Public Health Commons^™

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Second-Hand Smoke In A University Campus: Attitudes And Perceptions Of Faculty, Staff And Students, Cecilia M. Watkins, Sandeep Mishra, Herpreet Kaur Thind, Srinivasa B. Gokarakonda, Grace Lartey, Monia Chahal

Public Health Faculty Publications

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting …

Maternal Health Behaviours During Pregnancy In An Irish Obstetric Population And Their Assocations With Socio-Demographic And Infant Characteristics, Roslyn Tarrant, Katherine Younger, Margaret Sheridan-Pereira, John Kearney

Articles

Objectives: To examine the prevalence and combined occurrence of peri-conceptional folic acid (FA) supplement use, smoking and alcohol consumption during pregnancy in a sample of women in Dublin, and determine the factors associated with these health behaviours.

Subjects/Methods: A prospective observational study (2004-2006) involving the recruitment of 491 pregnant women from antenatal clinics in a Dublin maternity hospital, with postpartum follow-up of 450 eligible mothers. Data on FA use, maternal smoking and alcohol consumption patterns during pregnancy were collected from the antenatal patient-administered questionnaire, which was completed by participants, and returned to the investigator on the day of recruitment. …

Lifeskills Training Wellness Program: An Application For Young Adults In Supermarkets, Christopher Williams, Jessica Samuolis, Kenneth W. Griffin, Gilbert J. Botvin

Psychology Faculty Publications

To address the need for workplace substance use prevention programming, National Health Promotion Associates (NHPA) developed the LifeSkills Training Wellness Program (LST-WP) with funding from the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Young Adults in the Workplace (YIW) grant program. LST-WP adapts and extends the highly effective, school-based LifeSkills Training (LST) model program (Botvin, 1998; Botvin et al., 1995) and provides comprehensive skills training for adolescent and young adult employees in communication, problem-solving, conflict resolution, drug resistance, and related life skills. Overall, the program is designed to be highly flexible to meet employee and manager needs across different …

Who Are The Health Center Patients Who Risk Losing Care Under The House Of Representatives' Proposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On February 20, 2011, the United States House of Representatives approved more than $61 billion in discretionary spending reductions for the remainder of FY 2011. The legislation includes $1.3 billion in direct spending cuts for community health centers. Using the NACHC patient estimates, we present evidence on the characteristics of patients whose continuing access to health center services is at risk. We arrived at these estimates using data from the Uniform Data System (UDS), the federal reporting system in which all health centers must participate, as well as national estimates from the Medical Expenditure Panel Survey (MEPS), and published reports …

Who Are The Health Center Pati Ents Who Risk Losing Care Under The House Of Representatives’ Pr Oposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

A Study Of Riders' Noise Exposure On Bay Area Rapid Transit Trains, Alexis Dinno, Cynthia Powell, Margaret Mary King

Community Health Faculty Publications and Presentations

Excessive noise exposure may present a hazard to hearing, cardiovascular and psychosomatic health. Mass transit systems, such as the Bay Area Rapid Transit (BART) system, are potential sources of excessive noise. The purpose of this study was to characterize transit noise and riders' exposure to noise on the BART system using three dosimetry metrics. We made 268 dosimetry measurements on a convenience sample of 51 line segments. Dosimetry measures were modeled using linear and non-linear multiple regression as functions of average velocity, tunnel enclosure, flooring, and wet weather conditions, and presented visually on a map of the BART system. This …

Prevalence Of Metabolic Abnormalities In Children With Varying Degrees Of Obesity, Leah Sabato

Master of Public Health Program Student Publications

As the prevalence of obesity among children has risen, metabolic syndrome, a cluster of abnormalities which includes obesity, altered glucose metabolism, hypertension, and dyslipidemia, has increasingly become recognized in the pediatric population. Metabolic syndrome has been studied extensively in adults, and there is increasing interest to understand the condition in adolescents; however, studies of metabolic syndrome in younger children are limited. The purpose of this study is to examine the prevalence of metabolic syndrome and its individual components among children aged 6-10 years. Demographic, anthropometric, and biochemical data were gathered retrospectively from the medical records of 222 obese children aged …

The Association Between Neighborhood Walkability, Type 2 Diabetes, And Socioeconomic Status In Residents Of Eight Ohio Counties, Dawn L. Ebron

Master of Public Health Program Student Publications

Objective: Regular physical activity is beneficial in preventing type 2 diabetes. Walking, either for recreation or to travel to a destination, is an inexpensive way to meet physical activity guidelines. Disadvantaged populations with low socioeconomic status (SES) have a higher prevalence of type 2 diabetes and are more likely to live in unwalkable neighborhood. The purpose of this study was to determine the association between SES and neighborhood walkability in eight Ohio counties with highest prevalence of type 2 diabetes in the state.

