Social and Behavioral Sciences Commons^™

Exploring The Process, Models, And Outcomes Of Hospital-Public Health Partnerships, Danielle M. Varda, Jessica H. Retrum, Carrie Chapman

Frontiers in Public Health Services and Systems Research

Health care reform has resulted in changes throughout the health system, including the Affordable Care Act (ACA) requirement that hospitals conduct community health needs assessments, taking into greater consideration the public health of their respective communities. This has led to growing strategies to develop partnerships between hospitals and public health (PH) as a way to meet these needs¹. Meantime, there is a need for data on Hospital-PH partnerships, due to the growing emphasis that these types of partnerships get implemented in practice. In this paper we analyze a secondary data set to explore how hospitals and public health …

Listening To The Ranks: Perceptions Of The U.S. Air Force Occupational Health And Safety Training, Melissa Jo Breunig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational health and safety hazards are abundant in military environments. Due to the hazardous occupational settings, injuries remain a public health concern in the United States military. Public health plays a critical role in injury reduction by addressing the need for comprehensive safety education training, and more specifically, exposure related injuries. A secondary data analysis was completed using Communication Theory as the overarching framework to analyze 13 qualitative interviews conducted with Airmen to gain their perceptions of the occupational health and safety training at Nellis and Creech Air Force Base (AFB). Pedagogy and training content were the two main themes …

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, 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. 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. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …

Black Infant Deaths Point To Flaw In U.S. Health Care System, Vanessa Lopez-Littleton

UCF Forum

In a recent interview on The Daily Show, TV host Jon Stewart asked Fox political commentator Bill O’Reilly: “Does white privilege exist?” O’Reilly denied the existence of white privilege but conceded that as a collective, blacks carry more of a burden than whites.

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Health Management and Policy Presentations

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

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.

Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.

Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.

A Meta-Analysis Of The Prediction Of Violence Among Adults With Mental Disorders, Hing Po Lam

Dissertations, Theses, and Capstone Projects

The study of the risk for violence among persons with mental disorders has received substantial scientific attention over the past few decades; however, many uncertainties and controversies remain due to the wide disparities in the reported results. Using the state-of-the-art perspective of public health, a meta-analysis was conducted to clarify the ambiguities by synthesizing quantitative findings from 85 research reports (completed between January 1970 and May 2010) on violence risk assessment among mentally disordered adults. Results of this meta-analytic study revealed that the estimates of the prevalence of violence among the psychiatric population varied considerably from 1.1% to 78.4% with …

Using The Minority Stress Model To Understand Depression In Lesbian, Gay, Bisexual, And Transgender Individuals In Nebraska, Molly Mccarthy, Christopher M. Fisher, Jay A. Irwin, Jason D. Coleman, Aja D. Kneip Pelster

Sociology and Anthropology Faculty Publications

Previous studies demonstrated the utility of the minority stress model in understanding health disparities for lesbian, gay, bisexual, and transgender (LGBT) populations. Since most research has considered large metropolitan areas, predominantly in coastal regions of the United States, this research focuses on a midwestern state, Nebraska. This study sought to assess the relationships between depressive symptoms experienced by participants (N = 770) and minority stress variables, including experiences with violence, perceptions of discrimination, and respondents’ degree of self-acceptance of their LGBT identity. Regression analysis revealed that after controlling for demographic variables, self-acceptance, and perceived discrimination were correlated with depressive symptoms. …

Conversations With The Community: An Ethnography Of Two Case Studies Highlighting Community-Research Partnerships In Springfield, Ma, Vanessa Martinez

Doctoral Dissertations

This dissertation is both qualitative and collaborative. It emphasizes the participant observation and ethnographic documentation of two community-researcher partnerships on community-level health interventions in Springfield, MA. Drawing upon critical theories and reflexive methods, I explore and analyze the process of building and sustaining researcher-community partnerships in an era of limited funding. Two Springfield, MA-based projects – one on healthy cooking/eating, and the other on contingency management – serve as case studies to provide a concrete picture of the complex relationships of researcher-community collaborations. I use ethnographic storytelling to provide a multi-dimensional look at two different community-research partnerships on health disparities …

