Social and Behavioral Sciences Commons^™

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Estimating Scale And Scope Effects In Public Health Delivery: Implications For Regionalization, Glen P. Mays, Rachel A. Hogg, Rick Ingram, Kristina Rabarison

Health Management and Policy Presentations

OBJECTIVES: The nation's public health delivery system comprises nearly 3000 local public health agencies that vary widely in capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources to enhance delivery and improve population health.

METHODS: A longitudinal cohort design is used to analyze changes in the availability and perceived effectiveness of services delivered by local public health providers. A stratified random sample of the nation's 3000 local public health agencies (n=497) were surveyed in 1998 and again in 2006 and 2011 (70% response) to measure the availability of 20 …

Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.

Sensemaking In The Shadow Of A Superfund Site: Defining Atsdr Roles And Goals In An Agency-Saturated Community, Anna G. Hoover, Lindell Ormsbee, Stephanie W. Jenkins, Ashley M. Bush

Anna G. Hoover

By working directly in Superfund communities, the Agency for Toxic Substances and Disease Registry is embedded within a complex tapestry of federal and state agencies, local government entities, and other organizations that community stakeholders encounter regularly. The diversity of statutory obligations and expertise among these organizations, particularly as they relate to stakeholders’ health concerns, presents challenges for creating shared understanding between agencies and the communities they serve. Thus, addressing key elements of individual sensemaking during engagement activities is essential for those who work in communities.

Because sensemaking helps individuals determine the seriousness of a situation, decide how to react to …

Socioeconomic Challenges Of Patients With Clinical Blindness In Rural China, Yuen Aimee Chan

Kaleidoscope

Clinical blindness of 20/200 vision or greater in both eyes is rampant throughout Africa. Remarkably, most of these cases are either curable or preventable. There are 45 million blind people in the world and those who live in sub-Saharan Africa have a mortality rate four times higher than other areas worldwide [1]. Unite For Sight (UFS) is a non-profit organization that promotes eye health and reduce preventable blindness in communities worldwide. UFS has assisted over 1,000,000 patients and has provided 32,000 sight-restoring surgeries free of charge [2]. An opportunity for combination of volunteer work with research will contribute to this …

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Health Management and Policy Presentations

This presentation describes recent progress and new directions for estimating the value of public health strategies and infrastructure.

Quantifying The Value Of Public Health Investments, Glen P. Mays

Health Management and Policy Presentations

This session reviews recent findings from a series of studies that estimate the health and economic effects attributable to investments in public health services and delivery systems.

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Consequently, HHS recently used a consensus-based process to develop a framework for improving quality in public health and to identify a set of nine priority areas for improvement. As next steps in operationalizing this framework, measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. This presentation profiles the methodology developed …

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Scale And Scope Effects In Public Health Delivery: Estimating Gains From Regionalization, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Current approaches to health system reform under the Affordable Care Act include efforts to enhance the delivery of public health services that promote health and prevent disease and injury on a population-wide basis. The nation’s public health delivery system comprises nearly 3000 local public health agencies that vary widely in size, resources, and capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources and expertise across local jurisdictions to enhance delivery and improve population health. This analysis uses longitudinal observations on a national sample of local public health agencies …

Expanding The Evidence Base For Accreditation And Qi: Progress In Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Studies that examine the implementation and impact of quality improvement strategies in public health are underway through the Public Health Practice-Based Research Networks.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

Investing In A Healthier Future: Iom Dissemination Workshop, Glen P. Mays

Health Management and Policy Presentations

This session discusses strategies for implementing new financing strategies and funding mechanisms for public health services.

Patterns Of Interaction In Public Health Research Networks: Insight From Network Analysis, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Studies from the past three decades have found evidence of wide variation in public health practices and policies across states and communities despite an expanding evidence base of efficacious public health strategies, suggesting gaps in implementation and translation processes. Practice-based research networks (PBRNs) are expected to accelerate research participation and translation. This study uses social network analysis methods with twelve Public Health PBRNs to study processes influencing the implementation and translation of research within diverse public health settings.

DATA and METHODS: A cross-sectional network analysis survey was validated and fielded with participants in two cohorts of public health PBRNs …

Public Health Governance And Population Health Outcomes, Scott P. Hays, Janine Toth, Matthew J. Poes, Peter F. Mulhall, David M. Remmert, Thomas W. O'Rourke

Frontiers in Public Health Services and Systems Research

Research reviews have identified a gap in understanding the diversity of health department governance structures and in understanding how the variations in governing relates to health outcomes. This report details the categorization of local public health governance and reveals that certain governance types may be better suited to achieve better population health outcomes. State systems achieve the poorest health outcomes, but the best health outcomes are achieved when the political branches have a key role in local public health governance. Public health systems should consider greater local control and involvement in governance; but local governance should include the political branches …

Using State And Local Health Survey Data To Advance Phssr, Glen P. Mays

Health Management and Policy Presentations

State and local health survey data can be used to evaluate the implementation and impact of public health delivery innovations in real-world practice settings.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

Uncertainty about the magnitude and timing of economic returns associated with spending on public health services has contributed to policy debates about the optimal role of the federal government in financing these services.

Public Health Spending, Preventable Outcomes, And Medical Cost Offsets: Questions For Health Reform, Glen P. Mays

Health Management and Policy Presentations

Uncertainty continues to surround the health and economic effects that can be expected from increased federal spending on public health and prevention strategies. Recent research provides some insight into the question of whether spending on public health strategies can offset the need for future spending on medical care.