Methods: Using data from the 2010 Ohio Behavioral Risk Factor Surveillance System (BRFSS) survey and Walk Score …

Long-Term Effects Of Self-Control On Alcohol Use And Sexual Behavior Among Urban Minority Young Women, Kenneth W. Griffin, Lawrence M. Scheier, Bianca Acevedo, Jerry L. Grenard, Gilbert J. Botvin

CGU Faculty Publications and Research

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, …

Ua12/4 Stall Street Journal, Vol. 3, Wku Health Services

WKU Administration Documents

Broadsides developed by WKU Health Services to convey public health information in students in bathroom stalls.

Decomposing The Intergenerational Disparity In Income And Obesity, Qi Zhang, Buhong Zheng, Ning Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Intergenerational disparity in income and health violates the norm of equal opportunity and deserves the attention of researchers and policy makers. To understand changes in intergenerational disparity, we created the intergenerational mobility index (IMI), which can simultaneously measure changes in income rankings and in health outcomes across two generations. We selected obesity as one health outcome to illustrate the application of IMI due to its severe health and financial consequences for society and the significant changes in the distribution of obesity across income groups. Although obesity has increased in all income groups in the last four decades, higher income groups …

Colorectal Cancer In Montgomery County, Ohio: A Descriptive Analysis, Ursula Turner

Master of Public Health Program Student Publications

In the United States colorectal cancer (CRC) is one of the most common malignancies, and is the third leading cause of cancer deaths (Sharma & O’Keefe, 2007). Approximately 270,000 cases of colorectal cancer were diagnosed in 2008 with 81,900 cases resulting in death. There were 16,520 cases diagnosed in African Americans and 7,120 resulted in death or significant illness (American Cancer Society, 2008). Mortality as the result of CRC is greater among the African American population with 27% and 38% higher death rates for African American males and females when compared with Caucasian males and females (Agarwal, 2005). CRC is …

A Geospatial Analysis Of The Role Of Urban Forestry In Outdoor Ambient Air Pollution Reduction In Dayton, Ohio, Nicholas P. Clemens

Master of Public Health Program Student Publications

Objective: Air pollution is associated with negative respiratory and cardiovascular health outcomes. According to the American Lung Association listing for 2011, the Dayton-Springfield-Greenville, OH area ranks 22 out of 277 US cities for year round particulate pollution. The tree canopy cover plays a significant role to reduce air pollution. The purpose of this analysis was to quantify the role of urban forestry in the Dayton, Ohio metropolitan area in reducing air pollution.

Methods: Using a peer-reviewed model designed by the US Forest Service, the imagery data was analyzed to create a descriptive analysis of the canopy cover in the Dayton, …

Nation's Future: Preparedness For Burn Victims, Jacqueline Tippett

Master of Public Health Program Student Publications

Natural and manmade disasters have occurred throughout the decades, within the United States and around the globe. Increased incidence and awareness of terrorist attacks have caused the US to re-evaluate its safety and preparedness efforts to prevent such events from happening and to develop an adequate response plan if such unfortunate events do occur. Therefore, the purpose of this research is to (1) review and discuss the American Burn Association’s (ABA) paradigm for emergency planning in burn disasters, (2) give recommendation about the National Response Framework (NRF) guidelines on “all hazards” response as they pertains to burns, and (3) give …

An Examination Of Ohio’S Physical Education Academic Content Standard 4, Benchmark A For Grades 9-12, Gabriel Jones

Master of Public Health Program Student Publications

Objective: The purpose of this study was to describe select physical education teachers’ perceptions of the effectiveness and accuracy of the assessments for Ohio's Physical Education Academic Content Standard 4 Benchmark A in determining the fitness and physical activity levels of high school students. A secondary purpose was to describe the fitness levels of high school physical education students, based on assessment data.

Methods: Participants were forty-one physical education teachers and ninety high school students from southwest Ohio. Data were collected from the teachers through an online questionnaire and from students with FITNESSGRAM testing. FITNESSGRAM data from one local school …

Acl Injuries In Montgomery County, Oh: Moving Toward The Development Of A Prediction Model, Kelly Estes

Master of Public Health Program Student Publications

Anterior cruciate ligament (ACL) tears are one of the most frequent soft tissue injuries of the knee. A torn ACL leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the dimensional details of knee joints suffering ACL tears and a prediction model for individuals susceptible to tears is needed. Using a cross-sectional study design, magnetic resonance images (MRIs) of 72 patients with knee injuries were evaluated from an orthopedic surgery group practice. The status of the ACL was the main variable of interest, creating …

Impact Of Congestive Heart Failure Discharge Planning On Congestive Heart Failure Re-Admission Rates, Sula E. Mazimba

Master of Public Health Program Student Publications

Background: Congestive Heart Failure (CHF) is the most common diagnosis accounting for more healthcare costs than any diagnosis. CHF readmissions contribute significantly to this expenditure. Quality of care in heart failure is linked to process based performance measures. This study evaluated the relationship between adherence to performance metrics and 30 day readmission rates.

