Medicine and Health Sciences Commons^™

Strengthening Immigrants' Health Access: Current Opportunities, Leighton C. Ku

Health Policy and Management Issue Briefs

This brief summarizes key opportunities helping the nation’s newcomers in gaining health insurance coverage and health access that are possible under the current law. Provisions of the Affordable Care Act (ACA) will help millions of legal immigrants gain access to affordable health insurance coverage. At the same time, however, immigrants will also face new responsibilities. Like citizens, lawfully present immigrants will be responsible for having health insurance coverage or paying a tax penalty, although some are exempt. Rules about immigrants’ access to health insurance benefits are often complicated because they depend on specific immigration categories, as well as eligibility for …

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

Economic Impact Of Medical Education Expansion In Nevada: Economic Impact Assessment And Recommended Approach, Tripp Umbach

Lincy Institute Reports and Briefs

In May 2013, The Lincy Institute1 commissioned, Tripp Umbach2 to prepare an economic impact report to show the value of a new, four-year allopathic medical school (hereinafter referred to as the new four-year medical school) in Las Vegas. To accomplish this task, Tripp Umbach evaluated multiple medical school development models in order to recommend the optimal model that would provide the greatest economic impact to the state of Nevada and the Las Vegas Metropolitan area.

A Profile Of Community Health Center Patients: Implications For Policy, Peter Shin, Carmen Alvarez, Jessica Sharac, Sara J. Rosenbaum, Amanda Van Vleet, Julia Paradise, Rachel Garfield

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers are a key source of comprehensive primary care in medically underserved communities across the country, and their role is expected to grow as health coverage expands under the Affordable Care Act (ACA). To sharpen understanding of the health center patient population, this brief compares it to the overall low-income population, using data from the Health Center Patient Survey and the National Health Interview Survey,respectively. The pre-ACA profile of health center patients that emerges sets the stage for measuring change following implementation of the reform law and can inform health center policy, planning, and assessment moving forward.

How Medicaid Expansions And Future Community Health Center Funding Will Shape Capacity To Meet The Nation's Primary Care Needs, Leighton C. Ku, Julia Zur, Emily Jones, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

A new report by Drs. L. Ku, J. Zur, E. Jones, P. Shin and S. Rosenbaum examines the impact of federal and state policy decisions on community health centers and their ability to continue providing primary care to the nation's poorest residents. The report estimates that under a worst-case scenario the nation's health centers would be forced to contract, leaving an estimated 1 million low-income people without access to health care services by 2020.

Research Brief: "Peer Mentoring And Financial Incentives To Improve Glucose Control In African American Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about whether peer mentoring and financial incentives given to African American veterans with diabetes improves their glucose levels. In policy and practice, African American veterans should join peer mentoring programs to help them control their diabetes and consult with their physician about peer mentoring; the VHA should create a peer mentoring program for veterans with diabetes to help with diabetes management. Suggestions for future research include using a larger, more diverse sample, looking at how the peer mentoring helps veterans, and looking at the ways in which veterans lowered their glucose levels in addition to taking part …

Identifying And Describing The Network Of Health, Education, And Social Service Non-Profit Organizations In Southern Nevada, Shannon M. Monnat, Anna Smedley

Lincy Institute Reports and Briefs

Many of the economic, social, and demographic issues facing southern Nevada are dynamic and interrelated, requiring a coordinated approach on the part of southern Nevada’s non‐profit community. The coordination of services, skills, and talents enables community needs to be addressed in ways that exceed the scope and capacity of any single organization. With the increasing desire of funding organizations to support collaborative efforts, maintaining sustainable connections between southern Nevada’s non‐profit organizations is needed now more than ever before.