Privatization And Performance In The Implementation Of Temporary Assistance To Needy Families, Adam Michael Butz

Theses and Dissertations--Political Science

In response to the passage of the Personal Responsibility Work Opportunity Reconciliation Act (PRWORA) and its lead cash assistance program Temporary Assistance to Needy Families (TANF), states have taken unique and divergent approaches to welfare policy implementation. One popular approach to workfare delivery, known as privatization, involves contracting with non-profit and for-profit entities operating within the private sector. The General Accounting Office reports that nearly every state is privatizing TANF services to some degree through third-party contracts, but very little is understood about why variation in contracting exists and the ramifications for the program outcomes of welfare recipients. This dissertation …

Fuel Price, State Taxation, And Fleet Mileage Reduction, Kris Harmon

MPA/MPP/MPFM Capstone Projects

This paper utilizes several models to gauge the annual impact of state gasoline taxes and pump prices on the vehicle miles traveled in the United States. Regression models in first differences were used to analyze annual changes in the variables. The models indicate that annual increases in pump prices correspond to significant decreases in mileage, while state fuel taxes do not significantly impact mileage. With local, state, and federal taxation only composing 12 percent of the pump price of fuel, the impact of changes to these taxes are diminished. This suggests that if policymakers choose to adopt a policy of …

Can Drug Court Results Be Predicted? Completion And Termination Of Drug Court Participants, Christopher D. Geisler

MPA/MPP/MPFM Capstone Projects

The substantial growth in Kentucky’s prison population since the 1980s has resulted in increased spending on corrections, both the total amount and as a percentage of total general fund spending. The sustained growth in corrections spending combined with shrinking budgetary realities has created an incentive to explore ways to reduce costs without compromising public safety. Community supervision programs are one alternative to addressing this problem. They are an attractive approach to dealing with certain types of criminals because the cost is significantly lower than incarceration. Drug courts are an example of community supervision that allows drug offenders to avoid imprisonment …

Adequate Yearly Progress And Dropouts: An Analysis Of Kentucky High Schools & Districts, Michelle Schardein

MPA/MPP/MPFM Capstone Projects

Education accountability measures, especially since the passage of No Child Left Behind, have been assessed for a variety of factors in empirical research. A large portion of this literature finds that overall, accountability measures increase performance, but also increase the achievement gap. These findings have inspired this research to examine what other marginal groups of students have been affected by the unintended reaction to the consequence-based incentives found in minimum competency accountability programs, such as No Child Left Behind.

In particular, this research looks at how the changes in a high school or school district’s Adequate Yearly Progress marks affect …

Voter Ideology, Tax Exporting, And State And Local Tax Structure, John M. Foster

Theses and Dissertations--Public Policy and Administration

State and local governments play an important role in financing and delivering public services in the United States. In 2008, state and local governments collected 57 percent of total federal, state, and local revenue (Urban Institute and Brookings Institution, Tax Policy Center, 2009). The decentralization of fiscal responsibility has enabled a high degree of variation in state and local tax structures to emerge. This dissertation presents two empirical studies that extend the positive literature on state and local tax policy.

The extant literature contains evidence of a direct relationship between voter ideology and state and local tax progressivity. However, the …

Characteristics Of Kentucky Agricultural Operations Participating In Nrcs Conservation Programs, Carmen T. Agouridis

MPA/MPP/MPFM Capstone Projects

The Natural Resource Conservation Service (NRCS) designs and promotes a wide variety of conservation practices and programs that enhance the environment by reducing soil erosion, improving water quality, and enhancing and creating wildlife habitat. The impact of these practices and programs is largely dependent on the voluntary participation of landowners. Thus, central to the success of the NRCS conservation programs is an understanding of the characteristics of landowners and operations participating in these programs.

Using operator and operation characteristics from the 1997, 2002, and 2007 Censuses of Agriculture and controlling for county fixed effects, this study 1) identifies significant characteristics …

Analyzing The Retroreflectivity Mandate, Karyn L. Leverenz

MPA/MPP/MPFM Capstone Projects

The purpose of this analysis is to examine the costs and benefits of the federal mandate that requires local agencies to assess, replace and maintain the retroreflectivity of all traffic signs that are on a public road as outlined in 23 Code of Federal Regulations (CFR), Part 655, Subpart F (FHWA, 2011). It is also a requirement that all signs be inventoried along with their GPS locations for easier maintenance in the future.

Sign retroreflectivity maintenance is important because crash rates at night are much higher than they are during the day despite there being fewer cars on the road. …

An Analysis Of Regularizations Of Undocumented Residents In Spain And The Underground Economy: Insight For United States Policy Makers, Jon R. Davis

MPA/MPP/MPFM Capstone Projects

There were an estimated 11 million undocumented residents in the United States in 2010. The issue of undocumented migration and how it should be addressed is a contentious topic in the United States. However, the discussions about how to address illegal migration into the United States rarely include any comparisons to other measures that have been taken in other countries. There are many countries, such as Spain, that have large undocumented resident populations.

This analysis looks at policies that have been enacted in Spain since 1985 to enable undocumented residents to receive legal resident status, referred to as regularizations and …

Policy Outcomes In Indonesia Before And After Democratization, Aung Kyaw Phyo

MPA/MPP/MPFM Capstone Projects

Different types of regimes face different political situations and have different incentives to pursue different policies. In this paper, I am examining whether there are any differences in economic and social policy outcomes under democracy and dictatorship in Indonesia. The study is divided into two periods. The first period covers the authoritarian rule of President Suharto(1966 to 1998) and the second period covers the new democratic government(1999 to 2010). I set out by analyzing the rules used in distinguishing democracy from dictatorship and discussing the process by which Suharto's regime was categorized as a dictatorship and the Indonesian government after …