Public Health Commons^™

Association Between Community Health Center And Rural Health Clinic Presence And County-Level Hospitalization Rates For Ambulatory Care Sensitive Conditions: An Analysis Across Eight Us States, Janice C. Probst, James N. Laditka, Sarah B. Laditka

Faculty Publications

Background: Federally qualified community health centers (CHCs) and rural health clinics (RHCs) are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS) conditions.

Methods: We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties). …

Community Health Centers In Indiana: State Investments And Returns, Avi Dor, Patrick Richard, Ellen Tan, Sara J. Rosenbaum, Peter Shin, Lee Repasch

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Indiana Community Health Centers (I-CHC), including Federally Qualified Health Centers (FQHCs) and State Funded Health Centers (SFHCs), play a vital role in caring for the state's most vulnerable populations. Although their patient base tends to be poorer and experience greater health challenges than the general population, these health centers have generated substantial health care savings while providing high quality, low cost care. In this brief, key findings are presented from a recent study, conducted for the Indiana State Department of Health by GWU faculty and staff that was designed to estimate the cost savings and benefits generated by the state's …

Solid Waste Driver Dies After Single Vehicle Rollover, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On the morning of a fall day in 2008, a 59 year-old male solid waste worker (Driver 1) entered the cab of a company solid waste truck parked in his driveway and drove to a restaurant a few miles away. After leaving the restaurant, the driver was observed weaving by another solid waste driver (Driver 2) at least two times in the northbound lane of a two-lane state highway. After he had driven 1.8 miles in a little over 2 minutes away from the restaurant, the driver entered a right-hand curve in the highway. While in the curve, the driver …

Estimating The Effects Of Health Reform On Health Centers' Capacity To Expand To New Medically Underserved Communities And Populations, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Nearly 100 million persons reside in urban and rural communities that can be considered medically underserved as a result of inadequate supply of primary care physicians and elevated health risks. A report by the National Association of Community Health Centers and the Robert Graham Center estimated that 60 million people are "medically disenfranchised" and lack access to adequate primary health care because of where they live, even though many have health insurance. This brief assesses the potential effects of national health reform on health centers and on the number of patients they can serve. Because improving primary care access is …

Hp Newsletter June 2009 Download Full Pdf

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Book Review: Global Health And Global Aging, Safiya Abouzaid Pharmd

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Impact Of Serious Medication Errors For Health Care Providers

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Public-Private Balance In Healthcare: Political And Economic Tipping Points

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Follow-On Biologics, Patient Safety And Policy Focus Of Jsph Program In Dc

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Patient Navigator Outreach And Chronic Disease Prevention Act Of 2005: A Bipartisan Approach To Improving Access To Care And Addressing Health Disparities, Natalia M. Urrea

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Impact Of Education On Health Care Quality: The 18th Annual Dr. Raymond C. Grandon Lecture

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Master Of Science In Healthcare Quality And Safety (Ms-Hqs), Susan Desharnais Phd, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The University Clinical Skills And Simulation Center: A Jefferson Gem Part Ii

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Jefferson Students' Improving Knowledge Of Issues In Health Policy, Daniel Z. Louis Ms

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

2009 Annual Quality/Risk Management Retreat

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Stimulus Money And Health Care Research And Investment, Eric Jutkowitz

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Losing My Dad, David B. Nash Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Knowledge, Attitudes And Practices Around Health Research: The Perspective Of Physicians-In-Training In Pakistan, Hassan Khan, Sadaf Khan, Arshad Iqbal

Department of Surgery Docs

Background:Health research training is an essential component of medical education and a vital exercise to help develop physician research skills. This study was carried out to assess the level of knowledge, attitudes and practices towards research amongst a group of Post Graduate Medical Trainees (PGMTs') at Aga Khan University (AKU), Pakistan.

Methods:

A cross sectional health research survey was carried out on all PGMTs' at AKU Pakistan. AKU is a tertiary care health facility which offers residency in 28 specialties and fellowship in 16 programs. Knowledge, attitudes and practices related to health research were assessed using a pretested, structured …

National Health Reform: How Will Medically Underserved Communities Fare?, Sara J. Rosenbaum, Emily Jones, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This brief examines the factors underlying medical underservice. It finds that the number of Americans living in communities at risk for medical underservice is more than double the number of persons who are uninsured. The report notes that even with health insurance reform, these communities and providers that serve them will continue to be affected by elevated numbers of low income uninsured persons, as well as persons who may be seriously under-insured because of poorer health status and lower family income.

Describing health insurance expansion as the single most important strategy to alleviate medical underservice, the Brief also identifies a …

A Functional Difficulty And Functional Pain Instrument For Hip And Knee Osteoarthritis, Alan M. Jette, Christine M. Mcdonough, Pengsheng Ni, Stephen M. Haley

Dartmouth Scholarship

The objectives of this study were to develop a functional outcome instrument for hip and knee osteoarthritis research (OA-FUNCTION-CAT) using item response theory (IRT) and computer adaptive test (CAT) methods and to assess its psychometric performance compared to the current standard in the field.

