Health Economics Commons^™

Give A Man A Fish: A Narrative Approach To A Case Study Of Soup Kitchens In The Wentworth Community, Evelyn Shen

Independent Study Project (ISP) Collection

This study uses a narrative approach to explore the role of soup kitchens in the predominantly Coloured and English-speaking Wentworth community. Many of the community’s churches1 and non-profit organizations host soup kitchens regularly, rotating so that there is a meal available each day of the week.

Qualitative data was gathered through volunteering with the soup kitchens as a participant observer and having conversations and open-ended interviews with soup kitchen guests and hosts. Institutional context was provided by interviews with the Convener of the War Room and the Ward Councillor, and representatives of three non-profits in the community. In order to …

Caste-Ethnic Disparity In Vaccine Use Among 0- To 5-Year-Old Children In Nepal: A Decomposition Analysis, Satis Devkota, Christopher Butler

Economics & Management Publications

Objectives To examine what factors, if any, could account for caste/ethnic disparities in vaccine utilization between upper caste and indigenous, and upper caste and low caste (Dalit) groups in Nepal.

Methods Using the Institute of Medicine (IOM) approach to calculate disparity, we estimate the disparity between upper caste and indigenous, and between upper caste and Dalit 0- to 5-year-old children in Nepal. Then we use Fairlie’s non-linear regression-based decomposition technique to account for those disparities in immunization.

Results Using nationally representative data (the Nepal Living Standard Survey II and III), we construct a pooled cross-sectional series and calculate the disparity …

Is There A Trade-Off? Infant Health Outcomes And Managed Care Competition, Shana L. Moore

Theses and Dissertations--Public Policy and Administration

This study offers insights into the impact of competition among Managed Care organizations (MCOs) on infant birthing charges and birth outcomes. Kentucky provides one of the nation’s first case studies to determine successes and failures of Medicaid MCOs, and by doing so, provides a prediction of the impact of Patient Protection Affordable Care Act (PPACA) competition on healthcare costs and birth outcomes. An analysis of a natural policy experiment in the state of Kentucky reveals that infants insured by a Medicaid MCO stay longer in hospitals, are less healthy, and cost more than those insured under Traditional Medicaid prior to …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Living Arrangements And Psychological Well-Being Of The Elderly After The Economic Transition In Vietnam, Ken Yamada, Bussarawan Teerawichitchainan

Research Collection School of Social Sciences

Objectives: We examine the relationship between living arrangements and psychological well-being of the older adults in Vietnam, where there is an influence of Confucian values and a lack of close substitutes for family care of the older adults, by exploiting a great deal of regional variation in economic development. We also examine the role of living arrangements in well-being differentials across regions. Method: We estimate a triangular simultaneous-equation discrete-response model, which accounts for the simultaneity between living arrangements and psychological well-being (happiness, depression, loneliness, poor appetite, and sleep disorder), using a nationally representative sample of 2,225 adults aged 60 and …

The Effects Of Social Status On The Quality And Affordability Of Healthcare, Robert O. Burns

Honors College Theses

Access to healthcare is very important in today's society, as is the quality of said healthcare. The socioeconomic status (SES) of an individual is the most important factor when it comes to determining both the accessibility and quality of said care, and as such has been studied extensively. Across different countries, lower SES has been linked to the decreased affordability and success rates of medical treatments such as coronary heart disease medication or health risk prevention regimes. In many cases, low SES patients were found to be less likely to seek treatment than higher SES patients as the debt they …

Premature Births And Maternal Health: An Analysis Of Risk Factors That Affect The Rate Of Prematurity / Los Nacimientos Prematuros Y La Salud Materna: Un Análisis De Los Factores De Riesgo Que Afecta La Tasa De Prematuridad, Alexandria Mickler

Independent Study Project (ISP) Collection

Research Question: What are the major socio-demographic risk factors influencing the rate of preterm birth in Valparaiso, Chile? Objectives: The objective of this study is to identify risk factors that influence the rate of preterm birth in an urban population of women living in Valparaiso, Chile. This study aims to understand whether a relationship exists between socio-demographic characteristics, such as economic level, education, lifestyle, access to medical attention and resources and the risk of prematurity. The outcomes of this study seek to determine the major biological, cultural, and social relationships and identify at-risk social groups. Additionally, this study considers the …