At Risk For Ptsd: The Public Health Implications Of Trauma, Madeline Peyton

Master's Projects and Capstones

The fieldwork experience is the summation of six semesters of graduate level public health training. At commencement, students are to be proficient in basic data analysis and epidemiological principles, in how environmental risks impact health, and demonstrate strong program planning, evaluation and leadership skills. Throughout, students are encouraged to focus their academic work on an area of public health that interest them and on a problem that they hope to impact in their professional work. I continued in an area I began as an undergraduate student of medical anthropology and explored the systems that interact to influence mental health of …

Social Actors Fight The Rising Tide Of Hiv In U.S. Southern Poor, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

The greatest number of persons living with HIV in the United States are now living in the South, and they face poorer health outcomes and increased AIDS-related deaths as compared to the rest of the country. The southern United States has a disproportionate share of low-income individuals, with many lacking access to health care and health insurance. Health facilities are also comparatively fewer and more difficult to reach than in other areas of the United States. The impacts of this already poor health infrastructure on low-income people living with HIV in the South can be life-threatening.

This policy brief summarizes …

Public Health Regulation: Convergence, Divergence, And Regulatory Tension: An Asian Perspective, Locknie Hsu

Research Collection Yong Pung How School Of Law

Regulatory issues relating to public health, including regulation of access to medicines and tobacco control have increasingly been the source of tension in recent trade and investment negotiations, treaties and disputes. The ongoing Trans-Pacific Partnership negotiations, which include a number of developing Asian states, are an example that brings some of these issues to the fore and show a divergence of negotiating views.

The intersection between public health regulation and trade and investment treaties has given some Asian states significant pause for thought; it has further led the international system to a critical need to confront the overlap of legal …

Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …

The Reproductive Lives Of Chuukese Women: Transnationalism In Guam And Chuuk, Sarah Ann Smith

USF Tampa Graduate Theses and Dissertations

Chuuk, one state of the Federated States of Micronesia (FSM), experiences significant transnational migration to the United States (U.S.), particularly to the Territory of Guam. This migration is facilitated by the Compact of Free Association (COFA), an agreement with several Micronesian countries previously under U.S. administration that allows for free movement of their citizens into the U.S. Although part of Micronesia, Guam's colonized residents resist an identity connected to rest of Micronesia. With very poor health outcomes, the Chuukese represent a political and social body of bodies that bring sickness, babies and increased costs to the Guam government without adequate …

Oceano Community Health Plan, Eugene Phillip Brennan

Master's Theses

ABSTRACT

Oceano Community Health Plan

Phillip Brennan

Recent, mounting research shows that chronic disease, the leading causes of death and primary driver of health care costs, cannot be effectively addressed through education or preventative health alone. A physical environment that promotes health—through access to healthy food, opportunities for physical activity, quality housing, transportation options, and safe schools—is an integral part of making our communities healthier. This research and accompanying Healthy Community Plans will serve as a way for the County to begin looking in-depth at the ways the built environment (our streets, parks, and neighborhoods) contribute or detract from the …

Reporting Risk, Producing Prejudice How News Reporting On Obesity Shapes Attitudes About Health Risk, Policy, And Prejudice, Abigail C. Saguy, David Frederick, Kjerstin Gruys

Psychology Faculty Articles and Research

News reporting on research studies may influence attitudes about health risk, support for public health policies, or attitudes towards people labeled as unhealthy or at risk for disease. Across five experiments (N = 2123) we examined how different news framings of obesity research influence these attitudes. We exposed participants to either a control condition, a news report on a study portraying obesity as a public health crisis, a news report on a study suggesting that obesity may not be as much of a problem as previously thought, or an article discussing weight-based discrimination. Compared to controls, exposure to the public …

How Will Public Health And Primary Care Come Together In Massachusetts?, Javier Crespo

Public Affairs Capstones Collection

The Patient Protection and Affordable Care Act aims to place public health and prevention practice closer to the clinical care delivery system by mandating basic preventive services and creating a national prevention plan. The Massachusetts health care system has a number of elements that can help foster closer linking of public health practices in the primary care setting. This research set out to examine whether the current healthcare system in Massachusetts will enable public health and primary care integration as intimated upon by the Affordable Care Act. This study will assess the current connection between public health and primary care …

The Public Health Impacts Of Concentrated Animal Feeding Operations On Local Communities, Michael Greger, Gowri Koneswaran

Michael Greger, MD, FACLM

Large-scale farm animal production facilities, also known as concentrated animal feeding operations (CAFOs), release a significant amount of contaminants into the air and water. Adverse health effects related to exposure to these contaminants among CAFO workers have been welldocumented; however, less is known about their impact on the health of residents in nearby communities. Epidemiological research in this area suggests that neighboring residents are at increased risk of developing neurobehavioral symptoms and respiratory illnesses, including asthma. Additional research is needed to better understand community-scale exposures and health outcomes related to the management practices and emissions of CAFOs.

