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Full-Text Articles in Public Health

The Effectiveness Of Best Management Practices Implemented At Lake Gregory, Crestline, Ca, Devin Darrow May 2022

The Effectiveness Of Best Management Practices Implemented At Lake Gregory, Crestline, Ca, Devin Darrow

Electronic Theses, Projects, and Dissertations

Water quality deterioration of recreational surface waters from excess pollution inputs is a significant concern for the health of the public and aquatic ecosystem. This study will examine the effectiveness of Best Management Practices (BMPs) in reducing pollution inputs into Lake Gregory, Crestline, CA. The effectiveness of the BMPs was examined by testing for water quality parameters including dissolved oxygen, temperature, pH, conductivity, turbidity, nitrate (NO3-), ammonium (NH4+), total coliform, and Escherichia coli on weekly to bi-weekly basis for a period of 1 year. A statistical analysis involving descriptive statistics, Pearson’s correlation, the Efficient Ratios (ER) and Percent Removal Rates …


Barriers To Public Health In Latino American Indigenous Communities, Wilzave Quiles Guzman Apr 2022

Barriers To Public Health In Latino American Indigenous Communities, Wilzave Quiles Guzman

Honors Program Theses and Research Projects

This paper focuses on barriers to public health in Latino American Indigenous communities. Indigenous people throughout the world are at a public health disadvantage due to a lack of clearly defined practices within the decision-making processes to plan, evaluate, and control finances from governmental and non-governmental entities in charge of managing health services. I argue that political, social, and institutional changes are still needed to achieve health equity in Indigenous communities and that these changes should go beyond implementing a universal health care program. I must recognize improvements made by many Latino American countries like Brazil, which prepared a plan …


Emergency Department Antimicrobial Use In A Low-Resource Setting: Results From A Retrospective Observational Study At A Referral Hospital In Liberia, Sojung Yi, Anu Ramachandran, Lane Epps, Alex Mayah, Taylor W Burkholder, Michael Senyu Jaung, Ahson Haider, Paul Whesseh, John Shakpeh, Kayla Enriquez, Corey Bills Apr 2022

Emergency Department Antimicrobial Use In A Low-Resource Setting: Results From A Retrospective Observational Study At A Referral Hospital In Liberia, Sojung Yi, Anu Ramachandran, Lane Epps, Alex Mayah, Taylor W Burkholder, Michael Senyu Jaung, Ahson Haider, Paul Whesseh, John Shakpeh, Kayla Enriquez, Corey Bills

Faculty, Staff and Students Publications

OBJECTIVE: Data on antimicrobial use in low-income and middle-income countries (LMICs) remain limited. In Liberia, the absence of local data impedes surveillance and may lead to suboptimal treatment, injudicious use and resistance against antimicrobials. This study aims to examine antimicrobial prescribing patterns for patients in the emergency department (ED) of a large Liberian public hospital. Secondarily, this prescribing was compared with WHO prescribing indicators.

DESIGN: Retrospective observational study.

SETTING: An adult ED of a large public hospital in Monrovia, Liberia.

PARTICIPANTS: A total of 1082 adult patients (>18 years of age) were recorded in the ED, from 1 January …


The Relationship Between Leader-Member Exchange And Citizen Willingness To Comply With Governmental Public Health Mandates Concerning Covid-19 In Dougherty County, Georgia: A Mixed Methods Analysis, Travis H. Goodson Apr 2022

The Relationship Between Leader-Member Exchange And Citizen Willingness To Comply With Governmental Public Health Mandates Concerning Covid-19 In Dougherty County, Georgia: A Mixed Methods Analysis, Travis H. Goodson

Doctoral Dissertations and Projects

As of February 8, 2022, more than 394,381,395 individuals across the globe have contracted COVID-19; and from this number, reportedly more than 5,735,179 have died due to the virus (World Health Organization, 2022). Amid the COVID-19 pandemic, local, state, and federal governments have fielded a host of public health mandates in an attempt to curtail the spread of the virus; however, little is known about the efficacy of such mandates and how willing compliance is obtained through perceived high-quality leader-member exchanges. Compliance is best defined as willing conformity to official requirements; here, compliance is examined through the lens of relational …


Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk Apr 2022

Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk

Senior Theses

The Latino population in the United States faces a heightened risk in terms of contracting HIV/AIDS and experiencing negative health outcomes from said infection. HIV/AIDS continues to disproportionately impact ethnic/racial minorities, and the Latino population exemplifies this unfortunate trend, with Latino Americans making up around 18.4% of the national population, but nearly 30% of the HIV/AIDS infections (US Office of Minority Health, 2021). More enduring changes to the current resources available to this population will need to be made in order to address this disparity. Thus, the current study examined social determinants, how they increase risk of infection, and how …


