Public Health Commons^™

Breast Cancer Diagnosis And Treatment During The Covid-19 Pandemic In A Nationwide, Insured Population, Jennifer L Caswell-Jin, Maryam N Shafaee, Lan Xiao, Mina Liu, Esther M John, Melissa L Bondy, Allison W Kurian

Center for Medical Ethics and Health Policy Staff Publications

Purpose: The early months of the COVID-19 pandemic led to reduced cancer screenings and delayed cancer surgeries. We used insurance claims data to understand how breast cancer incidence and treatment after diagnosis changed nationwide over the course of the pandemic.

Methods: Using the Optum Research Database from January 2017 to March 2021, including approximately 19 million US adults with commercial health insurance, we identified new breast cancer diagnoses and first treatment after diagnosis. We compared breast cancer incidence and proportion of newly diagnosed patients receiving pre-operative systemic therapy pre-COVID, in the first 2 months of the COVID pandemic and in …

Review Of Cannabis Use Among Aboriginal And Torres Strait Islander People, Julia Butt, Mandy Wilson, Jocelyn Jones, Simon Lenton

Journal of the Australian Indigenous HealthInfoNet

The health effects of cannabis use may not always be seen as a high priority for Aboriginal and Torres Strait Islander communities. However, the impact of cannabis use on physical and mental health can have significant consequences. It is known that the use of high potency cannabis has increased over the last two decades, with a corresponding increased risk to health. In particular, young people are at increased risk of experiencing harms to mental health. Physical harms to health include effects on the respiratory system, cardiovascular system, an increased risk of cancer, and in-utero effects from maternal use. The review …

Bringing People Back Into Public Health Data: Community Feedback On A Set Of Visualization Tools - Summary Report, Alejandro Cerón, Mia Glover, Quisi Rodriguez-Oregel, Dani Thompson, Tom Adams, Naomi Asakura, Kaela Belknap, Anna Block, Nicole Boehler, Hannah Boeve, Sarah Bomers, Sasha Borovok, Grace Bryan, Kate Buffington, Majesty Cain, Beth Carideo, Haley Chesno, Grace Connell, Jake Corbett, Camille Cruz, Chloe Dawkins, Anna Denniston, Lydia Dickens, Sophie Duplock, Samuel Dwinell, Avery Ess, Sam Ferman, Ellis Geis, Ethan Graupmann, Xander Hedrick, Angel Hernandez-Miramontes, Grant Huyghe, Sara Ibrahiem, Anna Jamieson, Ian Kang, Allie Kris, Erin Lawrence, Maddie Leake, Ryan Leary, Taylor Loh, Charlotte Monroe, Alexander Nguyen-Lopez, Henry O’Daffer, Cat Parish, Jaylee Recountre, Grace Rizzo, Noah Roseth, Grace Rothstein, Katie Sage, Marie Saltzmann, Stephen Shlain, Riley Shores, Mackenna Simson, Mark Teneza, Jack Weinmeister, Justin Weinzweig, Alison Wenman, Patch Whelan, Lea Zimmerman

Anthropology: Undergraduate Student Scholarship

This course-based study is a product of the University of Denver’s Spring 2022 The Social Determination of Health (ANTH 2424) class. The study aimed to understand how well a set of public health visualization tools tells the data stories about people in Colorado, and about important public health problems. For this, a team of almost sixty undergraduate students taking the class, coordinated by three graduate teaching assistants, and directed by the course instructor interviewed a total of fifty-six people from Colorado, qualitatively analyzed those interviews, and wrote reports that draw conclusions and recommendations.

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Headquarters Report: Without Mda Advocacy, Michigan Dentistry Would Look Very Different, Karen Burgess Cae

The Journal of the Michigan Dental Association

This Headquarters Report reflects on the impactful advocacy efforts of the Michigan Dental Association (MDA) over the past three years. Highlighting various scenarios, the report envisions a different landscape for dentistry in Michigan without MDA advocacy. The article emphasizes the critical role played by MDA in addressing issues related to COVID-19, regulations, funding, public protection, and dental policies. The advocacy initiatives have not only protected dental professionals but have also ensured the best interests of the public, contributing to a resilient and thriving dental community in Michigan.

