Economics Commons^™

Optimizing Public Health Systems For Population Health Improvement: Institutions, Economics, And Metrics, Glen P. Mays

Health Management and Policy Presentations

This lecture reviews the evidence concerning the institutional and economic characteristics of public health delivery systems and their impact on population health. Emerging findings from these studies suggest promising pathways for transforming the U.S. public health system in ways that strengthen its effectiveness, efficiency and equity in producing health. .

Reassessing The Effects Of Unemployment Insurance Generosity On Search Intensity: New Evidence From Earnings Histories, Lewis Warren

University of Kentucky Center for Poverty Research Discussion Paper Series

This paper provides the first nationally representative estimates of how unemployment insurance (UI) generosity in the United States affects the search intensity of unemployed individuals using individual level variation in UI generosity. The paper expands the current literature through fully simulating monetary eligibility and entitlement to unemployment insurance at the individual level where past studies have been unable to examine monetary eligibility and have relied on state variations in the maximum weekly benefit amount which can differ significantly from an individual’s actual benefit amount. To simulate monetary eligibility and entitlement, work histories of unemployed respondents were obtained through fully matching …

Value And Cost-Effectivess Of Chw Programs: Implications For Home Care Workers, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews studies on the health and economic value of strategies to improve the coordination of medical care, public health, and social support services for high-need and high-risk populations. Community health worker (CHW) programs feature prominently in these strategies, particularly for rural and low-resource community settings. Home care workers have the potential to function as CHWs in many settings, and as such present powerful opportunities for scaling up CHW programs that connect medical care, public health, and social services delivery.

Cost Estimates Of Foundational Public Health Capabilities: Pilot Test Results Of An Expert Consensus Methodology In Kentucky, C. B. Mamaril, Glen P. Mays

Health Management and Policy Presentations

The Institute of Medicine's 2012 report on U.S. public health financing recommended research to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be made available in every U.S. community. We present results from pilot testing of a proposed methodology for estimating the costs and resource requirements for a set of foundational public health capabilities identified by the Public Health Leadership Forum. Using pilot data from Kentucky public health settings, we estimate both current and projected costs under a range of assumptions about the resources required to fully implement the capabilities at …

Ending Failures, Showing Results, Improving Population Health: Insights From Research & Reform In The U.S., Glen P. Mays

Health Management and Policy Presentations

A growing body of empirical research supports the value of aligning the delivery systems for public health, medical care, and social services for populations with shared needs and risk factors. This presentation reviews selected studies from the field of public health services & systems research (PHSSR) in the U.S. that suggest pathways for achieving greater system alignment in the Canadian context.

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.

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.

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.

Childhood Stress: A Qualitative Analysis Of The Intergenerational Circumstances Of Child Hunger, Mariana Chilton, Molly Knowles

University of Kentucky Center for Poverty Research Discussion Paper Series

Adverse Childhood Experiences (ACEs), including abuse, neglect, and household instability, affect lifelong health and economic potential. While relationships between household food insecurity and caregiver’s childhood exposure to abuse and neglect are underexplored, preliminary evidence indicates that caregivers reporting very low food security report traumatic events in their childhoods that lead to poor physical and mental health. Building on this evidence, this study investigates how adverse childhood experiences are associated with the intergenerational transmission of household food insecurity.

Distributional Effects Of Welfare Reform Experiments: A Panel Quantile Regression Examination, Carlos Lamarche, Robert Paul Hartley

University of Kentucky Center for Poverty Research Discussion Paper Series

In an influential article, Bitler, Gelbach and Hoynes (American Economic Re- view, 2006; 96, 988-1012) illustrate the importance of estimating heterogeneous impacts of welfare reform experiments. They find that the mean treatment effect offers an uninfor- mative summary of opposing effects, while the treatment effects are significantly different across quantiles. We replicate their results and evaluate the robustness of their findings to accounting for individual-specific heterogeneity possibly associated with welfare program participation. We find results that are in general similar to Bitler’s et al. findings, although the interpretation of labor supply effects in the upper tail is revised. We find …

Learning From Networks: Care Transitions, Market Competition, & Community Interventions, Glen P. Mays

Health Management and Policy Presentations

Social network analysis methods offer many avenues of inquiry for studying new developments in health policy and health care delivery. The expanding availability of large linkable electronic clinical and administrative data sources allows for novel SNA applications with dependent data structures. Opportunities include the study of delivery patterns within accountable care organizations (ACOs), and other multi-provider networks, price and quality competition within new health insurance exchanges, and population health effects attributable to complex community-level interventions.