Superfund And Society Benumbed: An In-Depth Look At Environmental Justice In South Carolina, Sydney A. Hampton Apr 2022

Superfund And Society Benumbed: An In-Depth Look At Environmental Justice In South Carolina, Sydney A. Hampton

Senior Theses

This thesis investigates the relationship between superfund sites in minority communities and their public health through the lens of social vulnerability. Various demographic parameters were used to assess the risk associated with minority communities and exposure to hazardous waste. After investigating the history of the Environmental Justice movement, three superfund sites of interest in South Carolina, and demographic and public health data; each community was analyzed to determine association between exposure to hazardous waste and minority status. Each examined community exhibited characteristics contributing to heightened social vulnerability, potentially causing increased susceptibility to negative health outcomes from exposure to hazardous waste.


Medical Visits Related To Firearm Injuries Increased During Covid-19, Rachel Chernet, Margaret K. Formica Mar 2022

Medical Visits Related To Firearm Injuries Increased During Covid-19, Rachel Chernet, Margaret K. Formica

Population Health Research Brief Series

When COVID-19 began its initial wave in the United States in March 2020, gun sales surged across the country. The increase in first time gun owners, stress, anxiety, and lack of safety training courses has corresponded with a significant increase in firearm injuries, with especially large increases in the Spring and Summer of 2020 among males, non-Hispanic Blacks, ages 20 to 29, and residents of the Midwest and South. Given the especially large rise in unintentional firearm injuries, policymakers should consider interventions that increase education, training, and regulation over safe firearm access and storage.


The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups, Jan M. Eberth, Pelvin Hung, Gabriel A. Benavidez, Janice Probst, Whitney E. Zahnd, Mary-Katherine Mcnatt, Ebony Toussaint, Melinda A. Merrell, Elizabeth L. Crouch Feb 2022

The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups, Jan M. Eberth, Pelvin Hung, Gabriel A. Benavidez, Janice Probst, Whitney E. Zahnd, Mary-Katherine Mcnatt, Ebony Toussaint, Melinda A. Merrell, Elizabeth L. Crouch

Faculty Publications

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being …


Learning From South Korea’S Covid-19 Response: Why Centralizing The United States Public Health System Is Essential For Future Pandemic Responses, Meghan Ricci Jan 2022

Learning From South Korea’S Covid-19 Response: Why Centralizing The United States Public Health System Is Essential For Future Pandemic Responses, Meghan Ricci

Seattle Journal of Technology, Environmental, & Innovation Law

The COVID-19 pandemic revealed stark differences in governmental preparedness across the globe. The United States, once thought of as a global leader in public health, had the theoretical skill and efficiency to handle the pandemic but failed to utilize those skills and resources during an actual health crisis. In the spring of 2020, everyone watched the U.S.’s reaction to the unfolding of the COVID-19 pandemic due to its historic placeholder as a global leader and innovator. However, the performance of the U.S. in response to the global pandemic disappointed both global commentators and U.S. citizens. This paper will compare the …


Becoming A Public Health Professional: Millennials’ Perspective On Organizational Assimilation And Professional Identity, Tony K. Winters Jan 2022

Becoming A Public Health Professional: Millennials’ Perspective On Organizational Assimilation And Professional Identity, Tony K. Winters

College of Graduate Studies: Theses & Dissertations

ABSTRACT

Public health must confront the ongoing challenge of workforce transitions and the impending exodus of existing employees. The millennial generation rises as an option to fill this workforce gap. Using the Socialization Resource Theory as a framework and qualitative data from in-depth interviews with 27 millennial professionals from federal, state, local, and non-governmental public health agencies, this study describes (a) the organizational assimilation (OA) process for millennial public health professionals, (b) explores the impact of OA on professional identity, and (c) describes how the OA process may impact the retention of public health professionals.

The results from this study …


Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young Jan 2022

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …


Stemming The Shadow Pandemic: Integrating Sociolegal Services In Contact Tracing And Beyond, Medha D. Makhlouf Jan 2022

Stemming The Shadow Pandemic: Integrating Sociolegal Services In Contact Tracing And Beyond, Medha D. Makhlouf

Faculty Scholarly Works

The COVID-19 pandemic has shed light on the challenges of complying with public health guidance to isolate or quarantine without access to adequate income, housing, food, and other resources. When people cannot safely isolate or quarantine during an outbreak of infectious disease, a critical public health strategy fails. This article proposes integrating sociolegal needs screening and services into contact tracing as a way to mitigate public health harms and pandemic-related health inequities.