Boosting Health Information Technology In Medicaid: The Potential Effect Of The American Recovery And Reinvestment Act, Brad Finnegan, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The American Recovery and Reinvestment Act of 2009 (ARRA) will invest approximately $49 billion to expedite health information technology (HIT) adoption through Medicare and Medicaid. Our analysis of 2006 NAMCS data found that approximately 15 percent of the practicing office-based physicians in the country would qualify for up to $63,750 over six years in Medicaid financial incentives for HIT adoption. Included within the 45,000 eligible physicians are about 99 percent of all community health center physicians. If all qualifying physicians apply for the Medicaid incentives and receive the maximum level of payments, the federal government would invest more than $2.8 …

Public Health Genomics: The Essentials. By Claudia N. Mikail, Rosemary M. Caron

Health Management & Policy

The sequencing of the human genome in 2001 provided researchers, clinicians, policymakers, ethicists, and public health practitioners with a myriad of information to potentially improve disease outcomes on an individual and population basis. Genomics is a burgeoning field of study that examines the interactions among the genetic material in the human body, including interactions with environmental and behavioral factors. The role of public health in this new field of study is complementary, since population trends, health disparities, and the social determinants of health contribute to our understanding of the underlying causes of disease provided by genomic research. Thus, the new …

Maine Barriers To Integration Study: The View From Maine On The Barriers To Integrated Care And Recommendations For Moving Forward, John A. Gale Ms, David Lambert Phd

Mental Health / Substance Use Disorders

Following up on the Environmental Scan report (http://muskie.usm.maine.edu/Publications/rural/Barriers-to-Integration-Environmental-Scan.pdf), the authors interviewed representatives from Maine’s business community, payers, purchasers, professional associations, state legislators, advocacy organizations, state government, and provider organizations. The interviews provided a context to understand the barriers to integration in Maine and develop recommendations to overcome them. Our Final Report presents key findings from the study, recommendations for addressing barriers, and next steps for moving forward. This study recognizes the need for integration of behavioral and physical health services in all settings. Although most discussions of integration focus on the development of behavioral health services in primary care settings, …

Health Insurance Profile Indicates Need To Expand Coverage In Rural Areas, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, Andrew F. Coburn Phd, Nathaniel J. Anderson Ms, Mph

Access / Insurance

Key Findings: A greater percentage of rural residents than urban residents are uninsured, especially those living in remote areas Among adults over age 50, uninsured rates are highest in the most remote rural places Compared to urban adults, rural adults are less likely to be in employment situations where private coverage is offered.

Prevalence Of Rural Intimate Partner Violence In 16 Us States, 2005, Matthew J. Breiding, Jessica S. Ziembroski, Michele C. Black

United States Public Health Resources

Context: Intimate partner violence (IPV) is a public health problem that affects people across the entire social spectrum. However, no previous population-based public health studies have examined the prevalence of IPV in rural areas of the United States. Research on IPV in rural areas is especially important given that there are relatively fewer resources available in rural areas for the prevention of IPV.

Methods: In 2005, over 25,000 rural residents in 16 states completed the first-ever IPV module within the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a Centers for Disease Control and Prevention-sponsored annual random-digit-dialed …

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Prescriptions For Excellence In Health Care Summer 2009 Download Full Pdf Issue 5

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

Carbohydrate Intake And Overweight And Obesity Among Healthy Adults, Anwar T. Merchant, Hassanali Vatanparast, Shahzaib Barlas, Mahshid Dehghan, Syed Mahboob Ali Shah, Lawrence De Koning, Susan E. Steck

Faculty Publications

Background - Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective - To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults

Design - We used a cross-sectional analysis

Subjects/setting - The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures - Outcome variables were body mass index (BMI; calculated as kg/m^{2 …}

Reasons Why Women Do Not Initiate Breastfeeding: A Southeastern State Study, Chinelo A. Ogbuanu, Janice C. Probst, Sarah B. Laditka, Jihong Liu, Jongdeuk Baek, Saundra Glover

Faculty Publications

Purpose - Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics.

Methods - Data are from the 2000-2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n = 2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the χ^{2 …}

Impact Of Allhat Publication On Antihypertensive Prescribing Patterns In Regione Emilia-Romagna, Italy, Vittorio Maio, Pharmd, Ms, Msph, Joshua J. Gagne, Pharmd, Ms

College of Population Health Faculty Papers

Background and objective: Studies from the US and Canada observed changes in antihypertensive prescribing patterns in accordance with Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) study findings immediately after the study's publication, but little is known about the impact of ALLHAT in Italy. The objective of this study was to examine antihypertensive prescribing patterns in Regione Emilia-Romagna (RER), Italy, following the publication of the ALLHAT main results.

Methods: We conducted a time series analysis using automated pharmacy data of approximately 4 million RER residents between 1 January 2000 and 31 December 2003. We computed monthly relative percentages …