This is the first comprehensive study of southern Nevada’s health, education, and social service non‐profit network. Via a web‐based survey of nearly …

Health Promotions 2.0: The Future Of Wellness Programs In America, Rajiv Kumar

Center for Policy Research

In no small part because of technology, the way we live and work is being transformed. I believe that those of us who are interested in health policy can play an important role in guiding that transformation. I submit to you that unhealthy living is a social issue; that conditions such as obesity and diabetes are social diseases and that their prevalence is a social problem. If we have a social problem, then we need a social solution. I believe part of that solution can be found in the worksite health promotion and wellness programs that have taken root across …

Research Brief: "Investing In Vets: Strategies To Help Returning Gulf War Vets Enter The Civilian Work Force Successfully", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study found that corporate leadership, veteran-specific training, and a long-term commitment to veterans’ employment were all significant factors in diminishing barriers to veteran employment and reintegration. In practice, social workers who understand business and organizational change can be leaders in supporting veterans in the workplace, and also in advocating for positive social change for veterans and their families. For employers, increased cultural competence concerning military populations would be helpful. In policy, organizations should work on creating coalitions of corporate leaders who have the power to change policies, programs, and practices, and who will monitor the success of these policy …

Assessing The Potential Impact Of The Affordable Care Act On Uninsured Community Health Center Patients: A Nationwide And State-By-State Analysis, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In this brief, we estimate the number of uninsured community health center (CHC) patients who would gain coverage under the Affordable Care Act using data from the 2009 HRSA Survey of CHC patients and 2011 Uniform Data System. We find that were all states to implement the Affordable Care Act Medicaid expansion, an estimated 5 million uninsured health center patients – or two-thirds of all uninsured patients served by CHCs nationally – would be eligible for coverage. However, over one million uninsured patients – 72% of whom live in southern states – who would have been eligible for coverage will …

Visiting Lecturer Will Link Public Health Risks To Climate Change, Public Affairs & News Bureau, Old Dominion University

News Items

No abstract provided.

Los Determinantes De La Diferencia En La Tasa De Fecundidad Adolescente Entre Comunidades Pobres Y Ricas En Buenos Aires, Emily Turner

Independent Study Project (ISP) Collection

The city of Buenos Aires has some of the lowest rates of teenage fertility in Argentina (Gogna, Binstock, Fernández, Ibarlucía, & Zamberlin, 2008). However, this aggregated number obscures the huge variance within the city. In the most current available data (2010/2012) from the government of the city of Buenos Aires (GCBA) broken down by comunas (areas) highest fertility rate for 15-19 year olds was 81.6 births (per 1000) versus the lowest fertility rate which was only 6.2 (D. d. e. d. GCBA). This discrepancy is huge and reflects the incredible economic disparity in Buenos Aires. The comunas with the three …

Gender Disparities In Access To Hiv Testing And Antiretroviral Treatment Services, Wyatt Lombard Smith

Independent Study Project (ISP) Collection

Throughout a six-week practicum period at TASO Mulago in Kampala, Uganda and St. Francis Naggalama Hospital in Naggalama, Uganda, the researcher aimed to find methods to increase male engagement in all facets of comprehensive HIV/AIDS care. Women and children generally receive most global attention on the issue of HIV/AIDS in Uganda but men are beginning to demand more attention. Antiretroviral treatment has been critical in allowing countless people to live functionally with HIV but many research projects have hypothesized that delayed access to HIV/AIDS treatment and prevention methods has resulted in men exhibiting higher mortality rates upon initiation of this …

La Situación De Las Cataratas En La Ciudad De Buenos Aires: Un Estudio De Caso En El Hospital Ramos Mejía / The Situation Of Cataracts In The City Of Buenos Aires: A Case Study In Ramos Mejía Hospital, Katie Elizabeth Kessler

Independent Study Project (ISP) Collection

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Ndank-Ndank: How Governmental Health Organizations Can Take Their First Step To Help Other’S Take Their First Step: A Case Study Of A Prosthetics And Orthotics Rehabilitation Center In Dakar, Senegal, Sarah Jacobi

Independent Study Project (ISP) Collection

The number of people with disability in the world is very large, however; what having a disability means for each person is even more alarming. In a developing country, it is extremely difficult for people with disabilities to receive the health care they need. The organizations that offer health care to people with disabilities are faced with a number of challenges; but they continue to do the best they can. This study was done at a prosthetics and orthotics rehabilitation center in Dakar, Senegal. It is a case study that examines the difficulties the workers face, the motivations the workers …