La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins

Independent Study Project (ISP) Collection

Background: In Argentina, abortion is illegal under all circumstances except for when a woman has been raped, has a mental disability or her life is in danger. There are approximately 500,000 abortions practiced each year in Argentina, and the majority is performed in an unsafe manner, which can result in complications that require medical attention. In 2010, over 50,000 women were hospitalized because of complications post-abortion. These complications can include hemorrhages, infections, or other toxic illnesses. After the International Conference on Population and Development in 1994 they identified post-abortion care as a worldwide problem. Subsequently, Argentina created a guide for …

Sexual And Reproductive Health And Rights Of Aymara Women In The Intercultural Health System In Chile / Salud Y Derechos Sexuales Y Reproductivos De Las Mujeres Aymara En El Sistema De Salud Intercultural De Chile, Ariela Schnyer

Independent Study Project (ISP) Collection

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews …

Mountain Monitor - 4th Quarter 2013, Kenan Fikri, Mark Muro

Mountain Monitor Quarterly

The quarter’s Mountain Monitor finds that the pace of economic recovery in the Mountain West region’s major metropolitan areas converged toward that of the rest of the nation in the last quarter of 2013.

While quarterly performance on the Monitor’s four indicators of economic recovery—employment, output, the unemployment rate, and house prices—varied considerably across the 10 major metro areas of the region, their combined performance broadly slowed to track with the rate of national economic recovery. The quarter’s average job growth remained unchanged in the region at 0.4 percent as the national economy caught up. The gap between the national …

The Fate Of Local Food Systems In The Global Industrialization Market: Food And Social Justice In The Rural South, Wylin D. Wilson, Reuben C. Warren, Stephen O. Sodeke, Norbert Wilson

Professional Agricultural Workers Journal

This paper investigates the connection between local food systems, health disparities, and social justice in the rural South. It begins with the relationship between food insecurity and health disparities that disproportionately affect racial and ethnic minority populations, and non-minority women and children. First, we discuss the concept of health disparities within the context of bioethics and public health ethics in order to explore the link between the food system and health as a social justice issue. Second, we define health disparities and discuss how they have historically plagued and disadvantaged racial minority populations. Third, we examine these disparities within the …

Mountain Monitor - 3rd Quarter 2013, Kenan Fikri, Mark Muro

Mountain Monitor Quarterly

The quarter’s Mountain Monitor marks the four-year anniversary of Brookings Mountain West's quarterly tracking of the uneven pace of recovery across the major metro areas of the Intermountain West and it finds that, although the region continues to outperform the national economy the rate of recovery slowed moderately in the region’s metro areas.

As a group, Mountain region metro areas advanced on all four indicators of economic recovery tracked by the Monitor—employment, output, unemployment, and house prices—but their progress was more restrained in the third quarter of 2013 than it was in the second.

Beneath the regional headline of moderating …

The Primacy Of Context: An Exploration Into The Causes Of Food Insecurity In Kitere, Kenya., William O. Aludo

Capstone Collection

The purpose of this study was to explore the specific reasons why households in Kitere village, Kenya experience persistent food insecurity every year while the region enjoys the advantage of two planting/harvest seasons in a year. Kitere village lies within the lakeside region of Nyanza Province in Kenya, generally considered to be one of the more agriculturally productive parts of the country. The Participatory Rural Appraisal method was employed to gather qualitative data on the causes of food insecurity in Kitere village. The data sources were focus groups and a self-administered, one-time survey of random and non-random samples of key …

Mountain Monitor - 2nd Quarter 2013, Kenan Fikri, Mark Muro

Mountain Monitor Quarterly

Economic recovery progressed steadily across the metropolitan Mountain West in the second quarter of 2013. Many of the region’s major metro areas counted among the strongest economic performers nationally, but output growth slowed over the quarter and the region‘s unemployment recovery looked to be stagnating. Moderate job growth and a fast and accelerating housing recovery buoyed the Mountain West economy in the second quarter.

