Community Health and Preventive Medicine Commons^™

Using Primary Care To Bend The Cost Curve: The Potential Impact Of Health Center Expansion In Senate Reforms, Leighton C. Ku, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This analysis of reforms being considered in the United States Senate reaches conclusions similar to those of our prior analyses of reforms being considered in the House of Representatives. The combination of expanded health insurance coverage and investments in the expansion of community health centers can produce substantial long-term savings both for the overall health care system and for the federal government. Our analysis of the Senate provisions from the HELP and Finance Committees estimates $369 billion in total medical savings, including $105 billion in federal Medicaid savings. The Senate provisions produce larger savings because they authorize larger funding increases …

Estimating The Economic Gains For States As A Result Of Medicaid Coverage Expansions For Adults, Peter Shin, Leighton C. Ku, D. Richard Mauery, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This policy research brief examines the Medicaid eligibility expansions under the pending legislative proposals, including the House Tri-Committee bill, the Senate Health, Education, Labor and Pensions Committee bill and the Senate Finance Committee bill. Using new Census Bureau data, the researchers find that under both the House and Senate Finance Committee proposals, about 9.6 million nonelderly adults would gain Medicaid eligibility by 2014. Furthermore, the federal and state expenditures are less than Medicaid's positive impact on the economy amounting in a return of three dollars in new business activities for every dollar of state Medicaid investment. Because Medicaid is designed …

Using Primary Care To Bend The Curve: Estimating The Impact Of A Health Center Expansion On Health Care Costs, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief, the third in a series examining the link between national health reform proposals and community health centers, estimates the cost savings that would be realized by making important investments in non-profit health centers as an element of national health reform. Key findings include:

Increasing health center capacity by another 20 million patients by 2019 (to 39 million patients) under health reform can be expected to generate an additional $35.6 billion savings in 2019 and $212 billion in additional savings over the 2010-2019 ten-year time period.

Were the Medicaid prospective payment rate system to be applied to exchange …

Health Center Data Warehouses: Opportunities And Challenges For Quality Improvement, A. Seiji Hayashi, Emily Jones, David M. Stevens, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This Policy Research Brief reports on a pilot effort to leverage the growing presence of health center data warehouses to advance health care quality improvement through data sharing and exchange. This project builds on a partnership between the Michigan Primary Care Association and The George Washington University's Geiger Gibson/RCHN Community Health Foundation Research Collaborative that centers on developing approaches to using existing health center data for quality improvement.

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 …

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 …

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 …

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 …

To Vaccinate, Or Not? Health Care Providers And The Hpv Controversy, Nicole Elizabeth Hanbury

Honors Scholar Theses

Gardasil® – the vaccine was first thought to be a medical breakthrough in the fight against cancer, but it quickly became plagued with controversy. Despite wide media coverage, little attention has been paid to today’s health care professionals who are ultimately responsible for prescribing the vaccine, and who may be the most knowledgeable about it. The present study seeks to expand on previous literature by investigating health care providers’ current beliefs and practices with the human papillomavirus (HPV) immunization. It is essential that more recent research be performed in order to encompass current views of the vaccine, post FDA-approval.

Data …

Examining The Experiences Of Puerto Rico's Community Health Centers Under The Government Health Insurance Plan, A. Seiji Hayashi, Brad Finnegan, Peter Shin, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief examines the experiences of Puerto Rico's community health centers under the Commonwealth’s 1994 Government Health Insurance Plan (GHIP) – the Commonwealth's Medicaid program – also known as the Reforma. Of particular interest are the effects of Medicaid under-financing coupled with health centers' continuing obligations to furnish subsidized care for uninsured patients. To finance GHIP, the Commonwealth substantially curtailed its involvement with the direct provision of health care in both community and inpatient settings, transforming the former system of direct care provision into health insurance premium subsidies.

In 2007, the 47 operating sites of Puerto Rico's 19 federally …

Implications For Child Welfare Teaching And Human Services Personnel Perspectives Experiences Of Children With Special Needs, Sarah Huesmann

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

College Of Health And Human Services International Service Learning Program: Gales Point, Belize, Jordan Norris, Carrierobin Menapace

Impact Belize

No abstract provided.

Eligibility, Recruitment, And Retention Of African Americans With Severe Mental Illness In Community Research, Michelle Hampton, Mary White, Linda Chafetz

Faculty Publications

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

Constructions Of Disease In Mayo Village, Rachel Eades

Independent Study Project (ISP) Collection

Understanding how individuals and institutions negotiate illness and construct ideas about disease is important to public health efforts across the globe. Countries in sub-Saharan Africa suffer from a variety of health problems that many regions of the world have long since eradicated. Economic hardship, combined with high rates of communicable diseases, food poverty, lack of sanitation, and poor water quality make countries in sub-Saharan Africa some of the poorest and sickest in the world. Tanzania is a prime example. The purpose of this study was to explore how people in one rural, Tanzanian village construct ideas about disease – its …

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith M. Williams, Carlos J. Crespo, Joan Dorn