Environmental Racism In Baltimore: A Geographical Study Into The Connections Between Environmental Toxins And Public Health, Genevieve Block Jan 2022

Environmental Racism In Baltimore: A Geographical Study Into The Connections Between Environmental Toxins And Public Health, Genevieve Block

Honors Theses

An investigation into the relationship between environmental toxins and environmental racism in Baltimore City, Maryland.


Exploring How Public Health Partnerships With Community-Based Organizations (Cbos) Can Be Leveraged For Health Promotion And Community Health., Senila Yasmin, Rayna Haque, Kaneza Kadambaya, Marzia Maliha, Maha Sheikh Jan 2022

Exploring How Public Health Partnerships With Community-Based Organizations (Cbos) Can Be Leveraged For Health Promotion And Community Health., Senila Yasmin, Rayna Haque, Kaneza Kadambaya, Marzia Maliha, Maha Sheikh

Student Papers, Posters & Projects

The Academic Public Health Corps (APHC) works to support local public health in Massachusetts through varying models of collaboration. In the setting of the COVID-19 pandemic, one initiative of the APHC has been to partner with community-based organizations (CBOs) to address vaccine hesitancy and improve overall community health. The purpose of this article is to share how the APHC partnered with CBOs in Massachusetts to address COVID-19 concerns within their respective communities, and present strategies to empower communities, share resources, and increase health promotion. The APHC partnered with 2 CBOs who received the Massachusetts COVID-19 Community Grants distributed by Health …


Recharge Moments, Scott Keel Jan 2022

Recharge Moments, Scott Keel

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract Title: Recharge Moments

Background: Recent articles from the CDC and other healthcare agencies have demonstrated the detrimental effects that the COVID-19 pandemic is having on the physical and mental health of the healthcare workforce. Unfortunately, they were less informative in regard to those working for local public health departments. Pre-pandemic and concurrent publications on mindfulness-based interventions have demonstrated the positive and protective effects mindfulness-based interventions can have on burnout prevention and resilience promotion. To gain a better understanding of how the current pandemic might be affecting the public health workforce and to assess whether mindfulness-based interventions would be helpful …


Circadian Factors And Cancer Survivorship: A Mini Review, Jiaqi Cui Jan 2022

Circadian Factors And Cancer Survivorship: A Mini Review, Jiaqi Cui

Public Health Theses

Circadian clocks are molecular clocks that govern the temporal control of physiology to preserve homeostasis. The disruption of the circadian rhythm is important in carcinogenesis and aids the development of cancer hallmarks. On the other hand, carcinogenic activities disrupt circadian rhythms directly. In cancer treatment, pharmacological regulation of core clock genes is a novel approach. The use of circadian biology in cancer research opens up new avenues for improving cancer treatment effectiveness. This mini-review provides an overview of relationship between circadian factors including circadian gene expression, circadian genotype, circadian disruption and circadian gene methylation and the cancer survivorship. The review …


Pharmacists’ Responses To Medication Management Following Disasters, Rellamichelle W. Tyree Jan 2022

Pharmacists’ Responses To Medication Management Following Disasters, Rellamichelle W. Tyree

Walden Dissertations and Doctoral Studies

Disasters, both natural and human made, can cause emerging health threats in the United States and the Caribbean. The disasters that pharmacists experienced and reported for this study included hurricanes, snowstorms, ice storms, flooding, and a pandemic. The purpose of this research was to investigate the challenges and outcomes associated with pharmacists’ medication management practices during and following disasters. This generic qualitative study focused on pharmacists’ experiences and their responses to disaster planning and medication management activities. The ecological model of disaster management was the conceptual framework used to investigate the pharmacists and their responses and actions used to address …


Health Policy, Equity, And The Lead Poisoning Crisis: A Conversation With Dr. Mona Hanna-Attisha, Mona Hanna-Attisha Jan 2022

Health Policy, Equity, And The Lead Poisoning Crisis: A Conversation With Dr. Mona Hanna-Attisha, Mona Hanna-Attisha

Center for Policy Research

Dr. Mona Hanna-Attisha delivered the 33rd Annual Herbert Lourie Memorial Lecture on Health Policy on Thursday, September 23, 2021. This year's lecture was titled, "Health Policy, Equity, and the Lead Poisoning Crisis: A Conversation with Dr. Mona Hanna-Attisha"

Mona Hanna-Attisha, MD, MPH, FAAP, is founder and director of the Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative, an innovative and model public health program in Flint, Michigan.

