhood Experiences – Just Comorbidities?, Darejan Dvalishvili

Brown School Graduate Student Theses and Dissertations

Both child abuse and neglect (hereafter maltreatment) and poverty are serious social and public health problems that are related to numerous negative and costly outcomes as well as being related to other so-called adverse childhood experiences (ACES). A significant, yet recent, body of work suggests a strong, perhaps causal, relationship between poverty and maltreatment. Much remains unknown about how they are associated and whether or not a true causal relationship exists while controlling for other potential risks in the ecology. This dissertation conducted a secondary analysis of the Panel Study of Income Dynamics (PSID) to help address this gap. First, …

Financial Well-Being Of Frontline Healthcare Workers: The Importance Of Employer Benefits, Mathieu Despard, Sophia Fox-Dichter, Haotian Zheng, Grace Anderson, Olivia Borland, Kourtney Gilbert

Social Policy Institute Research

Frontline healthcare workers – especially direct care workers (DCWs), such as home health aides, struggle due to low pay, lack of benefits, and difficult working conditions. The need for these workers is growing. Unless frontline healthcare jobs improve, positions may be difficult to fill, and care for vulnerable members of society may be compromised.

In this study, we surveyed 2,321 frontline healthcare workers and conducted in-depth interviews with 30 of these workers concerning pay, benefits, work conditions, and financial well-being. Key survey findings included:

• Only 39% of workers were eligible for at least four out of five major benefits (e.g., …

Global Child Development Accounts: A “Moon Shot” To Develop Every Child And The Planet, Michael Sherraden, Li Zou

Center for Social Development Research

The early 21st century has been marked by several global stresses. Effective responses, note Michael Sherraden and Li Zou, require large, bold solutions. In this concept note, they propose a global Child Development Account initiative, a global project for building assets for all children to invest in their full development. The times require audacity, Sherraden and Zou assert, but big changes are possible.

Democratizing The Economy Or Introducing Economic Risk? Gig Work During The Covid-19 Pandemic, Daniel Auguste, Stephen Roll, Mathieu Despard

Social Policy Institute Research

Though the growth of the gig economy has coincided with increased economic precarity in the new economy, we know less about the extent to which gig work (compared with other self-employment arrangements and non-gig work) may fuel economic insecurity among American households. We fill this gap in the literature drawing on a sample of 4,756 workers from a unique national survey capturing economic hardships among non-standard workers like app-and platform-based gig and other self-employed workers during the COVID-19 pandemic. Results from generalized boosted regression modeling, utilizing machine learning to account for potential endogeneity, demonstrated that gig workers experienced significantly greater …