Mountain Monitor-1st Quarter 2013, Kenan Fikri, Mark Muro

Mountain Monitor Quarterly

Economic recovery gained strength across the major metro areas of the Mountain West in the first quarter of 2013. Multiple metro areas achieved long-awaited full employment recoveries in the first quarter and regional production surpassed pre-recession levels of output for the first time. The region’s strong housing rebound continued to be a boon. Additionally, a special supplement to the Monitor shows that the healthcare sector has been an outsized contributor to recovery throughout the region. Despite progress on multiple fronts, though, many Mountain metro areas remain scarred with high unemployment rates, severely depressed house prices, and daunting jobs deficits.

Explaining Political Activeness And Attitudes Toward Unionization Among Nurses In The United States., Crystal L. Lesmeister

Political Science Theses and Capstones

There is no question; nurses play a key role in healthcare. Nurses provide direct care, coordinate health promotion activities, educate, and provide support and advocacy to patients. Today, there are over two million registered nurses in the United States. My research aims to determine the variables that influence some nurses to be more politically active and more engaged in unionization than their counterparts. I analyze The National Sample Survey of Registered Nurses 2004 looking at a variety of potential explanations for union participation. Findings show a strong regional variation in the percentage of unionization, however, some of the conventional explanations …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

The Growing Concern Of Poverty In The United States: An Exploration Of Food Prices And Poverty On Obesity Rates For Low-Income Citizens, Catherine Gillespie, Kathy Gray, Ethan Bailey, John Zivalich

Undergraduate Economic Review

Studies demonstrate the link between income and obesity, determining factors to explain the strong correlation between high body mass index and low socioeconomic status. Many focus on uncovering predictors but few use a systems approach: identifying the interaction among predictors and their relative magnitude concerning obesity. This study asks: do poverty or food price indicators have a statistically stronger relationship with obesity?

By collecting data, evaluating trends, and analyzing statistics, this study extends research by revealing a stronger relationship between obesity and food prices as opposed to obesity and poverty.

Who Is Covered And Who Under-Reports: An Empirical Analysis Of Access To Social Insurance On The Egyptian Labor Market, Rania Roushdy, Irene Selwaness

Poverty, Gender, and Youth

This working paper investigates the dynamics and determinants of having access to social insurance coverage on the Egyptian labor market among wage and non-wage workers. The results show that men, older, married, better educated, and white collar highly skilled workers are more likely to have social insurance coverage. Access to social insurance is more likely to exist in the public sector and in large private enterprises. Furthermore, acquiring social insurance coverage in the private wage work sector does not often come at first entry; but it takes some time to gain such access. In contrast, experience is not important for …

Social Protection In Egypt: A Policy Overview, Maia Sieverding, Irene Selwaness

Poverty, Gender, and Youth

The need to address the shortcomings of Egypt’s current social protection system as part of a broader process of developing a new social contract between the Egyptian government and its citizens has been noted for a number of years. With a new government recently put in place, Egypt is now at a potential turning point in terms of implementing unfinished reforms to the system or proposing alternative ones. The aim of this paper is therefore to provide an overview and assessment of current public social protection mechanisms and suggest directions for new policy measures. The social and health insurance systems …

Poor Women With Sexually Transmitted Infections: Providers’ Perspectives On Diagnoses, Genevieve R. Cox

Sociology

This article presents results from a study of health care providers, mainly nurses and nurse practitioners, who routinely diagnose sexually transmitted diseases (STDs) in rural low-income populations in West Virginia (WV). A qualitative analysis of eighteen semi-structured interviews reveals that providers who consistently work with low-income populations believe patients undergo a negative change in self-image in response to a chronic STD diagnosis. Providers express concerns about a number of issues related to low-income, rural women’s access to sexual health care and see the need for more sexuality education, more funding for free and reduced cost clinics, and more available health …

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Book Review: Social Justice: The Moral Foundations Of Public Health And Health Policy, Robin West

Georgetown Law Faculty Publications and Other Works

This essay is a review of Social Justice: The Moral Foundations of Public Health and Health Policy by Madison Powers & Ruth Faden (2006).