A pediatrician, scientist, activist, and author, Dr. Hanna-Attisha has testified three times before the United States Congress and was awarded the Freedom of Expression Courage Award by PEN America. She …


Determinants Of Social Distancing Adherence, Philip Gerretsen, Julia Kim, Eric E Brown, Lena C Quilty, Samantha Wells, Fernando Caravaggio, Jianmeng Song, Marcos Sanches, Branka Agic, Bruce G Pollock, Ariel Graff-Guerrero Jan 2022

Determinants Of Social Distancing Adherence, Philip Gerretsen, Julia Kim, Eric E Brown, Lena C Quilty, Samantha Wells, Fernando Caravaggio, Jianmeng Song, Marcos Sanches, Branka Agic, Bruce G Pollock, Ariel Graff-Guerrero

Faculty, Staff and Student Publications

Introduction: Governments and public health authorities across many jurisdictions implemented social (physical) distancing measures to contain the spread of the 2019 novel coronavirus disease (COVID-19). Adherence to these measures is variable and likely influenced by various factors. This study aimed to 1) identify the individual sociodemographic, COVID-19 and social distancing related, and psychological determinants of social distancing adherence, and 2) explore regional differences in social distancing adherence in the United States (U.S.) and English-speaking Canada based on each region's discrepant response to social distancing restrictions.

Methods: A web-based repeated cross-sectional survey was conducted in 4,942 English-speaking participants from the four …


A Participatory Group Process To Collect And Disseminate Covid-19 Needs Assessment Data, Areebah Ahmed Jan 2022

A Participatory Group Process To Collect And Disseminate Covid-19 Needs Assessment Data, Areebah Ahmed

Undergraduate Research Posters

The Richmond, VA COVID-19 Needs Assessment Survey (RVA CoNA) was created in March 2020 to identify behaviors and needs related to COVID-19 in Richmond area adults ages 18 and over. Results are being used to inform support, strategic efforts, and educational outreach of local community organizations. The purpose of this study is to (1) summarize the process used to develop the RVA CoNA, (2) summarize preliminary survey results from a second phase of data collection as well as initial feedback from community partners, and (3) summarize initial conclusions and results dissemination strategies.Community partners and researchers at Virginia Commonwealth University jointly …


Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis Jan 2022

Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis

Walden Dissertations and Doctoral Studies

AbstractThe Zika virus does not have a known treatment, despite ongoing efforts since 2016 to develop a vaccine. The Zika virus has been labeled by World Health Organization and the Department of Defense as a threat to the readiness, resiliency, and preparedness of military service members and dependents that currently travel or serve in areas where high concentrations of the virus are present. As such, it is important to understand how the military community understanding of the Zika virus is impacted by military health services and education. A phenomenological qualitative approach was utilized to conduct this study. Twenty active-duty military …


Creating A Collaborative Trauma-Informed Interdisciplinary Citywide Victim Services Model Focused On Health Care For Survivors Of Human Trafficking, Juhi Jain, Mackenzie Bennett, Mark D Bailey, Daniel Liaou, Sheri-Ann O Kaltiso, Jordan Greenbaum, Kimberly Williams, Mollie R Gordon, Melissa I M Torres, Phuong T Nguyen, John H Coverdale, Victor Williams, Cayla Hari, Samantha Rodriguez, Temilola Salami, Jonell E Potter Jan 2022

Creating A Collaborative Trauma-Informed Interdisciplinary Citywide Victim Services Model Focused On Health Care For Survivors Of Human Trafficking, Juhi Jain, Mackenzie Bennett, Mark D Bailey, Daniel Liaou, Sheri-Ann O Kaltiso, Jordan Greenbaum, Kimberly Williams, Mollie R Gordon, Melissa I M Torres, Phuong T Nguyen, John H Coverdale, Victor Williams, Cayla Hari, Samantha Rodriguez, Temilola Salami, Jonell E Potter

Center for Medical Ethics and Health Policy Staff Publications

Although human trafficking is recognized as a public health issue, research on the health effects of human trafficking and best intervention practices is limited. We describe 2 citywide collaborative victim services models, the THRIVE (Trafficking, Healthcare, Resources, and Interdisciplinary Victim Services and Education) Clinic at the University of Miami and Jackson Health System in Miami, Florida, and the Greater Houston Area Pathways for Advocacy-based, Trauma-Informed Healthcare (PATH) Collaborative at Baylor College of Medicine, CommonSpirit Health, and San Jose Clinic in Houston, Texas, funded in part by the Office for Victims of Crime, which focus on trauma-informed health care delivery for …


Managing Covid-19: Legal And Institutional Issues, Yon-Shik Lee Nov 2021

Managing Covid-19: Legal And Institutional Issues, Yon-Shik Lee

Minnesota Journal of Law, Science & Technology

No abstract provided.


