Social and Behavioral Sciences Commons^™

Nonprofit Hospital Community Benefit Requirements: An Exploration Of National Health Policy Models, Justin P. Swearingen

Dissertations and Theses

Introduction: Nonprofit hospital organizations are public charities with complete tax immunity. Such exemptions are worth $24.6 billion and impact the health of hundreds of millions of people, yet what these charities must do to meet the current “community benefit standard” to maintain their tax-exempt status remains a policy debate. To help inform policymaking, an evaluation of four national requirement models was performed: Tax Value Requirement (at least the value of the tax exemptions must be spent on community benefit), Grassley Requirement (at least 5% of revenue must be spent on community benefit), Expense Requirement (at least 3% of expenses must …

Patients And Nurses And Doctors Oh My!: Nurse Retention From A Multi-Foci Aggression Perspective, Kevin Oliver Novak

Dissertations and Theses

Attrition is a serious issue in the nursing industry. One factor influencing rates of attrition in nursing is aggression victimization at work (Estryn-Behar et al., 2010). However, there is little research in the aggression literature that examines how aggression from different sources affects attrition (both job and career turnover) differently. This study attempts to better understand the linkages between aggression victimization and nursing attrition; specifically how aggression from different sources (i.e. patients/patients’ families, coworkers, and licensed independent practitioners) differentially affects retention factors (i.e. job satisfaction, turnover intentions, and career commitment). This study also attempts to understand the role that prosocial …

Socioeconomic Determinants Of Health Disparities By Race And Ethnicity: The Mediating Role Of Social, Psychological And Behavioral Factors, Amanuel Zimam Melekin

Dissertations and Theses

Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by which SES may influence health status are not widely studied.

Using the Health and Retirement Study (HRS) data, this dissertation examined the pathways by which SES, via social, psychological, and behavioral factors predicted physical impairment and overnight hospitalization, and asked whether these indirect relationships differed by race/ethnicity. The HRS is a nationally representative multistage area probability sample administered biennially to respondents over the age of 51 and their spouses. Data …

Exploring The Health Effects Of Precarious Employment By Sex/Gender Using Mixed Methods, Kathleen Flandrick

Dissertations and Theses

Employment in the United States has changed dramatically since the mid-1970s. Labor market forces like globalization and diversification of the American workforce have led to a heavily segmented labor market where new types of flexible employment such as temporary, contingent, and nonstandard work arrangements are increasingly common. These newer types of work are often on the lower end of the precarious employment continuum, categorizing jobs by their degree of: 1) temporariness, 2) disempowerment, 3) vulnerability, 4) compensation (wages), 5) rights, and 6) ability to exercise worker rights. The increase in precarious employment likely disproportionately affects women when compared to men, …

The New York City Childcare Influenza Vaccine Mandate: A Case Study, Amy E. Metroka

Dissertations and Theses

Background. In 2014, New York City (NYC) became the third jurisdiction in the United States (US) to enact a childcare influenza vaccine mandate, after the states of New Jersey and Connecticut. The mandate was enacted by the NYC Board of Health by amending the NYC Health Code. The mandate’s goal was to increase vaccination rates among 6-59-month-olds attending city-regulated public and private childcare programs, including prekindergarten, to protect children, families, and the community against influenza. Children younger than 5 years are at high risk for severe illness and complications from influenza. Children are also known to be a major source …

Rural Interprofessional Health Care Education: A Study Of Student Perspectives, Curt Carlton Stilp

Dissertations and Theses

As the cost for health care delivery increases, so does the demand for access to care. However, individuals in a rural community often do not have access to the care they need. Shortages of rural health care professionals are an ever-increasing problem. The Affordable Care Act of 2010 sought to increase health care access by focusing on team-based care delivery. Thus, the need to educate health care students in the fundamentals of team-based practice has led to an increased emphasis on Interprofessional Education (IPE). While past research focused on urban IPE, a literature gap exists for the effects of a …

The Role Of Socioeconomic Context In The Association Between Educational Attainment And Morbidity And Mortality, Jennifer Brite

Dissertations and Theses

Although the association between educational attainment and health is one of the most studied in the social science, little is known about the role of social and economic context. Fundamental Cause Theory suggests that the education-health gradient will be weakest in contexts where the better educated are unable to leverage their resources to achieve better health. This dissertation tests several different factors that may moderate the association between educational attainment and morbidity and mortality: 1. Demographic characteristics, including race, immigration status, and gender, 2. Status consistency (defined as education equivalent to that required for current occupation), 3. Unemployment rates at …

Transitional Healthcare Coordination In New York City Jails Among People With Chronic Health Conditions: Contributions To Reduced Reincarceration And Improved Health, Janet J. Wiersema

Dissertations and Theses

People in correctional settings often have poorer health than the general US population. For example, it is estimated that 27.9% of persons in jail have hypertension, 8.1% have diabetes, and 1.6% have HIV, compared to 25.6%, 6.5%, and 0.5%, respectively, in the general population. Jail and other correctional settings are also increasingly recognized as viable places to engage poor and underserved communities into the healthcare system by offering transitional care coordination services to connect people to healthcare and other services to meet priorities after incarceration. At the same time, recidivism is an issue—over 50% of persons in New York City …

Incorporating Place And Space: A Hierarchical Spatial Approach To Exploring Preventable Congestive Heart Failure Hospitalizations In New York City, Rachael Weiss Riley

Dissertations and Theses

Background: Faced with rising medical care costs, increasing prevalence, and widening health disparities, preventing congestive heart failure (CHF) hospitalizations is a central public health concern. Despite evidence of geographical clustering in preventable CHF admissions, there is a lack of research designed to examine spatial patterning of CHF and the local area neighborhood determinants that contribute to this variability. This study sought to assess and evaluate the importance of both space and place in analyzing preventable CHF hospitalizations and readmissions by applying appropriate statistical techniques, clarifying the assumption inherent in each method, and interpreting the findings within the context of existing …

From Food To Food Justice: Pathways And Narratives Of Young Food Activists In New York City, Amy Kwan

Dissertations and Theses

With a rise in obesity and other non-communicable, diet-related health problems and the persistence of food insecurity among many vulnerable populations, the involvement of young people in the current, burgeoning food-justice movement has the potential to bring forth transformative changes to our food system and thus improve population health. While much is known about the outcomes of providing opportunities for young people to be actively and civically engaged in their communities, there is a lack of research on the pathways, narratives, and experiences that bring young people into food justice activism.

Through semi-structured, in-depth interviews with 25 young food activists …