Methods: This was a single center case-control study that evaluated 6063 consecutive patients admitted with CHF from December 2001 through December 2008. Data was collected for readmission to the hospital within 30 days and compliance to the heart failure performance measures at discharge.

Results: The rate of …

State Preparedness: A Study Of State Plans, Zachary Fehrman

Master of Public Health Program Student Publications

Non-pharmaceutical interventions (NPIs) have been used since the early years of public health. The Centers for Disease Control and Prevention (CDC) provides a standard definition for NPI and what NPI strategies are contained within the definition. This paper seeks to discover if state pandemic influenza plans use the term NPI and its strategies, and if states’ use of NPI strategies in their state pandemic plans is consistent with the CDC definition. To determine how states were defining and using the term NPI and NPI strategies a survey of forty-eight (48) state plans was conducted using each respective states’ pandemic plan. …

Assessment And Management Of Adult Obesity In A Primary Care Practice, Sherry M. Adkins

Master of Public Health Program Student Publications

Purpose: The purpose of this project was to describe primary care physician adherence to National Heart Lung and Blood Institute (NHLBI) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998) and to explore patient characteristics associated with physician assessment and management behaviors. Patient characteristics included age, sex, race, BMI, associated disease risk, and Medicaid coverage.

Methods: A chart abstraction of 99 randomly selected adult patients with at least one visit to a particular primary care practice during a 12-month period was completed. Patients were not pregnant during the year of review, and had a …

The Influence Of School Eating Environment On Children's Eating Behaviors: An Examination Of The Snda-Iii, Sabrina M. Neeley

Master of Public Health Program Student Publications

The prevalence of childhood overweight and obesity in the United States has prompted researchers to examine the factors that contribute to children’s food choices and consumption. Schools provide ample opportunities to teach children healthy eating habits, as well as create eating environments that are conducive to healthy eating behaviors. The National School Lunch Program (NSLP) provides federally assisted meals to millions of children every day and the assessment of the NSLP provides an opportunity to examine the school-eating environment. Hierarchical and logistic modeling of the SNDA-III, the USDA assessment of the NSLP, was conducted to determine relationships between environmental factors …

Understanding Health Profile Of The Middle-Aged Residents In Tsuen Wan, Tsuen Wan Safe And Health Community, Tsuen Wan Adventist Hospital, Asia-Pacific Institute Of Ageing Studies, Lingnan University

APIAS Research Report 研究報告

Modernization marked the progress of society and posed various changes to human life as well as the epidemiological transition. Improvements in public health care, living conditions, income and the control of infectious diseases were important factors in the first half of the twentieth century that led to the increases in life expectancy, while in the second half it was improvements in social conditions, health technologies such as antibiotics, and widespread immunization. The existences of advanced medical services effectively get rid of the prevalence of infectious disease that caused immediate human threats such as Measles and Smallpox.

Given that technological advancement …

2011 Community Benefit, Children's Mercy Hospital

Community Benefits

Fiscal year report on the community benefits provided by Children's Mercy Kansas City to the communities in the Kansas City region.

Prevalence, Knowledge, And Concern About Bed Bugs, Mary Beth Kaylor

Master of Public Health Program Student Publications

Recent research suggests that the United States and the world are on the verge of a bed bug pandemic. Assumptions have been made that socioeconomic status is not an indicator and that bed bugs are not competent disease vectors. However, little information is available at the local level about the prevalence of bed bugs in private homes. This study aimed to identify prevalence, knowledge, and concern about bed bugs in one village in Ohio. Responses from 96 individuals who completed the Prevalence, Knowledge, and Concern about Bed Bugs (PK CABB) survey were utilized for data analysis. The majority of the …

Worksite Wellness: An Administrative Perspective, Neha Kumar

Master of Public Health Program Student Publications

Objective: To develop a better understanding of businesses’ goals and purpose for offering worksite wellness opportunities and the level of administrative support for worksite wellness programs.

Method: Human resource directors, benefit managers, or other administrators of 76 businesses that have contracted with Premier Community Health in the past 2 years were contacted by e-mail to complete a standardized online survey on SurveyMonkey®. The survey included questions about the businesses worksite wellness current programs and future interests. In addition, data on how often businesses have utilized each of the PCH worksite offerings over the past 2 years was collected from the …

Migration And Hiv In India: Study Of Select Districts, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Alka Narang, Umesh Chawla

HIV and AIDS

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant …