Public Health Commons^™

Associations Between Alcohol Consumption And Fasting Blood Glucose In Young Adults, Julie Ann Lucca

Master's Theses

Current research shows moderate alcohol consumption is associated with decreased risk of diabetes and excessive consumption or binge drinking can cause insulin resistance and diabetes. In 2010, diabetes was the seventh leading cause of death in the United Statesand was responsible for significant health complications: blindness, kidney failure, and limb amputations, and is a large national economic burden. Fasting blood glucose (FBG) is a tool used to help diagnose diabetes. Abnormally high FBG, ≥100 mg/dl, is indicative of diabetes and pre-diabetes. Few studies have observed diabetic prevalence among young adults or college students. Studying young adults can help provide added …

Estimating Return On Investment: Approaches And Methods, Glen P. Mays

Health Management and Policy Presentations

Continuing fiscal constraints in the public sector and large-scale policy changes associated with health reform implementation in the U.S. are giving heightened attention to questions about the health and economic value of public health programs, services, and policies -- strategies designed to protect health and prevent disease and injury on a population-wide basis. This session provides an overview of approaches for conducting return-on-investment (ROI) analyses and related economic evaluation studies in public health settings in order to inform policy and administrative decision-making. New opportunities and resources created through CDC's National Public Health Improvement Initiative (NPHII) and RWJF's Public Health Practice-based …

Optimizing The Value Of Public Health Services: Lessons From Research & Practice, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health programs and policies holds considerable potential for improving population health and constraining the growth in health care spending. Achieving such expansions efficiently, particularly in low-resource settings, requires careful attention to interorganizational and intergovernmental relationships in public health delivery.

Fearless: Kevin Lugo, Kevin B. Lugo

SURGE

This summer, recent graduate Kevin Lugo will bike over 4,000 miles across the country to benefit the Ulman Cancer Fund for Young Adults. His choice to bike for seventy days from Baltimore to Seattle makes him fearless! His goal is to raise $7,476 for the organization, and he reached that goal last night (although more donations are always welcome in support of fighting cancer)! Kevin explains that when he studied abroad in Denmark in the fall of 2011, he “fell in love with sustainable transportation, especially cycling.” Not only does his fearless endeavor raise money to fight cancer, but he …

Analyzing The Health Care Cost Curve: A Case Study, Robert Lieberthal

College of Population Health Faculty Papers

This case study uses data from a self-insured employer plan to perform an analysis into the properties of the health care cost curve. The analysis shows that one statistical property of the health care cost curve is that costs rise continuously, not on an annual or monthly basis. Graphical analysis indicates that managed care techniques used to restrain costs can also smooth utilization, producing the continuously growing cost curve observed. The analysis further illustrates that there is no one ‘‘cost curve’’—analysis must be segmented by population. Finally, the power of predictive models to fit the cost curve varies by population. …

Next Generation Public Health Delivery: Optimizing Health And Economic Impact, Glen P. Mays

Health Management and Policy Presentations

Improving population health in the context of significant policy and economic change will require governmental public health agencies to rethink their roles within the U.S. health and social services systems, giving much greater attention to "catalytic" functions intended to mobilize, direct, and coordinate the actions of others. A growing body of evidence and experience suggests that such changes are likely to be feasible, effective, and efficient.

Access To Essential Medicines In Pakistan: Policy And Health Systems Research Concerns., Shehla Zaidi, Maryam Bigdeli, Noureen Aleem, Arash Rashidian

Community Health Sciences

NTRODUCTION:

Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns.

METHODS:

An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. …

Dsm V: Hope Or Hype?, Amresh Srivastava

Data and Test Instruments

DSM V: HOPE OR HYPE? Amresh Shrivastava, MD,MPM,MRCPsych,FRCPC Associate professor of Psychiatry Western University London, Ontario Since more than 50 years psychiatric diagnostic is being developed by a number of organisations. As research has advanced in understanding mental illnesses,need for a common language has been felt in order to provide best possible care to our patients. The process of psychiatric diagnosis has evolved significantly. WHO as well APA both have made significant advances in developing diagnostic systems. DSM 5 recently approved by board of trustees by Americal psychiatric Association is scheduled to be released on 18th of May. This document …

The Value Of Public Health Financial Data, Glen P. Mays

Health Management and Policy Presentations

Effective policy and administrative decision-making in public health requires reliable information on the amount of resources invested in governmental public health programs and how these resouces are allocated and used across the U.S. public health system. This session examines current and potential uses of public health financial data in the U.S., and considers expanded roles for research in informing policy and administrative decisions.

Discrimination In Medical Settings And Attitudes Toward Complementary And Alternative Medicine: The Role Of Distrust In Conventional Providers, Tetyana Shippee, Carrie Henning-Smith, Nathan Shippee, Jessie Kemmick Pintor, Kathleen T. Call, Donna Mcalpine, Pamela Jo Johnson

Journal of Health Disparities Research and Practice

This study examines the relationship between racial/ethnic discrimination in medical settings, distrust in conventional medicine, and attitudes toward complementary and alternative medicine (CAM) among a racially/ethnically diverse sample. We also investigate how this relationship differs by nativity. Data are from a 2008 statewide stratified sample of publicly insured adults in Minnesota (N=2,194). Discrimination was measured as self-reported unfair treatment in medical settings due to race, ethnicity, and/or nationality. Outcomes are trust in conventional providers/medicine and attitudes toward CAM modalities. Discrimination in medical settings was positively associated with 1) distrust in conventional providers and 2) favorable attitudes toward CAM. Foreign-born …

A Single Long-Term Acute Care Hospital Experience With A Pressure Ulcer Prevention Program, Daniel Young, Cathy Borris-Hale

Interdisciplinary Research Scholarship Day

This study describes the experience of a single, long-term care acute hospital (LTAC) with the Medline Pressure Ulcer Prevention Program (mPUPP)

• The growing light being shed on pressure ulcer (PrU) costs for the people that get them and the health care systems that treat them, has challenged care facilities to look for programs to reduce nosocomial PrU
• Each PrU can cost between $700 and $135,000 in medical care related expenses and litigation
• Recent evidence suggests that successful PrU prevention programs have common characteristics

Development Of A Case-Mix Funding System For Adults With Combined Vision And Hearing Loss, Dawn M. Guthrie, Jeff Poss

Kinesiology and Physical Education Faculty Publications

Background: Adults with vision and hearing loss, or dual sensory loss (DSL), present with a wide range of needs and abilities. This creates many challenges when attempting to set the most appropriate and equitable funding levels. Case-mix (CM) funding models represent one method for understanding client characteristics that correlate with resource intensity.

Methods: A CM model was developed based on a derivation sample (n = 182) and tested with a replication sample (n = 135) of adults aged 18+ with known DSL who were living in the community. All items within the CM model came from a standardized, …

Vital Statistics: The State Of The Public Health Pbrn Program, Glen P. Mays

Health Management and Policy Presentations

The Robert Wood Johnson Foundation's Public Health PBRN Program has continued to expand during the 2013 program year with new networks, new research projects, and expanded translation and dissemination initiatives. The program plays an increasingly powerful role in helping to transform the U.S. public health enterprise into a rapid-learning system for health improvement.

Testing Integrated Primary Care And Public Health Models For Prevention Delivery, Glen P. Mays

Health Management and Policy Presentations

Improving the delivery of evidence-tested prevention interventions to populations at greatest risk requires strong coordination between primary care providers and public health organizations. This presentation reviews current research on models for integrated delivery of primary care and public health services, and identifies emerging research needs and opportunities. Of particular interest are the roles that practice-based research networks (PBRNs) can play in building this evidence.

The Characteristics Of Women Seeking Funding From The Dc Abortion Fund, Karin Elizabeth Bleeg

GW Research Days 2013

Objectives: To determine whether the population DCAF serves, based on current research, are those most in need of its financial services. Describe the population that DCAF is supports by age, race and ethnicity, poverty, educational attainment, union status, contraceptive method used, referral source, and number of prior pregnancies.

Methods: An adapted version of The Guttmacher Institute's National Patient Survey will be used to collect data from women who contact DCAF for financial assistance for their abortion (n=150). The data will be collected for one month and then analyzed in SPSS.

Results: Between January and March 2013 approximately 400 women contacted …

Public Health Roi: Evidence, Experience And Remaining Questions, Glen P. Mays

Health Management and Policy Presentations

Expanding the delivery of efficacious public health and prevention strategies holds considerable potential for improving health outcomes and constraining costs across the U.S. health system. Unfortunately, lingering certainties about the costs required to expand public health delivery systems and about the health and economic effects of such expansions has muted private and public support for increased public health expenditures. This lecture examines recent evidence from public health services and systems research studies that examine the health and economic value of public health delivery, and identifies remaining research needs for the field.

Legislative Impact Of The Construction Of An “Abortion Culture”: A Comparative Analysis Of The Enaction And Impact Of Abortion Restriction Legislation In The Netherlands And The United States, Anna Schmitz

Independent Study Project (ISP) Collection

This study investigates the different socio-political causes leading to the implementation of similar abortion restrictions (mandatory parental notification for minors, mandatory counseling, and a waiting period) in the Netherlands and the United States. It first investigates the “abortion cultures” of the two countries, using personal interviews with Dutch and American citizens to analyze the social perceptions of abortion and a comparison of sexual health and legislation data to create a wider picture of abortion within both countries. It then investigates the political opportunity structure leading to the implementation of the restrictions of abortion in each country, and then investigates differences …

[Sabbatical Report], Emmanuel Iyiegbuniwe

Sabbatical Reports

The main purpose of this sabbatical leave was to provide me the opportunity to conduct relevant research and subsequently write two book chapters on environmental health and policy issues in two countries: Belize (a developing country) and Canada (a developed country). Specifically, the two book chapters were titled "Analysis of Environmental Health Policy in Belize" and "Analysis of Environmental Health and Policy Issues in Canada." As called for in my proposal, I was able to travel to Belize with a group of CHHS faculty and students during the 2013 winter term. During the leave period, I success fully conducted research …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

La Contaminación De La Cuenca Matanza-Riachuelo: Análisis De La Respuesta Institucional Con Respecto A La Salud De La Población Del Barrio De La Boca., Ishaira Nieto Rosas

Independent Study Project (ISP) Collection

La intención de esta investigación fue presentar un panorama de la respuesta de diferentes organizaciones del barrio de La Boca a los riegos de salud ambiental con respecto a la contaminación histórica y continua de la Cuenca Matanza-Riachuelo. Basado en el entendimiento que la salud es el completo bienestar físico, mental y social, este proyecto abordó el tema de contaminación ambiental a través de la participación en un taller de monitoreo social de la Cuenca y entrevistas con miembros del Equipo Local de Salud Ambiental del CESAC 41, el Presidente de la Asociación de Vecinos de La Boca y comerciantes …

Migrant Farmworkers And Access To Health Care In Minnesota: Needs, Barriers, And Remedies, Rachel L. Gunsalus

Sociology Honors Projects

Every year, migrant farmworkers (MFWs) travel from southern Texas to Minnesota to provide the temporary labor needed to harvest seasonal Minnesotan crops. Migratory agricultural labor exposes workers to increased risk of occupational hazards, communicable disease, and chronic illness. However, the agricultural industry does not offer employer-based health insurance to these seasonal workers, and provides wages insufficient to otherwise cover the cost of health care services. This research investigates the financial and non-financial barriers to health care for Minnesota’s MFWs through interviews with staff from Migrant Health Service, Inc., the only federally-designated Migrant Health Center (MHC) in Minnesota. The findings show …

Annual Report 2012, Forum Staff

National Health Policy Forum

This annual report describes the activities of the Forum during the 2012 calendar year, and provides a snapshot of our resources.

Health Status Of Children Entering Kindergarten: Results Of The 2012-2013 (Year Five) Nevada Kindergarten Health Survey, Nevada Institute For Children's Research And Policy Reports, All Nevada County School Districts, Nevada School District Superintendents, Nevada State Health Division, Head Start Collaboration & Early Childhood Systems Office, Amanda Haboush, Dawn Davidson, Tara Phebus, Enrique Lopez, Chad Pitts

Nevada Institute for Children's Research and Policy Reports

Academic achievement for children is vital to their success in life. Those that do well in school have greater opportunities for post-secondary education, and later have better prospects for employment. One of the major factors that can affect a child’s academic achievement is his or her health status. Academic outcomes and health conditions are consistently linked in the literature (Taras & Potts-Datema, 2005). Children with poor health status, and especially those with common chronic health conditions, have increased numbers of school absences and more academic deficiencies (Taras & Potts-Datema, 2005). In a study concerning excused versus unexcused absences, children with …