Vectors: Immunity In Commercial Aviation, Timothy M. Ravich Nov 2021

Vectors: Immunity In Commercial Aviation, Timothy M. Ravich

William & Mary Business Law Review

COVID-19 nearly wiped out demand for commercial air travel in 2020, driving down passenger traffic by a jaw-dropping 94.3% from the previous year. The airline industry thus understandably lobbied for a government bailout to manage what was nothing short of an existential crisis, with losses exceeding $35 billion. Less worthy of sympathy, however, were the ad hoc policies airlines unhelpfully put in the path of their customers even while securing for themselves $25 billion in payroll grants together with a similar sum in low-interest loans. For example, carriers refused to provide refunds or liquidate travel credits in a straightforward way …


Vol 2 November '21 Full Issue, Donna L. Williams Nov 2021

Vol 2 November '21 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.


The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr. Oct 2021

The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr.

Faculty Publications

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample.

Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed …


Hpv Vaccination In The Virginia Context: Demographic Disparities, Patient-Provider Gender Concordance And The Impact Of Changing Recommendations, Isha Patel, Norma M. Benitez, George L. Maxwell, Fabian T. Camacho, Rajesh Balkrishnan Oct 2021

Hpv Vaccination In The Virginia Context: Demographic Disparities, Patient-Provider Gender Concordance And The Impact Of Changing Recommendations, Isha Patel, Norma M. Benitez, George L. Maxwell, Fabian T. Camacho, Rajesh Balkrishnan

Virginia Journal of Public Health

Objective: Despite its effectiveness in preventing several cancers, there are marked disparities in HPV vaccination initiation and series completion. The present study sought to understand disparities in HPV vaccinations among patients in northern Virginia (ages 9-26) and the impact of patient and provider gender concordance, in lieu of CDC’s vaccine recommendation changes in 2016, which reduced the recommended doses from three to two, in this population. Design: Analyses of electronic medical records collected from 2012 to 2017. Setting: A large health care system in Northern Virginia. Participants: A total of 37,427 patients, ages 9 to 26, were included in analyses. …


Knowledge Of The Human Papillomavirus Vaccine: An Analysis Using Together For Health Virginia Population Health Survey, Mythili Vigneshwar, Sunny Jung Kim, Carrie A. Miller, Bernard Fuemmeler, Rajesh Balkrishnan Oct 2021

Knowledge Of The Human Papillomavirus Vaccine: An Analysis Using Together For Health Virginia Population Health Survey, Mythili Vigneshwar, Sunny Jung Kim, Carrie A. Miller, Bernard Fuemmeler, Rajesh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to identify key predictors which impact knowledge of the Human Papillomavirus vaccine in adults aged 21 to 45 in Virginia.

Methods: Data was collected from the Together for Health Virginia Population Surveys administered by Virginia Commonwealth University and the University of Virginia. Logistic regression was performed on data using the variables sex, age, rurality, race, education, income, occupation, and type of health insurance coverage.

Results: There was a statistically significant positive relationship between knowledge of the HPV vaccine and part-time occupation (OR: 4.288, CI: 1.492-13.325), younger age (OR: 2.31, CI: 1.088-4.905), and …


Envh 7235 – Field Methods In Environmental Health, Marina Eremeeva Oct 2021

Envh 7235 – Field Methods In Environmental Health, Marina Eremeeva

College of Public Health: Faculty Syllabi (2014-2021)

This course introduces students to an overview of current and accepted field methods for environmental sampling and occupational exposure monitoring.


Hspm 7433 – U.S. Health Systems, Jeff Jones Oct 2021

Hspm 7433 – U.S. Health Systems, Jeff Jones

College of Public Health: Faculty Syllabi (2014-2021)

This course discusses the history and evolution of health systems in the United States and in other countries. Topics include the U.S. legislative process and the health policies underpinning these approaches. This course also includes comparative approaches from other countries in dealing with insurance, immunizations, health access, drug addiction and regulation.