Community Health Faculty Publications and Presentations

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Tuberculosis Por Los Ojos De La Vida Aymara: La Correlación Entre Estilo De Vida Y Tuberculosis En Los Aymara Del Norte De Chile, Sam Percy

Independent Study Project (ISP) Collection

Background: Explanations for disparities in health between groups of people are complex, and based in differences in genetics, environment, access to medical care, socioeconomic, educational, and cultural factors. In short a person’s lifestyle is inextricably related to a person’s health and their propensity to contract disease. Members of the indigenous group Aymara who live in Arica, Chile have 6 times the rate of morbidity from Tuberculosis (TB) as non-Aymara and 9 times the rate of mortality from the disease. This study examined if there was a link between the rate of TB amongst the Aymaran people and the way Aymarans …

Restoring Medicaid And Schip Coverage To Legal Immigrant Children And Pregnant Women: Implications For Community Health And Health Care For Tomorrow's Citizens, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In the coming weeks, Congress will consider the reauthorization of the State Children's Health Insurance Program (SCHIP), whose legislative authorization will expire on March 31, 2009. SCHIP's overarching goal, in tandem with Medicaid, is to assure coverage of low-income children, regardless of race or national origin. As the proportion of uninsured immigrant children grows, a crucial question is whether the SCHIP reauthorization will address the need to restore eligibility for legal immigrant children and pregnant women. Although SCHIP and Medicaid have been successful in improving health insurance coverage for most low-income American children since the mid-1990s, the health coverage gaps …

A Pilot Study Of A Brief Smoking Cessation Intervention At The Student Health Center., Theodore Cooper, Jennifer Venegas, Denise Rodriguez De Ybarra, Thom Taylor, Jasjit Ahluwalia

Selected Works Temporary Series

No abstract provided.

Characteristics Associated With Smoking In A Hispanic Sample., D. Rodriguez Esquivel, Theodore Cooper, J. Blow, M. Resor

Selected Works Temporary Series

No abstract provided.

Assessing A Smoking Cessation Program For Veterans In Substance Use Disorder Treatment., Theodore Cooper, Y. Hunt, R. Burke, C. Stoever

Selected Works Temporary Series

No abstract provided.

Differences Between Intermittent And Light Daily Smokers In A Population Of U.S Military Recruits, Theodore Cooper, Thom Taylor, Ashley Murray, Margaret Debon, Mark Vander Weg, Robert Klesges, G. Wayne Talcott

Selected Works Temporary Series

No abstract provided.

Potential Demographic And Cultural Predictors Of Heavy Episodic Drinking In Hispanic College Students., Theodore Cooper, Jennifer Venegas, Natahsa Naylor, Brenda Hanson

Selected Works Temporary Series

No abstract provided.

Obesity-Relevant Behaviors: Patterns And Correlates In A Hispanic College Sample., D. Hu, T. Taylor, Theodore Cooper

Selected Works Temporary Series

No abstract provided.

Club Drug Use In Hispanic College Students, Michelle Resor, Theodore Cooper

Selected Works Temporary Series

No abstract provided.

Predictors Of Amount Smoked Per Day In Light Smoking College Students: A 7 Day Diary Assessment., Thom Taylor, Theodore Cooper

Selected Works Temporary Series

No abstract provided.

Occupational Health And Safety Status Of Indigenous And Latino Farmworkers In Oregon, Stephanie Farquhar, Nancy M. Goff, Nargess Shadbeh, Julie Samples, Santiago Ventura, Valentin Sanchez, Pamela Rao, Shelley Davis

Community Health Faculty Publications and Presentations

Exposure to pesticides poses great risk to agricultural workers and their families. Of the approximately 174,000 agricultural workers in Oregon, studies estimate that up to 40% of the workers in Oregon are indigenous and may be particularly vulnerable to the health risks of working in pesticide treated areas. Surveys conducted with Oregon farmworkers suggest that Latino and indigenous farmworkers differ demographically and may have diverse occupational and health needs. All Latino workers reported Spanish as their native language, while indigenous workers spoke several different native languages. Latino workers were employed mostly in orchards (28%) and nurseries (24%), while indigenous workers …

Ua12/4 Stall Street Journal, Vol. 1, Wku Health Services

WKU Administration Documents

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

Affective Decision-Making Predictive Of Chinese Adolescent Drinking Behaviors, Lin Xiao, Antoine Bechara, Jerry L. Grenard, Alan W. Stacy, Paula Palmer, Yonglan Wei, Yong Jia, Xiaolu Fu, C. Anderson Johnson

CGU Faculty Publications and Research

The goal of the current investigation was to address whether affective decision making would serve as a unique neuropsychological marker to predict drinking behaviors among adolescents. We conducted a longitudinal study of 181 Chinese adolescents in Chengdu city, China. In their 10th grade (ages 15–16), these adolescents were tested for their affective decision-making ability using the Iowa Gambling Task (IGT) and working memory capacity using the Self-Ordered Pointing Test. Self-report questionnaires were used to assess academic performance and drinking behaviors. At 1-year follow-up, questionnaires were completed to assess drinking behaviors, and the UPPS Impulsive Behavior Scale was used to examine …