La Percepción Del Sistema De Salud Intercultural Y La Generación De Una Nueva Discriminación: Estudio De Los Centros De Medicina Mapuche En Nueva Imperial Y Puerto Saavedra Con Población Adulta, Jannet Guadalupe Sánchez

Independent Study Project (ISP) Collection

The main objective of this project was to investigate to what extent intercultural health experiences in the Araucanía region of southern Chile can help overcome situations of discrimination or how they may help generate new ones. This project surfaces from the known history of discrimination against the mapuche population that has resulted in poor health status and how the installation of intercultural health financed by the governments' own ministry of health tries to alleviate the problem. To achieve the main objective, both surveys and interviews were conducted at two intercultural health centers in order to determine actual and perceived health …

An Exploration Of Diabetes Care In Durban, Kwa-Zulu Natal, Suburbs As Seen Through The Work Of Diabetes South Africa, Mallory Bernstein

Independent Study Project (ISP) Collection

This study portrays the lived experiences of diabetics and diabetes caregivers in Durban suburbs through the lens of Diabetes South Africa (DSA), a Non-Governmental Organization (NGO) operating out of Durban. Furthermore, this study also analyzes the progression of the treatment and services offered to diabetics. The specific aim of this study was to understand the situation of diabetic care in the suburbs and the obstacles to improvement. Because diabetes is registered by the World Health Organization (WHO) as a worldwide epidemic and because the rate of diagnosis will be increasing (World Health Organization: Diabetes updated March 2013), it is necessary …

Cost Estimation Methods: Strategies And Examples For Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

This webinar reviews methods for conducting cost studies in public health settings, including strategies for estimating the financial and ecnomic costs of delivering public health services, and analytic approaches to identifying factors that influence delivery costs. These types of studies are of increasing importance to policy and practice stakeholders given the need for evidence about the return-on-investment (ROI) generated through public health delivery.

Monitoring Qi Maturity Of Public Health Organizations And Systems In Minnesota: Promising Early Findings And Suggested Next Steps, Kimberly J. Miner Gearin, M. Elizabeth Gyllstrom, Brenda M. Joly, Renee S. Frauendienst, Julie Myhre, William Riley

Frontiers in Public Health Services and Systems Research

Public health departments and systems are increasing investments in quality improvement. This paper presents methods used to identify a select number of items from a previously validated QI Maturity Tool as the basis for calculating organizational and system-level QI maturity scores that could be followed over time. Findings suggest that the abbreviated tool measures variation in QI maturity across LHDs, and differences in scores among divisions within a state health department. Minnesota has incorporated the abbreviated tool into an annual reporting system for the MN Local Public Health Act, thereby enabling stakeholders to monitor a system median score and distribution …

Using The Qi Maturity Tool To Classify Agencies Along A Continuum, Brenda M. Joly, Maureen Booth, Prashant Mittal, Yan Zhang

Frontiers in Public Health Services and Systems Research

Major investments have been made to encourage health departments to implement quality improvement (QI) efforts. Yet, there are few empirically tested tools for public health agencies that assess these efforts and classify health departments along a QI continuum. This paper presents a new classification scheme for measuring QI Maturity in public health agencies based on a validated tool. The findings can be used to establish benchmarks, make comparisons and conduct future research linking QI and population health outcomes.

Rediscovering The Core Of Public Health, Steven Teutsch, Jonathan E. Fielding

Frontiers in Public Health Services and Systems Research

The success of public health has been its ability to understand contemporary health problems, to communicate the needs successfully, to identify solutions, and to implement them through programs and policies. In the past 50 years, those successes can be attributed largely to control of infectious disease, improved maternal and child health, delivery of other personal health care services, and changes in behaviors, particularly smoking. Yet health is primarily a product of our social, cultural, and physical environments. To continue to improve the nation’s health and reduce disparities, public health needs to return to its historical roots and engage with other …

Accelerating And Expanding Knowledge Transfer In Public Health Settings: Frontiers In Phssr, Glen P. Mays

Health Management and Policy Presentations

Creating a "rapid-learning" system in public health requires mechanisms for the continuous exchange of knowledge and evidence among researchers, practice settings, and policy decision-makers. The open-access platform Frontiers in Public Health Services and Systems Research provides a new mechanism for this exchange.