Factors Associated With The Nutritional Status Of Infants And Young Children From Rural Honduras, Ana M. Palacios, Mario Keko, Aishat Adewoye, Haresh Rochani, Asli Aslan, Dziyana Nazaruk, Ana Gisela Ramos, Weston L. Oliver, Laura Manship

Health Policy & Community Health: Faculty Publications

Objectives

Malnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras.

Methods

This secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Benign Prostatic Hyperplasia (Bph): A Comprehensive Analysis Of The Malaise And Summarizing Possible Management Options Through Phytotherapeutic Agents, Shan Sasidharan, Kumarapillai Parameswaran Srinivasakumar, Sandeep Poddar, Amiya Bhaumik, Sreemoy Kanti Das, Hareendran Nair J

Kesmas

Benign prostatic hyperplasia (BPH) is a severe illness affecting middle-aged and geriatric male patients. This disease normally occurs at the age of 40 or above and is also associated with sexual dysfunction. Alpha-blockers and 5α-reductase inhibitors are the preferred drugs practiced to treat BPH. However, invasive surgical therapy remains the gold standard for managing the condition in the case of refractory and intricate BPH conditions. Due to the fear of sexual dysfunction and the detrimental influence on their quality of life, most patients seek to avoid synthetic drugs and surgery. For this reason, several patients turn to phytotherapy and other …

Treatment Adherence And Incidence Of Coronary Heart Disease In Type 2 Diabetes Mellitus Patients, Ahmad Sahlan Baniu, Rani Sauriasari, Woro Riyadina, Pradana Soewondo

Kesmas

Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed …

Local Wisdom Enriching Complementary Feeding Practices During Disaster Situations In Indonesia, Astuti Astuti, Happy Hayati, Fajar Tri Waluyanti, Dessie Wanda

Kesmas

This study aimed to analyze complementary food fulfillment during disaster situations in Indonesia since it frequently experiences natural disasters and young children face unique challenges related to their feeding needs in disaster situations. This qualitative case study based on the Mount Merapi eruption and Sumedang landslide in 2021 collected data using observations, forum group discussions, and in-depth interviews; then, a thematic analysis was conducted. This study involved 17 participants, including Non-governmental Organizations (NGO) activists, health workers, residents involved in making complementary foods, and primary caregivers of children aged 6–24 months. This study found that there were five themes generated from …

Muscle Dysmorphia In Fitness Center Members: Its Affecting Factors And Impacts, Deny Yudi Fitranti, Nurmasari Widyastuti, Etika Ratna Noer, Ayu Rahadiyanti, Fillah Fithra Dieny, Rachma Purwanti, Dewi Kurnia Sandi, Widya Destikasari

Kesmas

Muscle dysmorphia (MD) has several impacts on the decline in social and health functions. This study aimed to determine the correlation between MD with eating behaviors and exercise loading among fitness center members and analyze the factors affecting it. This study used a cross-sectional design with 100 subjects chosen by a consecutive sampling method at three fitness centers in Semarang City. The subjects were all male members of an active fitness center between 17 and 45 years. The data of MD were obtained using the Drive Muscular Scale (DMS), while eating behavior data were obtained using the Eating Attitude Test-40 …

Determinants Of The Coexistence Dual Form Of Malnutrition In Pairs Of Mother And Child Aged 6 – 59 Months In Bogor District 2019, Maulina Dwi Krismanita, Triyanti Triyanti, Ahmad Syafiq, Trini Sudiarti

Kesmas

The dual form of malnutrition (DFM) is defined as multiple nutritional problems in the same household and time. This study aimed to determine the related factor to DFM incidence in pairs of mothers and children aged 6–59 months in Bogor District in 2019. This cross-sectional study used secondary data on the Nutrition and Health of Babakan Madang Subdistrict Toddlers in 2019 and Nutrition Intake and Stunting of Children Under-Five in Bogor District, West Java Province, involving a total sample of 274 households. The dependent variable in this study was DFM, while the independent variables were maternal age during pregnancy, maternal …

The Influence Of Intrapersonal Constraints On Travel Intention Of People At High Risk From Covid-19 During The New Normal, Dyah Widiyastuti, Ikasari Kusuma Wardhani