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 …

Income, Program Participation, Poverty, And Financial Vulnerability: Research And Data Needs, James P. Ziliak

University of Kentucky Center for Poverty Research Discussion Paper Series

The aim of this paper is to assess the adequacy of the data infrastructure in the United States to meet future research and policy evaluation needs as it pertains to income, program participation, poverty, and financial vulnerability. I first discuss some major research themes that are likely to dominate policy and scientific discussions in the coming decade. This list includes research on the long-term consequences of income inequality and mobility, issues of transfer-program participation and intergenerational dependence, challenges with poverty measurement and poverty persistence, and material deprivation. I then summarize what information we currently collect in the U.S. that is …

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.

Producing Population Health: Collective Action Requires Infrastructure, Incentives & Evidence, Glen P. Mays

Health Management and Policy Presentations

Population health improvement strategies are collective action problems that require targeted infrastructure, incentives, and information to succeed. Research on collective action problems and solutions in public health and other spheres of practice offer insight for the successful scale and spread of population health innovations.

Effects Of Maternal Depression On Family Food Insecurity, Kelly Noonan, Hope Corman, Nancy E. Reichman

University of Kentucky Center for Poverty Research Discussion Paper Series

Theory suggests that adverse life events—such as unemployment or health shocks—can result in food insecurity, which has increased substantially in the U.S. over the past decade alongside the obesity epidemic. We test this proposition by estimating the effects of a specific and salient mental health event—maternal depression during the postpartum year—on child and family food insecurity. Using data from the Early Childhood Longitudinal Study—Birth Cohort, we estimate the effects of maternal depression on food insecurity using both single- and twostage models, and explore potential buffering effects of relevant public assistance programs and supports. We find that moderate to severe maternal …

Health Reform Implementation: Update And Implications For Kentucky, Glen P. Mays

Health Management and Policy Presentations

This talk reviews the progress of health reform implementation in Kentucky with a focus on opportunities for aligning systems for medical care, public health, and social support delivery to improve population health.

Unifying Systems For Population Health: Infrastructure, Incentives & Evidence For Collective Action, Glen P. Mays

Health Management and Policy Presentations

This presentation, part of the SBM Presidential Symposium on Aligning Family, Clinical, and Community Systems, reviews the collective action problems that are commonly encountered in implementing multi-sector population health improvement strategies, and examines research on ways of using public health strategies and infrastructure to overcome these problems.

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.

The Role Of Cps Nonresponse On The Level And Trend In Poverty, Charles Hokayem, Christopher R. Bollinger, James P. Ziliak

University of Kentucky Center for Poverty Research Discussion Paper Series

The Current Population Survey Annual Social and Economic Supplement (ASEC) serves as the data source for official income, poverty, and inequality statistics in the United States. There is a concern that the rise in nonresponse to earnings questions could deteriorate data quality and distort estimates of these important metrics. We use a dataset of internal ASEC records matched to Social Security Detailed Earnings Records (DER) to study the impact of earnings nonresponse on estimates of poverty from 1997-2008. Our analysis does not treat the administrative data as the “truth”; instead, we rely on information from both administrative and survey data. …

Beyond Income: What Else Predicts Very Low Food Security Among Children?, Patricia M. Anderson, Kristin F. Butcher, Hilary W. Hoynes, Diane Whitmore Schanzenbach