The Human/Animal Interface: Emergence And Resurgence Of Zoonotic Infectious Diseases, Michael Greger

Michael Greger, MD, FACLM

Emerging infectious diseases, most of which are considered zoonotic in origin, continue to exact a significant toll on society. The origins of major human infectious diseases are reviewed and the factors underlying disease emergence explored. Anthropogenic changes, largely in land use and agriculture, are implicated in the apparent increased frequency of emergence and reemergence of zoonoses in recent decades. Special emphasis is placed on the pathogen with likely the greatest zoonotic potential, influenzavirus A.

Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays

Health Management and Policy Presentations

This session reviews progress in the field of public health services & systems research (PHSSR), with a specific focus on findings that can inform the implementation and impact of health reform strategies on the U.S. public health system.

Playing To Our Strengths: An Academic/Health Department Collaboration To Facilitate Public Protections Against Tuberculosis, Thaddeus L. Miller, Erin K. Carlson, Nuha A. Lackan

Frontiers in Public Health Services and Systems Research

Background:

Economic modeling and analysis can facilitate evidence-based policy and practice. Such analyses may exceed the technical capacity and mission of public health agencies, yet may be critical to sustain health protections such as tuberculosis (TB) control. The net effect of TB prevention is incompletely understood, hampering objective value judgments of national TB elimination policies. This may promote inefficiencies and threaten individual and public health protections.

We describe how a HRSA-funded Texas Public Health Training Center (TPHTC) coordinated specialized analytical skills with the needs of a state public health department to create a user-friendly tool to inform planning and resource …

Employment And Economic Development In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Wealth influences a person’s health. People who are higher on the socioeconomic scale tend to have better health outcomes. To improve the health of a community, it is important to understand the employment opportunities of the people living in the community.

Southern Nevada’s economy was hit hard between 2008 and 2012. Unemployment rates in the region exceeded national and peer regions between during this time period. Construction; leisure and hospitality; trade, transportation and utilities; and professional and business service sectors experienced the greatest job loss during the recession. The Education and Health Services sectors did not experience a decrease in …

Demographic Makeup And Population Projections For Southern Nevada: Understanding The Emerging Healthcare Needs In Our Community, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Even with a leveling-off of population growth from 2008 to 2011, Southern Nevada had one of the fastest growing populations in the nation over the past decade. While population growth is projected to increase for the next ten years, the rate of growth will be slower than in the past decade. The Hispanic population, as a percentage of the total population, is projected to surpass the White population somewhere near the year 2030. The Southern Nevada population is aging, as the median age in the region increased between 2000 and 2010. The 65+ age group is projected to increase as …

Building A Sustainable Community Through Public Engagement: A Study Of Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

This manuscript is the first of a series written for the Nevada Journal of Public Health. The series is result of research conducted for the Southern Nevada Strong, Sustainable Communities Grant. During Year One of the planning process, we created a Southern Nevada Existing Conditions Report. This report highlighted where the region stood on key metrics including: demographics and population projections, access to healthcare and health outcomes, healthy community, housing, environment, economy and education. For this special issue of the Nevada Journal of Public Health, the report was separated into seven articles related to each of these metrics. The articles …

Understanding Hiv Care Delays In The Us South And The Role Of The Social-Level In Hiv Care Engagement/Retention: A Qualitative Study, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. …

Creating Learning Systems: Lessons From Public Health Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Practice-based research networks (PBRNs) provide powerful mechanisms for implementing research studies that evaluate the health and economic effects of delivery system innovations. This presentation reviews strategies, emerging findings, and lessons learned from PBRNs and related studies conducted in U.S. public health settings. We give special focus to studies that examine multi-organizational and cross-sectoral strategies for population health improvement.