Kesmas

Due to the COVID-19 pandemic, tourism constraints have created a challenge for inclusive tourism, especially for older people and people with comorbidities. This study examined intrapersonal constraints’ effect on the travel intentions of people facing fewer opportunities for tourism due to the COVID-19 pandemic, which could disrupt their well-being fulfillment. The data were collected through an online survey of Jakarta citizens aged 46 years and older from the end of June to September 2021, and a total of 337 responses were accumulated. This study applied partial least square structural equation modeling to test the moderating effect of intrapersonal constraints toward …

Zoom Fatigue During The Covid-19 Pandemic: Is It Real?, Putri Winda Lestari, Adhila Fayasari

Kesmas

The coronavirus disease 2019 (COVID-19) pandemic has caused drastic changes to social lives moreover the activities done outside, such as work and school. The policy of large-scale social restrictions (LSRR)/Pembatasan Sosial Berskala Besar (PSBB), which makes people stay at home, also plays an important role in changing the face-to-face activity online. As a solution to the major change, people use video conferencing to keep in touch and still feel like doing "offline" activities. The increasing use of video conferencing has raised concerns about the resulting fatigue, termed "Zoom fatigue." This study aimed to describe Zoom fatigue during the COVID-19 pandemic …

Diabetes Mellitus And Mortality Among Covid-19 Patients In Jakarta, March-August 2020, Endang Widuri Wulandari, Sudarto Rotnoatmodjo, Ngabila Salama

Kesmas

Diabetes mellitus (DM) comorbidity is one of the risk factors for coronavirus disease 2019 (COVID-19) mortality. This study aimed to determine the association of comorbid DM and mortality among COVID-19 confirmed cases in DKI Jakarta Province, controlled with confounding variables from March to August 2020. The study design was a retrospective cohort using cox proportional hazard regression, with a total sample of 1,480. The data consisted of 740 COVID-19 cases with and 740 without comorbid DM. The inclusion criteria were COVID-19 confirmed cases with polymerase chain reaction (PCR) laboratory testing reported to the DKI Jakarta Provincial Department of Health, and …

Knowledge, Attitudes, And Covid-19 Prevention Practices Of Healthcare Workers In Indonesia: A Mobile-Based Cross-Sectional Survey, Besral Besral, Zulvi Wiyanti, Dion Zein Nurizin, Milla Herdayati, R Sutiawan, Martya Rahmaniati, Popy Yuniar

Kesmas

Knowledge of disease can affect attitudes and prevention practices, and wrong attitudes and practices can directly increase the risk of disease infection. This study aimed to describe the knowledge, attitudes, and COVID-19 prevention practice of healthcare workers in Indonesia and factors associated with prevention practices. A mobile-based cross-sectional survey was conducted in August 2020 with 254 healthcare workers in Indonesia. The self-administered questionnaire consisted of four parts: 1) sociodemographic information, 2) knowledge of COVID-19, 3) attitudes and anxiety toward COVID-19, and 4) COVID-19 prevention practices. The results indicated that healthcare workers in Indonesia had excellent knowledge and positive attitudes about …

Infarct Diameter For Predicting Cognitive Dysfunction In Ischemic Stroke Survivors In West Nusa Tenggara, Indonesia, Herpan Syafii Harahap, Setyawati Asih Putri, Yanna Indrayana, Hasan Amin, Fransisca Ika Mahardika

Kesmas

Cognitive dysfunction is an important consequence of ischemic stroke, which can progress in the first few years and is primarily determined by clinical factors. This study aimed to investigate the clinical determinants of cognitive dysfunction in stroke survivors in West Nusa Tenggara Province, Indonesia. This cross-sectional study assessed 255 ischemic stroke survivors with a mean age of 57.1±9.3 years old and 29–79 years old, recruited consecutively in three main hospitals in West Nusa Tenggara Province between March 2019 and October 2021. Categorical data collected included age, sex, education level, clinical determinants of ischemic stroke, and cognitive status of the patients. …

Interprofessional Collaborative Practice And Health Workers Retention At Remote Primary Health Care: Case Study From Nusantara Sehat Team-Based Program, Prastuti Soewondo, Retno Pujisubekti, Ade Widyati Prastyani, Nurul Maretia Rahmayanti