University of Kentucky Center for Poverty Research Discussion Paper Series

We examine characteristics and correlates of households in the United States that are most likely to have children at risk of inadequate nutrition – those that report very low food security (VLFS) among their children. Using 11 years of the Current Population Survey, plus data from the National Health and Nutrition Examination Survey and American Time Use Survey, we describe these households in great detail with the goal of trying to understand how these households differ from households without such severe food insecurity. While household income certainly plays an important role in determining VLFS among children, we find that even …

Kentucky Forestry Economic Impact Report 2013-2014, Jeff Stringer, Billy Thomas, Bobby Ammerman, Alison Davis

Kentucky Forestry Economic Impact Reports

Forests are a valuable part of Kentucky’s landscape providing signifi­cant resources and opportunities benefi­ting the Commonwealth. One important and veri­fiable bene­fit is the economic contributions of Kentucky’s forest and wood industries. Analysis of these industries indicated a total economic impact of $12.8 billion and 59,000 jobs in 2013. Kentucky is one of the leading producers of hardwood forest products in the south and exports wood products across the nation and the world. This economic impact was generated from forests located in all 120 counties of the Commonwealth providing resources harvested by over 1,800 logging ­firms and processed at 703 facilities …

Troubles In Paradise: The United States’ Biggest Challenge In The Carribean, Juan Clar

Ex-Patt Magazine

As many Caribbean economies grow, and the threat of Cuban communism fades, the challenge in the Caribbean for the US comes from the Commonwealth of Puerto Rico.

Kentucky's Innovation Ecosystem, Center For Business And Economic Research, Gatton College Of Business And Economics, University Of Kentucky, Innovation Network For Entrepreneurial Thinking

CBER Infographic Posters

Changes in our economy and our society are redefining how we create economic opportunity and build successful enterprises. These changes are compelling critical examinations of how we pursue economic development in Kentucky. Given the importance of young high-growth firms for wage and job growth, it is vital for states, regions, communities, and universities to effectively leverage their assets toward the development of entrepreneurs, creation of startups, and sustaining high-growth enterprises.

Strengthening The Science Of Public Health Delivery: Complexities In Implementation, Inference & Translation, Glen P. Mays

Health Management and Policy Presentations

Delivery systems for public health programs and policies are diffuse and heterogeneous across the U.S., reflecting wide variation in the capacity to implement population-level health improvement strategies. This lecture examines strategies for evaluating the causes and consequences of variation in public health delivery across the U.S., with a focus on identifying pathways for improving the health and economic effects of policy and practice.

The Changing Nature Of Manufacturing, Christopher R. Bollinger

Issue Brief on Topics Affecting Kentucky’s Economy

No abstract provided.

The Replacement Of The Brent Spence Bridge: Tolls, Commuting Patterns And Economic Activity In Northern Kentucky, Christopher R. Bollinger, Derrick Jenniges

CBER Research Report

Executive Summary:

In this report, we investigate the impact of proposed tolls levied on users of the replacement for the Brent Spence Bridge, including impacts on commuting patterns and overall economic activity in Northern Kentucky. Overall, consistent with economic literature, the economic impact of the improved bridge will be positive and the toll, while slightly mitigating that impact, is likely to have only small effects on commuting patterns, trucking and retail and food service industries.

• We estimate that the net impact of the new bridge and the toll under our estimated likely scenarios would reduce commuter traffic by less than …

Snap And Food Consumption, Hilary W. Hoynes, Leslie Mcgranahan, Diane W. Schanzenbach

University of Kentucky Center for Poverty Research Discussion Paper Series

In this paper we describe the relationship between SNAP and food consumption. We first present the neoclassical framework for analyzing in-kind transfers, which unambiguously predicts that SNAP will increase food consumption, and then describe the SNAP benefit formula. We then present new evidence from the Consumer Expenditure Survey on food spending patterns among households overall, SNAP recipients, and other subgroups of interest. We find that a substantial fraction of SNAP-eligible households spend an amount that is above the program’s needs standard. We also show that the relationship between family size and food spending is steeper than the slope of the …