Social and Behavioral Sciences Commons^™

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

Introduction To Special Topic: Rural Education Finance And Policy, Christiana Stoddard, Eugenia F. Toma

Public Policy and Administration Faculty Publications

This special topic takes stock of the current state of rural education finance and policy research. Taken together the articles in this special topic highlight a major point. Rural districts and schools not only differ from those in urban areas but also differ from one another. This is perhaps not surprising given the heterogeneity of school size, community size, demographics, and the degree of rurality of schools across the United States. The articles pose a challenge for policymakers. Policies that serve one state or one rural community may not be relevant or helpful to another. Policy solutions must recognize the …

Strategic Educational Leadership Within The Policy-Making Arena: The Promulgation, Passage, And Practice Of Tennessee's High Performing School Districts Flexibility Act Of 2013, Robert Lawrence Hullett Jr.

Theses and Dissertations--Education Sciences

In 2010, Tennessee’s 106th General Assembly passed the First to the Top Act (2010), a companion legislation for the federal Race to the Top Act (2009) program launched by the Obama Administration. A provision of this state law required that half of teacher and principal evaluations be based upon student achievement, which included a component of required continuous academic growth. For school districts whose students scored at the highest academic performance levels, the continuous growth component would negatively impact their teachers’ and principals’ annual evaluations. In 2012, the Williamson County Schools (WCS) superintendent requested mitigation for relieve from the Tennessee …

“We’Re, Like, The Most Unhealthy People In The Country”: Employing An Equity Lens To Reduce Barriers To Healthy Food Access In Rural Appalachia, Kathryn Cardarelli, Emily M. Dewitt, Rachel Gillespie, Heather Norman-Burgdolf, Natalie Jones, Janet Tietyen Mullins

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity disproportionately affects rural communities, and Appalachia has some of the highest obesity rates in the nation. Successful policy, systems, and environmental (PSE) interventions to reduce obesity must reflect the circumstances of the population. We used a health equity lens to identify barriers and facilitators for healthy food access in Martin County, Kentucky, to design interventions responsive to social, cultural, and historical contexts.

Methods

We conducted 5 focus groups in Martin County, Kentucky, in fall 2019 to obtain perspectives on the local food system and gauge acceptability of PSE interventions. We used grounded theory to identify perceived barriers and …

Access To Autism Spectrum Disorder Services For Rural Appalachian Citizens, Angela Scarpa, Laura S. Jensen, Denis Gracanin, Sharon L. Ramey, Angela V. Dahiya, L. Maria Ingram, Jordan Albright, Alyssa J. Gatto, Jen P. Scott, Lisa Ruble

Journal of Appalachian Health

Background: Low-resource rural communities face significant challenges regarding availability and adequacy of evidence-based services.

Purposes: With respect to accessing evidence-based services for Autism Spectrum Disorder (ASD), this brief report summarizes needs of rural citizens in the South-Central Appalachian region, an area notable for persistent health disparities.

Methods: A mixed-methods approach was used to collect quantitative and qualitative data during focus groups with 33 service providers and 15 caregivers of children with ASD in rural southwest Virginia.

Results: Results supported the barriers of availability and affordability of ASD services in this region, especially relating to the need for more ASD-trained providers, …

Examining The Effects Of Public Policies And Addiction On Purchase Of Tobacco Products With Causal Inference And Machine Learning Methods, Xueting Deng

Theses and Dissertations--Agricultural Economics

My three essays explore the effects of tobacco policies and addiction on the consumption of e-cigarettes and other tobacco products. Recently, jurisdictions imposed taxes and other regulations on e-cigarettes, with the hope to raise tax revenues and address health concerns regarding e-cigarette use, especially youth addiction. My first essay in Chapter 1 focuses on the effects of e-cigarette taxes on sales of e-cigarettes. It compares the two types of tax policies on sales of e-cigarettes, cigarettes, and smoking-cessation products. This comparison provides information for lawmakers on decisions of taxes regarding the perspectives of revenue generation and tobacco control. Second, after …

Understanding Haitian Women’S Health Care In Immokalee, Florida, Usa, Michele Leigh Flippo Bolduc

Theses and Dissertations--Geography

This social science research project takes a critical approach to understanding the health of a population by using the health care system as an entry point through which we can see how large-scale social processes produce a particular health care landscape in the rural, im/migrant farmworker community of Immokalee, Florida, USA. Using a multi-scalar analysis of health care, I investigate how anti-immigrant legislation and neoliberal economics influence the experience of health care for health care providers and Haitian im/migrant women navigating these processes. First, I argue that anti-immigrant and pro-market discourses have been successful in limiting the accessibility to health …

A Multidimensional Poverty Index For The United States, Nate Kratzer

Theses and Dissertations--Public Policy and Administration

A multidimensional poverty index for the United States is designed, evaluated, and defended as a useful measurement tool for policymakers to evaluate poverty. Chapter 1 presents a normative case for the index. Chapter 2 reviews the literature on poverty measures. Chapter 3 constructs the proposed index. Chapter 4 is a statistical examination of the internal structure of the index. Chapter 5 explores the index across states, over time, and among population subgroups, as well as presenting policy applications.

Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves

Nursing Faculty Publications

Background: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada.

Methods: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies.

Results: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban’s …

Policymakers Identify Priorities For Phssr, Katherine Froeb Papa

Frontiers in Public Health Services and Systems Research

A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund.

In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes the evidence gaps identified, and provides strategies for communicating with decision makers.

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Health Management and Policy Presentations

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Commentary: Moving Beyond The Numbers, Effectively Using Research To Influence Policy, F. Douglas Scutchfield, Marylou Wallace

Frontiers in Public Health Services and Systems Research

This seventh issue of Frontiers reflects the variety of PHSSR. One emerging theme, however, is the notion of public health and its role in policy and policy development. PHSSR focuses on several potential users, researchers, practitioners and policy makers. As it concerns policy makers, PHSSR delivers research that allows them to make decisions about policy change that not only influences public health status, but creates healthy conditions. In this way, PHSSR essentially influences decisions about support for public health services.

Why Are So Many Americans On Food Stamps? The Role Of The Economy, Policy, And Demographics, James P. Ziliak

University of Kentucky Center for Poverty Research Discussion Paper Series

1 in 7 Americans received assistance from SNAP in FY2012, which is a rate 141 percent higher than in FY2000, but only 59 percent higher than in FY1980. In this chapter I describe the socioeconomic and policy climate in recent decades that had bearing on SNAP participation, along with a formal empirical analysis of those determinants and detailed simulations of the relative contributions of the economy, policy, and demographics to changes in SNAP participation over time. The results suggest that SNAP is operating effectively as an automatic fiscal stabilizer—nearly 50 percent of the increase in participation from 2007-2011 is due …

Diffusion Of Innovation Across A National Local Health Department Network: A Simulation Approach To Policy Development Using Agent-Based Modeling, Mark Orr, Jacqueline Merrill

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues is sparsely connected, which may limit the spread of innovative practices. We used agent-based simulation modeling to find out if a policy to promote more connections improved the network’s capability to diffuse innovation. We found that unanticipated effects could result, depending on the requirements of the policy and the proportion of health officials involved. With carefully crafted assumptions and reliable data it is possible to untangle complex processes using simulation modeling. The results represent how the world might actually work which may provide useful decision support for policymakers …

Health System Contributions To Public Health Activities Amid Policy And Economic Change: Estimating Complementarities, Substitutions, And Network Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created new incentives for hospitals, insurers, employers, public health agencies, and others to contribute to activities designed to promote health and prevent disease an injury, potentially changing the structure of public health delivery systems and expanding the delivery of strategies that improve population health. At the same time, the economic recession has constrained government and private sector spending on health and health care, necessitating changes in the scope and scale of public health delivery. This study uses data from the 1998-2012 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and …

Addressing Health Inequalities In The United States: Key Data Trends And Policy Action, Sara N. Bleich, Marian P. Jarlenski, Caryn N. Bell, Thomas A. Laveist

Frontiers in Public Health Services and Systems Research

Health inequalities, which have been well documented for decades, have recently become policy targets in the United States. This report summarizes current patterns and trends in health inequalities, commitments to reduce health inequalities, and progress made to eliminate health inequalities. Time trend data indicate improvements in health status and major risk factors but increases in morbidity, with black and lower-education individuals experiencing a disproportionate burden of disease. A common policy response has been priority setting in the form of national objectives or goals to address health inequalities. More research and better methods are needed to precisely measure relationships between stated …

"Courting" Time: Assessing The Policy And Planning Issues Related To Adoption Of Case Processing Standards In The Kentucky Judicial System, John B. Dobson

MPA/MPP/MPFM Capstone Projects

No executive summary.

Does Race Based Redistricting Matter For Policy?, Ebonya Washington

University of Kentucky Center for Poverty Research Discussion Paper Series

During the 1990 congressional redistricting many states were mandated to create additional majority minority-resident districts in order to elect more minorities to Congress. Civil rights groups and Republicans cheered. The Party views Democratic districts stripped of Black voters as opportunities to repaint blue districts red. The academic literature agrees, attributing the Republican return to House control in 1994 to race based redistricting. However, this literature generally focuses on the district as the unit of analysis, a focus that is too narrow, as some districts gain Black residents while others lose them. I focus on states, the level at which redistricting …

School Lunch Programs And The American Diet: Exploring A Contested Food Terrain, Rebecca Som Castellano

University of Kentucky Master's Theses

This study examines the social actors and issues involved in constructing and contesting the National School Lunch Program (NSLP), in order to identify whose interests are involved in shaping an institution which transmits dietary habits and food knowledge to the nation’s children through the mid day meal.

For the historical analysis, I collected data from historical accounts of the NSLP, congressional hearings, laws, and newspaper articles. For the contemporary analysis, I interviewed 15 actors representing organizations key to federal NLSP policy making. To frame my analysis, I utilize a model of power, based on the work of Arts and Van …