Kesmas

The Nusantara Sehat Team (NST), established in 2015 and consist of multi-professional health workers, implemented to provide comprehensive services at remote primary health cares (PHCs) for two years. This study aimed to explore how the NST leverages the Interprofessional Collaboration (IPC) and its impact on the future career prospects of health workers. Using a qualitative approach, the information was gathered from 48 informants drawn from the current 30 NST recruits and 18 alumni through semi-structured interviews. Of these 48, 20 were clinical practitioners, while the rest were non-clinical health workers. The findings revealed several challenges in promoting collaborative practice, including …

Telemedicine And Electronic Health Record Implementation In Rural Area: A Literature Review, Arifah Alfiyyah, Dumilah Ayuningtyas, Agus Rahmanto

Journal of Indonesian Health Policy and Administration

The Indonesian Minister of Health 2019 issued regulations regarding the implementation of telemedicine services between health service facilities. Telemedicine is aimed primarily at rural areas. This research aims to look at the quality of telemedicine-based services, which are documented in an electronic health record (EHR) with complete information. This research uses the narrative literature review method: Garuda journal channels, Google Scholar, IEEE Explorer, ProQuest, PubMed, Science Direct, and Scopus. With the input-output process approach, eight scientific articles were published on countries with telemedicine/telehealth policies in rural areas. The implementation of telemedicine has advantages and disadvantages depending on the things supported …

Policy Implementation Of Halal Product Assurance For Pharmaceutical Products In Indonesia, Hilyatul Fadliyah, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

After the implementation of halal product assurance (HPA) became a public policy, the assurance for halal pharmaceutical products is a must. However, the implementation has been relaxed for several years. This shows that the policy implementation is complicated. This study aimed to analyze and evaluate the implementation process of the HPA policy for pharmaceutical products in Indonesia. We applied Van Meter Van Horn’s theory using the qualitative method through in-depth interviews with eight informants and a review ten documents. The result shows that the implementation is going well but is still not optimal, especially from the point of view regarding …

Covid-19 Pandemic Handling Strategies By The Baduy Tribe, Randi Irmayanto, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

The first case of COVID-19 in Indonesia was announced by the President on March 2, 2020. As of June 22, 2022, the cumulative number of confirmed positive cases in Indonesia is 6,072,918 cases, with 5,904,825 recoveries and 156,702 deaths. In response to this case, the government made a policy starting with Large-Scale Social Restrictions contained in Government Regulation Number 21 of 2020 until the Enforcement of Restrictions on Community Activities based on levels (4, 3, 2, and 1) set by the Ministry of Home Affairs. The government's strategy to deal with this is through the 5M health protocol (wearing masks, …

Implementation Of The Covid-19 Risk Communication Policy In Pandeglang 2022, Nahda Salimah, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

Currently, the world is experiencing a non-natural disaster, the COVID-19 pandemic. The Indonesian Government issued instructions for handling and controlling COVID-19 by implementing health protocols and vaccinations to reduce the rate of COVID-19 cases. The handling and control of COVID-19 are delivered by increasing public knowledge about COVID-19 through a risk communication approach. Pandeglang area, Banten, had the lowest dose one and two vaccination coverage rates in Banten Province in 2021. Implementing the risk communication policy needs to be considered in successfully handling and controlling COVID-19. This research is qualitative with case study type research. The method of collecting data …

The Roles And Policies For The Use Of Telemedicine In Handling Covid-19 Self-Isolation: Literature Review, Rafika Stany Yonathan, Mardiati Nadjib

Journal of Indonesian Health Policy and Administration

The current COVID-19 pandemic has had various impacts on the world. The unpredictable spike in cases led to an explosion in patient numbers. The problem of limited treatment facilities forces patients to self- isolate at home. Along with technological advances, various facilities have also been created, one of which is telemedicine. This study aims to look at the role of telemedicine as a strategy for handling COVID-19 self-isolated patients in various countries. This study was conducted descriptively with a literature review. The search was carried out on articles published in Indonesian and English through Google Scholar, Pubmed, and Science Direct …

A Pandemic Of Separation Of Powers Violations In Texas: The Interrelationship Of The Texas Disaster Act And Texas Gov’T Code Section 22.0035, Ron Beal