Towards A Framework Convention On Global Health, Lawrence O. Gostin, Eric A. Friedman, Kent Buse, Attiya Waris, Moses Mulumba, Mayowa Joel, Lola Dare, Ames Dhai, Devi Sridhar

Georgetown Law Faculty Publications and Other Works

A global health treaty, a Framework Convention on Global Health (FCGH)–grounded in the right to health, with the central goal of reducing immense domestic and global health inequities–could serve as a robust global governance instrument to underpin the United Nations post-2015 Millennium Development Goals (MDGs). It would ensure for all people the three essential conditions for a healthy life–public health, health care, and the positive social determinants of health–while advancing good governance, responding to drivers of health disadvantages for marginalized populations, elevating health in other legal regimes, and enhancing people's ability to claim their rights.

The legally binding nature of …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2006, major health care reform legislation was enacted in Massachusetts. In many ways a prototype for the Affordable Care Act (ACA), the Massachusetts law required nearly all state residents to obtain health insurance, and made insurance accessible and affordable by reforming the health insurance market and providing subsidies for coverage through expansions of Medicaid and CHIP and a new program for low-income adults who are not eligible for Medicaid, known as Commonwealth Care. The law also created the “Connector,” which, like the ACA’s health insurance Marketplaces, is designed to facilitate and simplify access to insurance for individuals, families, and …

Research Brief: "Substance Use Among Military-Connected Youth: The California Healthy Kids Survey", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This research studies the correlation between youth with deployed family members in their lifetime and recent substance use in youth, and found substance use positively correlated with the number of family member deployments. Implications of these findings suggest that monitoring behavior could potentially lead to providing the emotional support necessary to prevent adolescents from turning to substance use, and policy should reflect this by implementing emotional support programs for adolescents with deployed family members. Future research in this area should investigate alternative coping mechanisms for youth dealing with the deployment of a family member, as well as the efficacy of …

First Steps Phase Ii Initiative: Improving Developmental, Autism, And Lead Screening For Children, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Martha Elbaum Williamson Mpa

Population Health & Health Policy

First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine's CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine's First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine's Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in …

Research Brief: "Prospectively Assessed Post-Traumatic Stress Disorder And Associated Physical Activity", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the connection between physical activity and symptoms of post-traumatic stress disorder in veterans. In policy and practice, service members who experienced combat should have high levels of physical activity in order to reduce the possibility of developing PTSD, clinicians should mention the importance of physical activity for mental health to service members, as well as recommend alternatives for veterans who are unable to do high levels of physical activity. The VA should implement and promote fitness programs for service members and veterans to lower the possibility of developing PTSD, and policymakers should fund physical activity programs …

Research Brief: "Predictors Of Psychiatric Disorders In Combat Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the predictors of mental health diagnoses within a sample of Marines who experienced combat in Iraq and Afghanistan. In policy and practice, support networks should be implemented for servicemembers to share with their peers, clinicians should give female servicemembers and others who have a higher likelihood of developing a mental health disorder after combat information on how to prevent certain psychiatric disorders, and families should know the signs of psychiatric disorders to help servicemembers in their re-adjustment period after deployment. Military branches and policymakers could improve counseling for servicemembers returning from combat and encourage servicemembers to …

Research Brief: "Mental Health Diagnosis And Occupational Functioning In National Guard/Reserve Veterans Returning From Iraq", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the employment or enrollment in school of recently returned National Guard and Reserve OIF/OEF veterans who have a mental health diagnosis compared to those veterans without a mental health diagnosis. In policy and practice, the US military should implement pre- to post-deployment programs to help adjustment into work/school role functioning, and policymakers should partner with universities to help veterans cope with academic stress. Suggestions for future research include using a larger and more comprehensive sample of National Guard/Reserve OIF veterans and studying the effectiveness of programs and support for veterans.