In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate? In a world filled with inequalities in health and well-being, which inequalities matter most and are the most morally urgent to address? In order to answer these questions, Powers and Faden develop a unique theory of social justice that, while developed for the specific contexts of public health and health …

Examining Adherence And Sexual Behavior Among Patients On Antiretroviral Therapy In India, Avina Sarna, Indrani Gupta, Sanjay Pujari, A.K. Sengar, Rajiv Garg, Ellen Weiss

HIV and AIDS

With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. However, optimism related to ART’s success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. To determining the sexual behavior of HIV-positive persons on ART, the Horizons program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and …

Using Incentives To Encourage Aids Programs And Policies In The Workplace: A Study Of Feasibility And Impact In Thailand, Simon Baker, Srisuman Sartsara, Patchara Rumakom, Philip Guest, Katie D. Schenk, Anthony Pramualratana, Suparat Suksakulwat, Surachai Panakitsuwan, Sikarat Moonmeung

HIV and AIDS

A recently completed Horizons study in Thailand examined the question of how to encourage the private sector to become actively involved in developing and improving workplace HIV/AIDS programs. The study found that the AIDS-response Standard Organization (ASO) initiative mobilized a moderate proportion of different types of companies to develop and improve HIV/AIDS workplace policies and programs. The data also reveal that companies that were eligible for the insurance discount made the greatest improvements. Thus a financial incentive combined with efforts to tap into managers’ willingness to respond to the epidemic can be important motivators for certain companies to improve their …

Identifying Compliance Issues In The Community Health Care Clinic Environment, Faye K. Beery

Graduate Theses

This study explored the high number of failed appointments and follow-up appointments at a community health care children’s clinic. A thirty-seven item questionnaire was randomly given to 112 participants seeking health care at the clinic on a random basis. Based on literature reviews, five hypothesis were generated to examine reasons for failing to keep appointments for children: 1. Communication difficulties between healthcare personnel and parents regarding patient comprehension of instructions and bottle directions were anticipated. 2. Patient/physician/clinic relationships were expected to influence patient compliance. The need for more reminder calls for appointments was anticipated to be a factor in patient …

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Carolyn Barnes, Erica Keogh, Nontokozo Nemarundwe, Loveness Nyikahadzoi, Ellen Weiss

HIV and AIDS

This study, conducted in Zimbabwe, sought to better understand the relationship between a microfinance program, Zambuko Trust, and how microentrepreneurs’ households cope with the impact of HIV/AIDS. The study examined how HIV/AIDS is affecting Zambuko’s operations and what microfinance institutions (MFIs) can do to lessen the impact of HIV/AIDS on their clients and operations. The findings indicate several small yet important ways that MFI programs help microentrepreneurs and their families respond to these impacts through access to credit and business management training. Participation in a microfinance program led to income smoothing and better financial management, which can help households mitigate …

The Economic Cost Of Depressive Disorders: Evidence From A Large Midwest Public University, Alketa Hysenbegasi

Dissertations

This dissertation aims to estimate the total cost of depression and the benefits of its treatment per diagnosed depressed student in Western Michigan University. To accomplish this, first, I measure the overall impact of depression and the effectiveness of its treatment on the student school performance. The empirical evidence show that diagnosed depression decreases student GPA by 0.48 points (almost a half grade), but this impairment is reduced by treatment about 0.43 points. Further, I develop and validate different measurements of student school performance and I observe that the negative effect of diagnosed depression and the positive effect of treatment …

The Professional Decline Of Physicians In The Era Of Managed Care, Aimee E. Marlow

New England Journal of Public Policy

Physicians have long enjoyed prestige, power, and autonomy, but the rise of managed care organizations has drastically changed their status. Many doctors are in thrall to the financial well-being of the corporations that employ them, their knowledge and expertise controlled and manipulated in the interest of profit maximization. This article investigates the professional decline of physicians, citing the use of gag clauses, incentives to withhold care, and the breakdown of their authority. In an effort to regain some measure of control, physicians have taken their concerns to the public, supporting state and federal legislation that attempts to curb questionable managed …

Allied Health Professions In The Health-Sector Job Structure, Françoise J. Carré

New England Journal of Public Policy

This article reviews the characteristics of allied health professions in the U.S., Massachusetts, and Boston health sectors. These occupations are considered in the broader context of the multitiered job structure of the health sector and their gender and ethnic composition. The discussion includes surveys of vacancy rates and wage levels for selected allied health professions in Massachusetts hospitals. The article concludes with a more detailed, albeit national, picture of these occupations in the hospital sector per se, their demographic composition, and earnings level.