St. Mary's Law Journal

This Article is on the interrelationship of the Texas Disaster Act and Texas Government Code Section 22.0035. The author demonstrates that the Governor of Texas and the Texas Supreme Court have grossly violated the separation of powers on a continuing basis since March 29, 2020 by Governor Abbott issuing Executive Order 13, which prohibits the granting of bail to anyone awaiting trial, and the Texas Supreme Court’s unwillingness to invalidate that order administratively or judicially. Finally, the Article addresses the nearly one thousand district and county court judges who are constantly violating the separations of powers by failing to invalidate …

Assessing The Influence Of Food Insecurity And Retail Environments As A Proxy For Structural Racism On The Covid-19 Pandemic In An Urban Setting, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Kathrybn A. G Knoff, Hadis Dastgerdizad, Noel Kulik, James Mallare, Kibibi Blount-Dorn, Winona Bynum

Urban Studies and Planning Faculty Research Publications

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was …

Sexually Transmitted Diseases (Stds) In The Mountain West, 2015 - 2019, Kristian Thymianos, Saha Salahi, Zachary Walusek, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines data on sexually transmitted diseases (STDs) in the Mountain West as originally reported in the “STD Surveillance Report 2019” published by the Center for Disease Control (CDC). This includes data for Mountain West states and metropolitan statistical areas (MSAs) on the following STDs: chlamydia, gonorrhea, and primary and secondary syphilis.

Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins

Research Days

Watch recording of live presentation.

Background: Adverse childhood experiences (ACEs) have been shown to be associated with poor health outcomes, and children living in poverty are more likely to experience ACEs. Our objective was to estimate the association between spending on benefit programs and cumulative exposure to ACEs among children.

Methods: This cross-sectional study examined state and federal spending, at the state-level, on 5 categories of public benefit programs: cash, housing, and in-kind assistance; housing infrastructure; childcare assistance; refundable Earned Income Tax Credit; and Medical Assistance Programs (e.g., Medicaid). The primary exposure was median annual spending per person living below …

A Geographically Targeted Approach For A Preceptor Tax Incentive Using Primary Care Health Professional Shortage Areas (Hpsas), Julia Mattingly, Sarah Belcher, Samuel C. Kessler

Commonwealth Policy Papers

Years before the COVID-19 pandemic brought on a health care shortage in Kentucky, its rural areas were already struggling to obtain and attract primary care medical practitioners. Even though the number of medical school graduates in the U.S. has steadily increased throughout the years, there is a general disinterest in rural or small-town practice, and legislators throughout the country have pondered ways to address this issue plaguing communities. Versions of Preceptor Tax Incentive legislation in Kentucky have been proposed in the General Assembly to address care shortages in the state, however, all have been unsuccessful at truly targeting rural areas …

Community Characteristics And Financial And Operational Performance Of Rural Health Clinics In The United States: A Chartbook, John Gale Ms, Zachariah Croll Mph, Jamar Croom Ms, Louisa Munk Mph, Yvonne Jonk Phd

Rural Health Clinics

This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues using data from CMS’s Provider of Services file, Medicare Cost Reports, and the Robert Wood Johnson Foundation’s’ County Health Ranking and will be useful to policymakers and others interested in the performance of RHCs nationally. It can also be useful to RHC administrators to benchmark staffing patterns, productivity, and efficiency. Finally, it provides a discussion of the challenges related to collection and reporting of RHC quality data.

For more information, please contact John Gale, [email protected]

If A Tree Falls In The Forest: Presidential Press Conferences And Early Media Narratives About The Covid-19 Crisis, Masha Krupenkin, Kai Zhu, Dylan Walker, David Rothschild

Business Faculty Articles and Research

Throughout the COVID-19 crisis, as we confronted questions about social distancing, masking wearing, and vaccines, public safety experts warned that the consequences of a misinformed population would be particularly dire due to the serious nature of the threat and necessity of severe collective action to keep the population safe. Thus, the media and the political elites (e.g., President of the United States) who possess the power to set the information agenda around COVID-19 bear a huge responsibility for the general welfare. Through automated text analysis of complete transcripts of national cable, network, and local news, we explore their narratives surrounding …