Medicaid Expansion, Long-Term Care Financing In Retirement States And The Post World War Ii Birth Cohort, Toni P. Miles

Center for Policy Research

This policy brief contains a formal consideration of ideas discussed during a presentation to the 2012 Syracuse Seminar on Aging. Like most briefs, it will appeal to policy makers and academics craving detailed demographic, fiscal and policy data. Before diving into this brief, I would encourage readers to view the presentation video (available at http://www.youtube.com/ watch?v=bsv8K7DdJFY). As you will see, the seminar was informal and the discussion was wide ranging. In contrast, this brief focuses on limitations faced by states as they finance longterm care. It is primarily concerned with the Medicaid expansion and growing need for care as the …

Research Brief: "Employment Status Of Veterans Receiving Substance Abuse Treatment From The U.S. Department Of Veterans Affairs", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study investigates how the severity of PTSD symptoms relates to employment and earnings, it found that Veterans with more severe symptoms of PTSD, were more likely to work part-time or not at all rather than have full time work. In practice, treating PTSD, even if some symptoms remain, could result in better employment outcomes for veterans. In policy, Policy makers should consider providing previously successful programs for veterans with PTSD for individuals with other mental health conditions. Suggestions for future research include A large, controlled, longitudinal survey would allow researchers to investigate more thoroughly how PTSD symptoms relate to …

Research Brief: "Prevalence Of Childhood Trauma Among U.S. Army Soldiers With Suicidal Behavior", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the link between childhood trauma and servicemember suicide risk within the US Army. In policy and practice, communities should be willing to discuss abuse with servicemembers who experienced childhood trauma, healthcare providers should tell veterans and servicemembers about their treatment options, and family members should assist with the mental health treatment of veterans and servicemembers. Policymakers should create programs that encourage social networks and increase the number of veteran and military support groups. Suggestions for future research include using a different data source for the study, adding a control group, and broadening the sample of veterans …

Research Brief: "Weight Change Following U.S. Military Service", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about weight change among veterans before, during, and after discharge from the military. In policy and practice, physicians should discuss strategies to prevent unhealthy weight gain with veteran patients; the VA should better tailor its MOVE! weight management program to younger veterans. Suggestions for future research include looking at the reasons behind weight gain in discharged servicemembers, analyzing the strategies used by members of the Reserve/National Guard to limit weight gain, and using more samples of younger veterans to generalize results.

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Putting Regulatory Data To Work At The Service Of Public Health: Utilizing Data Collected Under The Clean Water Act, Jyotsna S. Jagai, Barbara J. Rosenbaum, Suzanne M. Pierson, Lynne C. Messer, Kristen M. Rappazzo, Elena N. Naumova, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Under the Clean Water Act, the US Environmental Protection Agency (EPA) collects information from states on intended use and impairment of each water body. We explore the feasibility of using these data, collected for regulatory purposes, for public health analyses. Combining EPA impairment data and stream hydrology information we estimated the percent of stream length impaired for any use, recreational use, or drinking water use per county in the US as exposure variables. For health outcomes we abstracted county-level hospitalization rates of gastrointestinal infections, GI (ICD-9CM 001-009 excluding 008.45) and gastrointestinal symptoms, GS (ICD-9CM 558.9, 787) among US adults aged …

Racial Disparities In The Use Of Cardiac Revascularization: Does Local Hospital Capacity Matter?, Suhui Li, Arnold Chen, Katherine H. Mead

Health Policy and Management Faculty Publications

Objective: To assess the extent to which the observed racial disparities in cardiac revascularization use can be explained by the variation across counties where patients live, and how the within-county racial disparities is associated with the local hospital capacity.

Data Sources: Administrative data from Pennsylvania Health Care Cost Containment Council (PHC4) between 1995 and 2006.

Study Design: The study sample included 207,570 Medicare patients admitted to hospital for acute myocardial infarction (AMI). We identified the use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) procedures within three months after the patient’s initial admission for AMI. Multi-level hierarchical …